Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

They don’t make protocols for patients like me

Dan McCoy, MD
Physician
December 11, 2011
Share
Tweet
Share

The instruments were indicating to the two co-pilots at the controls of the Airbus that they needed to pull back on the stick.

They held back on the stick for 54 seconds.

This is the position they were in when the Air France jet plunged into the cold water of the Atlantic killing everyone on board.

The fix?

Recognizing that a protocol or guideline might be giving them wrong instructions, seeing that there might be a stall occurring and the airplane was falling out of the sky — by applying basic airmanship learned during the early hours of learning to fly — push forward on the stick, gain airspeed, and fly the airplane out of the stall.

So does this happen in medicine? Are we putting patients in the ground by following protocols and not practicing medicine?

Certainly, protocols have revolutionized patient safety in hospital settings. From central line infections, ICU ventilator management, antibiotic use in surgery, suicide prevention with ER counseling — there are too many to list.

And these successes have lead to a plethora of committee created guidelines for care and protocols. A physician recently spoke at the American Medical Association meeting that one of the largest and most well respected hospitals in the country now has a protocol and guideline for a Whipple procedure.

This is a complex surgical procedure relating to bowel and pancreas resection and the protocol covers the entire hospital stay. Can a committee really dictate all of the ins and outs of a hospital stay of 10 to 14 days duration?

The protocol discussion has also become a huge issue in the mid-level provider debate. When individuals are attempting to practice medicine without the complete training of a physician, nothing is better than a set of rules to follow. And for visits like well child visits and hypertension management — these work very well.

But can you really develop protocols and guidelines for complex medical procedures or illnesses?

Or more importantly, what parts of your own healthcare would you want managed with a protocol?

I know that if I’m really sick I want a pilot at the controls that can recognize that this time the protocol doesn’t apply.

Because at some point in my life my body will be in the situation of flying out of La Guardia, hitting a flock of geese, and having to be hand flown without power into the Hudson River.

ADVERTISEMENT

They don’t make protocols for patients like me.

Dan McCoy is a dermatologist who blogs at docdano.com.

Submit a guest post and be heard on social media’s leading physician voice.

Prev

The myth of physician omniscience

December 11, 2011 Kevin 3
…
Next

The erosion of psychiatric training has consequences

December 11, 2011 Kevin 9
…

Tagged as: Dermatology, Public Health & Policy, Specialist

Post navigation

< Previous Post
The myth of physician omniscience
Next Post >
The erosion of psychiatric training has consequences

ADVERTISEMENT

More by Dan McCoy, MD

  • a desk with keyboard and ipad with the kevinmd logo

    Are our privacy rules robust enough to protect our patients?

    Dan McCoy, MD
  • a desk with keyboard and ipad with the kevinmd logo

    End of life care requires individual family decisions

    Dan McCoy, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Is Medicare the biggest challenge to seeing the doctor of your choice?

    Dan McCoy, MD

More in Physician

  • How I learned to love my unique name as a doctor

    Zoran Naumovski, MD
  • What Beauty and the Beast taught me about risk

    Jayson Greenberg, MD
  • Creating safe, authentic group experiences

    Diane W. Shannon, MD, MPH
  • How tragedy shaped a medical career

    Ronald L. Lindsay, MD
  • A doctor’s guide to preparing for your death

    Joseph Pepe, MD
  • How policy and stigma block addiction treatment

    Mariana Ndrio, MD
  • Most Popular

  • Past Week

    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • How new loan caps could destroy diversity in medical education

      Caleb Andrus-Gazyeva | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • From nurse practitioner to leader in quality improvement [PODCAST]

      The Podcast by KevinMD | Podcast
    • The crushing bureaucracy that’s driving independent physicians to extinction

      Scott Tzorfas, MD | Physician
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • Love, birds, and fries: a story of innocence and connection

      Dr. Damane Zehra | Physician
  • Recent Posts

    • Why Hollywood’s allergy jokes are dangerous

      Lianne Mandelbaum, PT | Conditions
    • How I learned to love my unique name as a doctor

      Zoran Naumovski, MD | Physician
    • My first week on night float as a medical student

      Amish Jain | Education
    • What Beauty and the Beast taught me about risk

      Jayson Greenberg, MD | Physician
    • Creating safe, authentic group experiences

      Diane W. Shannon, MD, MPH | Physician
    • The diseconomics of scale: How Indian pharma’s race to scale backfires on U.S. patients

      Adwait Chafale | Meds

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 15 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • How new loan caps could destroy diversity in medical education

      Caleb Andrus-Gazyeva | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • From nurse practitioner to leader in quality improvement [PODCAST]

      The Podcast by KevinMD | Podcast
    • The crushing bureaucracy that’s driving independent physicians to extinction

      Scott Tzorfas, MD | Physician
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • Love, birds, and fries: a story of innocence and connection

      Dr. Damane Zehra | Physician
  • Recent Posts

    • Why Hollywood’s allergy jokes are dangerous

      Lianne Mandelbaum, PT | Conditions
    • How I learned to love my unique name as a doctor

      Zoran Naumovski, MD | Physician
    • My first week on night float as a medical student

      Amish Jain | Education
    • What Beauty and the Beast taught me about risk

      Jayson Greenberg, MD | Physician
    • Creating safe, authentic group experiences

      Diane W. Shannon, MD, MPH | Physician
    • The diseconomics of scale: How Indian pharma’s race to scale backfires on U.S. patients

      Adwait Chafale | Meds

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

They don’t make protocols for patients like me
15 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...