On my first night of Surgery call, the night-float resident (PGY-2) told me that "all the ER docs are f------ idiots" and that "she had to yell at them alot b/c they were so stupid." I was then treated to 2 months of barely controlled disaster when it came to patient care. Whenever I brought up a problem with one of my patients (including a really screwy, almost pericarditis-looking EKG) I was told something to the effect of "we're surgery, we don't care about stuff like that."
Similarly, I just got to watch 7 Medicine residents stumble their way through a code. 2 of them were PGY-3. 1 of those starting Pulm/CC this summer. Total chaos, everyone with thumbs up arses. My favorite was when the PGY-2 who was ostensibly "running the show" said, "hmm, should we be doing chest compressions?"
Anyway, not trying to hijack the thread, just venting.
I think the greatest irony of the anti-EM bias in the hospital is that when you are doing your IM/Surg/Peds rotations you are never making a freaking DDx. Why? B/c the "f------ idiot EP" dx'ed the patient before they came upstairs.
Hijack? - this is exactly what this thread is about! Not just the personal discouragement, but it is also irritating to hear people rag on my chosen field. I was on GI the other day, and the ED did a CT and caught a large abscess in the lining of someone's stomach. The first thing my attending says is, "Bah - if he came in with a little stomach pain and constipation, why did they do a CT?" (Me: Um, because they suspected something like THIS). Then, "Oh Lord, why did they give antibiotics! Why? Why don't they leave it to the people who will be taking care of the patients to give antibiotics? I bet they didn't even take blood cultures!" (Yes, they did take clx, and they probably gave the antibiotics because he had an ABSCESS and THEY were taking care of him at the time).
I accept the whole whipping boy thing, especially if it makes other people feel smart because, once the EP makes the initial diagnosis and starts the treatment and resuscitation, they can afford to sit around doing special studies for days just so they can usually confirm the working diagnosis in the ED. They even occasionally cough up some additional diagnoses or a variation on the original theme. Anyone notice the diagnoses we do get to make on the floors are usually of untreatable things or of things that should be managed the same way as the original diagnosis?
No one appreciates that EPs run circles around medicine docs on surgery, and circles around surgery docs on medicine, while thumping everyone on resuscitation, as AmoryBlaine reports.
AND - I'm bored with them! I do appreciate what they do, but the down time kills me (are you sure you want to do a 2nd consult? Aren't you tired? NO - bored!). Surgery is not as slow, of course, but I do lose interest during a long case...
Considering all of the above, I just want to laugh in the IM and/or Surgery attending's face when they suggest I do what they do for the rest of my life.
