Ground Rules:
1. Identify city and state.
2. Identify hospital.
3. Rant away.
4. Profane or threatening posts will be deleted immediately.
Out.
Monday, March 10, 2008
Hey ER Docs! It's on Like Donkey Kong!
Three jobs since residency, three lies, three broken promises, three times closer to burnout. Here's your chance ladies and gentlemen. If you have either good or bad things to say about your group or hospital let's hear it. Tell us where you work, tell us if you are happy with your group, and tell us if you are happy with your hospital.
Thursday, January 31, 2008
Who is the Enemy?
FROM A PRIMARY CARE PHYSICIAN
Proposal: Doctors have been hoodwinked into arguing with each other to distract from the issue of PATIENT RESPONSIBILITY in our very wobbly system. An example of this can be seen in the first post. An ER doc gets dumped on and sees the FP/Internist as the culprit. Deeper, there are many culprits, not the least of which is the demand for and legislation of free health care. I am not arguing that we physicians can not do better, I am merely saying that we need to direct our energies, we need a reasonable but angry voice to speak out against the black comedy of EMTALA and the silliness of JCAHO.
Proposal: Doctors have been hoodwinked into arguing with each other to distract from the issue of PATIENT RESPONSIBILITY in our very wobbly system. An example of this can be seen in the first post. An ER doc gets dumped on and sees the FP/Internist as the culprit. Deeper, there are many culprits, not the least of which is the demand for and legislation of free health care. I am not arguing that we physicians can not do better, I am merely saying that we need to direct our energies, we need a reasonable but angry voice to speak out against the black comedy of EMTALA and the silliness of JCAHO.
Monday, January 28, 2008
"Go to the ER"
FROM AN EMERGENCY MEDICINE PHYSICIAN...
Here's my biggest peeve. As an Emergency Physician, I actually enjoy helping out my colleagues in other specialties. I love calls from my consultants like the gastroenterologist who says "I've got a guy coming with melena who is on coumadin. I don't want to put him on the floor without knowing how badly he's bleeding, and I'm tied up at the other hospital. Please check him out for me and give me a call. I am truly happy to do this at all hours of the day.
What I hate are the "go to the ER" docs. This phenomenon usually arises about 4pm, is prevalent amongst the PCP's who use hospitalists (that way I either get to be the bad guy or I get to argue with the hospitalist about a bullshit admit), and is a metastatic problem on Fridays.
I used to cover for these guys, but I've stopped. When I hear (as I do every day): "My doctor sent me here for an MRI of my back and admission for pain control"....I just explain to the patient that their doc had the ability to order the test and arrange their admit by making 2 phone calls, but wouldn't. As a result of their doc's laziness and lack of concern, I also advise the patient that they will be getting a bill from the ER and from me which will add over a thousand bucks to their tab.
I then advise them to find a better PCP.
Yeah, patients lie about this, but I hear it all day, every day....so it isn't all patient driven. I know the PCP's are busy, but Christ, I am a lot busier, gimme a break.
Here's my biggest peeve. As an Emergency Physician, I actually enjoy helping out my colleagues in other specialties. I love calls from my consultants like the gastroenterologist who says "I've got a guy coming with melena who is on coumadin. I don't want to put him on the floor without knowing how badly he's bleeding, and I'm tied up at the other hospital. Please check him out for me and give me a call. I am truly happy to do this at all hours of the day.
What I hate are the "go to the ER" docs. This phenomenon usually arises about 4pm, is prevalent amongst the PCP's who use hospitalists (that way I either get to be the bad guy or I get to argue with the hospitalist about a bullshit admit), and is a metastatic problem on Fridays.
I used to cover for these guys, but I've stopped. When I hear (as I do every day): "My doctor sent me here for an MRI of my back and admission for pain control"....I just explain to the patient that their doc had the ability to order the test and arrange their admit by making 2 phone calls, but wouldn't. As a result of their doc's laziness and lack of concern, I also advise the patient that they will be getting a bill from the ER and from me which will add over a thousand bucks to their tab.
I then advise them to find a better PCP.
Yeah, patients lie about this, but I hear it all day, every day....so it isn't all patient driven. I know the PCP's are busy, but Christ, I am a lot busier, gimme a break.
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