Being a hospitalist sucks, and I'm quitting

[Splenda88]

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Exactly correct.

Bona fide rheumatology pts tend to go somewhat more smoothly (and faster), mostly because there is usually a more straightforward diagnosis and treatment (but in Rheumatology, this is not always the case!). The fibro/CFS/OA/vague symptoms crowd actually tend to be the most time consuming and annoying to deal with, because they try to consume a lot of time when there is actually very little “wrong” with them from a rheumatologic standpoint. I often joke that these are patients who have a 20 minute slot but want a 40 minute visit. As you might imagine, if you get a day where you have a lot of these patients, it’s difficult to run on time even when you’re seeing 20 a day. 40 a day? Lmfao.

I only spent probably 8 days at a rheum clinic during residency so I don't really remember how sick the patient population was. I can't even fathom having only 20 minutes to see patients if I was an outpatient PCP given how sick most of these people tend to be. I was always running behind in my residency clinic despite a slot time of 30 minutes

 

[helpfulApu]

also, the number of times I’ve introduced myself to a patient and said, hi, are you Mr. XYZ? And they have said yes and we proceed to do the interview until a few minutes later realizing they’re not that person has surpassed a dozen times. I knew everybody was functionally illiterate, but now I’m coming to the conclusion that their brain damaged too. It must be the HFCS over decades which is interesting, their visual spatial faculties tend to be spared because they can all road rage up and down town.

 

[DrMetal]

another day, another batch of delusional chronically ill with their pseudo intellectual “advocates” chomping at the bit to try and keep the jetski check coming through parlor-game level debate

and repeating myself days in a row to staff about why im not resuming antiHTNs in gi bleed pt needing transfusions (literally nobody reads my note except the neurotic mycharters)

this trash garbage society will keep checking BPs and BG telling themselves its ok as everything burns down around them

Do you drink? I highly recommend it. Neat whiskey, don't beat around the bush.

 

[dozitgetchahi]

also, the number of times I’ve introduced myself to a patient and said, hi, are you Mr. XYZ? And they have said yes and we proceed to do the interview until a few minutes later realizing they’re not that person has surpassed a dozen times. I knew everybody was functionally illiterate, but now I’m coming to the conclusion that their brain damaged too. It must be the HFCS over decades which is interesting, their visual spatial faculties tend to be spared because they can all road rage up and down town.

What bugs the hell out of me is the number of times I’ve said “so here are your lab results, this lab showed this, this lab showed this, we have to watch out because we got lab result XYZ”, and at the end of the visit the pt looks at me all quizzically and says “uh, so were my labs ok?”

Did you listen to a freaking thing I’ve been saying for the last 15 minutes?

This happens at least once a day, btw. At first I thought it was something I was doing wrong, so I tried explaining things different ways, saying **here are your lab results**, etc etc and the same **** keeps happening.

Yes, I’ve concluded that a substantial portion of the US population is asleep at the wheel, has zero attention span, is high out of their minds at all times, or is terminally brain damaged. (Maybe more than one of the above.)

 

[DrMetal]

Yes, I’ve concluded that a substantial portion of the US population is asleep at the wheel, has zero attention span, is high out of their minds at all times, or is terminally brain damaged. (Maybe more than one of the above.)

Or sometimes they're just not that sick, and so they don't really give an eFF. They just want attention. And we give it to them! Neat whiskey for everyone!

 

[glorifiedresident]

also, the number of times I’ve introduced myself to a patient and said, hi, are you Mr. XYZ? And they have said yes and we proceed to do the interview until a few minutes later realizing they’re not that person has surpassed a dozen times. I knew everybody was functionally illiterate, but now I’m coming to the conclusion that their brain damaged too. It must be the HFCS over decades which is interesting, their visual spatial faculties tend to be spared because they can all road rage up and down town.

Need to work on your communication skills. There are classes for this kind of thing.

 

[VA Hopeful Dr]

What bugs the hell out of me is the number of times I’ve said “so here are your lab results, this lab showed this, this lab showed this, we have to watch out because we got lab result XYZ”, and at the end of the visit the pt looks at me all quizzically and says “uh, so were my labs ok?”

Did you listen to a freaking thing I’ve been saying for the last 15 minutes?

This happens at least once a day, btw. At first I thought it was something I was doing wrong, so I tried explaining things different ways, saying **here are your lab results**, etc etc and the same **** keeps happening.

Yes, I’ve concluded that a substantial portion of the US population is asleep at the wheel, has zero attention span, is high out of their minds at all times, or is terminally brain damaged. (Maybe more than one of the above.)

Repeat the high points at least 3 times.

 

[dozitgetchahi]

Repeat the high points at least 3 times.

Oh, I do. I use the old Elmer Wheeler strategy (“tell ‘em what you’re gonna tell ‘em, tell ‘em, then tell ‘em you told ‘em). Sometimes I repeat the big themes or points even more times than that, and in different ways. Still, I feel like it doesn’t sink in for some folks.

 

[VA Hopeful Dr]

Oh, I do. I use the old Elmer Wheeler strategy (“tell ‘em what you’re gonna tell ‘em, tell ‘em, then tell ‘em you told ‘em). Sometimes I repeat the big themes or points even more times than that, and in different ways. Still, I feel like it doesn’t sink in for some folks.

I guess this is why they pay us a lot of money

 

[helpfulApu]

also, if your allergy list starts reaching double digits , and is full of stupidity like "oxycodone - nausea/itching" , "metoprolol - low heart rate" "ceftriaxone - UTI" you might want to stop and double take because your entire identity is just based around your health problems.

why do the PCPs not have heart to hearts with their patients ? when did it become forbidden to say anything except what the patient wants to hear ? oh wait , i know, because family will just report them and make life harder

 

[helpfulApu]

All this BS about mychart / access to records, satisfaction scores, boards and credential committees and risk foaming at the mouth to bite physicians heads in name of "patient safety", was all by design to destroy one of the last sacred relationships patients had - the one with their doctors. vast majority have already done away with any benefit they might obtain from speaking with clergy.

now, without a bonafide physician -patient relationship (and instead just the concierge style give em what they want, keep them happy BS) , these people have absolutely nothing in the way of wisdom or reality being delivered to them. they are just at the mercy of whatever way the breeze blows or whatever their propoganda medium of choice delivers to them

 

[helpfulApu]

i almost envy those damn boomers. they got to enjoy medicine when doctors called the shots (albeit often wrongly), when medical knowledge was tucked away in the shelves of books only those within the fold were privy to, (rather than being delivered without any nuance or context to the uninformed masses via your search engine or LLM of choice) , when nurses thought of it as a privilege if the physician actually spoke with them and gave verbal orders. those boomers enjoyed the heyday of medicine , and instead of treating the profession with any amount of sanctity, decided to see just how much they could squeeze their clinic schedules and bring on midlevels (much to the patients chagrin back then. if you think patients scoff at seeing NPs now [they only mildly do now, at most], there was a time when they would be furious if they didnt get to see an actual doctor) and open service lines / clinics left and righr. they damaged public trust and faith in physicians which was the only hook the propoganda machine needed to kick into gear, convince the populace that always second guessing their doctor was in their best interest, and next here we are explaining every single day that MCHC doesnt matter and consequently getting reported for it

now the boomers sit on the boards of SDGs and corporate practices , benefiting from the naive young idiot docs who subsidize their exorbitant malpractice and other overhead expenses. the boomers who arent on the boards are allowed ro march on , not following any common courtesy or basic professinalism or standards of documentation expected out of a MS3 let alone an attending.

the rank and file Gen X and Millenials fall quickly into line to the cultural marching drum that the boomers have been beating, and have adopted the same "F you brother, I got my $$$" attitude, some particularly socially inept ones post on SDN with cope about how its not that bad because tax lawyers have it worse so just buy golf clubs and watches (and cope with alcohol)

anybody with half a psyche will just leave. thats what im doing. the braindead docs can continue to start atorvastatin on their braindead patients.

 

[helpfulApu]

The only reassuring thing is is that those damn boomers who contributed to this mess will ultimately end up in the same SNF hell they created and , best case scenario be left to rot, worst case scenario beat up by angry staff, as their reverse mortgage runs out

there is no free lunch in life, boomers. you all just borrowed happiness and money from future generations , and payback time is coming. it may not entirely be financial, but you will pay it back, and trust me, you will regret your hedonism.

 

[helpfulApu]

i remember a laughable admission where an established-with-hospice patient collapsed at home and of course the death-fearing family called 911. she got brought in for vtach. instead of letting a stage iv metastatic octogenarian die we will be doing a stress test and giving metoprolol iv prn. then when her compensating, vasoconstrictove perfusion plummets we can talk about HD.

what a freaking joke. if i were to read my personal statement when i applied to medical school again i would probably become nauseous.

 

[DrMetal]

I smell a ban coming. There's no room for this much hatred and rage on SDN (unless it's coming from me).

 

[Splenda88]

I smell a ban coming. There's no room for this much hatred and rage on SDN (unless it's coming from me).

I don't see why the poster you might be referring to should be banned. He/she is venting the frustration, albeit in harsh language, that most of us practicing for last 15 yrs are feeling,

 

[glorifiedresident]

i remember a laughable admission where an established-with-hospice patient collapsed at home and of course the death-fearing family called 911. she got brought in for vtach. instead of letting a stage iv metastatic octogenarian die we will be doing a stress test and giving metoprolol iv prn. then when her compensating, vasoconstrictove perfusion plummets we can talk about HD.

what a freaking joke. if i were to read my personal statement when i applied to medical school again i would probably become nauseous.
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doing a stress test on this patient would be a failure on the physician's part, not the family's.

 

[helpfulApu]

I don't see why the poster you might be referring to should be banned. He/she is venting the frustration, albeit in harsh language, that most of us practicing for last 15 yrs are feeling,

its not a good look for them from a corporate / advertising standpoint

theyll pretend its for the usual reddit rule type reasons though

 

[VA Hopeful Dr]

its not a good look for them from a corporate / advertising standpoint

theyll pretend its for the usual reddit rule type reasons though

As long as you're not a huge jerk to other posters, we're not going to ban you for complaining about your job.

 

[bronx43]

I don't see why the poster you might be referring to should be banned. He/she is venting the frustration, albeit in harsh language, that most of us practicing for last 15 yrs are feeling,

would argue that the language is quite tame for what this POS system deserves

 

[DrMetal]

I don't see why the poster you might be referring to should be banned. He/she is venting the frustration, albeit in harsh language, that most of us practicing for last 15 yrs are feeling,

you're right. plus there's entertainment value in it. proceed!

 

[DrMetal]

i remember a laughable admission where an established-with-hospice patient collapsed at home and of course the death-fearing family called 911. she got brought in for vtach. instead of letting a stage iv metastatic octogenarian die we will be doing a stress test and giving metoprolol iv prn. then when her compensating, vasoconstrictove perfusion plummets we can talk about HD.

what a freaking joke. if i were to read my personal statement when i applied to medical school again i would probably become nauseous.

I think I mentioned this before, but it bears repeating. You're not wrong about anything you're posting. If venting is helping, then great. But none of these problems are going to go away, especially not overnight in the world of hospital medicine.

So either accept it, roll with it, do what you can do, control the controlables . . . or punch out and find something else to do.

 

[bronx43]

I think I mentioned this before, but it bears repeating. You're not wrong about anything you're posting. If venting is helping, then great. But none of these problems are going to go away, especially not overnight in the world of hospital medicine.

So either accept it, roll with it, do what you can do, control the controlables . . . or punch out and find something else to do.

For all future trainees and students, the tldr version of this thread is avoid medicine if possible. If not possible, then avoid clinical medicine. If that’s not possible then just work hard and GTFO asap.

Best of luck to you lot.

 

[glorifiedresident]

For all future trainees and students, the tldr version of this thread is avoid medicine if possible. If not possible, then avoid clinical medicine. If that’s not possible then just work hard and GTFO asap.

Best of luck to you lot.

Disagree. Medicine has been a great career, it has been both personally rewarding and financially rewarding.

 

[Splenda88]

Disagree. Medicine has been a great career, it has been both personally rewarding and financially rewarding.

What happens is a lot people romanticized medicine when they were premed and got disappointed when they start practicing. When I was taking prereqs as a nontrad, I often heard from those trad students "medicine is a calling" and I must admit as someone who had responsibility, I did not get what the heck they were talking about.

 

[LoudBark]

Disagree. Medicine has been a great career, it has been both personally rewarding and financially rewarding.

But here is the thing: We all know doctors can be an arrogant bunch of people. Many of them think if they never did medicine, whatever they would have done instead they would have been wildly successful and made a killing of dollars.

 

[bronx43]

But here is the thing: We all know doctors can be an arrogant bunch of people. Many of them think if they never did medicine, whatever they would have done instead they would have been wildly successful and made a killing of dollars.

I mean, the problem with doctors is that there are A LOT of us. So, the academic pedigree is a much wider range than for other highly paid industries such as big tech or private equity.

A Harvard medical student claiming that he/she could have cut it in tech or high finance is not an unreasonable statement. The same claim from another candidate may be a little less believable.

 

[bronx43]

What happens is a lot people romanticized medicine when they were premed and got disappointed when they start practicing. When I was taking prereqs as a nontrad, I often heard from those trad students "medicine is a calling" and I must admit as someone who had responsibility, I did not get what the heck they were talking about.

As we can observe from empirical match data, the "calling" of whatever specialty seems to be directly correlated to its MGMA median income.

 

[dozitgetchahi]

I mean, the problem with doctors is that there are A LOT of us. So, the academic pedigree is a much wider range than for other highly paid industries such as big tech or private equity.

A Harvard medical student claiming that he/she could have cut it in tech or high finance is not an unreasonable statement. The same claim from another candidate may be a little less believable.

It’s also different personality types and skill sets. I have no desire to do big finance, and I don’t think most of those people would do well in medicine. I considered law - nearly applied to law school, in fact - and I still think I probably would have been a good lawyer, but I’m damn happy I didn’t head down that road. The lawyers I know are much more miserable than the doctors, and aren’t paid as well.

 

[chessknt]

The only reassuring thing is is that those damn boomers who contributed to this mess will ultimately end up in the same SNF hell they created and , best case scenario be left to rot, worst case scenario beat up by angry staff, as their reverse mortgage runs out

there is no free lunch in life, boomers. you all just borrowed happiness and money from future generations , and payback time is coming. it may not entirely be financial, but you will pay it back, and trust me, you will regret your hedonism.

But what is your free lunch? You don't have to work in medicine anymore--cool--what was your exit ramp? How are you paying the rent/mortgage/taxes/food/etc bills? Id love to get paid to post angry **** on this forum instead of torture the elderly to death at incredible expense but nobody offered me that job.

 

[helpfulApu]

another Karen anecdote - I have lost count of the number of times I've asked my male patients permission to examine them, and their karen wife at bedside answers yes for them

 

[amoxicillin_resistant]

another Karen anecdote - I have lost count of the number of times I've asked my male patients permission to examine them, and their karen wife at bedside answers yes for them

is that a bad thing? do u need the male pt to answer for liability purposes?

 

[checkpointinhibitor]

Some employed jobs have a heavy emphasis on patient satisfaction scores and won’t renew your contract if they don’t meet a threshold. This means that not only do you have to reply to your patient messages within 24 hours, you also have to spend time making sure their pointless concerns and complaining are addressed to their liking. It’s much harder than just telling them to follow up in clinic. It only takes a couple patients with personality disorders or mental pathology to ruin your entire day.

Would decline the job respectfully soon after the interview for those ****ty metrics. Or I'd counter with - we will give ADMIN SATISFACTION scores and they would be booted out if we are unsatisfied. 😉

 

[Mehena]

@helpfulApu, you should not remain in this perpetual state of post-coital melancholy. Could it be workplace-related? Perhaps a change of scenery with locum tenens or another employed gig might help. Or is it that the love for medicine is gone?

 

[tantacles]

@helpfulApu, you should not remain in this perpetual state of post-coital melancholy. Could it be workplace-related? Perhaps a change of scenery with locum tenens or another employed gig might help. Or is it that the love for medicine is gone?

lmao post coital? what?

 

[tantacles]

Definitely feeling this post for different reasons. i've scaled down to 4-5 shifts per month with locums but worked 9 in July.

So happy to finally have a lighter month. Even 4-5 shifts feels awful.

For the record, I mostly do admitting shifts now.

Used to do nocturnist work, have done some day stuff, but this is all I want to do now (medicine-wise)

 

[LoudBark]

another Karen anecdote - I have lost count of the number of times I've asked my male patients permission to examine them, and their karen wife at bedside answers yes for them

Ok, you obviously hate being a hospitalist. Maybe I missed it, but with all your anecdotes on why you hate being a hospitalist, have you mentioned what you are now planning on doing? Outpatient.? Administration? Doing a fellowship in whatever speciality? Leaving clinical medicine altogether? Retiring? Please fill us in.

 

[chessknt]

Ok, you obviously hate being a hospitalist. Maybe I missed it, but with all your anecdotes on why you hate being a hospitalist, have you mentioned what you are now planning on doing? Outpatient.? Administration? Doing a fellowship in whatever speciality? Leaving clinical medicine altogether? Retiring? Please fill us in.

No he never has and he never will because he trollin

 

[dozitgetchahi]

Ok, you obviously hate being a hospitalist. Maybe I missed it, but with all your anecdotes on why you hate being a hospitalist, have you mentioned what you are now planning on doing? Outpatient.? Administration? Doing a fellowship in whatever speciality? Leaving clinical medicine altogether? Retiring? Please fill us in.

I think he’s just complaining and doesn’t have a plan.

Probably his best plan is to FIRE or something similar. But it doesn’t sound like he can stomach doing enough hospitalist work to FIRE that way.

OP, have you ever switched jobs? From your post history, it sounds like you are fairly fresh out of training and may have only had one job. You should know that a *lot* of first jobs as a physician really suck, and it’s not unusual to switch jobs until you find something better. My first hospital job as a rheumatologist was horrible. Now I’m in PP, and it’s a much better working environment (not to mention that I’m paid a lot better).

 

[helpfulApu]

i hate eliquis so much. i think its probably responsible for 90% of medicare hospitalization costs. for what exarctly? some tiny net negative stroke risk reduction that probably came from a ivory tower cardiology study that had the data sliced to make p value skim below the .05 cutoff probably

 

[LoudBark]

i hate eliquis so much. i think its probably responsible for 90% of medicare hospitalization costs. for what exarctly? some tiny net negative stroke risk reduction that probably came from a ivory tower cardiology study that had the data sliced to make p value skim below the .05 cutoff probably

Ok, enough with the trolling. How about just answer this: What do you plan to do after you quit being a hospitalist?
(There is a skill to being a good troll, if it is too obvious it just does not fly.)

 

[dozitgetchahi]

Ok, enough with the trolling. How about just answer this: What do you plan to do after you quit being a hospitalist?
(There is a skill to being a good troll, if it is too obvious it just does not fly.)

Also, if OP hates being a hospitalist that much, why not try being a PCP for a while? Or consider doing a fellowship?

If you hate hospitalist work, there are alternatives. You don’t have to bail out of medicine.

 

[helpfulApu]

Also, if OP hates being a hospitalist that much, why not try being a PCP for a while? Or consider doing a fellowship?

If you hate hospitalist work, there are alternatives. You don’t have to bail out of medicine.

I stated before, there's no reprieve in those fields. as a PCP you just get families sending long MyChart messages thinking they're pseudo intellectual rhetoric can fix dad's 25 problems. demanding the CT scan scheduled for a month from now be moved within the next 2 days prior to leaving for vacation, and yes it's currently Thursday afternoon and I know outpatient radiology closes Friday afternoons. just get him in. and I want celiac testing NOW All the slick consultants I know have angry scowls on their faces because they're just in the loop of clinic and consults themselves. and when they get consults from someone other than me the h& p is nonsensical because hospitalists pride themselves on how quickly they can write the note no matter if it makes any sense or not.

 

[helpfulApu]

we live in different times my friend. you got the millennial crowd listening to podcasts and educating themselves on actual wellness. and you've got boomers past median length of survival of various end stage illnesses demanding another 200 years of living. what is a PCP equipped to do besides check ASCVD scores and right blank notes that just auto populate CBCCMP lipids

 

[helpfulApu]

a naive pre-med or med student, or burnt out resident might read one of the PCPs here posting about how he cranks out 99214s and make significantly above average, this trainee will delude themselves that this is the life they want. but it's a life of pure inanity, helping nobody, and in order to survive in it you have to become a checked out carcass. hospitalist is not much different.

 

[VA Hopeful Dr]

I stated before, there's no reprieve in those fields. as a PCP you just get families sending long MyChart messages thinking they're pseudo intellectual rhetoric can fix dad's 25 problems. demanding the CT scan scheduled for a month from now be moved within the next 2 days prior to leaving for vacation, and yes it's currently Thursday afternoon and I know outpatient radiology closes Friday afternoons. just get him in. and I want celiac testing NOW All the slick consultants I know have angry scowls on their faces because they're just in the loop of clinic and consults themselves. and when they get consults from someone other than me the h& p is nonsensical because hospitalists pride themselves on how quickly they can write the note no matter if it makes any sense or not.

As a PCP I have experienced essentially none of that so far this year.

Scheduling imaging isn't my problem unless I think it's an urgent issue.

Overly long MyChart messages get an automatic "needs appointment" response.

 

[anonperson]

I stated before, there's no reprieve in those fields. as a PCP you just get families sending long MyChart messages thinking they're pseudo intellectual rhetoric can fix dad's 25 problems. demanding the CT scan scheduled for a month from now be moved within the next 2 days prior to leaving for vacation, and yes it's currently Thursday afternoon and I know outpatient radiology closes Friday afternoons. just get him in. and I want celiac testing NOW All the slick consultants I know have angry scowls on their faces because they're just in the loop of clinic and consults themselves. and when they get consults from someone other than me the h& p is nonsensical because hospitalists pride themselves on how quickly they can write the note no matter if it makes any sense or not.

You're vastly over stating the burden of my chart messages.

It's not even that bad .

Questions that are too long can be in person visits.

What physician has any control over image scheduling?

That's up to the imaging center. You literally have no control other than putting in an image order as routine or urgent.

 

[glorifiedresident]

helpfulApu has been exposed as a malcontent, move along nothing to see here.

 

[deleted87051]

i remember a laughable admission where an established-with-hospice patient collapsed at home and of course the death-fearing family called 911. she got brought in for vtach. instead of letting a stage iv metastatic octogenarian die we will be doing a stress test and giving metoprolol iv prn. then when her compensating, vasoconstrictove perfusion plummets we can talk about HD.

what a freaking joke. if i were to read my personal statement when i applied to medical school again i would probably become nauseous.
--
doing a stress test on this patient would be a failure on the physician's part, not the family's.

Need to biopsy that BCC too.

 

[helpfulApu]

As a PCP I have experienced essentially none of that so far this year.

Scheduling imaging isn't my problem unless I think it's an urgent issue.

Overly long MyChart messages get an automatic "needs appointment" response.

“ I have experienced essentially none of that so far this year”

Admits to experiencing essentially all of this year

That’s great that you all don’t care about annoying messages, annoying patients, annoying families ultimately the therapeutic alliance has been destroyed by adversarial patient/families and I don’t know why everybody is so adamant to deny that