I'm going to seek employment in one of these new residencies and teach the customer service curriculum. Lean into it. Chronic back pain? That sucks sorry my imaging metrics won't support me ordering an MRI but here have 50 percocet, 20 valium and see your PCP! 85 year old smoker with chest pain, a wide mediastinum on CXR and BP 220, that seems bad, but your EKG and first troponin look OK, so here have 50 percocet and see your PCP for a stress on monday. Uninsured IVDU with a new murmur and a fever? Document malingering and drug seeking behavior so they don't get a survey, then DC with no tests ordered.