helpfulApu
New Member
- Joined
- Oct 24, 2024
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- 17
Let me start by saying I respect all the hospitalists out there who have been grinding it out for years
The post that led me to start this thread is this one:
Let me just start by saying - I think that patient's have lost their minds (and manners) post pandemic. Every working day, I am astounded by the absolute arrogance, entitlement, and sheer stupidity of patients and their families. It seems that the collective neurosis of the general population has boiled down to self-soothing via checking BP and blood glucose. Patients/families either delude themselves regarding end stage conditions because "his blood pressure is good!", or abuse me because their otherwise well mother who was kept NPO for a procedure had BG of 90, and "you can't starve a [type 2, obese, with extensive fat reserves] diabetic!"
The 21st Century CURES Act only catalyzed the collective deterioration into mass psychosis. We don't fully trust interns - graduated doctors, may I add - to reliably interpret labs and diagnostic studies. Now, any patient/family, regardless of education level, can accost you about a hemoglobin "falling", or an eGFR "that used to be >90, but now is 87???!!!!!" Almost every patient encounter feels like I am an academic attending teaching to pre-meds who think they are my boss. Patients/families expect the utmost of respect from their hospitalist, no matter how much they fail in holding up their end of 2-way courtesy. It's funny, because none of them would allow for being told how to do their own jobs (typically at some cushy public servant job, where there is no accountability). But if you dare insinuate that they shouldn't tell a physician how to do his/her job, their jaw drops in shock, and their eyes immediately scan your name tag (in order to run to the system and report you)
There can't be any job more infuriating than hospitalist other than being a bedside RN. My stint as a hospitalist has only made me more empathetic towards our bedside RNs. At least I can leave after a brief interaction with delusional families and their actively-dying-since-2010 loved ones. I can't imagine being helpless RN subject to the mercy/wrath of these freaks. This is not even to mention the absolute abuse endured by ancillary staff such as nurse techs and food service - the patients/families treat these people like simultaneous emotional punching bags.
The job would be better if there was any sense of collegiality. Instead, it seems like all the specialists, ER physicians, and hospitalists around me have descended into a "F*ck you, I got mine" mentality. There is no minimum standard of care that we are trying to achieve - everyone just seems to be scraping the bottom of the barrel: anchoring diagnoses on whatever the minimum wage EMT said, not seeing patients but documenting as if they did, documenting that workups/treatments are ordered but not ordering them, and failing to even look 2 days in the past at prior records in order to fit a story together. On this point, if I have to admit another 100 year old that is on beta-blockers and eliquis for symptomatic bradycardia and GI bleeding, I am going to lose my mind. It seems that nobody has any common sense that even a high-schooler could summon regarding our patients. Instead, we admit and have Cardiology, EP, and GI consultations, only to discharge on some weird mixture of follow up instructions involving checking in with a Cardiologist in 7-14 days on whether the patient born in the Great Recession should resume her eliquis for net negative -1% risk reduction in annual stroke prevention
Maybe the families could center us intellectual, ivory-tower physicians, with their grit and common sense. But no - MeeMaw is a fighter, and provides a $800 social security check that can be used for jet-ski leases. So full code, and every aggressive measure possible, please!
Soupbone (the quote I included above) would agree - this job has only deteriorated over the years. I suspect the deterioration must be more than tangentially related to an overall societal decline. From what I see, the only hospitalists who stick it out are those with a ton of resilience. But, in this context, resilience is being mistaken for emptiness.
Before I took this job, I was advised that "hospitalist is only for those with thick skin"
I thought I had thick skin, but this job showed me that "having thick skin" is more about becoming a numb and hollow shell of who you once were. I feel sorry for my fellow hospitalists who grind it out, day in and day out, being abused by various specialists, patients, families, insurance peer 2 peer scheduling agents at the call center, janitors, and pretty much everyone you can think of. We are simultaneously secretaries and "the doctor!", expected to solve any acute problem at a moment's notice while simultaneously attending to "families highly concerned about why there hasn't been a 14th CT Head ordered" and knowing our role by slinking away while the slick specialists give their recommendations (without having any clue what their partner recommended 1 day prior, because chart review is for suckers and hospitalists)
One of the greatest reliefs I ever felt was turning in my notice of leaving this field. I feel sorry for whoever has to stick it out in this grind. I look forward to the posters who are as equally delusional as our patients/families, who will chime in with snide remarks about how great their specific job is, and how they are respected, and how they get paid $1M / annum to see 2 patients per day. I'll call a Psychiatry consult in for you, only to get snubbed by the Mental Health ARNP who thinks they are smarter than me.
I'm leaving, and never looking back. Last warning to graduating residents: don't do it, unless you're catatonic.
-helpfulApu
The post that led me to start this thread is this one:
’ve been practicing inpatient medicine exclusively for over 20 years. The pace hasn’t slowed, and the profession doesn’t necessarily become more fulfilling with time. If anything, the demands have intensified.
Burnout doesn’t go away — it just becomes more familiar. While you gain confidence in clinical judgment, the emotional and systemic weight of the job only grows. You stay in it because you’re committed, but not because it gets easier. Resilience becomes the baseline.
Let me just start by saying - I think that patient's have lost their minds (and manners) post pandemic. Every working day, I am astounded by the absolute arrogance, entitlement, and sheer stupidity of patients and their families. It seems that the collective neurosis of the general population has boiled down to self-soothing via checking BP and blood glucose. Patients/families either delude themselves regarding end stage conditions because "his blood pressure is good!", or abuse me because their otherwise well mother who was kept NPO for a procedure had BG of 90, and "you can't starve a [type 2, obese, with extensive fat reserves] diabetic!"
The 21st Century CURES Act only catalyzed the collective deterioration into mass psychosis. We don't fully trust interns - graduated doctors, may I add - to reliably interpret labs and diagnostic studies. Now, any patient/family, regardless of education level, can accost you about a hemoglobin "falling", or an eGFR "that used to be >90, but now is 87???!!!!!" Almost every patient encounter feels like I am an academic attending teaching to pre-meds who think they are my boss. Patients/families expect the utmost of respect from their hospitalist, no matter how much they fail in holding up their end of 2-way courtesy. It's funny, because none of them would allow for being told how to do their own jobs (typically at some cushy public servant job, where there is no accountability). But if you dare insinuate that they shouldn't tell a physician how to do his/her job, their jaw drops in shock, and their eyes immediately scan your name tag (in order to run to the system and report you)
There can't be any job more infuriating than hospitalist other than being a bedside RN. My stint as a hospitalist has only made me more empathetic towards our bedside RNs. At least I can leave after a brief interaction with delusional families and their actively-dying-since-2010 loved ones. I can't imagine being helpless RN subject to the mercy/wrath of these freaks. This is not even to mention the absolute abuse endured by ancillary staff such as nurse techs and food service - the patients/families treat these people like simultaneous emotional punching bags.
The job would be better if there was any sense of collegiality. Instead, it seems like all the specialists, ER physicians, and hospitalists around me have descended into a "F*ck you, I got mine" mentality. There is no minimum standard of care that we are trying to achieve - everyone just seems to be scraping the bottom of the barrel: anchoring diagnoses on whatever the minimum wage EMT said, not seeing patients but documenting as if they did, documenting that workups/treatments are ordered but not ordering them, and failing to even look 2 days in the past at prior records in order to fit a story together. On this point, if I have to admit another 100 year old that is on beta-blockers and eliquis for symptomatic bradycardia and GI bleeding, I am going to lose my mind. It seems that nobody has any common sense that even a high-schooler could summon regarding our patients. Instead, we admit and have Cardiology, EP, and GI consultations, only to discharge on some weird mixture of follow up instructions involving checking in with a Cardiologist in 7-14 days on whether the patient born in the Great Recession should resume her eliquis for net negative -1% risk reduction in annual stroke prevention
Maybe the families could center us intellectual, ivory-tower physicians, with their grit and common sense. But no - MeeMaw is a fighter, and provides a $800 social security check that can be used for jet-ski leases. So full code, and every aggressive measure possible, please!
Soupbone (the quote I included above) would agree - this job has only deteriorated over the years. I suspect the deterioration must be more than tangentially related to an overall societal decline. From what I see, the only hospitalists who stick it out are those with a ton of resilience. But, in this context, resilience is being mistaken for emptiness.
Before I took this job, I was advised that "hospitalist is only for those with thick skin"
I thought I had thick skin, but this job showed me that "having thick skin" is more about becoming a numb and hollow shell of who you once were. I feel sorry for my fellow hospitalists who grind it out, day in and day out, being abused by various specialists, patients, families, insurance peer 2 peer scheduling agents at the call center, janitors, and pretty much everyone you can think of. We are simultaneously secretaries and "the doctor!", expected to solve any acute problem at a moment's notice while simultaneously attending to "families highly concerned about why there hasn't been a 14th CT Head ordered" and knowing our role by slinking away while the slick specialists give their recommendations (without having any clue what their partner recommended 1 day prior, because chart review is for suckers and hospitalists)
One of the greatest reliefs I ever felt was turning in my notice of leaving this field. I feel sorry for whoever has to stick it out in this grind. I look forward to the posters who are as equally delusional as our patients/families, who will chime in with snide remarks about how great their specific job is, and how they are respected, and how they get paid $1M / annum to see 2 patients per day. I'll call a Psychiatry consult in for you, only to get snubbed by the Mental Health ARNP who thinks they are smarter than me.
I'm leaving, and never looking back. Last warning to graduating residents: don't do it, unless you're catatonic.
-helpfulApu