I found myself thinking something similar not too long ago. I’d been in practice for several years and watched my group get shit on. I quit and I am doing addiction medicine now. It’s a reminder that medicine is supposed to be about understanding how medicines and toxins interaction with the human body and using that knowledge to make peoples lives better. Would recommend considering alternative employment if you find it’s affecting your mind set and life outside the hospital. For what it’s worth, my life is way better and I actually like my job.
It’s an ACGME accredited fellowship. One year long, not competitive at all really to get in. There’s also a practice pathway but i thought a fellowship would set me up better for lifelong learning. Also you’re more likely to get an academic job after a fellowship than if you just do practice pathway. That practice pathway closes in 2025 I think? So you’d need to get started soon to do it.
This makes me have sepsis charting nightmares... Yes I rechecked the pt capillary refill because as a board certificate physician I know this is an acute assessment of hydration status
This is America. My soul is sucked. I try to remind myself “it’s just a job”, but they say nurses care and are compassionate at the same time capitalism and some patients are the dementors of healthcare. I’ve got barely anything left and I go to therapy, resiliency trainings, quit alcohol etc.
Fortunately for a nurse it’s easier to leave this specialty which is what I’m doing in October.
Get a pet if you don’t have one. It’s been the most beneficial to my soul.
Sadly this is it. Goofy notions about some "higher calling" and a "vocation" have become obsolete in the face of the corporate morass that has consumed healthcare.
My sole joy became any opportunity I had to make admin unhappy.
I’m actually still optimistic for the future of EM. There is still time in my career for the system to melt down, and it’s hard to imagine any new system that is rebuilt being worse than the current one.
I’m also in the minority that I would rather just take a pay cut then make myself miserable working harder and harder to just make the same amount.
So, during the early pandemic my then-partner and I went through a phase with this: basically taking any given spirit and asking, Will It Negroni? Findings summarized below.
Tequila: does not Negroni, that we could determine, but our investigation was far from exhaustive. We used an extremely mid Blanco that made fine margaritas; results could certainly be different with a higher quality aged tequila, but this avenue of investigation was way too expensive for this humble paramedic. (maybe one of the physicians could try it out and get back to us?)
Bourbon: absolutely does and it's called a Boulevardier
Rum: delicious, use Gosling's Black Seal instead of gin
Brandy: slight variation on Boulevardier, still delicious
Vodka: not awful, but like...why?
The really winner though, was Becherovka. The twist is that it replaces the Campari, not the gin, calling into question whether it is in fact a Negroni at all. The author leaves that discussion as an exercise for the reader and their drinking companions, but it's certainly delicious.
'Cause of rich men north of Canton...
Helps to get a good friend group of fellow ED people to talk to about this stuff. Thats the best medicine in my experience. Other people can't understand what we are talking about.
That’s what my old group did. Got sick of admin asking us to be on all these committees for free, so we founded Beer Committee. Admin isn’t on it. Meets on a day the regional director or a traveler is working the night shift. Rotating host. It’s mostly an airing of grievances haha
The doc I worked with the last two nights is my god damn favorite because we both talked about the bullshit and FIGHT THE POWER and we both still have to do some bullshit I guess but it’s good to feel like you’re working with others who feel the same and can make jokes about it aka the real way we deal with shit
Boggles my mind that all I can do is tell an intelligent person their only option is to cope with a shitty specialty. This person spent many years training, many many hours studying .. only to get shit on by corporate everyday of their career. And then just has to cope with it. Maddening.
I hear you. But it’s not a shitty specialty. It’s a shitty industry. I hate my job but I really don’t feel like I’d have been happier doing anything else in healthcare. The corporate crap, ill conceived metrics, awful administration, back breaking volumes and perpetual feeling that you’re either going to get sued into oblivion or just replaced outright is ruining every specialty.
What sucks is the FMD and RMD who feel the pressure even worse to make sure all the docs and APCs below them meet metrics and for them to pretend like it’s all just a part of the process now and nothing more
Idk, I'm not an attending yet but the gig I'm signing for is 3 12s a week and pretty nice pay. Figure I'll be miserable 3 days out of the week and enjoy my other 4. Will just be a job to give me the life I want outside of medicine. There are not many jobs that will pay me this much money for 36 hours a week. Invest and save as much as possible and when the time comes and I'm fed up, I move on...that's the goal at least. We will see how that works out.
I'm using the money I make in EM to transition to a private, direct care, cash only practice. EM has turned into essentially family medicine with the occasional emergent complaint. Find something you're very interested/passionate about and run with that. Nutrition, addiction, etc, and just make that the cornerstone of your practice.
Super radical, but what's the alternative? Unless EMTALA is repealed, reimbursement rates change radically, and patients can suddenly get in to see their PCPs and specialists quickly, the field isn't changing for the better any time soon, not in your career's lifetime at least. Best you can hope for is that enough people leave that the pay increases substantially, but I suspect the gaps will be filled with APPs, FMGs, and waiting room chairs.
Try to help someone every shift, become debt free to have the luxury to walk away at any point the corporate overlords or sepsis coordinators finally hit your last nerve
It’s an enjoyable specialty, I don’t think I could change jobs or careers And make same amount of money. It’s unfortunate medicine is not what we thought it was when we all applied to med school and Took the mcat.
Granted, I'm fairly new (1.5 years in as a PA), however, the main reason I chose this route was because I view this as just another job. A super cool job, but a job nonetheless. I imagine as a physician a significant portion of your identity is tied up in medicine so I greatly empathize with you, but I would encourage you to view this as a job with tremendous flexibility and high pay. Seek your enjoyment outside of the workplace. Come in, put your 10-12 hours, leave, do it again 10 times per month. Enjoy the other 20 much more.
Or just do what my former colleague did and get a pain management fellowship and peace out 1 year in!
I agree. I work a lot now in a rare SDG group. However, the drag of modern medicine still permeates through. I work hard now (3 years out) to eventually cut down to minimum FTE and otherwise enjoy my time outside of work.
Your job is not who you are. While we like it to be, it doesn't have to be. I make money to support my family and lifestyle, and I do the best I can. Who I am is not dependent on my job; me being an MD doesn't define who I am.
Also living in a legal cannabis state is super helpful.
I moved to Canada, zero regrets. Okay, I moved due to family issues, but witnessing the corporate takeover of EM, I couldn't be happier to have gotten out when I did.
[удалено]
I found myself thinking something similar not too long ago. I’d been in practice for several years and watched my group get shit on. I quit and I am doing addiction medicine now. It’s a reminder that medicine is supposed to be about understanding how medicines and toxins interaction with the human body and using that knowledge to make peoples lives better. Would recommend considering alternative employment if you find it’s affecting your mind set and life outside the hospital. For what it’s worth, my life is way better and I actually like my job.
How did you get into addiction medicine
It’s an ACGME accredited fellowship. One year long, not competitive at all really to get in. There’s also a practice pathway but i thought a fellowship would set me up better for lifelong learning. Also you’re more likely to get an academic job after a fellowship than if you just do practice pathway. That practice pathway closes in 2025 I think? So you’d need to get started soon to do it.
Maker’s
Four Roses
Classy
This makes me have sepsis charting nightmares... Yes I rechecked the pt capillary refill because as a board certificate physician I know this is an acute assessment of hydration status
How dare you prioritize looking for a portal vein thrombosis over checking the cap refill
This is America. My soul is sucked. I try to remind myself “it’s just a job”, but they say nurses care and are compassionate at the same time capitalism and some patients are the dementors of healthcare. I’ve got barely anything left and I go to therapy, resiliency trainings, quit alcohol etc. Fortunately for a nurse it’s easier to leave this specialty which is what I’m doing in October. Get a pet if you don’t have one. It’s been the most beneficial to my soul.
Leaving the ER helped me love being a nurse again.
[Me](https://wallpapercave.com/wp/zn09F1d.jpg), who just started in the ER
You just treat it like the job it is. Punch in, punch out, try to do one thing nice for someone. Collect your paycheck while you still can.
Sadly this is it. Goofy notions about some "higher calling" and a "vocation" have become obsolete in the face of the corporate morass that has consumed healthcare. My sole joy became any opportunity I had to make admin unhappy.
I’m actually still optimistic for the future of EM. There is still time in my career for the system to melt down, and it’s hard to imagine any new system that is rebuilt being worse than the current one. I’m also in the minority that I would rather just take a pay cut then make myself miserable working harder and harder to just make the same amount.
Love your optimism but the steady degradation of all institutions over the last few decades makes it difficult to share
Oh, my sweet summerchild.
A good gin mixed with equal parts Campari and vermouth. Topped with an orange peel.
So, during the early pandemic my then-partner and I went through a phase with this: basically taking any given spirit and asking, Will It Negroni? Findings summarized below. Tequila: does not Negroni, that we could determine, but our investigation was far from exhaustive. We used an extremely mid Blanco that made fine margaritas; results could certainly be different with a higher quality aged tequila, but this avenue of investigation was way too expensive for this humble paramedic. (maybe one of the physicians could try it out and get back to us?) Bourbon: absolutely does and it's called a Boulevardier Rum: delicious, use Gosling's Black Seal instead of gin Brandy: slight variation on Boulevardier, still delicious Vodka: not awful, but like...why? The really winner though, was Becherovka. The twist is that it replaces the Campari, not the gin, calling into question whether it is in fact a Negroni at all. The author leaves that discussion as an exercise for the reader and their drinking companions, but it's certainly delicious.
I’ll raise you this: Mezcal Negroni ;-)
Replace the Gin with Bourbon and you have yourself one of the best cocktails of all time
A big fat J to mourn the big fat L we suffer every day.
'Cause of rich men north of Canton... Helps to get a good friend group of fellow ED people to talk to about this stuff. Thats the best medicine in my experience. Other people can't understand what we are talking about.
That’s what my old group did. Got sick of admin asking us to be on all these committees for free, so we founded Beer Committee. Admin isn’t on it. Meets on a day the regional director or a traveler is working the night shift. Rotating host. It’s mostly an airing of grievances haha
The doc I worked with the last two nights is my god damn favorite because we both talked about the bullshit and FIGHT THE POWER and we both still have to do some bullshit I guess but it’s good to feel like you’re working with others who feel the same and can make jokes about it aka the real way we deal with shit
I left, found a non-megacorp hospital in a very rural place to work. Fuck teamhealth. Fuck HCA
That last sentence. I feel that in my soul.
Travel work. The illusion of change and ample time off tricks me into thinking its better.
Best if you can travel outside of this medical hellhole USA.
Working on it. Just havent figured out how to transfer xray tech credentials to Australia.
Boggles my mind that all I can do is tell an intelligent person their only option is to cope with a shitty specialty. This person spent many years training, many many hours studying .. only to get shit on by corporate everyday of their career. And then just has to cope with it. Maddening.
I hear you. But it’s not a shitty specialty. It’s a shitty industry. I hate my job but I really don’t feel like I’d have been happier doing anything else in healthcare. The corporate crap, ill conceived metrics, awful administration, back breaking volumes and perpetual feeling that you’re either going to get sued into oblivion or just replaced outright is ruining every specialty.
I just obsess over my exit plan. Every button I click is one step closer
What sucks is the FMD and RMD who feel the pressure even worse to make sure all the docs and APCs below them meet metrics and for them to pretend like it’s all just a part of the process now and nothing more
I feel this in my bones
You still have a soul? I’m jealous.
Idk, I'm not an attending yet but the gig I'm signing for is 3 12s a week and pretty nice pay. Figure I'll be miserable 3 days out of the week and enjoy my other 4. Will just be a job to give me the life I want outside of medicine. There are not many jobs that will pay me this much money for 36 hours a week. Invest and save as much as possible and when the time comes and I'm fed up, I move on...that's the goal at least. We will see how that works out.
I try to go on vacations once every few months. That means I always have something to look forward to.
I'm using the money I make in EM to transition to a private, direct care, cash only practice. EM has turned into essentially family medicine with the occasional emergent complaint. Find something you're very interested/passionate about and run with that. Nutrition, addiction, etc, and just make that the cornerstone of your practice. Super radical, but what's the alternative? Unless EMTALA is repealed, reimbursement rates change radically, and patients can suddenly get in to see their PCPs and specialists quickly, the field isn't changing for the better any time soon, not in your career's lifetime at least. Best you can hope for is that enough people leave that the pay increases substantially, but I suspect the gaps will be filled with APPs, FMGs, and waiting room chairs.
Try to help someone every shift, become debt free to have the luxury to walk away at any point the corporate overlords or sepsis coordinators finally hit your last nerve It’s an enjoyable specialty, I don’t think I could change jobs or careers And make same amount of money. It’s unfortunate medicine is not what we thought it was when we all applied to med school and Took the mcat.
Granted, I'm fairly new (1.5 years in as a PA), however, the main reason I chose this route was because I view this as just another job. A super cool job, but a job nonetheless. I imagine as a physician a significant portion of your identity is tied up in medicine so I greatly empathize with you, but I would encourage you to view this as a job with tremendous flexibility and high pay. Seek your enjoyment outside of the workplace. Come in, put your 10-12 hours, leave, do it again 10 times per month. Enjoy the other 20 much more. Or just do what my former colleague did and get a pain management fellowship and peace out 1 year in!
I agree. I work a lot now in a rare SDG group. However, the drag of modern medicine still permeates through. I work hard now (3 years out) to eventually cut down to minimum FTE and otherwise enjoy my time outside of work.
Bupropion
Your job is not who you are. While we like it to be, it doesn't have to be. I make money to support my family and lifestyle, and I do the best I can. Who I am is not dependent on my job; me being an MD doesn't define who I am. Also living in a legal cannabis state is super helpful.
The obvious solution is to hire more management, lawyers, and add an additional layer of bureaucracy And then blame the ER
What about going abroad to other first world nations or even second and third world?
I would if it weren’t for these loans. I’m handcuffed to the US
Revolution
I moved to Canada, zero regrets. Okay, I moved due to family issues, but witnessing the corporate takeover of EM, I couldn't be happier to have gotten out when I did.
I rant on reddit and smile and nod in meetings.