Terrible Sign Outs

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Terrible signs out is par for the course esp at moonlighting places. Moonlighting opportunities = poorly staffed = higher pay = crappier docs = terrible sign outs.

In 15+ yrs at my reg job with great EM docs, I can't think of any bad sign outs. I mean Zero. Some were borderline but understandable.

My moonlighting gigs with marginal docs, its the luck of the draw. I had a sign out (not unusual from this particular doc) that stated.

"Pt says he feels sick but exam benign. He looks fine. Just check the labs and send him home if neg"

I went to check labs and WBC > 20. Electrolytes out of wack. Initial vitals had him with HR in the 130s, Temp 102.

WTF...... Anyhow, figure out which is the poor docs and just rework the pts up. For the money they are paying at some of these places, it doesn't bother me one bit. There has to be a reason they are paying so much.

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This policy encourages, not discourages sign outs. RVUs to the last name on the chart is the standard in this industry, that is quite an odd policy.
This policy might be done to encourage signing up for pts early in order to decrease door to doctor times.
 
This policy might be done to encourage signing up for pts early in order to decrease door to doctor times.

It's simpler just to do what we do at my place. If you're swamped, and the next doc is coming in, just "sign up" for the patients in order to stop the clock and let the incoming doctor know they still need to be seen.
 
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Provider? was this an NP or something. Are there any places in EM without "providers" and only physicians?

Yes, but not here.

One of these days we will all be replaced by Big Hero 6.
 
This policy might be done to encourage signing up for pts early in order to decrease door to doctor times.

We are both paid by the last name on the chart (determines our RVU pay) and also paid by our bed-to-doc times, individually (determines a separate subset of pay).
 
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