Attention all useless administrators...

[FutureInternist]

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Update:

After 14 of the 20 physicians resigned, we got an email today that “in light of current events, and administrative challenges”

Long story short, they stopped the nonsense, promised to open the search again for a PHYSICIAN, and asked if we would all consider staying

We “quiet quit”… i.e worked exactly what we were paid for.

No committees
No “length of stay” meetings
No lectures to med students.
No extra shifts.
Mentioned to them how several prospective employees specifically mentioned the pay as the reason for not coming to us.

Couldn’t have 1-2 docs have targets on their backs, so had a “this doc will make this point and then this doc will back them up”

Next best thing to unionising..

50K raise 💪💪

 

[CliveStaples]

Update:

After 14 of the 20 physicians resigned, we got an email today that “in light of current events, and administrative challenges”

Long story short, they stopped the nonsense, promised to open the search again for a PHYSICIAN, and asked if we would all consider staying

Are you willing to say what hospital this was? Even privately? I think physicians need anecdotes like this to be able to inspire their colleagues to take bold steps like this when faced with the worst.

 

[Pudortu]

Update:

After 14 of the 20 physicians resigned, we got an email today that “in light of current events, and administrative challenges”

Long story short, they stopped the nonsense, promised to open the search again for a PHYSICIAN, and asked if we would all consider staying

Bravo. We hold all the power. They can’t bill without our names. It’s amazing what we can do with a collective mindset. Congratulations.

 

[sylvanthus]

Update:

After 14 of the 20 physicians resigned, we got an email today that “in light of current events, and administrative challenges”

Long story short, they stopped the nonsense, promised to open the search again for a PHYSICIAN, and asked if we would all consider staying

Gonan stay? Sounds like they are the type to pull bs down the road. But where is safe?

 

[sylvanthus]

We “quiet quit”… i.e worked exactly what we were paid for.

No committees
No “length of stay” meetings
No lectures to med students.
No extra shifts.
Mentioned to them how several prospective employees specifically mentioned the pay as the reason for not coming to us.

Couldn’t have 1-2 docs have targets on their backs, so had a “this doc will make this point and then this doc will back them up”

Next best thing to unionising..

50K raise 💪💪

This is the way.

 

[GassYous]

This is the way.

This is the way.

 

[cyanide12345678]

Still literally can't believe I read this.

Hours later.

Ive interviewed at a place where the assistant medical director was a PA. I was a little surprised by that too. But a noctor medical director????????? I mean come on….

 

[cyanide12345678]

Update:

After 14 of the 20 physicians resigned, we got an email today that “in light of current events, and administrative challenges”

Long story short, they stopped the nonsense, promised to open the search again for a PHYSICIAN, and asked if we would all consider staying

Y’all should still leave and come back as locums 😂

 

[Apollyon]

Y’all should still leave and come back as locums 😂

"Screw me? No, screw YOU!"

 

[gutonc]

Update:

After 14 of the 20 physicians resigned, we got an email today that “in light of current events, and administrative challenges”

Long story short, they stopped the nonsense, promised to open the search again for a PHYSICIAN, and asked if we would all consider staying

But what was their $/h or $/RVU offer to keep you?

You have them over a barrel...push down...hard.

 

[RustedFox]

This is the way.

This is the way.

 

[Siggy]

Does it matter that I'm doing a Hospice & Palliative Medicine fellowship and WONT BE CODING PEOPLE? Nope.

I've had a family member try to code in the ICU once. We noticed him start to slump over in a chair, went to assess and he was apneic and pulseless. Moved him to the floor, started compressions, but by the time we could get him on the monitor he had a weak rate that slowly improved. By the time we could get a gurney to the room he was back to being responsive.


/cool story bro.
//I don't have a good response to the other arguments, though, and am slightly annoyed that I have to recert BLS and ACLS every 2 years... despite being board certed in CCM.

 

[WilcoWorld]

I've had a family member try to code in the ICU once. We noticed him start to slump over in a chair, went to assess and he was apneic and pulseless. Moved him to the floor, started compressions, but by the time we could get him on the monitor he had a weak rate that slowly improved. By the time we could get a gurney to the room he was back to being responsive.


/cool story bro.
//I don't have a good response to the other arguments, though, and am slightly annoyed that I have to recert BLS and ACLS every 2 years... despite being board certed in CCM.

I mean, I have actually saved the lives of 3 people who were not my patients but coded within earshot of me while I was practicing palliative care. So, I get that, but I don't think it's a convincing argument for a few reasons:
1-It was my decade plus of EM attending experience that gave me the skills those folks needed in the moment, not the BLS class.
2- They were not my patients. In every case there was a rapid response team present or on the way. If I hadn't been there the RRT would've handled it (though probably not quite as well as they did under my direction).
3- If we're going to accept the fact that I might happen to help someone I'm not clinically responsible for as a reason to mandate skills, I should probably get trained in disarming an active shooter and bat containment (one of our ICU gets bat visitors on occasion, and all hell breaks loose).

 

[Siggy]

3- If we're going to accept the fact that I might happen to help someone I'm not clinically responsible for as a reason to mandate skills, I should probably get trained in disarming an active shooter and bat containment (one of our ICU gets bat visitors on occasion, and all hell breaks loose).

I’m sure I can find some active shooter “run, hide, fight” modules for you.

 

[CoolDoc1729]

I mean, I have actually saved the lives of 3 people who were not my patients but coded within earshot of me while I was practicing palliative care. So, I get that, but I don't think it's a convincing argument for a few reasons:
1-It was my decade plus of EM attending experience that gave me the skills those folks needed in the moment, not the BLS class.
2- They were not my patients. In every case there was a rapid response team present or on the way. If I hadn't been there the RRT would've handled it (though probably not quite as well as they did under my direction).
3- If we're going to accept the fact that I might happen to help someone I'm not clinically responsible for as a reason to mandate skills, I should probably get trained in disarming an active shooter and bat containment (one of our ICU gets bat visitors on occasion, and all hell breaks loose).

Ok the bat thing made me LOL.. imagining an icu where hell didn’t break loose when there were bats flying around …

 

[RustedFox]

Bats in the ICU?
Uhhm. Excuse me?

Like, Dracula shows up in bat form and wants to chill looking for the phlebotomist to forget a vial or what?

 

[NYEMMED]

I mean, I have actually saved the lives of 3 people who were not my patients but coded within earshot of me while I was practicing palliative care. So, I get that, but I don't think it's a convincing argument for a few reasons:
1-It was my decade plus of EM attending experience that gave me the skills those folks needed in the moment, not the BLS class.
2- They were not my patients. In every case there was a rapid response team present or on the way. If I hadn't been there the RRT would've handled it (though probably not quite as well as they did under my direction).
3- If we're going to accept the fact that I might happen to help someone I'm not clinically responsible for as a reason to mandate skills, I should probably get trained in disarming an active shooter and bat containment (one of our ICU gets bat visitors on occasion, and all hell breaks loose).

Wait…

Would you start everybody in the ICU at the time on rabies vaccinations?

 

[wholeheartedly]

Wait…

Would you start everybody in the ICU at the time on rabies vaccinations?

Every case is different and it should involve lenthy discussions with public health to assess risk but generally a sleeping patient thats not exactly aware of whats going on around them in the same room as a bat should get PEP. The rest of the ICU? ugh, sounds like a nightmare trying to figure out risk to other patients/where else bat might have been.

Best scenario is if you can safely capture the bat and get it tested, because if negative everyone can avoid costly PEP and all ensuing drama.

 

[dchristismi]

I actually still get rabies questions surprisingly often in my hospice practice. (No, squirrels don't carry rabies and yes, you should just go to the health department about a random dog bite. Not right now, and for the love of God, don't go to the ER - it can wait until tomorrow.) But back when I was in the ED and someone said "Hey doc, I have a question..." I'd often say "It's rabies" and run off before they could actually ask it in the moment the were thinking "wait, what?"

Last time I was asked about BLS, I think I actually said:
"Annie, Annie, are you ok? Time of death..."
Because that's how I roll. It got a laugh.

 

[FutureInternist]

Bats in the ICU?
Uhhm. Excuse me?

Like, Dracula shows up in bat form and wants to chill looking for the phlebotomist to forget a vial or what?

Easier to just go to the morgue… 😏

 

[ScepticSkeksis]

Your group should agree to accept a nurse as Medical Director IF the hospital agrees to let a physician be a CNO and CEO of the hospital. Also free energy drinks in the fridge for staff.

 

[Old_Mil]

I’m sure I can find some active shooter “run, hide, fight” modules for you.

It's hard to believe that some rent seeker in admin gets paid to promote what is instinct for pretty much everything on planet earth.

 

[emergentmd]

Slightly unrelated, but interesting anecdote: I went on a date with one of the new C-suite execs of one of the hospitals I work at the other day. Didn't know she was c-suite until after I had asked her out on a dating app. Within minutes of starting the date, she brought up ER holds and going on EMS diversion and how she always refuses EMS diversion requests at her prior job "because they don't work". My response was "what is your definition of 'doesn't work'?"

"Well, EMS can ignore a diversion request and everyone else will eventually just go on diversion."

"Well sure, but they typically don't ignore diversion requests unless there is a good reason, and if you don't go on diversion when necessary and everyone around you goes on diversion in a city of millions of people, you are going to set yourself up for a disaster situation."

"I've seen the numbers, it doesn't change anything?"

"You've seen what numbers? There is no way you are claiming that shutting down EMS traffic has no effect on patient volumes. From a boots on the ground perspective, the results are almost instantaneous when you are going from 10-15 new EMS patients an hour to 0."

"It doesn't shut down EMS traffic, but that's nice that y'all feel that it works."

"In our system, it effectively does outside of priority 1 patients and specific patient requests typically. And that's an aggressively condescending statement to an ER physician that's been doing this job for 7 years, and you just started doing yours 2 weeks ago."

"I did shadow the ER doctors I worked with at my last job, so I know what it looks like down in the ER when it's busy."

"Can we please just change the subject."

Amazingly she has been hitting me up for a second date. I might need to find a new job.

Gold Digger low level C suite. All she sees is a path to being housewife of Zebra Hunter

 

[emergentmd]

Yeah, but that only gets your foot in the door with me.

Rule #1.

 

[emergentmd]

BULLSHIIT

If she was hot and put out, you would all over that like bees around honey.
NO F'ING WAY THAT ISN'T TRUE. And if you claim that is true, amigo, you don't have two dangling organs between your legs producing testosterone.

I think there is some truth and joking in this. My friends would tell you that all the girls I have date/married were top 5% in looks. Yeah, I am vain and won't date someone less than an 8.

But if you are going to stay just b/c they are hot, that could end up being a very dark path. Better to just find a sugar baby, send her some gifts, and cut it off when you want.

There are some bat crazy women (and man) and typically if the are ultra HOT, there is a reason they are not married b/c this is their #1 goal.

 

[emergentmd]

I **** you not, I am resigning this morning.

Reason:
We were sent an email last night that the ED medical director is now a NPP.

Not working for that…

Nothing surprises me with admin, but this is a new one.

Please don't make a big deal out of this, just accept this. I need some daily fodder to entertain me and a weekly NP Medical director thread would be great.

The possibilities are endless

Wk 1 - ER is crashing, call the medical director
Wk 2 - Medical director would like all docs to run their patient's by the APP
Wk 3 - QA and pt care chart to be reviewed at MEC. CMO asks the ER "Medical director" their opinion on quality
Wk 4 - Doc is sick and no one can cover, call the medical director in
Wk 5 - MEC meeting with all the chiefs and then the ED chief walks in


PLEASE for the love of god, give her a chance..........

 

[NYEMMED]

Nothing surprises me with admin, but this is a new one.

Please don't make a big deal out of this, just accept this. I need some daily fodder to entertain me and a weekly NP Medical director thread would be great.

The possibilities are endless

Wk 1 - ER is crashing, call the medical director
Wk 2 - Medical director would like all docs to run their patient's by the APP
Wk 3 - QA and pt care chart to be reviewed at MEC. CMO asks the ER "Medical director" their opinion on quality
Wk 4 - Doc is sick and no one can cover, call the medical director in
Wk 5 - MEC meeting with all the chiefs and then the ED chief walks in


PLEASE for the love of god, give her a chance..........

Ahhahaha

Yea, clearly it wasn’t thought out.

Probably decided by one of the nurse administrators

Sometimes I wish physicians would be interested in Admin, to hopefully, make better decisions.

 

[emergentmd]

Ahhahaha

Yea, clearly it wasn’t thought out.

Probably decided by one of the nurse administrators

Sometimes I wish physicians would be interested in Admin, to hopefully, make better decisions.

Trust me this was and typically all an economic/control decision. APPs are cheaper and easier to control.

 

[Dred Pirate]

There are some bat crazy women (and man) and typically if the are ultra HOT, there is a reason they are not married b/c this is their #1 goal.

PS- I would probably get fired if I played this at work

 

[TooMuchResearch]

Ive interviewed at a place where the assistant medical director was a PA. I was a little surprised by that too. But a noctor medical director????????? I mean come on….

I just voted against hospital bylaw changes (that will almost definitely pass) to let PAs and NPs on physician medical staff.

 

[nexus73]

I just voted against hospital bylaw changes (that will almost definitely pass) to let PAs and NPs on physician medical staff.

keep us updated on the results

 

[EctopicFetus]

We stopped that about 18 months ago. Luckily I think where I work people are smart enough to know how ******ed these people are in general. We don’t let them in the doctors lounge either for now.

 

[NYEMMED]

We stopped that about 18 months ago. Luckily I think where I work people are smart enough to know how ******ed these people are in general. We don’t let them in the doctors lounge either for now.

How did you manage that? I feel like NPPs park in all the “physician only spots” and are taking up all the space in the physicians lounge

 

[EctopicFetus]

How did you manage that? I feel like NPPs park in all the “physician only spots” and are taking up all the space in the physicians lounge

Our docs in the hospitals don’t generally favor MLPs. Most of the MLPs in thenhosptail are hospital employees and there is still a decent bit of private practice docs who don’t think highly of these noctor types.