Anicillary services

[LadyJubilee8_18]

How important is it to go to a residency with good ancillary services? Right now it doesn't seem like that big a deal to me to have to do a little extra work picking up the slack for bad ancillary services, but I'm sure my prospective will be different as a resident. To those of you already in residency, what are your thoughts?

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[gutonc]

How important is it to go to a residency with good ancillary services? Right now it doesn't seem like that big a deal to me to have to do a little extra work picking up the slack for bad ancillary services, but I'm sure my prospective will be different as a resident. To those of you already in residency, what are your thoughts?

I went to a med school with horrible ancillary services and to residency at a place with (usually) excellent ancillary services. IMHO, it makes a HUGE difference.

At my med school, any labs other than routine AM labs had to be drawn by the team. This included admit labs, urgent labs (like troponins for chest pain), all blood cultures and anything you wanted before noon tomorrow. EKGs were done by house staff, as was a huge chunk of patient transportation.

At my residency, all labs are done by phlebotomy or nursing, all hours, all labs...period. EKGs are done by a tech 24/7 and transportation often gets to the patient before I have a chance to tell them I ordered that test.

All that time that was taken up by doing other people's jobs for them can now be used to do things like talking to your new admits, reading about cases and generally learning and taking care of patients. With work hour regulations getting tighter, you'll have far less time to do these sorts of things.

 

[Frugal Traveler]

It is the little things in life that get to you! After you experience poor ancillary services, you start appreciating everyone in the hospital much more. You have to remember that the practice of medicine is multi-disciplinary, and you have a ton of people with you for the patient's benefit (emphasis here on with... not for... because we are working for the patient, ego checked at the door).

A little task here and there for every patient can add up. Everyone makes fun of social workers, but they are really quite industrious people and get your patients out of the hospital.

When it came down to ranking, I did not rank some programs because of this issue. Life's too short, only so many hours in a day.

 

[gutonc]

Everyone makes fun of social workers, but they are really quite industrious people and get your patients out of the hospital.

I make fun of bad social workers. The good ones are worth more than the hospital president, CEO, Dept Chair, Division Chief and Program Director combined. I have 2 "go to" social workers, neither of whom are attached to my usual service anymore but who get stuff done in a fraction of the time it usually takes the others to do.

Again, do not underestimate the importance of good ancillary staff, especially when you're rolling in to hour 28 on call and still have 3 SNF discharges to get taken care of before you leave.

 

[LadyJubilee8_18]

I make fun of bad social workers. The good ones are worth more than the hospital president, CEO, Dept Chair, Division Chief and Program Director combined. I have 2 "go to" social workers, neither of whom are attached to my usual service anymore but who get stuff done in a fraction of the time it usually takes the others to do.

Again, do not underestimate the importance of good ancillary staff, especially when you're rolling in to hour 28 on call and still have 3 SNF discharges to get taken care of before you leave.

I hear that the NYC programs have poorer ancillary services because of the strong unions up there. Anyone have experience with that?