Hospitalist Stress Relief

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ZDoggMD

ZDoggMD

Evidence-based Comedian
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10+ Year Member
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Hey guys, I'm a hospitalist attending at a Bay Area academic hospital. It's a great gig, and I encourage residents to consider hospital medicine as a fulfilling career...on days when I'm not thinking of quitting myself and switching to radiology :D

For fun and stress relief I've started posting videos on youtube (I've mentioned this already in the All Students forum so hopefully I'm not spamming too much). I'm aiming not only at medical types but a broader general audience...still, residents in internal medicine may get a kick out of it and they're closest to my heart (plus, they do a lot of my dirty work in the hospital :oops:).

Take a look, gimme feedback or ideas for future episodes, or just tell this old man to shut the eff up. Also, you can check out my page at www.facebook.com/zdoggmd.

My youtube channel is: www.youtube.com/user/zdoggmd

Please leave comments on the videos if you can, and subscribe to the youtube channel if you like it. And I'm always happy to provide any career advice (if you trust me after watching this junk)!

Here are some of my latest attempts:
[YOUTUBE]vOXzClenOKc[/YOUTUBE][YOUTUBE]74oK6RFNmDg[/YOUTUBE][YOUTUBE]3pRONan-b7k[/YOUTUBE]
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What is your take on the hospitalist lifestyle in terms of schedule? I know that it depends on the type of practice. 7 on 7 off, maybe M-F 8-5, etc. Do you think there is a lot of burn out? As for switching to radiology I thought that was not possible as everyone essentially gets funding to do one residency and that is it.
 
C Chance said:
As for switching to radiology I thought that was not possible as everyone essentially gets funding to do one residency and that is it.
Click to expand...

I think it was mostly a joke. Also, you thought wrong.

You get 100% DME/IME funding from CMS for your first residency. After that (like for a 2nd residency or a fellowship) you get funded @ 50% DME and 100% IME (which works out to ~75% overall give or take 5-10%). It's neither as rare, nor as "impossible" as many people think it is.
 
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gutonc said:
I think it was mostly a joke. Also, you thought wrong.

You get 100% DME/IME funding from CMS for your first residency. After that (like for a 2nd residency or a fellowship) you get funded @ 50% DME and 100% IME (which works out to ~75% overall give or take 5-10%). It's neither as rare, nor as "impossible" as many people think it is.
Click to expand...


So if I completed an IM residency and did decide I wanted to do something else, either right away or after several years of practice, I could in theory pursue Radiology, Dermatology, Optho, Anesthesia, PM&R, etc?
 
gutonc said:
I think it was mostly a joke. Also, you thought wrong.

You get 100% DME/IME funding from CMS for your first residency. After that (like for a 2nd residency or a fellowship) you get funded @ 50% DME and 100% IME (which works out to ~75% overall give or take 5-10%). It's neither as rare, nor as "impossible" as many people think it is.
Click to expand...

I think both of your points are correct ;)

From personal experience, my wife finished internal med with me and board certified, but then decided to pursue radiology and got a position at our institution. Funding was an issue, but the private institutions tend to have some means to manage that; it may be more difficult at public institutions, but that's just a guess. Bottom line is that it can be done, and should be done if you are unhappy with where you are and are fairly sure that a second residency would alleviate that unhappiness (this requires a lot of self-knowledge, which is uncommon).

Regarding the questions about hospitalist burn out, schedule structure and workload are key to creating a sustainable hospitalist position. Everyone is different, but I think I might spontaneously combust if I had to do 7 on 7 off with 25 patients to see daily. Our schedule is more an 8-5 M-F with call thrown in about once a week, and off days to buffer more painful stretches of work (for example, if you work the weekend you may get most of the week off). It's a mix of academic hospital work with residents and community hospital stuff without residents. It is sustainable and we have a fair number of long-term folks in my group. I myself have been at it for almost 7 years (!!)
 
I don't think your material is mainstream enough for most people to find funny - although I do. Keep up the great work.
 
Pkboi24 said:
I don't think your material is mainstream enough for most people to find funny - although I do. Keep up the great work.
Click to expand...

Thanks for the feedback, this is always a tough challenge. I guess if a majority of educated people sort of get it, I'd be happy, but living in the bubble of medicine so long it's hard for me to gauge sometimes.
 
ZDoggMD said:
Thanks for the feedback, this is always a tough challenge. I guess if a majority of educated people sort of get it, I'd be happy, but living in the bubble of medicine so long it's hard for me to gauge sometimes.
Click to expand...

Your videos are funny. Keep them coming. These are jokes that only us sadistic medicine people can find funny. Your graduation speech is also great.
 
Oh man, if I was just talking to medicine people, there would be no holding back! It's a serious handicap having to play nice. I used to do standup at conferences and retreats for medical types, residents, and pharma people, and that was no holds barred and a real blast...I'd certainly wreck my career if I did that online, but it sure is tempting :laugh:
 
These are great, thanks for sharing.
 
Nice work!!!

I will be starting as a hospitalist in 2 months down in florida!! Looking foward to it!!
 
RIP Gary Coleman! For those of you old enough to remember Arnold, Mr. Drummond, and the gang, my buddy from med school Harry (a pediatrician) and I threw together a spontaneous tribute yesterday...Whatchu talkin' bout, Circle of Willis?

[YOUTUBE]s6-zlXZfP5s[/YOUTUBE]
 
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ZDoggMD said:
RIP Gary Coleman! For those of you old enough to remember Arnold, Mr. Drummond, and the gang, my buddy from med school Harry (a pediatrician) and I threw together a spontaneous tribute yesterday...Whatchu talkin' bout, Circle of Willis?

[YOUTUBE]s6-zlXZfP5s[/YOUTUBE]
Click to expand...

:thumbup:
 
Wow, I remember seeing that graduation speech on youtube about 4 years ago, before I had even started med school. Now, as I'm perusing SDN, I see it again, and you're the speaker. Thanks for the good laughs - I'll be watching for new videos.
 
Chonson said:
Wow, I remember seeing that graduation speech on youtube about 4 years ago, before I had even started med school. Now, as I'm perusing SDN, I see it again, and you're the speaker. Thanks for the good laughs - I'll be watching for new videos.
Click to expand...

Thanks a lot, we'll be working on some newer stuff soon time permitting. Perhaps some diagnostic criteria (major and minor) for this horrible new entity called Bieber Fever :scared:
 
So how does your wife like the switch to rads? Is she an attending yet?
 
gluon999 said:
So how does your wife like the switch to rads? Is she an attending yet?
Click to expand...

Oh man, she is MUCH happier. Was not the internal medicine type. She's an attending at our academic institution in Chest radiology.

In the end you really have to know yourself (or discover enough through experience about yourself) to find the right niche in medicine. I really feel there is a correct place(s) for everyone, but finding it is difficult and again requires understanding who you are. Much easier said than done, especially since they ask us to decide under extreme duress (med school, residency). Both my wife and I took a year off after residency to chill out, work (moonlighting, and for me working at a couple of startups), etc before we settled on what we would ultimately do. Now we're both relatively happy.
 
Your videos and advice is entertaining and useful. Keep it up
 
AsROMA said:
how difficult is it switch?
Click to expand...

Hard but not impossible; you need to get good letters from your prior program, so it helps not to burn any bridges there.

radiodoc99 said:
Your videos and advice is entertaining and useful. Keep it up
Click to expand...

Thanks, I'm working on a editing a new video right now, more stream of consciousness and spontaneous. Hopefully it won't totally suck :laugh:
 
Alright, post call rambling single-take into an arm's length camera, later edited with pics added in. Lemme know what you think! I'm also at http://www.facebook.com/zdoggmd if you are further interested in following the progression of my dementia.
[YOUTUBE]ojw-DJ2wp8M[/YOUTUBE]
 
ZDoggMD said:
Oh man, she is MUCH happier. Was not the internal medicine type. She's an attending at our academic institution in Chest radiology.

In the end you really have to know yourself (or discover enough through experience about yourself) to find the right niche in medicine. I really feel there is a correct place(s) for everyone, but finding it is difficult and again requires understanding who you are. Much easier said than done, especially since they ask us to decide under extreme duress (med school, residency). Both my wife and I took a year off after residency to chill out, work (moonlighting, and for me working at a couple of startups), etc before we settled on what we would ultimately do. Now we're both relatively happy.
Click to expand...


That is great that she is happier. I totally agree about knowing oneself, which is a lot harder than it seems.

BTW, I just realized you are the guy that gave the commencement speech. That was fantastic! I remember watching it 4 years ago before I started medical school and now saw it again after graduating. So true, so true!

If you ever get sick of being a hospitalist, there will always be a place for you in stand up. :thumbup:
 
gluon999 said:
BTW, I just realized you are the guy that gave the commencement speech.
Click to expand...

Yup, good times, medical school! I had written an entirely different speech comparing medical school to Star Wars, and literally the day prior to graduation I realized it sucked horribly and in a panic I wrote the speech copied below.

[YOUTUBE]mgnHH7Iz37c[/YOUTUBE]
 
Well, I'm a hospitalist in southeastern PA, and we have 7 on/7 off, with no limit to our service. It's been as high as 34 encounters a day, and as low as 12, but trending up.

SE PA is not a great place to practice; due to Medicare's domination of the reimbursement market, everyone is essentially volume based. The one upside is that we have no call, nighttime is staffed by moonlighters, although we can pick up shifts for extra cash if we want to.

How are other locations throughout the country? I've heard about a lot of variability.
 
Vaderize said:
Well, I'm a hospitalist in southeastern PA, and we have 7 on/7 off, with no limit to our service. It's been as high as 34 encounters a day, and as low as 12, but trending up.
Click to expand...

Dude, that schedule and workload sounds rough but I think it may be indicative of community hospitalist jobs in general. Our group is more of a hybrid because we do use housestaff at the academic center, but no housestaff at the community hospital. Ours is a very large multispecialty group that subsidizes the salary of the hospitalists somewhat, so we don't necessarily need to produce as many RVUs.
 
That's interesting...how do you cover weekends? We have a moonlighting service that handles all the nights, but we are employed, and the administration has a very tight budget for us, so expanding coverage has been rough.

No residents; they have committed to trying to limit encounters to 18-20 per day but oftentimes this does not happen. Also, would you count ICU as two encounters if you bill it as a level 1?

Thanks for you thoughts.
 
Why if she didn't love medicine did your wife finish IM? Did she just decide too late? Or didn't want to leave IM program with a hole?
 
MorrisDoc said:
Why if she didn't love medicine did your wife finish IM? Did she just decide too late? Or didn't want to leave IM program with a hole?
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She wanted to do pulm/critical care up until the end, when she had a change of heart. She actually board certified in medicine and everything before switching. If she had left IM in the lurch BTW, it's doubtful the same institution would have accepted her for radiology (lesson: never burn bridges).
 
My pediatrician buddy Dr. Harry had a BBQ, and after a couple of beers the camera came out and the wives stormed off in a huff. Check it out!

[YOUTUBE]http://www.youtube.com/watch?v=OMxi0S4Z-dA[/YOUTUBE]
 
ZDoggMD said:
Yup, good times, medical school! I had written an entirely different speech comparing medical school to Star Wars, and literally the day prior to graduation I realized it sucked horribly and in a panic I wrote the speech copied below.

[YOUTUBE]mgnHH7Iz37c[/YOUTUBE]
Click to expand...

Wow. That speech was awesome. Perfect blend ... nicely done.
 
ZDoggMD said:
Yup, good times, medical school! I had written an entirely different speech comparing medical school to Star Wars, and literally the day prior to graduation I realized it sucked horribly and in a panic I wrote the speech copied below.

[YOUTUBE]mgnHH7Iz37c[/YOUTUBE]
Click to expand...

I agree; terrific speech.
 
Thanks you guys, I can't believe that was eleven years ago now...time flies when you're getting crushed under the thumb of the medical establishment :laugh:
 
Our latest video is tailor-made for my homies on the forum who are still undecided on a speciality. Beatbox, Bluster, and Beiber -- the holy trinity!

[YOUTUBE]http://www.youtube.com/watch?v=UFttMtVWNuU[/YOUTUBE]
 
You're hilarious! I love the beatboxing you do, it's insane.
 
Awesome work man...keep it up:thumbup:
 
Thanks for the feedback y'all; let a brutha know if there's anything you'd like to see (destroy the whack beat box machine? or unleash it's full power :eek:)
 
ZDoggMD said:
Thanks for the feedback y'all; let a brutha know if there's anything you'd like to see (destroy the whack beat box machine? or unleash it's full power :eek:)
Click to expand...

Full power please

Also, MOAR drum solos. I'm NOT even joking. The drum solos are clutch cargo.
 
Those videos = awesome.
 
The wait is over, homies. Check tha' latest original rap from the ZDoggMD Crew. And pour some out, for the GI Bleedaz who didn't make it...

[YOUTUBE]JGh2FSdPDrg[/YOUTUBE]
 
ZDoggMD said:
And pour some out, for the GI Bleedaz who didn't make it...
Click to expand...

Here's one to my homeys with the GI bleeds! They'll make me some green one day:cool:

I've been showing your videos on my iPhone during down times in the MICU this month. They've been a hit so far. Keep up the good work!
 
West coast beats, medical raps and c-rolla's!! I love it!
 
Banged together another one yesterday, just a quick thing while we're working on an overly ambitious hip hop video about STDs. I know this one kinda sucks, but it's therapeutic for me in any case :p

[YOUTUBE]wcldId3A2nw[/YOUTUBE]
 
Actually I liked this one the most :p Best Yoda imitation I've ever heard.
 
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