Tuesday, June 23, 2015

Dr. Orthochick: High school sports clinic

As luck would have it, since I'm this month's sports chick, I got roped into helping with high school student sports physicals on Saturday. Technically I didn't have to, but the way it was worded meant I sort of had to if I wanted to pass this rotation. Also, Dr. Douche kept on talking about how this would not only benefit my education now, it would also benefit me in the future so I could have a job doing sports physicals. I guess he doesn't think I'm going to be a very good surgeon if my best option is to do sports physicals for the rest of my life.

Back in the olden days, when I was doing high school sports, you brought the form to your pediatrician, he signed it, and you were good to do sports for the year. That does not fly anymore. Now you need a comprehensive examination by a medical doctor, a musculoskeletal specialist, and a cardiologist before you get cleared to play sports. And if anyone in your family has heart disease, you need a transthoracic echocardiogram for clearance. So our Ortho group organizes it so that you can get all of this done on one day for free, which is a pretty sweet service because otherwise it would take a lot of time and money. (and my parents were into us doing sports, but if mom had to drag us to a cardiologist every year, I think she would have told us to get fat and make daisy chains in the backyard for exercise)

Physical-a-palooza started at 8AM, I got there around 8:30 because I had to change a wound vac before leaving the hospital and it took a little while, and there was a line of high school students and parents that curled around and outside the parking lot.

I started out in the musculoskeletal section, which consisted of doing a scoliosis check, anterior drawer tests of the knees, moving the hips, and checking neck and shoulder range of motion. On anyone who had a specific complaint I did a focused physical, but for the most part that was alls I did. I did it at least 25 times before I got switched to the medical stuff because they had enough musculoskeletal specialists but you need to be a doctor to do medical exams. (MSK can be done by a physical therapist or PA) I guess "ortho resident" falls under the realm of "doctor," but I feel like if we're going to all the trouble of cardiac screenings, we might want to have someone who uses a stethoscope on a regular basis do these medical exams. Not that it's hard and G-d knows I did a trillion heart-lung-abdomen exams in medical school, but by this point I don't remember which murmurs radiate to the carotids and which ones increase with valsalva etc etc etc. Good thing no one had a murmur. I did at least 50 medical exams, except I made it very clear that I was only going to do medical exams on girls. For boys you have to do a hernia check and yes, I do know how to do that, but I don't want to be in a room with a teenage boy who's naked from the waist down without a chaperon. I feel like that's putting me in a potentially litigious situation and whereas I'd like to think no one would accuse me of anything, honestly, I don't want to put myself in that position. Plus I feel like most teenage boys would probably prefer a male doctor doing that. So I did the girl stuff which involved asking a lot of questions about menses (r/o Female Athlete Triad) but didn't require anyone to disrobe.

Dr. Douche must have been bored because he kept on wandering over to my examining room to talk. He asked me repeatedly if i was learning about the importance of the physical exam and OK, it is important, but checking neck range of motion on 25 asymptomatic high school students is not going to convince me of that. Also, I'm not sure what he thinks I do all day if asking about menses is going to prepare me for the future.

So yeah, not sure I really got out of that what i was supposed to get out of that but I guess it's good to know that if this surgery thing doesn't work out in the future then yes, I feel very comfortable doing high school student sports physicals and I can make my living doing that.

6 comments:

  1. Ahaha! I really like your writing, Orthochick. It makes the trivial things of residency quite funny.

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  2. I'm shocked by how formalized (and expensive) high school physicals are in the US.

    As far as I know, there isn't even a basic boilerplate medical form in order to play high school sports, let alone being examined by a series of three different doctors in assembly-line fashion.

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    1. Sorry, that should have said "up here in Canada"

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  3. Wow... I never had to be certified as "OK to exercise" at any point in school...
    Was this following an accident? Is this all states?
    - from Oz

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  4. I have a question. In all that screening, was anyone screened out? Find any huge issue to make this worth it? Can you even say?

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  5. 1) I take a form to our family physician for my kids' sports physicals. No need to see multiple doctors.

    2) My cousin's aplastic anemia was caught during a high school sports physical. I guess you just never know what's going to pop up.

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