some rules for docs

Last year, I found an interesting book at the library titled ‘A Little Book of Doctors’ Rules’ compiled by Clifton K. Meador, M.D and I photocopied it.

There are 425 rules in it. Some are logical rules and some are quite funny.

Here are some of my favourites:

If you do not know what is wrong after you have taken a history, then take another history. If you still do not know, take a third history. If you do not know then, you probably never will.

In medicine, anything that can happen will happen.

About the time you think you have seen it all, you will encounter some new unbelievable

behaviour. There is no limit to the strangeness of human behaviour.

The mind readily sees and hears differences. It takes concentration and effort to see or hear similarities.

The appendix is where the surgeon finds it

Many patients do not change. They just change doctors

Use it or lose it. This rule applies to all parts of the body.

Never ignore an experienced nurse’s observation

Masses are either palpable or not. There is no such thing as a ‘suggestion of a mass’.

Only the patient knows how he or she feels. No one else does.

A physician who treats himself has a fool for a patient and a bigger fool for a physician
The physician’s belief determines the patient’s belief

Never wake a patient to give a sedative or a laxative.

Confusion is an essential phase of learning

No organ system fails in isolation

Weight gain or loss within 10 days is all water

Be very kind to nurses, they will be kind to you. Be unkind to nurses, they will make your life miserable

Do know harm. Do no harm

A hospital is a dangerous place. Use it wisely and briefly as possible

When you don’t know what to do, do nothing!

Speak so you can be heard

Write so others can read it

Doctors wives CAN have medical diseases

Wash your hands. Do it in front of your patients.

Be careful with labels. They can be hard to remove.

Much disease is self-inflicted, wittingly or not.

There is time for action. There is time for no action.

Use laboratory tests like a rifle not a shotgun… once shot at a time and with precision

When caring for a very sick patient, doubt all results of all tests

The pathophysiology of the diagnosed disease should explain the patient’s symptoms. If it doesn’t, you either have the wrong diagnoses or you are missing the 2nd disease that could explain the symptoms.

You cannot diagnose what is not in your differential diagnosis.

When a man seeks medical care, there is usually a woman urging him to do it. Talk with her

Most patients are women. (Do men worry them sick?)

Never take away hope

Stop all drugs if possible. If impossible, stop as many as possible.

You cannot be everybody’s physician

The interview is the beginning of treatment

Tell the patient to remove the foil from a suppository before insertion

Try to leave every patient smiling, no matter how grim the circumstances

Never order a test unless the result will help you direct the treatment or make a difference in what you tell the patient

Never appear shocked by anything the patient tells you

Listen for what the patient is NOT telling you

If you catch yourself thinking whether a patient might have either hyperthyroidism or hypothyroidism, then the patient does not have either.

if you need time to think, ask older patients to describe their bowel habits

Do not refer to patients as diseases.

No matter how much time you have spent in a patient’s waiting room explaining the condition, as you start to leave the family will ask one more question

Never tell a symptomatic patient, “Don’t worry. It’s all in your head”.

When you do not know what a patient has, do not say, “I don’t know what you have.” Say, “I don’t know what you have… YET.”