Thinking about quitting after 1st year residency

[the prodogy]

So I'm almost done with first year residency. I've felt that medicine wasn't for me since 2nd year medical school. I thought that one I started practicing, I would enjoy it more. Although I enjoy the knowledge learned, I can't get over the work requirement, not only in residency, but even with practicing doctors. It also doesn't help that I feel like I'm not really helping patients. I prescribe medications, antibiotics, teach them how to use insulin, but I'm a firm believer that our job should be lifestyle changes. Ive always wanted to go to a patients home, clean out there refrigerator, or even stay with them for a few days and check up on them regularly.
Anyways, I'm just not sure about the choice I made. I'm now 300k in the hole, and I'm wondering if anyone can help me with options I have or tips for anyone who has gone through a similar experience...

Thanks,
Someone feeling lost

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[DocJL]

You are probably at the toughest part of your training.

Easy to get depressed and want out at this point.


But I can't help but think that if you quit, you will always have regrets, and may not be able to come back and finish later.

Also, if you do not ever get to the income level of a practicing doctor, that huge loan will forever impact your quality of life.


Life will get better, once your training is complete.

 

[the prodogy]

I'm not going to lie, I'm also having a hard time applying the knowledge of medicine. So for my intern year, I'm lagging behind my peers a bit and I'm currently on probation, and if I don't pick things up in the next month, I may be out of the program. Unfortunately, I didn't get scared, not did I care much when I found this out.
If I do get kicked it off the program, what other options are there?

 

[Roguelyn]

You may like concierge medicine or doing home visits. You can can focus on lifestyle and integrative medicine if you want, too. Residency isn't a great model of what you can really do with your training.

 

[AtlasMD]

Hi everyone, boy i was right there with you. Med school is hard. Residency is hard. And just not losing your passion for medicine is hard during all of this.

but. it. does. get. better. I promise.

Have you explored direct primary care (aka concierge for the masses)? I saw the exact same thing in myself and my peers as i was going through residency. When i graduated in 2010, i started my dpc practice so that i could focus on patients and not paperwork. In march i helped a fp of 25 years convert to dpc model and in 2 weeks he said this was the first time he felt like he was doing medicine the right way for the right reasons.

please feel free to call or email me directly, [email protected] C 316.734.8096

we love helping docs learn about dpc and how it can be a real solution for them and their patients.

Not familiar with dpc? But basically we charge $10/mo/kids and $50/mo/adult for unlimited visits, no copays, free procedures, wholesale meds/labs/pathology/imaging for up to 95% savings.... we can then help them get health ins that is 30-60% cheaper.

don't lose your passion, just find ways around a broken system

 

[AtlasMD]

I'm not going to lie, I'm also having a hard time applying the knowledge of medicine. So for my intern year, I'm lagging behind my peers a bit and I'm currently on probation, and if I don't pick things up in the next month, I may be out of the program. Unfortunately, I didn't get scared, not did I care much when I found this out.
If I do get kicked it off the program, what other options are there?

missouri passed a law recently for Assistant Physicians - ie medical school grads who don't match in residency can work with a physician as a physician...

Also, most states will license you as a GP after 1 year of residency.

 

[the prodogy]

Thanks for the reply everyone.

Does anyone know anything about getting a license after 1 year of residency and getting a job afterwards? Are there groups or even urgent cares that hire physicians w/ only 1 year of residency experience if they are licensed? And does anyone know where I can find a list of states that allows for licensing after 1 year of residency, or perhaps a place that helps you w/ job search?

Thanks again

 

[deleted87716]

It will be VERY difficult to find a GOOD job without Board certification. Many insurance plans will not even credential you.

I'm not sure why these "GP" threads always pop up in this forum, because they actually have nothing to do with family medicine.

 

[Leo Aquarius]

So I'm almost done with first year residency. I've felt that medicine wasn't for me since 2nd year medical school. I thought that one I started practicing, I would enjoy it more. Although I enjoy the knowledge learned, I can't get over the work requirement, not only in residency, but even with practicing doctors. It also doesn't help that I feel like I'm not really helping patients. I prescribe medications, antibiotics, teach them how to use insulin, but I'm a firm believer that our job should be lifestyle changes. Ive always wanted to go to a patients home, clean out there refrigerator, or even stay with them for a few days and check up on them regularly.
Anyways, I'm just not sure about the choice I made. I'm now 300k in the hole, and I'm wondering if anyone can help me with options I have or tips for anyone who has gone through a similar experience...

Thanks,
Someone feeling lost

Have you considered switching specialties?

 

[VenturaResident]

Being a GP isn't really a thing anymore. It was legit back in the 50s, 60s, 70s, maybe even 80s, but at this point GP is generally synonymous with failure and lack of adequate medical knowledge and experience, which is why many insurance companies won't reimburse your services and most places won't hire you if that's the path you take. There are some places that will hire you, true, but the quality of care you would provide would be much worse than what you could do if you finish residency that it's hardly fair to the people you would be "serving." The other thing is that, as I'm sure you've noticed in the transition from med student to intern, it's hard to see some of the gaps in your knowledge from where you stand. Interns really truly don't know enough to be providing good medical care as independent providers. But they do know so much more than they did as med students that it's easy to feel "hey, I'm kind of getting the hang of it." But moving into second year you'll recognize (some) of the gaps that you didn't see as an intern, and as a third year you'll see big holes in your knowledge when you were a second year, and as an attending, you'll see how much things you really didn't even get as a third year. And eventually you'll fill in enough of the holes to be able to safely and responsibly practice, but to think that that is possible after intern year in this day and age (or god forbid, after medical school!) is dangerous hubris.

Do what you need to do to get through residency: switch specialties, get counseling, get meds, get hobbies, get perspective, get meditation, whatever it is you need. Or if you want, bail out for a non-clinical career as a researcher or drug rep or whatever you want to do. But don't plan to bail out now and think that you'll be any kind of reasonably competent clinician, because unfortunately, you won't be.

 

[W19]

Thanks for the reply everyone.

Does anyone know anything about getting a license after 1 year of residency and getting a job afterwards? Are there groups or even urgent cares that hire physicians w/ only 1 year of residency experience if they are licensed? And does anyone know where I can find a list of states that allows for licensing after 1 year of residency, or perhaps a place that helps you w/ job search?

Thanks again

In FL you can get a job in the prison system or county health department; the pay for health department is around 100k/year.

 

[deleted87716]

In FL you can get a job in the prison system or county health department; the pay for health department is around 100k/year.

Prison jobs are for nearly-retired, washed-up docs. You'll never be able to work anywhere else again.

 

[W19]

Prison jobs are for nearly-retired, washed-up docs. You'll never be able to work anywhere else again.

If you are a GP (1 year residency), that is pretty much what will be available to you.

 

[JustPlainBill]

I feel your pain -- I was in the wrong residency for me and it sucked from the first month through the last month -- I too was at the point with my GAF factor was at sub-zero readings -- And it's easy to become negative when you realize that what you thought medicine would be like vs what it really is are 2 completely different things -- most people, at least the kind you see in residency, don't want your help. They want what they want and will do what it takes to get it from you to go on their merry way -- it does suck. But about once every 6 months, you'll roll across the one patient that you can truly help who appreciates it and makes the previous 6 months worth it.

It doesn't necessarily change that much once you're out in terms of patient interactions -- you just get a lot nicer patients that you can interact with and you get paid a little better. You learn to make things fun and pick what you really want to "specialize" in -- if it's preventive medicine, go for it -- about 30% of my patients have no clue how to eat/exercise and would pay good money to have someone hold their hand, especially a "doctor" -- they likely will just make excuses and continue, but having a "doctor" advise them gives them an out that it's some organic cause or "thyroid problem" (love that one) and they sleep better at night. A few will really get with the program, follow your advice and improve their lives.

You have to face the facts -- human beings have in their heads what makes them happy -- healthcare to them is really about "fixing me so I can get back to what I want to do" not necessarily implementing change for better health --we want bandaids, not permanent change. That's probably very cynical and I've been out of residency around 2 years and board certified for around 1.5 so take it with a grain of salt.

I personally went through a period of "man, this really sucks" after residency but am coming out of it now -- I'm working hard to improve my knowledge and practice of medicine -- why? Self motivated to be the best at my craft. But my reason for working? To be able to enjoy the vacations, spend time with the family and set my kids up for a better future with passive income streams.

At the end of the day, my fulfillment comes from 3 things: 1) My relationship with my Creator 2) My relationship with my family 3) Being a part of something bigger than myself --

You may want to function check yourself: Do a mental exercise -- when you're lying on your deathbed and looking back over your life, will you be satisfied with what you did with your time on this earth? As I'm getting older, I've learned that a lot of stuff that used to be so important isn't worth my time now.

However, as far as quitting residency? I strongly considered it, was counseled by mentors to do it as it looked like the PD was after my glutes. Would have been the worst mistake I could have made --- stick it out or consider transferring -- if you're on probation now and being threatened with getting fired, you need to get your act together quickly -- go to your advisor and discuss what's going on -- if you can't, get a new advisor you can talk to -- if you get bounced, it's monumentally more difficult to recover from --

Good luck -- and don't let the b@#$!%ds grind you down ---

 

[MDROBIN001]

Being a GP isn't really a thing anymore. It was legit back in the 50s, 60s, 70s, maybe even 80s, but at this point GP is generally synonymous with failure and lack of adequate medical knowledge and experience, which is why many insurance companies won't reimburse your services and most places won't hire you if that's the path you take. There are some places that will hire you, true, but the quality of care you would provide would be much worse than what you could do if you finish residency that it's hardly fair to the people you would be "serving." The other thing is that, as I'm sure you've noticed in the transition from med student to intern, it's hard to see some of the gaps in your knowledge from where you stand. Interns really truly don't know enough to be providing good medical care as independent providers. But they do know so much more than they did as med students that it's easy to feel "hey, I'm kind of getting the hang of it." But moving into second year you'll recognize (some) of the gaps that you didn't see as an intern, and as a third year you'll see big holes in your knowledge when you were a second year, and as an attending, you'll see how much things you really didn't even get as a third year. And eventually you'll fill in enough of the holes to be able to safely and responsibly practice, but to think that that is possible after intern year in this day and age (or god forbid, after medical school!) is dangerous hubris.

Do what you need to do to get through residency: switch specialties, get counseling, get meds, get hobbies, get perspective, get meditation, whatever it is you need. Or if you want, bail out for a non-clinical career as a researcher or drug rep or whatever you want to do. But don't plan to bail out now and think that you'll be any kind of reasonably competent clinician, because unfortunately, you won't be.

 

[MDROBIN001]

GP is not necessary anonymous with failure! Ive trained with someone who was kicked out of the residency program just before the end of their 3rd year because he had an argument with the a chief resident regarding a medical decision where the chief was actually wrong but everyone backed up the chief. That person haven't even gotten credits
for his training except for a one year.. he got his Licence and now working successfully at an urgent care
making $105/h. Ironically enough, two years into practicing medicine, the chief is now facing a lawsuit after performing a hand laceration repair w/o referring the pt to a hand specialist. The pt had actually a tendon rapture that was retracted and has a permanent impairment! That was an example of many and much more details into that story which are beyond the scope of this thread.

 

[ThoracicGuy]

GP is not necessary anonymous with failure! Ive trained with someone who was kicked out of the residency program just before the end of their 3rd year because he had an argument with the a chief resident regarding a medical decision where the chief was actually wrong but everyone backed up the chief. That person haven't even gotten credits
for his training except for a one year.. he got his Licence and now working successfully at an urgent care
making $105/h. Ironically enough, two years into practicing medicine, the chief is now facing a lawsuit after performing a hand laceration repair w/o referring the pt to a hand specialist. The pt had actually a tendon rapture that was retracted and has a permanent impairment! That was an example of many and much more details into that story which are beyond the scope of this thread.

No one gets kicked out of residency for having an argument with the chief resident...

 

[W19]

GP is not necessary anonymous with failure! Ive trained with someone who was kicked out of the residency program just before the end of their 3rd year because he had an argument with the a chief resident regarding a medical decision where the chief was actually wrong but everyone backed up the chief. That person haven't even gotten credits
for his training except for a one year.. he got his Licence and now working successfully at an urgent care
making $105/h. Ironically enough, two years into practicing medicine, the chief is now facing a lawsuit after performing a hand laceration repair w/o referring the pt to a hand specialist. The pt had actually a tendon rapture that was retracted and has a permanent impairment! That was an example of many and much more details into that story which are beyond the scope of this thread.

He was right and they still kick him out!

 

[22031 Alum]

He was right and they still kick him out!

Don't be fooled. You don't get fired for arguing with your chief, unless physical assault was involved, or you have a history of issues and that was the final straw. People love to come here and post stories of their poor persecuted "friend," but never give all the information. Only what is necessary to make the program look evil. At the end of the day, programs need residents to cover services, and losing someone puts a huge burden on everybody else- including the faculty. There has to be an extremely compelling reason to fire someone. A program that had a habit of doing it out of pettiness would soon stop existing.

 

[candbgirl]

OP reported he was non renewed so he doesn't have to worry about this particular subject. OP are you a U.S. MD/DO or are you an IMG?

 

[the prodogy]

Thanks for all the replies again. I'm a DO. To be honest, I want to work in an urgent care. But I thought it would still be close to impossible to work in one, unless it was in the middle of no where

 

[ThoracicGuy]

Thanks for all the replies again. I'm a DO. To be honest, I want to work in an urgent care. But I thought it would still be close to impossible to work in one, unless it was in the middle of no where

Could you and should you are probably different answers. The best answer is to try and get a spot somewhere to finish your training even if you wish to do urgent care sort of work. Having only one year of residency will greatly limit your opportunities and open you up to more potential liability.

 

[MDROBIN001]

Don't be fooled. You don't get fired for arguing with your chief, unless physical assault was involved, or you have a history of issues and that was the final straw. People love to come here and post stories of their poor persecuted "friend," but never give all the information. Only what is necessary to make the program look evil. At the end of the day, programs need residents to cover services, and losing someone puts a huge burden on everybody else- including the faculty. There has to be an extremely compelling reason to fire someone. A program that had a habit of doing it out of pettiness would soon stop existing.

 

[MDROBIN001]

Don't be fooled. You don't get fired for arguing with your chief, unless physical assault was involved, or you have a history of issues and that was the final straw. People love to come here and post stories of their poor persecuted "friend," but never give all the information. Only what is necessary to make the program look evil. At the end of the day, programs need residents to cover services, and losing someone puts a huge burden on everybody else- including the faculty. There has to be an extremely compelling reason to fire someone. A program that had a habit of doing it out of pettiness would soon stop existing.

 

[MDROBIN001]

there is one program located in the south that persecuted a middle-aged resident who was from the Middle East and spoke with an accent.. this persecution is no doubt because the said resident was not blonde with blue eyes like a majority of the other residents in program. This particular hospital and program are notorious for "getting rid" of those residents who do not "fit in" resembling their praised blonde hair blue eyed Jesus! Exactly one year after resident with Middle Eastern accent sued program and settled.. one of the key attendings in law suit was fired for more than likely patient negligence! Although this conversation does pertain to previous threads- these detailed are beyond the scope of this thread .. don't assume that people post lies or other stories!

 

[22031 Alum]

there is one program located in the south that persecuted a middle-aged resident who was from the Middle East and spoke with an accent.. this persecution is no doubt because the said resident was not blonde with blue eyes like a majority of the other residents in program. This particular hospital and program are notorious for "getting rid" of those residents who do not "fit in" resembling their praised blonde hair blue eyed Jesus! Exactly one year after resident with Middle Eastern accent sued program and settled.. one of the key attendings in law suit was fired for more than likely patient negligence! Although this conversation does pertain to previous threads- these detailed are beyond the scope of this thread .. don't assume that people post lies or other stories!

Bolded for irony.

I say again, it is extremely burdensome on programs to let residents go. Those that do it lightly are not long for this world.

 

[MDROBIN001]

Not worth replying to your preconceived notions and set opinions.

 

[ThoracicGuy]

Not worth replying to your preconceived notions and set opinions.

That's just precious.

 

[styphon]

missouri passed a law recently for Assistant Physicians - ie medical school grads who don't match in residency can work with a physician as a physician...

Also, most states will license you as a GP after 1 year of residency.

This is true only if he went to a US medical school. If he is an IMG, most states will require 3 years of residency.

Thanks for the reply everyone.

Does anyone know anything about getting a license after 1 year of residency and getting a job afterwards? Are there groups or even urgent cares that hire physicians w/ only 1 year of residency experience if they are licensed? And does anyone know where I can find a list of states that allows for licensing after 1 year of residency, or perhaps a place that helps you w/ job search?

Thanks again

Each year it is becoming harder and harder for people who do not finish residencies to find a job for a multitude of reasons.

Example: The urgent cares in my area have shifted from hiring residents and people unable for whatever reason to finish residency to now hiring only boarded FM and EM doctors. This is due to insurance reimbursement and competition - one urgent care chain advertises "all of our doctors are boarded!" and to compete the other chains fall in line. There is also the fact that various organizations (urgent care groups, insurance groups) are pushing for urgent care specialization.

Example: Some insurances will refuse to have you on their "panel" if you have not finished residency. So if you are in an area with one major insurer and they refuse to take you on - good luck getting patients. This is also true for some malpractice policies.

I feel as if prison medicine will be the next to transform to this standard. There is even lots of talk of making a "prison medicine" fellowship or primary residency.

Almost every job I applied for wanted proof that I was boarded and these jobs were inner city and rural areas - not some fancy suburbs.

 

[notinkansas]

DO NOT QUIT. Even if you hate it, suck it up and finish a residency. Any residency. Changing specialties is Ok. I am here to tell you that not having board certification is a HUGE stigma. It sucks, and really limits your job options. I wound up not being BC, not by design, but due to trying a non medical job after bailing out of general surgery due to burnout. I thought if the non medical job didn't work out in a couple years, I'd just match into something else. I was wrong. Turns out, the medical community wants nothing to do with you if you take a break for a couple of years.

Your student loan debt will never go away and it will become a huge weight unless you can generate the income to pay it off. Finish a residency, get a high paying job, live like a student and throw the rest of the money at your debt. That is what I wish I had done. Being debt free gives you a lot of options.

 

[Board Vitals]

Thanks for the reply everyone.

Does anyone know anything about getting a license after 1 year of residency and getting a job afterwards? Are there groups or even urgent cares that hire physicians w/ only 1 year of residency experience if they are licensed? And does anyone know where I can find a list of states that allows for licensing after 1 year of residency, or perhaps a place that helps you w/ job search?

Thanks again

Hello,
Most states will allow you to obtain a medical license after one or two years of residency if you graduated from a U.S. medical school. It is state specific however and you need to check with each state's board licensing website. Locum tenens is a way where you can practice medicine with a license on a "as needed basis". There are plenty of job sites that offer locum tenens position in urgent care and outpatient medicine. If you obtain a license after 1 or 2 years of residency, it does not necessarily mean you are board certified eligible and many practices (not all) want a board certified physician. Definitely research this option as I know a lot of physicians who have done this. Hope this helps. - MD Author/ Editor for BoardVitals

 

[Ericslv]

If you are a GP (1 year residency), that is pretty much what will be available to you.

There is GP I know who has a DPC practice and is making much more than most FPs seeing far less patient a day. I also know of one who has a complete cosmetic practice and is doing very well (I have to say her practice was more difficult to start but now she is doing well and by well I mean making much more than the average FP and doing less hours).

I realize those just two examples but I don't think the DPC example is an isolated one. But if you want to work in mainstream, insurance based medicine at this time you will need to be board eligible or certified and that require one to finish residency.

 

[cabinbuilder]

Thanks for all the replies again. I'm a DO. To be honest, I want to work in an urgent care. But I thought it would still be close to impossible to work in one, unless it was in the middle of no where

If you want to work in urgent care you NEED AS MUCH TRAINING AS POSSIBLE. The cases are different every single day and are from simple to complex. You need to know what you can fix and what needs to be sent to the ER. You can't just send patients to the ER becuase its simple but you don't have the training. Additionally any decent urgent care job will require board certification due to all the governmental regulations and the need to be able to bill insurance. We just had the worst doctor ever working with our group who went through residency but never learned any procedures. THE WORST and couldn't wait to get rid of her. I can't imagine someone with one year residencdy training would be at all helpful to the flow.

 

[W19]

There is GP I know who has a DPC practice and is making much more than most FPs seeing far less patient a day. I also know of one who has a complete cosmetic practice and is doing very well (I have to say her practice was more difficult to start but now she is doing well and by well I mean making much more than the average FP and doing less hours).

I realize those just two examples but I don't think the DPC example is an isolated one. But if you want to work in mainstream, insurance based medicine at this time you will need to be board eligible or certified and that require one to finish residency.

I agree... My friend who became a GP about 3 months ago got a nice job in rural America making 180k/year + 25k loan repayment and 20k for relocation cost...

 

[Ericslv]

If you want to work in urgent care you NEED AS MUCH TRAINING AS POSSIBLE. The cases are different every single day and are from simple to complex. You need to know what you can fix and what needs to be sent to the ER. You can't just send patients to the ER becuase its simple but you don't have the training. Additionally any decent urgent care job will require board certification due to all the governmental regulations and the need to be able to bill insurance. We just had the worst doctor ever working with our group who went through residency but never learned any procedures. THE WORST and couldn't wait to get rid of her. I can't imagine someone with one year residencdy training would be at all helpful to the flow.

There are no govt. regulation that say you have to be board certified and board certification does not make a doctor good.

 

[cabinbuilder]

There are no govt. regulation that say you have to be board certified and board certification does not make a doctor good.

I didn't say that. I was giving a realistic real world view in the world of urgent care in the present.

 

[Ericslv]

I didn't say that. I was giving a realistic real world view in the world of urgent care in the present.

I agree with you realistic view. but you did say that govt. regulations require board certification. "urgent care job will require board certification due to all the governmental regulations" Thats what I was responding to. But I agree with you that if someone wants to work in the world of insurance they will need to be board certified unless they want to just take medicare.

One other thing about urgent care. If someone is working urgent care and does not know or is not comfortable with something that walks in and chooses to refer to the Er and the Er doc get angry about it, then its the er docs issue. I will simply tell him to go back to work and stop bothering me because I'm busy.

I don't work for him/her.

 

[cabinbuilder]

I agree with you realistic view. but you did say that govt. regulations require board certification. "urgent care job will require board certification due to all the governmental regulations" Thats what I was responding to. But I agree with you that if someone wants to work in the world of insurance they will need to be board certified unless they want to just take medicare.

One other thing about urgent care. If someone is working urgent care and does not know or is not comfortable with something that walks in and chooses to refer to the Er and the Er doc get angry about it, then its the er docs issue. I will simply tell him to go back to work and stop bothering me because I'm busy.

I don't work for him/her.

Damn, you have no clue what you are talking about. I was meaning all the regulations in place for an entity to get PAID by a doctor. Insurance companies (i.e. Obamacare) will not pay an entity for a non board certified physician to treat a covered patient.

Second:::: if you are working urgent care next door to an ER like I am currently and the ER and urgent care are run by the came company you bet your ass that you will get fired if you consistently send stupid urgent care type cases to the ER that is already overwhelmed.

Get off the thread already cuz you have NO CLUE what the hell you are talking about.

 

[Ericslv]

Damn, you have no clue what you are talking about. I was meaning all the regulations in place for an entity to get PAID by a doctor. Insurance companies (i.e. Obamacare) will not pay an entity for a non board certified physician to treat a covered patient.

Second:::: if you are working urgent care next door to an ER like I am currently and the ER and urgent care are run by the came company you bet your ass that you will get fired if you consistently send stupid urgent care type cases to the ER that is already overwhelmed.

Get off the thread already cuz you have NO CLUE what the hell you are talking about.

Wow. Are you always this rude and angry? I don't work for an urgent care that is run by the hospital and I've been an attending for much longer than you. I also take insurance in my practice and know exactly how thing are run. So I do have clue. Please don't respond back with rude and angry comments. I'm very offended.

 

[Ericslv]

One note to the OP. Procedures and urgent care aren't all that it's cut out to be. They get old quick. Especially urgent care.

Your best bet is to find a residency or program you can finish and to just that. Then you have more options. You can choose what procedures you want to do and which ones you'd rather send out. You can choose what type of patients you want to see. You can do most of that if you have a private practice. It will be HARD because right not it's hard to have a private practice but it can be done.

If you pay of your loans you can even work part time and enjoy life full time. It's up to you. But it's harder if you don't finish residency.

Some other resources for non-clinical work: SEAK they have seminars for doctors who no longer want to do clinical work.

Hope you find what you need.

 

[Makati2008]

I agree with you realistic view. but you did say that govt. regulations require board certification. "urgent care job will require board certification due to all the governmental regulations" Thats what I was responding to. But I agree with you that if someone wants to work in the world of insurance they will need to be board certified unless they want to just take medicare.

One other thing about urgent care. If someone is working urgent care and does not know or is not comfortable with something that walks in and chooses to refer to the Er and the Er doc get angry about it, then its the er docs issue. I will simply tell him to go back to work and stop bothering me because I'm busy.

I don't work for him/her.

I highly doubt you would tell a ER doc that but it's fine to be an internet tough guy lol.

 

[deleted87716]

I highly doubt you would tell a ER doc that but it's fine to be an internet tough guy lol.

I doubt an ER doc would get "angry" at somebody for referring something silly anyway. They'll treat 'em and street 'em, and they'll get paid for it. No skin off their nose. They'll probably think the referring doc is an idiot, but I guess that's their problem, too.

 

[VA Hopeful Dr]

I doubt an ER doc would get "angry" at somebody for referring something silly anyway. They'll treat 'em and street 'em, and they'll get paid for it. No skin off their nose. They'll probably think the referring doc is an idiot, but I guess that's their problem, too.

You'd be wrong there. Not 100% of the time, but I've been yelled at by more than a few ER docs for what they thought was stupid stuff.

 

[deleted87716]

You'd be wrong there. Not 100% of the time, but I've been yelled at by more than a few ER docs for what they thought was stupid stuff.

Well, there are dinguses everywhere. I've never had anyone get upset with any of my ER referrals, and I've been on the receiving end of some pretty lame crap, too. I always smile and say, "No problem, we'll take care of it." The subtext, of course, is "...since you obviously couldn't."

I should add that if I'm ever forced to send crap to the ER, I always start my conversation with the ER attending with something like, "Listen, I know this is BS, but here's the deal..."

 

[septoplasty]

You'd be wrong there. Not 100% of the time, but I've been yelled at by more than a few ER docs for what they thought was stupid stuff.

Likewise we "yell" at ER Docs for soft admits.. its all around isn't it?

No biggie..

 

[VA Hopeful Dr]

Well, there are dinguses everywhere. I've never had anyone get upset with any of my ER referrals, and I've been on the receiving end of some pretty lame crap, too. I always smile and say, "No problem, we'll take care of it." The subtext, of course, is "...since you obviously couldn't."

I should add that if I'm ever forced to send crap to the ER, I always start my conversation with the ER attending with something like, "Listen, I know this is BS, but here's the deal..."

My usual approach as well, and the vast majority are usually fine since we all make mistakes or BS consults every now and then. I'm still just pissed at the one asshat who called me back after seeing the patient I sent over to berate me.

 

[Doctor4Life1769]

My thoughts, the ED physician has no room to complain over "bs" referrals when they are king of doing the exact same thing "just in case..."

 

[Ericslv]

I highly doubt you would tell a ER doc that but it's fine to be an internet tough guy lol.

Not being a tough guy. It's just that if an attending physician wants to yell at me (another attending physician that does not work for him) then he is going to get the same. I have no obligation to him. They want my business. They act like they don't but it keeps the revenue coming in.

There are countless urgent care centers with countless FP's working in them with various degrees of skill.
Some are great at laceration repair up to a point and some are great at fracture care until it comes to a more complicated case. So, they will refer out.

Urgent care cases vary by season and location. I once had a guy come in at close to midnight because he was drinking with his buddies and playing with a pellet gun and shot himself in the side of the face. I had to spend 1/2 hour digging it out. It was close to closing time and I was very tempted to send him to the ER.

If the urgent care is attached to a hospital then there is going to be more equipment and expectations.

Why is everyone so touchy and angry in here?

 

[cabinbuilder]

Why is everyone so touchy and angry in here?

Because it's been a brutal ******* - ish type of week. I had an orthopedic surgeon bitch me over the phone for "refusing care" on a patient (who was a friend of his) who wasn't even checked into urgent care and I was trying to help the mom after hours on a film that was done as an out patient but the kid had a fracture and no plan if that happened. I got talked to by the clinic manager about being short with the surgeon.

Or how about the stupid waste of space locum doctor I have had to work with the past 8 weeks who knows NOTHING (I am locum too) who sent my triaged patient to the ER for "chest pain" after I determine that it's not that that. I had to sent the MA to the ER to retrieve the patient and see him since he had the full cardiac workup 2 weeks prior. He had rib dysfunction which I fixed in the office with some OMT and he left pain free.

So, yes, I'm tired - I worked 8 days in a row - 97 hours. I am doing my best to hold it together. SOOOOO if I sound angry. WHATEVER!!!!!!. Just please try to sound like you know what you are talking about because my patience is ZERO and I don't have time to ***** foot someone else's feelings. PERIOD.

 

[W19]

@cabinbuilder Look at the bright side: You make over 12k in 8 days if your hourly rate is $125/hr