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Weird how there is a strong positive correlation between training and quality...
EM Future
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Outside of hospital and insurance corporation-backed talking points that were made up in a board room, I have never heard of Canadian healthcare being subpar for a developed nation. Do you have anything to support your assertion with?
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The metrics for waiting time for time-sensitive medical problems like CAD, and cancer are well known and publicized.
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PA programs are expanding quite a bit in the last few years. Makes me wonder if this will continue to be true.
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I can see a real difference between a "fellowship" trained PA (also newer PA) and the non-fellowship trained but more experienced PA. The fellowship trained PA is much stronger in emergency medicine. N=2.
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I think @VA Hopeful Dr is referring to actual PA school, the implication being that the proliferation of PA programs will lead to a decrease in educational standards at those newer schools.
I can't say I disagree. I learned recently that there are online PA programs now.
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Because that's what we need... more PLPs with limited grasp on the underpinnings of medical knowledge.
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Making post more succinct:
Academic EM is oblivious and/or doesn't care about how bad things are getting. Suspect they'll care more next year, when at that point, there will have been two classes of residents not getting jobs.
Academic EM is oblivious and/or doesn't care about how bad things are getting. Suspect they'll care more next year, when at that point, there will have been two classes of residents not getting jobs.
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Academics will always tell you medicine is better than other fields
“Goldman Sachs underlings are griping over grueling, 100-hour weeks that they say have caused their mental health to decline — and, they claim, have pushed them closer to leaving the bank.
“What is not ok to me is 110-120 hours over the course of a week! The math is simple, that leaves 4 hours for eating, sleeping, showering bathroom and general transition time This is beyond the level of ‘hard-working,’ it is inhuman/ abuse,” the analyst complained.
“The sleep deprivation, the treatment by senior bankers and physical stress… I’ve been through foster care and this is arguably worse,” another added.
“Junior bankers should not be expected to do any work after 9 p.m. Friday or all day Saturday without a pre-approved exception, as that is the only safe-guarded personal time that we get,” they wrote in the presentation.
Tired Goldman Sachs underlings beg to work ‘just’ 80 hours a week, instead of 100
The complaints come from 13 first-year analysts in Goldman’s investment banking group, who surveyed themselves, according to a presentation that is making the rounds on social media.
nypost.com
Goldman Analysts Work Too Hard
Also penny stocks, mutual-fund voting and Bitcoin liquidity.
www.bloomberg.com
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Academics will always tell you medicine is better than other fields
“Goldman Sachs underlings are griping over grueling, 100-hour weeks that they say have caused their mental health to decline — and, they claim, have pushed them closer to leaving the bank.
“What is not ok to me is 110-120 hours over the course of a week! The math is simple, that leaves 4 hours for eating, sleeping, showering bathroom and general transition time This is beyond the level of ‘hard-working,’ it is inhuman/ abuse,” the analyst complained.
“The sleep deprivation, the treatment by senior bankers and physical stress… I’ve been through foster care and this is arguably worse,” another added.
“Junior bankers should not be expected to do any work after 9 p.m. Friday or all day Saturday without a pre-approved exception, as that is the only safe-guarded personal time that we get,” they wrote in the presentation.
Tired Goldman Sachs underlings beg to work ‘just’ 80 hours a week, instead of 100
The complaints come from 13 first-year analysts in Goldman’s investment banking group, who surveyed themselves, according to a presentation that is making the rounds on social media.
Goldman Analysts Work Too Hard
Also penny stocks, mutual-fund voting and Bitcoin liquidity.
Do bankers get abused and assaulted by their customers like we get do by our patients? I didn't think so.
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I agree in my admittedly limited
damnAcademics will always tell you medicine is better than other fields
“Goldman Sachs underlings are griping over grueling, 100-hour weeks that they say have caused their mental health to decline — and, they claim, have pushed them closer to leaving the bank.
“What is not ok to me is 110-120 hours over the course of a week! The math is simple, that leaves 4 hours for eating, sleeping, showering bathroom and general transition time This is beyond the level of ‘hard-working,’ it is inhuman/ abuse,” the analyst complained.
“The sleep deprivation, the treatment by senior bankers and physical stress… I’ve been through foster care and this is arguably worse,” another added.
“Junior bankers should not be expected to do any work after 9 p.m. Friday or all day Saturday without a pre-approved exception, as that is the only safe-guarded personal time that we get,” they wrote in the presentation.
Tired Goldman Sachs underlings beg to work ‘just’ 80 hours a week, instead of 100
The complaints come from 13 first-year analysts in Goldman’s investment banking group, who surveyed themselves, according to a presentation that is making the rounds on social media.
Goldman Analysts Work Too Hard
Also penny stocks, mutual-fund voting and Bitcoin liquidity.
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Omg that Bloomberg link was a hilarious read!Academics will always tell you medicine is better than other fields
“Goldman Sachs underlings are griping over grueling, 100-hour weeks that they say have caused their mental health to decline — and, they claim, have pushed them closer to leaving the bank.
“What is not ok to me is 110-120 hours over the course of a week! The math is simple, that leaves 4 hours for eating, sleeping, showering bathroom and general transition time This is beyond the level of ‘hard-working,’ it is inhuman/ abuse,” the analyst complained.
“The sleep deprivation, the treatment by senior bankers and physical stress… I’ve been through foster care and this is arguably worse,” another added.
“Junior bankers should not be expected to do any work after 9 p.m. Friday or all day Saturday without a pre-approved exception, as that is the only safe-guarded personal time that we get,” they wrote in the presentation.
Tired Goldman Sachs underlings beg to work ‘just’ 80 hours a week, instead of 100
The complaints come from 13 first-year analysts in Goldman’s investment banking group, who surveyed themselves, according to a presentation that is making the rounds on social media.
Goldman Analysts Work Too Hard
Also penny stocks, mutual-fund voting and Bitcoin liquidity.
"One of those skills — surely the least useful, but also the most salient — is formatting presentations.
other ones are, like, talking confidently in meetings after limited hasty prep. The presentation-formatting thing is totally dumb, but it is an easily legible signal. I’m sorry these analysts are sad and planning to leave Goldman, but at least they will leave with marketable skills.
Anyway they’re real sad. “How satisfied are you with this firm,” the survey asks (slide 8), on a scale of 1 to 10 with 10 being the best; the median answer is 2. “How satisfied are you with your personal life” (slide 8) gets a median answer of 1. “How likely are you to recommend GS as a place to work to aspiring talent” (slide 9) gets an average answer of 4.2, which sounds exactly right: These analysts absolutely hate it, but they don’t mind if other people experience it. The point of hazing is to make the victims of the hazing want to haze the next class of victims."
So many commonalities with medicine hahaha.
Least useful, but most salient skill: patient satisfaction.
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I worked EM at the Pit for close to 20 yrs typically seeing 3pph. I have never been assaulted by pt or even close to it. If they look angry or dangerous, I stand close to the open door and do a very limited visual exam.
I have worked manual jobs when I was HS/College. To say that an EM doc work is harder than my manual job is downright WRONG.
I worked hand picking blueberries in 100 degree heat. I have worked in a newspaper warehouse in Tx without AC and must be 110 inside with paper dust all over the place.
Anyone who thinks an EM doc working in an AC place essentially talking the whole shift is difficult is downright incorrect.
I am not saying EM is easy but I rather do that than my manual jobs for $200/hr.
I have worked manual jobs when I was HS/College. To say that an EM doc work is harder than my manual job is downright WRONG.
I worked hand picking blueberries in 100 degree heat. I have worked in a newspaper warehouse in Tx without AC and must be 110 inside with paper dust all over the place.
Anyone who thinks an EM doc working in an AC place essentially talking the whole shift is difficult is downright incorrect.
I am not saying EM is easy but I rather do that than my manual jobs for $200/hr.
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So, what was the intent of your reply here? To downplay fears? To tell folks "they don't know how good they have it" when the job market is a giant flaming turd?
I have been assaulted at work. Your n=1 doesn't mitigate the dangers of our job.
I just don't get the point of replying "Well, I've never been assaulted...and you spoiled millennials don't know how good you have it!".
I mean, sure, man. I could quit my job and go dig ditches in the heat. Or I could not. I just don't understand this point of view. Very boomerish.
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It’s the classic “you don’t have it bad because things could be so much worse” argument. Just as dumb as saying “you can’t possibly be happy because you could have it so much better.”
D
deleted941485
Why engage with these boomers? they don't care. They got theres and that is all that ever mattered.
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I love how my parents-in-law talk about how they "deserve" Medicare because they "paid into it". Never mind that the average Boomer will take out much much more than they contributed. I'm all for giving them back exactly what they paid in.....
D
deleted941485
Never mind that this was the same cohort that grew up during the Free-Market Grab Everything you can and screw everyone else group that deliberately cut its taxes time and again. LOL. Now this group is ready to fist-f*** the medicare rolls and they want their medical care good and cheap because they deserve it. Screw em let me know when the funeral is for these greedy idiots.
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Honestly this dude is just a clown now.
Did he do 11-12 years of training with six figure debt to work at his newspaper warehouse?
Also, I worked manual labor before too in just as hot weather. Yeah it's hard, but EM is also hard in a different way.
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I wouldn't be so sizzling mad at them if they actually took care of themselves and lived healthily; but I can't remember the last time that I saw a non-obese BOOMER when I walk thru the grocery store. I swear I can see their med lists above their heads, hovering like quick-display data in a video game as they walk about confusedly. Even the font that I see is pixelated as the words seem to hover there in space, against a backdrop of frozen foods and potato chips.
" WALTER McBOOMER: 69 M"
- DIOVAN HCT
- SYNTHROID
- LOSARTAN
- LISINOPRIL
- METOPROLOL +
- METFORMIN
- GLYBURIDE
- SIMVASTATIN
- NOVOLOG/LANTUS
- ARICEPT
- XARELTO
- ASA/PLAVIX ++
- FLOMAX
- LEVITRA
- PREDNISONE
- +6 OTHERS...
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You guys are the biggest bunch of whinny babies. No one is saying things are peachy or EM is the best job ever. I am sure most of you depressed, whiny, cliff jumping babies are still pulling in 175+/hr. So what you put in 11 yrs of post HS work, so did the every PHD in any field. You are worth what you worth and the number of years you put in does not always correlate to the best jobs.
If making less than 250+/hr means life is terrible or you have to move to find a job or CMGs are not fawning as in past years equates to how terrible your situation is, then you need a better perspective to salvage your sanity. Bunch of you guys need to step back, hire a shrink, or find a hobby.
99.9% of this world would have no pity for you just b/c you can't name your price in any location.
Im done with this thread and will let you guys go ahead and continue to depress everyone who reads this.
If making less than 250+/hr means life is terrible or you have to move to find a job or CMGs are not fawning as in past years equates to how terrible your situation is, then you need a better perspective to salvage your sanity. Bunch of you guys need to step back, hire a shrink, or find a hobby.
99.9% of this world would have no pity for you just b/c you can't name your price in any location.
Im done with this thread and will let you guys go ahead and continue to depress everyone who reads this.
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Aside from all the whinging, I think my most pressing concerns are that I believe we are on a declining trajectory (rehashed so many ways) which means that I am less optimistic about the future.
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I will be the first to admit that EM work environment, salary, and job openings are the worst I have seen in 20 yrs. I have a medical director friend that wanted me to go work up north for $325/hr but the hospital sounded terrible and I have more work than I really want right now. That 325/hr were plentiful 3-5 yrs ago so yes the market has gone downhill.
But compared to other fields, its not terrible. A post on IM has a job
Major city in AZ
Hospitalist 7 days on/off
Salary: 282k/yr ($1550/day for 182 days)
That works out to $129/hr. I would say most EM docs still make 175+/hr.
But compared to other fields, its not terrible. A post on IM has a job
Major city in AZ
Hospitalist 7 days on/off
Salary: 282k/yr ($1550/day for 182 days)
That works out to $129/hr. I would say most EM docs still make 175+/hr.
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The difference you're missing, again, is that you cannot even find a job in nearly any city in AZ right now in EM. That's the difference. Salary will very quickly follow as grads say they'll work for any wage to get a job there, or insert other even mildly desirable area.
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This! And there aren't many cities with decent EM jobs in AZ.
- Phoenix - mostly CMGs with Banner. If your mission statement for medical school included I like blinding co-signing charts of unqualified MLPs, over coding charts, and fighting with hospitalists while striving for excellent Press Gainey scores written by Section 8 residents of Phoenix, then you might be working in the right place!
- Casa Grande? That is a malignant hospital with terrible staffing and is medmal central. However you'll get really good at ultrasound guided IVs on the super morbidly obese 40 year old grandparents who are on dialysis. The hospitalists are much more agreeable as they are on H1B visas and can't rock the boat. Think not having medical staff rights is an issue? How about deportation!
- Flagstaff? Good luck getting a job. The nurses (and hospital) have the docs by the b*lls. Super inefficient and likely on the endangered species list.
- Tuscon - Sound Physicians. 'Nuff said.
- IHS - even those jobs are scarce now.
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Aren't EM physicians employed by Banner Medical Group? Like Hospitalists?
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Last time I was there it was TeamHealth.
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Phoenix is saturated because it's a desirable place to live ? Just EM or all specialities ?
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Most major metro areas are considered 'desirable places to live'...
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Wasn't there a projection a few years ago that by 2050 it'd be >100 degrees in Phoenix for over 1/3 of each year?
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People don't care about that. They see big city, nice schools and restaurants, affordable property, and they will move there. Look at florida.
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I agree with this. If you are regularly getting assaulted by patients you are doing it wrong.
I don't want to say it never happens. But I have worked in inner city knife-and-gun club level 1 trauma centers, rural meth-capital ERs, psych ERs with huge numbers of psychotic patients. Never been physically injured by a patient so far (knock on wood).
That being said, I don't take any excessive risks. Person seems dangerous, they get a door way exam until they are sedated and restrained.
Person seems likely to get agitated or starting to escalate, I start to premedicate with sedatives before things have completely boiled over.
Once the boil-over is already in full swing and the patient is in excited/agitated delirium/psychosis I call for full security response, I specifically request at least 3-4 officers.
I liberally use hard restraints and high doses of sedatives.
When I work at hospitals with no security presence, if law enforcement is not immediately on scene I simply allow the patient elope from the ER and call law enforcement to track them down somewhere in the outside world. If they find them, they find them. If not, they don't. It gives me no pause.
Those of you who are tackling, restraining, physically fighting patients: This is a no win situation for a physician.
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Agreed. The only time I'll engage is if other staff is already trying and at risk of getting hurt without additional assistance.
I'll try to get the staff out of the scuffle or help restrain the pts last limb if they just need one more set of hands. But I'm not going mono e mono or anything of the sort.
A few years ago a shop I worked at actually brought in a martial arts instructor to teach us how to strike patients. Obviously it was only if the patient had already engaged and we needed a last resort to protect ourselves. It was so damn refreshing for admin to acknowledge that our well-being matters.
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What a thread.
Banner is mostly Emcare (Good sam and the like0 it is such a big system that they actually have Team and APP there as well. App bought the quasi private group at Banner desert. Phoenix used to have a ton of SDGs now i think the only one left is at St joes and that place has been and still is a ****hole. Was considered the worst SDG back in the day.
WRT emergent comparing EM jobs to picking fruit just makes you seem so out of touch. Reality is the education, intelligence and hard work should have us comparing ourselves to lawyers, accountants, bankers and executives. White collar jobs.
Within medicine we can and should compare ourselves to our fellow docs who did well above avg on their STEPs, above average in class etc.
While I know there are some US IMGs on here (I think veers) prior to the explosion of residencies it was hard for these guys to get spots. Same for DOs (no offense intended). Now there are so many spots its a joke. People cant find jobs, many of the jobs are malignant or require you to carry headaches of poorly trained underlings over whom you have no real control.
Its bad folks and its gonna get way way way worse. ED visits are going to permanently decline. We saw the push of healthcare to keep people out of the ED pre covid. Now it will be much more coordinated. VOlumes were flat pre covid and again now will get way worse. Throw in a potential loss of commercially insured patients, more self pay etc.
If I could go on WSB I would be shorting the $hit out of EM.
Banner is mostly Emcare (Good sam and the like0 it is such a big system that they actually have Team and APP there as well. App bought the quasi private group at Banner desert. Phoenix used to have a ton of SDGs now i think the only one left is at St joes and that place has been and still is a ****hole. Was considered the worst SDG back in the day.
WRT emergent comparing EM jobs to picking fruit just makes you seem so out of touch. Reality is the education, intelligence and hard work should have us comparing ourselves to lawyers, accountants, bankers and executives. White collar jobs.
Within medicine we can and should compare ourselves to our fellow docs who did well above avg on their STEPs, above average in class etc.
While I know there are some US IMGs on here (I think veers) prior to the explosion of residencies it was hard for these guys to get spots. Same for DOs (no offense intended). Now there are so many spots its a joke. People cant find jobs, many of the jobs are malignant or require you to carry headaches of poorly trained underlings over whom you have no real control.
Its bad folks and its gonna get way way way worse. ED visits are going to permanently decline. We saw the push of healthcare to keep people out of the ED pre covid. Now it will be much more coordinated. VOlumes were flat pre covid and again now will get way worse. Throw in a potential loss of commercially insured patients, more self pay etc.
If I could go on WSB I would be shorting the $hit out of EM.
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Agreed. I dont feel the need to prove my toughness. Is not my job. Ill help my team for sure. I can hold my own but if you think i care more about proving how tough i am with some psych patient at the risk of one hair on my body being harmed you are all wrong.
When the hospital CEO shows up to hold down a patient ill join in. Its not his job nor mine. I am liberal with the use of chemical restraints. This comes from years of experience and having people who i work with get hurt with these psych patients.
Of the top of my head (on top of weapons found after the fact), Maxialla fx, mandible fx with tooth loss, ACL tear. I am sure there was a slew of others. All these injuries happened at different hospitals i worked at. The hospital will give me a "healthcare hero" banner to make me feel better while I miss 6 weeks of work with no pay. No thanks. the psych patient can do as they please and the hospital can deal with the PR backlash and lawsuit.
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What do you do now? Still full-time in the pit? Still seeing 3 pph?
Veers is Canadian, and graduated from [a US] med school. I'm one of the USFMGs.
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WHAT?! 🤣
Any place that gets above 110* isn't desirable.
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Last year already had 144 days above 100 and people are still moving here like crazy
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I'd disagree with you there. Grew up in - 40 degrees and would.neved.go back to it.
Emergent, I have no specific problem with you, but I have been on this forum a long, long time, and wasted far too much time here.
I remember another doctor who was “whining” nonstop in the late 2000s despite making twice what we make and wanting to switch to radiology. It was you (I quoted the thread above).
So try to tap into that memory and have a little empathy for people who are feeling similar angst to what you did. Hopefully they find the same peace with the field that you eventually came to.
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Insanity
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Same in Vegas. They can't build houses fast enough, despite long, blistering Summers and short miserable Winters.
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HAHAHA
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