Anyone happier in Urgent Care

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TrailRun

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1st year out of residency, realizing very quickly this is not sustainable. Primarily the nights/circadian disruption, but also the constant stress of the job. Work at a small community hospital without OB, Peds, or other resources so the constant worry of a disaster case in one of those areas weighs on me. And things that never used to bother me, like angry drunk people, Or unvaccinated people with known Covid who come in for myalgias, are starting to get to me. Perhaps I’m just tired/burned out. I’ve never actually done an urgent care shift but I imagine it’s similar to the low acuity patients we see in the ER. There’s a local group of urgent cares staffed entirely by ER docs without NP/PA and the pay is fairly similar to what I’m making in the ER. I’m picking up a few shifts to try it. Anyone made the switch and happier? And if I do, will that forever close the door to returning to work in the ER in the future?
 
You shouldn't get burned out that quickly, one year out of residency, BTW.

You need to make some adjustments.

That being said, if there is an Urgent Care near you that pays similar and you don't have to worry about EMTALA, then it's worth picking up some shifts. I personally think Urgent Care is basically a waste of health care resources and doesn't increase the overall health of the public. I wouldn't mind so much if it were 100% paid by the patient (i.e. not insurance), as the patient can spend their money as they see fit. But I think insurance picks up a big portion of the tab, and most things that arrive to Urgent Care could just be ignored and they would turn out OK. Kind of like the ER. 🙂
 
You gotta do what’s best for you amigo.

Pick up the shifts and see how you feel.

But yeah, if you go full time UC it’ll be a one way street. Heck I was worried about that with the freestandings, even though it wasn’t true, and left to go back in the pit. Now I’m back to putting down drunks on Saturday nights. It’s the cats @ss I tell ya.

Don’t know why I’m posting at 1:30 am on my night off.
 
You are doing too many shifts or got into a job that is prob not the best fit for a New doc. EM medicine can be lonely when you are working at a small Single coverage ER that takes care of trainwrecks without support. Docs working in these places need to be at the top of their game b/c there is no one to help.

I was 15 yrs out of residency, and almost never asked anyone for help with cases working at a receiving hospital. Did a few shifts at a small ER, and although slow I just didn't have the same level of "ease".

Cut down to 100 hrs a month. If that doesn't do it, then Do a few shifts at UC to test the water. If you like UC do 50 hrs UC, 50 hrs Hospital.

You are too young to work in UC full time and will be blacklisted if you ever want to jump back into a receiving hospital in a big city unless they are desperate.
 
As others have said above, going full time UC is a one way street. Another downside is that if you think that EM has become pointlessly customer service based, UC is 10x worse. The idiot patients who send in formal complaints for not getting abx or narcs in the ED get filtered out. The same patients in urgent care get a formal response (they still don't get their antiviral abx or their percocet for an ankle sprain, but you do now have to spend time responding to this nonsense).

I'm 5 yrs out and have been doing basically 85% ED, 15% UC since I graduated. I just quit UC completely as I couldn't deal with the above idiocy anymore.

Also, FWIW, your annoying "I have covid and everything hurts" patients? That makes up a solid 25% of my urgent care business. The grass isn't always greener. Work less, and/or find a better shop.
 
UC provides regular hours but I think that's the only real advantage. Most can be antibx mills. You might be switching one headache for the next. I personally won't work in an UC unless I own one or have a stake. But that's just me.
 
Kryptocoin said:
UC provides regular hours but I think that's the only real advantage. Most can be antibx mills. You might be switching one headache for the next. I personally won't work in an UC unless I own one or have a stake. But that's just me.
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You have to have insurance/money to be seen at an UC.

Very few of them have IV/IM narcotics.

The UCs around here have a "No controlled substances" policy spelled out everywhere. Individual doctors can decide to write for them, but it makes it clear that you likely won't get any.

Basically if you are OK with being an antibiotic pusher, the rest isn't too bad. Especially compared to the ED, at last from how many of y'all describe it.
 
I’m part owner of one. I worked there some when we started it up. Haven’t had to see patients there in some time. It’s less stress, nicer patient population for sure, no nights or major holidays is nice. Fundamentally though you are still in a box waiting for people to complain about things, some of which you can acutely help, much of it you can’t. At least in this area there’s not too much pushback on not giving antibiotics though it’s the nature of the beast that there will always be some.

Edit: I’d also say it can be tough to switch out of the ED practice pattern. It can be tough for some to comfortably manage things like chest and abdominal pain without being able to get immediate labs, imaging etc. There will be people who should absolutely go to the ED with things who will flat out refuse etc.
 
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Do what makes you happy. Why come back to the ED world if you are happy in UC? Do both if you want to. Best to learn how to run the UC while you are doing it and open your own when you get the capital.
 
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OP, were you burned out during residency too? If so, maybe it's a problem with the specialty.

If this is a brand new feeling (that is, you felt fine during residency), then it probably is just a bad job situation.
 
Idk do what’s best for you but for me UC is 1/2 the pay for 3/2 the work and 1/10th the fun. If I can’t render someone unconscious to correct a deformity, cardiovert, place a PIV when no one else can or wake up nsgy at 0300 for some bs ich what’s even the point of going to work?
 
It’s worth trying the UC and doing that on the side. It sounds more like you need to find a different EM job. UC is usually a much faster pace, with way more nonsense and a demanding set of patients who can take their business elsewhere. If you dont love press ganey scores and such UC may not be for you.
 
Thanks for all the responses, it may just be my particular EM job isn’t a good fit, will try UC and maintain my current job in case.
 
EctopicFetus said:
Is this a fact? I think maybe in Texas but haven’t heard a lot else about this.
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Yes. I was let go of a rural job and replaced with midlevels. And it's only going to get worse in the future as long as CMGs are at the helm.
 
Kryptocoin said:
Yes. I was let go of a rural job and replaced with midlevels. And it's only going to get worse in the future as long as CMGs are at the helm.
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Flip side. Once there are too many eps rates will approach mid levels and we can have those jobs back at mid level pay rates. It’s all screwed.
 
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