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Reborn24
why are there so many people into it?
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Weirdoc said:
Let's see:
1. No call
2. More days off
3. Fast paced
4. General vs. specialized medicine
5. Helping the sickest patients
6. Not needing to worry about health insurance coverage
7. Lots of hands on proceedures
8. The whole "work hard, play hard" attitude
9. You never know what you're going to deal with when you go to work
10. Good pay compared to most generalists (i.e. FM, IM, Peds)
Need I go on? (If you can't tell already, I'm heavily leaning towards EM)
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I wouldn't say you're seeing the sickest patients. Most of the patients I saw in the ER could have been seen in a primary care office. The sickest patients are in the ICU. As for no worry for insurance-- you do have to worry about insurance sometimes. A lot of the patients without primary doctors will get assigned the on-call doc that's listed under their insurance plan for that day.
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Weirdoc said:
Because you make a lot of money for doing basically what a triage nurse does.
😱 😱
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Dp
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11. Shorter residency
Not for me but I can see the appeal.
Not for me but I can see the appeal.
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It's never the same.
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On a similar note, why are so many people into radiation oncology?
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anon-y-mouse said:
Are you kidding me...It's a lifestyle choice. starting salary in the mid 300s and no call or emergencies. relatively low malpractice. as well as helping that pt population..
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glorytaker said:
The only way to get to the ICU is through the ER.
Every ICU patient was once an ER patient.
Specific physicians are not assigned to specific patients in the ER. It simply depends on which chart you grab next.
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OSUdoc08 said:
Or be admitted off the floor...
Or come from the OR...
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Weirdoc said:
It's a specialty for those students who want to sell out but dont have the numbers for derm. Basically for the slap-d!cks who want to be called "Dr." but have the responsibility level of a nurse.
Most doctors think it should never have been made a specialty.
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yposhelley said:
I've got the utmost respect for FP. It was actually several FP's that first told me EM should have never been made a specialty.
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usnavdoc said:
What do radiation oncologists do...? Are they just in charge of making / monitoring a radiation treatment schedule for their cancer patients?
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usnavdoc said:
There's call and emergencies in rad-onc.
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Why EM:
Get to see a little bit of everything - from ear infections to car accidents. First line of defense for many sick people. Get to see immediate results from a lot of what you do. Keep ALL your skills up for those of us who are interested in working abroad, in hospitals that don't have any other doctors. Have a somewhat controllable life (although it's really NOT a lifestyle specialty, contrary to whatever people may say about "sell outs who couldn't get into derm"). No call. Fast pace for those of us who like to "go, go, go" and don't want to be pulmonologists (joke there, for anyone who has ever done a PFT).
Midweek skiing 🙂.
Get to see a little bit of everything - from ear infections to car accidents. First line of defense for many sick people. Get to see immediate results from a lot of what you do. Keep ALL your skills up for those of us who are interested in working abroad, in hospitals that don't have any other doctors. Have a somewhat controllable life (although it's really NOT a lifestyle specialty, contrary to whatever people may say about "sell outs who couldn't get into derm"). No call. Fast pace for those of us who like to "go, go, go" and don't want to be pulmonologists (joke there, for anyone who has ever done a PFT).
Midweek skiing 🙂.
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tigershark said:
"slapd!ck!....hahahaha ... i like it.....now learn the basics of using a computer....
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tigershark said:
This from someone going into radiology!?! Into the only specialty (besides Path) that requires seeing NO patients at all. The one where you don't actually have to know anything or do anything as long as you can type the phrase "Study indeterminate. Clinical correlation required." Please. EM is for those folks who can handle making serious decisions based on their history taking and clinical exam skills. Basically the opposite of Radiology - which explains the animus.
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tigershark said:
Generally because FPs lost out and then sued in order to keep control of EM. They lost. Seems odd that they continue, however, to attempt to obtain board certification in Emergency Mediicne if the job is so awful.
Hmm, meethinks this smells like the underside of a bridge...
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OSUdoc08 said:
Agreed. do you think that these floor patients and OR patients just come from home and walk into an OR or a floor.
Sure there are direct admits and day surgery etc..., but those aren't the people getting transferred to the ICU generally.
again........it is obvious that tigershark hasn't spent anytime in an ED. (ie trolling pre-med/pre-clinical medstudent).
it is almost so obvious I'm embarassed to draw attention to him.
later,
someone who will be matching in EM in March 2006!
yiipeee.
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I smell a ban coming on.....tigershark said:
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I've spent just as much time in the ER as any other 4th year medical student. EM is almost entirely protocol driven. Every ER I've been in has had a wall of protocols for any presentation you could think of.....it requires zero thought, just go down the checklist. There's nothing an EM doc does that any FP or IM isnt qualified to do, and 99% of it can be done by PA's and NP's (which is what happens in most ERs) . In most major academic centers an ER doc does nothing but decide who to consult.
I've yet to hear anything positive about EM as a specialty from any attending or private practice doc.
I've yet to hear anything positive about EM as a specialty from any attending or private practice doc.
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OSUdoc08 said:
And what does an MS2 know about it, besides what he/she saw on ER?
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tigershark said:
well...its true that FP doctors can be trained to do the same things an ER doc does. My mother is a FP who moonlights in a local ER every other weekend-BUT there are things that she can't do-and she calls an ER doc to come in and do-simply because she doesn't get to practice that particular skill enough-ie intubating. Similarly, an FP doc can deliver babies, but if they don't do it often, they will be less able to handle problems when they come up.
A lot of what FP docs do is just sort out whether or not they can treat the problem and then refer the patient to someone who can treat their problem. Similar to ER docs in that way. That is a necessary step in recieving care. A main difference is that ER docs get to perform more procedures than FP docs.
Its true that many of the patients who come in to the ER are patients who should really go to some primary care doc-but that is just the way ERs are-its due to the fact that people who don't have insurance neglect care until they are forced to go to the ER, and its due to ignorance as well---patients don't wait until monday morning when they really should have.
If there was not a need for ER docs, then there wouldn't be jobs for them. Its really that simple.
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tigershark said:
LOL. And how many times have I heard:
"Well, I think it's just a cold, but my family doc told me to come to the ER because it's after 5."
The next time you hear that, ask the family doc if they will start to come down to the hospital (at all hours of the night, and days of the week) to examine, admit, and care for all of their emergent patients. Don't get me wrong, I have a lot of respect for FP. It's just seems that how people see the train usually depends on what side of the tracks they're on.
D
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San_Juan_Sun said:
More likely, the patient simply doesn't want to wait until regular office hours to be seen. Not the doc's fault. I do my best to manage after-hours calls as medically appropriate, but if someone basically demands a referral to the ER for their runny nose, they'll get it. Why shouldn't they? It's their problem, not mine. 🙂
San_Juan_Sun said:
In most locales, that's no longer possible, even if we wanted to. Hospital regulations frequently prohibit private physicians from treating patients in the ER.
D
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yposhelley said:
How is that different from what any other doctor does? 😉
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I think the only specialty on here that REALLY deserves to be bashed is probably radiology.
I mean jeeesh. who needs a radiologist to read a chest film? A third year medical student can do that.
And obviously in the future most studies will be read in India etc....who would choose this specialty? I mean really.
Most of the docs I talk to don't even think radiology should be a specialty. The surgeons read their own studies, cardiologists read their own studies, ER docs can't wait for the studies to be read etc...
I hear that there is a movement to make radiology a technical level training program in a community college somewhere in the northeast. Obviously, radiology doesn't require knowledge of what most people would call "medicine".
Actually, when you think about it why are radiologists allowed to be called "doctors" anyway. They definately don't "practice" medicine.
Most of how they read things is based on protocols ie. "right patient, right study, foreign objects etc..."
The walls of most radiology dark rooms consist of atlases and protocols on how to read radiology studies.
I know this because I've spent as much time in radiology as any 4th year medical student.
I also know several radiologists and they all confirm what I've said. Plus, my mother's ex-boyfriends neighbor told me that radiology is just a copout for people who have no social skills and he said they've done some studies that most radiologists are actually schizoaffective.
Besides, who'd wanna sit in a dark room all day never "helping" anyone.
(this post intended only for tigersharks benefit) 😀
I mean jeeesh. who needs a radiologist to read a chest film? A third year medical student can do that.
And obviously in the future most studies will be read in India etc....who would choose this specialty? I mean really.
Most of the docs I talk to don't even think radiology should be a specialty. The surgeons read their own studies, cardiologists read their own studies, ER docs can't wait for the studies to be read etc...
I hear that there is a movement to make radiology a technical level training program in a community college somewhere in the northeast. Obviously, radiology doesn't require knowledge of what most people would call "medicine".
Actually, when you think about it why are radiologists allowed to be called "doctors" anyway. They definately don't "practice" medicine.
Most of how they read things is based on protocols ie. "right patient, right study, foreign objects etc..."
The walls of most radiology dark rooms consist of atlases and protocols on how to read radiology studies.
I know this because I've spent as much time in radiology as any 4th year medical student.
I also know several radiologists and they all confirm what I've said. Plus, my mother's ex-boyfriends neighbor told me that radiology is just a copout for people who have no social skills and he said they've done some studies that most radiologists are actually schizoaffective.
Besides, who'd wanna sit in a dark room all day never "helping" anyone.
(this post intended only for tigersharks benefit) 😀
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KentW said:
its true that a lot of what 'any' clinician does is ruling out/ruling in and then referring to the proper person. The difference is that specialists are supposed to be able to fix problems that generalists can't. Surprised you are asking. 😕 If you refer a patient with cancer to an oncologist-he is not going to go "hmmm...well, its cancer. I guess i'd better refer him back to an FP."
I think FPs often feel like they haven't really 'done' anything for their patients at the end of the day. Especially when its one of those days when all you see is people with colds or problems that you can't treat and need to refer them out. Its still an important job-to figure out what needs to be ruled out, but some people like to do more 'hands-on' procedural things (like ER docs do), thats all. And btw-I'm pretty sure I'll be going into FP so its not like I'm trying to diss the specialty. 😉
D
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yposhelley said:
No, but you can be sure they'll send 'em back to me for everything but their cancer.
Not this one. If the FPs you know actually feel that way, I highly recommend you find new role models.
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KentW said:
I understand that you are an FP and that you are happy with your job, and I'm glad for you. My mother is an FP and I'm sorry-but I'll have to choose her for a role model rather than an internet stranger on SDN.
What I am trying to say here is that I think it is good to be realistic about the benefits and drawbacks of each profession-as you percieve them. The same thing that draws me to FP is the same thing that might push another person away. If you don't consider that kind of thing before you get into your residency, you might end up disapointed.
You seem to have made the right choice for yourself, so thats good. But probably it is in part the right choice for you because it suits your personality. I like the idea of FP because I enjoy long-term care and developing a close relationship with my patients. I think that there is a special relationship between the FP doc and the patient. But I do know that there will be trying days, and days when I feel that all I have done is refer and prescribe, and not really done much good. If you haven't felt that way before, I guess you must be a super-doctor. Good for you-go buy a cape. 🙂
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OSUdoc08 said:
No, when they admit a patient, they check which insurance they got if they don't have a primary who has privledges at the hospital and they call the on-call doctor who takes their insurance. The ER doc don't take care of patients once they're admited and on the floor.
D
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yposhelley said:
Who's a stranger? 😉
http://www.tpmgpc.com
Well, duh. 😉 I think I've made that abundantly clear in previous threads.
I don't own a cape, but I can honestly say that hardly a day goes by that I can't see that I did something good for somebody. That's the great thing about medicine in general, and primary care in particular. If your mother isn't telling you the same thing, I have to wonder why not.
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OSUdoc08 said:
Where are you getting this from? A large # of ICU patients at a major teaching hospital where I worked for 3 years came from the OR; I helped process them myself... Perhaps it varies from hospital to hospital. The hospital's surgical specialty is neurosurgery, so maybe that's perhaps a reason.
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Yes, there have been times that I've transfered patients to the ICU from the floor that they were just sent up to by the ED. There have also been times when an ED doc put me on the right track with a patient, making my work up much easier. Radiologists are invaluable in interpreting odd things you see on studies. (And, when was the last time you trusted an FP or IM doc to read your or your loved one's mammogram????) FP's are invaluable in keeping well people well, and IM is good at keeping sick people out of the hospital and treating them when they are in. WE ALL NEED EACH OTHER! Yes, we should be able to handle the simple things in each specialty, but we do need each other for the other stuff. Besides, how, as medical students, can really believe that you know so much about each specialty to feel so free to bash them?
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Silly thread.. Tigershark good luck with Rads. Im quite happy with EM.. traige nurse or not.. FP or IM whatever. BTW in large hospitals the Surgical pts go to the SICU, and the medical ones to the MICU.. Most of the MICU pts go through the ED. Im not gonna bash rads... good for them that they like what they do. Im gonna enjoy the benefits of my job! Hope your not at the hospital I match at.
BTW the IM guy cant treat kids adequately, and from my experience with FP they dont exactly excel in treating ICU type patients. If you spent that much time in a decent sized ED you realize that that EM Docs sometimes manage ICU patients for 24 hours or more in the ED.
NOw the above isnt meant to bash IM or FP just stating my own experience with it.
BTW the IM guy cant treat kids adequately, and from my experience with FP they dont exactly excel in treating ICU type patients. If you spent that much time in a decent sized ED you realize that that EM Docs sometimes manage ICU patients for 24 hours or more in the ED.
NOw the above isnt meant to bash IM or FP just stating my own experience with it.
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KentW said:
Aaarrggghhhh...I don't want to know where you live or work. Thats too creepy. You've totally screwed up the beauty of an anonymous online forum. You ARE a stranger to me.
I'm sure that you don't understand what I'm trying to say-otherwise you wouldn't have been arguing with me in the first place. My mom does feel like she is performing a service and she likes her job. That doesn't mean that she never has days that are less fulfilling than others. 'not a day that goes by that you don't do some good' can mean that some days you prescribed one antibiotic, and the rest of your patients you referred out or just scratched your head. If that makes you wonder, I have to wonder about YOU. And now if you'll excuse me, I have to go beat some more immunology into my head.
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