u/Miss_May_1600

I am a little frustrated that several of my male patients (ages 50+ mostly) keep calling me by my first name. I introduce myself at the lobby entrance and then again in my office as “Dr. X.” I also ask every patient at the start of an intake how they want to be addressed. I thought at first it was because I was inheriting patients from a NP who was going by her first name. However, today a completely new patient did it.

I don’t know whether to correct it, or let it go. On the one hand, I think I should let it go because I don’t want to ruin the rapport. On the other hand, it seems to mostly be people with some cluster-B traits, so I wonder if holding the boundary would actually be better for them / the relationship in the long run.

I also think that it’s important that they know my credentials and that I am a physician. Despite starting with “I’m Dr. X and I’m a psychiatrist,” the patient later asked “wait, you’re my psychiatrist?” Yet then again, still used my first name. Since I do look younger than my age, I think sometimes they really do forget what my role is and I feel like enforcing the title could help.

Thoughts?

I inherited a patient panel from a NP and it’s a complete mess. The NP has bad clinical judgement - not establishing diagnoses, not considering underlying medical problems, not prescribing safely considering underlying medical problems, not getting monitoring labs for meds prescribed, not giving enough time or high enough dose for a therapeutic trial (this was all one patient mind you). Also there is a lot of trying to treat “a symptom” that is a super common side effect of another medicine prescribed without considering it could be the cause. So everyone is on 5-7 psych meds. Now I get to come in and be “the bad” guy who has to counsel on polypharmacy and how high dose Adderall in an 80 year old with cardiac issues who has never even had a cognitive screening is a bad idea. It’s frustrating to “be the bad guy” for practicing evidence based medicine. Too many patients say “well so-and-so was willing to do it.” So-and-so was not a good prescriber. Can anyone relate?

It’s been a month and a half since my last day of residency. Since then, I have mostly been a blob. I did move across the country and I have seen some friends and family. However, most of the time I have just been rotting and have no desire to do anything else. I have a couple weeks left before I start my first attending job. I want to make the most of it, but also maybe it’s okay to do nothing after an 8 year grind? I’m also trying to use my ADHD meds sparingly since I don’t know how long it will take to find a psychiatrist here, so that’s not helping…

Did anyone else experience this? Does anyone else struggle with constantly feeling like they should be productive?

Boards are in about a month. I just finished Spiegel and Kenny review. Not sure whether to look over old PRITEs next or go through the book again.

Also, does anyone have a good Anki deck for the cytochromes? Or for the defense mechanisms?

Thanks in advance!

Hello. I have two 5 year old domestic shorthair cats in good health and UTD on vaccines. Vet prescribed 200 mg of Gabapentin every 8 hours. It worked pretty well yesterday during the day, but last night one of the cats was up all night meowing. Since we are driving a huge moving truck, we need to be alert. I don’t know how to help her. I tried the feline spray. She had lots of time to get used to the hotel. We have 3 days of driving left. What should I do?

I have two five year old cats. They hate having their nails trimmed so I rarely do it. They are wonderful animals who rarely scratch the furniture. They use all the cat trees and corrugated cardboard I set out. One cat seems to “keep” her nails longer. The other keeps them shorter, but has never been very good at retracting them so still gets stuck on blankets or curtains sometimes.

I want to know if letting them maintain their nails is fine, or if I should be trimming them too. I can’t tell if it’s fear mongering or real advice. We just had our annual vet visit a couple months ago and I forgot to ask.

Thanks!

Thank you for taking the time to read

My 5 year old fixed indoor-only cat who is UTD on vaccines and healthy other than gingivitis (undergoing oral cleanings under sedation 1x per year) keeps jumping up onto the kitchen counter and then up on top of the cabinets. I wouldn’t care, except that I rent and she is scratching the wood as she scrambles up. She is not deterred by aluminum foil. The tops of the cabinets already flare out. I have kind of tried spraying her with water when I catch her, but read online that you shouldn’t do that because they don’t learn? I do think they learn as I spray-trained cats when I was growing up. Still, I don’t like seeing her sad, so I don’t do it.

For additional context, I live alone in a one bedroom home with just her and her bonded pair who is also five. We will be moving to a bigger space soon.

I would appreciate any advice!

It’s a strange feeling to know what it’s like to not have medical knowledge and walk in as a patient and then to be on the other side of the desk. The online world is so polarizing. I see common themes in complaints by patients about doctors and visa versa and I empathize with both. Sometimes it feels like a double life or an identity pulled in multiple ways. Sometimes I wish I could say, “you don’t have to explain what a compulsion feels like, I GET it.”

Hello! I’m 32 and having progressive issues with intermittent esotropia in my right eye. I have already had surgery on both lateral eye muscles of my right eye as a young child (6 months and 15). I’m really worried about re-operation because of the scar tissue. For people who had surgeries in childhood and then repeat surgeries in adulthood, how did it go?

I don’t know if this is ADHD, or the product of living in a world dominated by screens and the 40 hour office work life. Probably both. I am bored 90% of the time, to the point I will feel enraged. I am so jealous of the people around me who are doing so many “cool” things. I have no motivation to start anything. I have done years of therapy and I’m on meds. At this point I wonder if this is what my life is doomed to be. I’m either asleep/trying to sleep, anxiously ruminating about how my life is not what I want it to be, or worst of all, enraged because the boredom feels so intolerable.