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with Rod Moser, PA, PhD

Stories from behind the examining room door, as told by Rod Moser, PA, a primary care physician assistant with more than 35 years of clinical experience.

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Tuesday, September 11, 2007

Why Don’t Doctors Get Sick?

Doctors, PAs, and other medical professionals DO get sick. As a matter of fact, I am fighting an upper respiratory infection right now, and it has been hanging on for about two weeks. If illnesses were dependent solely on the amount of exposure that one gets, I should have been dead years ago.

Medical providers, depending on the type of practice, are exposed to sick people nearly every day. Working in primary care; working in pediatrics; and having an “open schedule” that allows sick people immediate access, puts me in the forefront of germs. For viral infections, people are most contagious early in their disease, when I get to see them.

Exposure comes in many forms, but typically hand-to-hand (direct contact during an examination), indirect contact (fresh germs on surfaces, like door knobs, sinks, etc.), or airborne (coughing, sneezing, flying snot, etc.). On some visits, I get ‘em all.

Fall is the season for upper respiratory infections, from simple colds to influenza, and their complications (sinus infection, pneumonia, and bronchitis). It is also the the season for gastrointestinal infections (vomiting and diarrhea), often wrongly called the “stomach flu”. Flu shots should be arriving soon, but keep in mind the influenza vaccines ONLY helps protect a person from influenza, not colds, and certainly not gastrointestinal viruses.

There have been some lengthy discussions on the ALL EARS BLOG regarding sanitation, especially in the schools, including the lack of disinfection by the janitorial staff. Last year, on the Blog, I did a series on the Dirty Dozen – Twelve of the dirtiest, germiest, places. Of course, schools AND medical offices were prominent on that list.

I typically work in my clinic until 9 PM three days a week, taking care of acutely ill children. Working late, I have the unique opportunity of watching our janitors at work. Janitorial service is provided by the landlord of our building, and is not a crew that the medical group hires. Unlike the janitor in my old grade school, who held the same job for generations, this crew changes like the weather. Some are good; some are unbelievably bad. Nearly all of them, just pick up the trash, mop the floors, and wipe off counter tops. I observed one janitorial crew (no longer there) actually using a feather duster instead of a disinfectant. The vast majority of our after-hour cleaning crew are Hispanic; some have been Russian. Our geographic area is a rich cornucopia of ethnic groups. Many do not speak English, but they are friendly and smile at me when I try to tell them what area needs “extra cleaning”.

In a medical office, it is EVERYONE’S responsibility to keep things cleaned and sanitized. Basically, if you witness the breach, you need to see that it gets cleaned properly. If I see a child chewing on a chair, or wiping something or other on the wall, then it is really up to me to decontaminate it. However, I do not know what goes on behind those closed doors.

I think our office has one of the worst ventilation systems ever. I never feel air coming out of vents. You would think that in an office where a large percentage of the patients still poop in their pants, a better ventilation system would be present. No windows open, either. If germs were visible in the air, some exam rooms would look like Los Angeles in the summer.

Mothers are pretty good at cleaning up messes made by their children. I see them wiping up things, washing their hands, and picking up the Cheerios on the floor (so the next child will not find and eat them). I have to say that I do not trust the Dads. They don’t wipe up anything and they are notorious for hiding poopy diapers (a big no-no) in the bottom of the trash can. Coupled with our poor ventilation system, a few, hidden poopy diapers can shut us down. When you walk in a stinky room, it is really not politically correct to comment about it. You never know WHO created the stink. My PA wife once apologized for a stinky room, thinking that the prior patient put a poopy diaper in the trash. While gloved-up and fishing around in the trash can for the offending diaper, her adult patient sheepishly admitted to farting. If you are ever impatient about waiting for your medical provider to come into the examining room, just fart and I can guarantee they will come right in.

Speaking of bad days, in a past Blog, I did share that terrible day (February 16, 2006 – a day that will live in infamy) that I tried to teach a young mother how to insert a rectal suppository. During my hands-on demonstration using her child, his little butt literally exploded, covering both of us with feces. Hey, poop happens! Surprisingly, I did not get sick. I suspect it is because of all of the crap I dealt with in the past. Apparently, I am immune.

Yes, Virginia, doctors and other medical professionals do get sick; more often than we would like to admit. Medicine is not for sissies.

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Technorati Tags: medicine, colds, flu, health and wellness

Posted by: Rod Moser, PA, PhD at 9:12 am

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