Fired from Residency?

[skypilot]

Agreed.

When is enough enough in medicine? When are doctors going to stand up for themselves?

I swear next year, I am going to find a lawyer to file a class action lawsuit agains the GME and the licensing boards. This crap needs to stop. I mean it's not like we are so damn privileged and respected anymore for this crap to continue. We need to rise up and stand for our rights!!!

Nice! Just when I am going to make a stand I remember my mortgage, my kids in school, and my excellent compensation. We are trained to knuckle under from the first day of Medical school. But in truth, you can say no. And you will probably will be just fine and maybe even respected for doing so. And no one can force you into a practice model you don't want to practice in. They might not hire you, but they can't force you to do anything. Just say no, if you have to and let the chips fall where they may. You might just get what you want.

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[chocomorsel]

Nice! Just when I am going to make a stand I remember my mortgage, my kids in school, and my excellent compensation. We are trained to knuckle under from the first day of Medical school. But in truth, you can say no. And you will probably will be just fine and maybe even respected for doing so. And no one can force you into a practice model you don't want to practice in. They might not hire you, but they can't force you to do anything. Just say no, if you have to and let the chips fall where they may. You might just get what you want.

I hear you!
I have never seen credentialing paperwork that doesn't ask about mental health. And I have had privileges in over 15 hospitals.
Nor have I seen state licensure paperwork that doesn't include that in some form or way either.

 

[aneftp]

Agreed.

However in residency, it is extremely difficult to procure a new residency spot should you get fired for whatever reasons. I mean, getting fired in residency is almost always a career ender.

How does the rest of the world deal with getting fired? They get another job. And the law is on their side as in whether or not they give permission to the New employer to contact the last employer. Not quite so in medicine. The PD's for some reason always have to talk to each other. As in, it's hard to move to another program when you are having problems in your program, because they always want to ask of a "PD letter". Trust me, I tried. I emailed over 100 residencies when I was a resident trying to swap and the few that had a spot always had to have a PD letter. And yes, when I have to answer "yes" to a question on a medical license and hospital credentialing, I get angry. It's unnecessary scrutiny and hoops to jump through.

I feel like this is illegal and should be made illegal in the medical world. But medicine seems to fly by its own rules.
Just like when they ask about mental health issues on credentialing and licensing applications. That is illegal based on the Americans with Disabilities Act. But somehow in medicine, it is standard and you can get a license or hospital privileges denied or postponed for this s hit.

When is enough enough in medicine? When are doctors going to stand up for themselves?

I swear next year, I am going to find a lawyer to file a class action lawsuit agains the GME and the licensing boards. This crap needs to stop. I mean it's not like we are so damn privileged and respected anymore for this crap to continue. We need to rise up and stand for our rights!!!

That’s why you have to play by the rules when you are in training.

 

[Arch Guillotti]

That’s why you have to play by the rules when you are in training.

Bingo.

 

[chocomorsel]

Bingo.

The rules are not created equally for everyone.
But yeah.

 

[Drangue]

The TY director called the radiology program and convinced them to fire him.

Yikes....

Is that even possible??? The TY PD convinces the Radiology PD to just fire him???

 

[Drangue]

Damn, I had OB residents ask one time if I wanted t do the EUA, said hellllllll no!

During our gyn rotation in surgery we were "told" to do this and then the attending would ask us the position of the uterus whether it was anteverted or retroverted etc. then tell the gyn resident to do the same to verify. Then he would follow up with a series of pimp questions about issues with both.

"If you don't want to participate on my rotation then don't show up." - Attending

I have heard of about a resident who got fired because the resident was stealing supplies from the hospital.

What kind of supplies we talking here? Attendings, residents and even the PD encourage medical students to used to grab silks, ties, suture removal kits, and practice at home. I know residents who grab bandages, dermabond, hydrogen peroxide, alcohol and other supplies right from the closet and take them home. This is not just a couple residents. What kind of stuff are these residents taking and then being fired for?

I keep reading these stories and they are nothing like what I was told when I was in med school doing my rotations. During my IM rotation the PD used to tell us stories about how HARD it is to get fired. I feel like there is a lot of information missing from these stories.

 

[nimbus]

During our gyn rotation in surgery we were "told" to do this and then the attending would ask us the position of the uterus whether it was anteverted or retroverted etc. then tell the gyn resident to do the same to verify. Then he would follow up with a series of pimp questions about issues with both.

"If you don't want to participate on my rotation then don't show up." - Attending




What kind of supplies we talking here? Attendings, residents and even the PD encourage medical students to used to grab silks, ties, suture removal kits, and practice at home. I know residents who grab bandages, dermabond, hydrogen peroxide, alcohol and other supplies right from the closet and take them home. This is not just a couple residents. What kind of stuff are these residents taking and then being fired for?

I keep reading these stories and they are nothing like what I was told when I was in med school doing my rotations. During my IM rotation the PD used to tell us stories about how HARD it is to get fired. I feel like there is a lot of information missing from these stories.

Agree. Often the stated reason is not the actual reason.

 

[Twiggidy]

Agreed.

However in residency, it is extremely difficult to procure a new residency spot should you get fired for whatever reasons. I mean, getting fired in residency is almost always a career ender.

How does the rest of the world deal with getting fired? They get another job. And the law is on their side as in whether or not they give permission to the New employer to contact the last employer. Not quite so in medicine. The PD's for some reason always have to talk to each other. As in, it's hard to move to another program when you are having problems in your program, because they always want to ask of a "PD letter". Trust me, I tried. I emailed over 100 residencies when I was a resident trying to swap and the few that had a spot always had to have a PD letter. And yes, when I have to answer "yes" to a question on a medical license and hospital credentialing, I get angry. It's unnecessary scrutiny and hoops to jump through.

I feel like this is illegal and should be made illegal in the medical world. But medicine seems to fly by its own rules.
Just like when they ask about mental health issues on credentialing and licensing applications. That is illegal based on the Americans with Disabilities Act. But somehow in medicine, it is standard and you can get a license or hospital privileges denied or postponed for this s hit.

When is enough enough in medicine? When are doctors going to stand up for themselves?

I swear next year, I am going to find a lawyer to file a class action lawsuit agains the GME and the licensing boards. This crap needs to stop. I mean it's not like we are so damn privileged and respected anymore for this crap to continue. We need to rise up and stand for our rights!!!

Sadly, in our litigious society it comes down to one word. Liability. It's much easier to deny privileges or licensure then to deal with a potential problem down the line.

Now, having said that arguable statement, I'm looking at a licensure application right now and it doesn't ask anything about mental health. This is from a more liberal state so I'm not sure what the applications for more conservative states look like. This application does ask about discipline action, drug use, etc and I'm not opposed to that. I'm sorry, being someone who hasn't had an issue in the past, I'm not mad at a hospital of medical board asking questions of people who HAVE had discipline issues in the past. The is basically a "medical background check" and since people's lives are at stake I don't think it's a problem to know the background of people taking care of patients.

 

[skankhunt42]

Is that even possible??? The TY PD convinces the Radiology PD to just fire him???

I imagine the conversation was along the lines of 'if you don't fire him, I will fire him and you still won't get him.' And how hard do you think the TY guy had to argue to get him fired. What the guy did was egregious....

 

[chocomorsel]

Sadly, in our litigious society it comes down to one word. Liability. It's much easier to deny privileges or licensure then to deal with a potential problem down the line.

Now, having said that arguable statement, I'm looking at a licensure application right now and it doesn't ask anything about mental health. This is from a more liberal state so I'm not sure what the applications for more conservative states look like. This application does ask about discipline action, drug use, etc and I'm not opposed to that. I'm sorry, being someone who hasn't had an issue in the past, I'm not mad at a hospital of medical board asking questions of people who HAVE had discipline issues in the past. The is basically a "medical background check" and since people's lives are at stake I don't think it's a problem to know the background of people taking care of patients.

Nurses take care of patients. They don’t have to answer questions like these.

 

[Guillemot]

This is an interesting thread... I do believe that how difficult it is to fire someone is mainly based on if those that make those decisions like the person, how easy vs how much of a hassel it would be to keep them around, and probably mutiple other merit and non-merit related factors. Incompetence alone is definitely not enough for discharge. During residency I worked with multiple incompetent and marginally competent attendings. Obviously, these people werent fired. They have now taken it upon themselves to teach the next generation. Life is complex.

 

[anbuitachi]

Nurses take care of patients. They don’t have to answer questions like these.

Nurses have rights

 

[chocomorsel]

Nurses have rights

and we don’t?
Or are we too blinded by the damn money?

 

[DocVapor]

and we don’t?
Or are we too blinded by the damn money?

During residency, not blinded. Wrapped in chains, tied to a concrete block, and thrown overboard in shark infested waters with an O2 tank good for just long enough to be picked up if we don't thrash around enough to catch the attention of said sharks.

 

[deleted171991]

During residency, not blinded. Wrapped in chains, tied to a concrete block, and thrown overboard in shark infested waters with an O2 tank good for just long enough to be picked up if we don't thrash around enough to catch the attention of said sharks.

It doesn't get much better even afterwards. Physicians' rights is an oxymoron.

Let me correct that: You have the right to remain silent (and be a good dog and lick everybody's hands). Anything you say, especially to a nurse, may be used against you in a kangaroo court. You have no right to an union representative be present, because you're too dumb to have a union. If you have an attorney instead, that just means you are guilty and doing damage control (and we may not allow him/her to be present anyway). If you decide to answer questions without an attorney being present, good luck, because if you don't answer our questions we will consider you guilty. (Only guilty people have things to hide.) You have the right to protest the absence of any other real rights, but that will only piss us off and expose you to more unpleasant consequences. Just be a good doggie...

 

[deleted480308]

During residency, not blinded. Wrapped in chains, tied to a concrete block, and thrown overboard in shark infested waters with an O2 tank good for just long enough to be picked up if we don't thrash around enough to catch the attention of said sharks.

Exactly.

I’m not fighting battles in residency. If it doesn’t mess with graduation or my license you can call me whatever horrible crap, give me whatever dumb schedule, or do whatever

Eyes on the prize

 

[chocomorsel]

@FFP, why don’t physicians unionize?
Makes no damn sense.
I think it’s that we are so afraid of possibly losing all this money we get paid that we cower down. People are easily bullied due to money.

 

[deleted171991]

@FFP, why don’t physicians unionize?
Makes no damn sense.
I think it’s that we are so afraid of possibly losing all this money we get paid that we cower down. People are easily bullied due to money.

Historically, physicians used to be employers, not employees, hence we couldn't unionize (legally). Because of that, many physicians still believe we are not allowed to. Which is not true, for those of us who are employed.

I first realized how insignificant physicians are in America when, during residency, a "cleaning specialist" bumped into me, turning a corner while he was talking on the phone, and then started chastising me for not apologizing (while he was clearly the one not having paid attention). Only in America can you have a person with maybe a high school diploma treating somebody with 6+ more years of real education as if he were his less than equal.

 

[chocomorsel]

Historically, physicians used to be employers, not employees, hence we couldn't unionize (legally). Because of that, many physicians still believe we are not allowed to. Which is not true, for those of us who are employed.

Well then let’s start a damn Union!

Hmm..... how do we do that? Reach out to the unions and invite them over for cheese and cocktails?

 

[pgg]

Obstacle one: Physicians generally lean conservative, and as they get older, lean further conservative, and accepted doctrine #1 of conservativedom is that Unions Are Evil.

Obstacle two: As a rule, physicians are hardworking individualists who make direct connections between how hard they have worked (individually) and the rewards they have reaped (individually). Becoming a doctor is very, very much an individual effort. This isn't really a team sport. The essence of unions is being willing to strike, and take one for the team so that the other guys get a better deal. Good luck getting the GI guy on board with walking out over the rural pass through law when he gripes daily about the anesthesiologists not being at his beck and call for the noon ERCP he wants to squeeze in.

I am not holding my breath for physician unions to materialize.

 

[Arch Guillotti]

Historically, physicians used to be employers, not employees, hence we couldn't unionize (legally). Because of that, many physicians still believe we are not allowed to. Which is not true, for those of us who are employed.

There are a fair number of us that are not employed by a hospital or health care system and thus do not have the ability to unionize.

 

[deleted103644]

Obstacle one: Physicians generally lean conservative, and as they get older, lean further conservative, and accepted doctrine #1 of conservativedom is that Unions Are Evil.

Obstacle two: As a rule, physicians are hardworking individualists who make direct connections between how hard they have worked (individually) and the rewards they have reaped (individually). Becoming a doctor is very, very much an individual effort. This isn't really a team sport. The essence of unions is being willing to strike, and take one for the team so that the other guys get a better deal. Good luck getting the GI guy on board with walking out over the rural pass through law when he gripes daily about the anesthesiologists not being at his beck and call for the noon ERCP he wants to squeeze in.

I am not holding my breath for physician unions to materialize.

They already exist for residents in several hospitals.

Considering the power disparity with potential for permanent career damage at the whims of your superiors, long hours and relatively bad pay, sometimes verbal abuse, it makes a lot of sense.

I was never a part of it, but considering how vulnerable residents are to a variety of kinds of exploitation and abuse, more people should probably look into it.

Committee of Interns and Residents

 

[anbuitachi]

Well then let’s start a damn Union!

Hmm..... how do we do that? Reach out to the unions and invite them over for cheese and cocktails?

I imagine itd be very difficult to make an effective union in todays day and age. After residency, people go all over the country for jobs. You would have to have a union with MANY members to even be effective. Otherwise they'll just hire the non union people from elsewhere.

maybe one day AMC turn good and have every anesthesiologist join and be almost like a union . . . .

 

[deleted697127]

During residency, not blinded. Wrapped in chains, tied to a concrete block, and thrown overboard in shark infested waters with an O2 tank good for just long enough to be picked up if we don't thrash around enough to catch the attention of said sharks.

Solid quote

 

[deleted171991]

There are a fair number of us that are not employed by a hospital or health care system and thus do not have the ability to unionize.

I don't see why not, unless you own a piece of the business.

Funny thing is that I am talking about physician unions, but I think pretty much like @pgg. It would take a good amount of extreme capitalism for me to join one.

 

[chocomorsel]

I don't see why not, unless you own a piece of the business.

Funny thing is that I am talking about physician unions, but I think pretty much like @pgg. It would take a good amount of extreme capitalism for me to join one.

Own a piece of what business? The anesthesia practice? Or the hospital?

 

[chocomorsel]

Obstacle one: Physicians generally lean conservative, and as they get older, lean further conservative, and accepted doctrine #1 of conservativedom is that Unions Are Evil.

Obstacle two: As a rule, physicians are hardworking individualists who make direct connections between how hard they have worked (individually) and the rewards they have reaped (individually). Becoming a doctor is very, very much an individual effort. This isn't really a team sport. The essence of unions is being willing to strike, and take one for the team so that the other guys get a better deal. Good luck getting the GI guy on board with walking out over the rural pass through law when he gripes daily about the anesthesiologists not being at his beck and call for the noon ERCP he wants to squeeze in.

I am not holding my breath for physician unions to materialize.

Ehh, the old-foggie conservatives in medicine are gradually getting replaced by younger more liberal people who believe in this thing called work life balance. As in, many of them just want to put in their hours and collect their paychecks while not killing themselves for the almighty dollar. Hopefully this new younger liberal generation will eventually change things in Medicine since many of them are employees. I am about to join those ranks myself.

And yes, medicine is a very individual sport. I get that. But my honest assessment of the situation is simply money driven. Physicians make a pretty good chunk of change and many of us are OK with some of the abuse we receive because hell, "we can laugh all the way to the bank". How many times have you heard anesthesiologists justify their abuse from surgeons because they make damn good money, even more than the surgeons? I have heard it too many damn times. Like we don't care if we get the same amount of respect because money is what really matters.

Ehh, the individualistic attitude in medicine is gonna sink the ship. We need to do a better job of looking out for each other and for the whole field of Medicine instead of just caring about our damn bank accounts. If we were making 60-100k across the board, I bet there would be way more people interested in unions. But that's my take.

 

[chocomorsel]

They already exist for residents in several hospitals.

Considering the power disparity with potential for permanent career damage at the whims of your superiors, long hours and relatively bad pay, sometimes verbal abuse, it makes a lot of sense.

I was never a part of it, but considering how vulnerable residents are to a variety of kinds of exploitation and abuse, more people should probably look into it.

Committee of Interns and Residents

I was a proud paying member. It was completely worth it to me. They helped me through tough times.

 

[deleted171991]

Own a piece of what business? The anesthesia practice? Or the hospital?

The business that employs you. There may be some legal entanglements if one is an employee partner.

 

[chocomorsel]

The business that employs you.

Well then he/she must be an owner/partner.

 

[Twiggidy]

Well then let’s start a damn Union!

Hmm..... how do we do that? Reach out to the unions and invite them over for cheese and cocktails?

It is much more complicated than that, as I'm sure you know. In the simplest terms Unions are formed as a way to protect the workers from being abused by ownership. Autoworkers, nurses, hell, even the multi-million dollar atheletes still have to answer to "the man" and the have unions to keep "the man" from working them into the ground, therefore, they collectively bargain, so that in theory, everyone gets what they want. The hospital has a nursing staff and nurses aren't getting abused by the system, so to speak. Again, IN THEORY, because everyone finds something to complain about.

Physicians are in the space where we are for the most part "the owners, especially so if you find yourself as a shareholder in a group. It get interesting when it comes to the "service fields", ie anesthesia. If there's a branch of physician who could potentially unionize it is anesthesiologists because we are workers for the system, theoretically, but now you're talking about getting legions of anesthesiologist to, again, in simple terms, organize. Even then, who are we "bargaining" with? The hospital? The surgeons? The medical board? That'll just never happen. There will be "free agents" out there (think locums) who will just come into any OR, getting credentialed and just do all the work, and maybe even for a better pay than the "striking anesthesiologists". So we put up with what we have to because we need to pay the bills and in the long run, despite the complaining the occurs on this forum, we get paid pretty darn well to do it. That's in the simplest terms of why there isn't a physician's union and more so an anesthesiologists union.

 

[pgg]

Ehh, the old-foggie conservatives in medicine are gradually getting replaced by younger more liberal people who believe in this thing called work life balance. As in, many of them just want to put in their hours and collect their paychecks while not killing themselves for the almighty dollar. Hopefully this new younger liberal generation will eventually change things in Medicine since many of them are employees. I am about to join those ranks myself.

Well you know the saying, variously attributed ... but it first appeared in one form or another a couple hundred years ago ...

If you're not a liberal at age 20 you have no heart, and if you're not a conservative at age 40 you have no brain.


If attitudes are changing it's because the deal is getting worse (less $, less autonomy, more JC, more CMS, more "empowered" nurses) and people are making rational work/life decisions. I don't think it has anything to do with younger more liberal people. We're always going to be a profession dominated by middle age and old people because training is so long, and that cohort has skewed conservative for thousands of years.

 

[Twiggidy]

Well you know the saying, variously attributed ... but it first appeared in one form or another a couple hundred years ago ...

If you're not a liberal at age 20 you have no heart, and if you're not a conservative at age 40 you have no brain.


If attitudes are changing it's because the deal is getting worse (less $, less autonomy, more JC, more CMS, more "empowered" nurses) and people are making rational work/life decisions. I don't think it has anything to do with younger more liberal people. We're always going to be a profession dominated by middle age and old people because training is so long, and that cohort has skewed conservative for thousands of years.

Yeah. I think it has very little to do with politics and much to do with the fact the the nursing union is VERY strong and for the most part, public opinion on just about any issue with be on the side of the nurses. There are literally commercials on television touting how great it is to be a nurse.

 

[MaximusD]

Yep I also lube the rear tip for insertion

If you have to I guess you can use a tongue blade or even a laryngoscope for placement but igels slide in pretty easily for the most part. The toughest part is keeping the tongue from sticking to it. I have only placed about 100 lmas in my career.

Sometimes aiming up toward the pallet is more useful, thus avoiding the tongue. I always finish the placement with a jaw thrust and a gentle pull back to ensure good seating. YMMV.

 

[Ronin786]

Ehh, the old-foggie conservatives in medicine are gradually getting replaced by younger more liberal people who believe in this thing called work life balance. As in, many of them just want to put in their hours and collect their paychecks while not killing themselves for the almighty dollar. Hopefully this new younger liberal generation will eventually change things in Medicine since many of them are employees. I am about to join those ranks myself.

I disagree. That mentality is one of the reasons why medicine is being overrun by administrators and suits. Physicians today would rather cash their check and go home at the end of the day and in return we've given over control of not only our own ability to decide how we work, but also what is best for our patients. You have even less control as an employee than you do as an owner.

 

[dannyboy1]

I disagree. That mentality is one of the reasons why medicine is being overrun by administrators and suits. Physicians today would rather cash their check and go home at the end of the day and in return we've given over control of not only our own ability to decide how we work, but also what is best for our patients. You have even less control as an employee than you do as an owner.

Don’t care. The suits and administrators want to make everyone an employee and take as much of the profits as they can. Let them deal with the admistrative headaches. Me, I just work here bro

 

[deleted171991]

@dannyboy1, let me tell you about work-life balance:

Scenario 1: You're an employee. You work happily 45-50 hours/week, get paid X and retire at 65.
Scenario 2: You're an owner. You work 65 hours/week, make 2*X, stash a ton in retirement accounts, retire at 50. Or, even better, go part-time at 45, work even happier 30 hours/week for X, still stash a ton in retirement accounts.
No brainer.

 

[dannyboy1]

@dannyboy1, let me tell you about work-life balance:

Scenario 1: You're an employee. You work happily 45-50 hours/week, get paid X and retire at 65.
Scenario 2: You're an owner. You work 65 hours/week, make 2*X, stash a ton in retirement accounts, retire at 50. Or, even better, go part-time at 45, work even happier 30 hours/week for X, still stash a ton in retirement accounts.
No brainer.

Maybe for some. But working 65 hours a week makes me cranky. Since I am closer to 35 than to 50 I can’t imagine doing that for 15 years. A lot of important stuff happens in those years. Btw I am still putting a lot away into retirement and should be able to go part time by 50 (hell, I could go part time today and still live comfortably)

 

[TheLoneWolf]

Back to OP.

2 firings happened at my program in last 4 years.

1) student from top 10 medical matched to our program. Friendly, above average performance. Developed habit in intern year of disappearing for hours at a time and not answering pager. Advanced to CA1 year and continued to do this after finishing assigned cases for the day but before dismissal. Caught few times, he threatened legal action if he were to be fired alleging discrimination based on sexual orientation. Caught leaving hospital on camera, leaving airway pager in call room and disappearing for several hours. Only senior resident was in house and was not informed. Luckily no one harmed because of this.

2) CA1 caught by police for allegedly diverting IV pain meds. Allegedly found empty syringe with fentanyl sticker. Resident states took it home accidentally after hard call, slipped into street clothing and didn't know he had it on his person. Prosecutor drops charges but still fired by department. Likely will sue the program for termination.

To my knowledge, no one removed for poor clinical or academic performance. Few failed the basic a three times and still in program as CA3s.

 

[deleted171991]

The second case is tough. Unless the resident tested positive for opiates, I don't see the reason for firing him. That was cruel and unusual punishment.

 

[DocVapor]

The second case is tough. Unless the resident tested positive for opiates, I don't see the reason for firing him. That was cruel and unusual punishment.

I dunno. I'm not sure how I could get an empty syringe from my scrubs into my street clothes accidentally. Much, much, much higher chance that the syringe ends up in the laundry with a blunt needle attached and the hospital gets fined $50,000 but can't trace it back to anyone.

 

[deleted171991]

I dunno. I'm not sure how I could get an empty syringe from my scrubs into my street clothes accidentally. Much, much, much higher chance that the syringe ends up in the laundry with a blunt needle attached and the hospital gets fined $50,000 but can't trace it back to anyone.

I was wondering about the same thing. The only explanation is absentmindedness after a long call.

As a CA-3, I once returned my opiates to the collection box at the end of the day, and was so tired that 20 minutes later I forgot about it and started to look for them everywhere, frantically. In the end, I went to report them missing. The pharmacy tech listened to my story, then bet me that I had returned them without even realizing it. So we went to check, and lo and behold there they were.

Why would somebody take an empty syringe with them, if guilty? He would have just disposed of it in the first garbage bin. It doesn't make sense. Had I been him, the first thing I would have done would have been to insist on a blood and urine tox screen.

 

[TheLoneWolf]

I was wondering about the same thing. The only explanation is absentmindedness after a long call.

As a CA-3, I once returned my opiates to the collection box at the end of the day, and was so tired that 20 minutes later I forgot about it and started to look for them everywhere, frantically. In the end, I went to report them missing. The pharmacy tech listened to my story, then bet me that I had returned them without even realizing it. So we went to check, and lo and behold there they were.

Why would somebody take an empty syringe with them, if guilty? He would have just disposed of it in the first garbage bin. It doesn't make sense. Had I been him, the first thing I would have done would have been to insist on a blood and urine tox screen.

Wasn't a particularly popular resident, somewhat annoying. I feel if this happened to any of the golden boys/girls at the department, the program would have gone all out in their defence.

 

[chocomorsel]

I disagree. That mentality is one of the reasons why medicine is being overrun by administrators and suits. Physicians today would rather cash their check and go home at the end of the day and in return we've given over control of not only our own ability to decide how we work, but also what is best for our patients. You have even less control as an employee than you do as an owner.

Well, maybe that mentality was born out of the “good old days” of Medicine no longer being good old days.

As in for this generation, the suits are already there, the practices have already been sold out, the nurses are taking a huge bite out of the pie and physician “disruption” is rampant. Therefore, why kill oneself when you are treated like a commodity and are completely replaceable? Sometimes even by a nurse.

I mean I would rather be my own boss and own a piece of the pie, but the system has already changed. So while I hold out hope for the old system of being in charge of my practice, I am noticing that this is not where medicine is currently heading and am being more flexible.

It’s not like Private Practices don’t screw over their junior partners. We all know that ain’t nobody gonna screw you over as well as your own people in Medicine. So if a PP offers a pseudo partnership versus a good employed position with better money and equal treatment from day one, I am gonna with the employed position.

Even the good PP are always at risk getting kicked out of their contracts unfortunately. For me, I am moving to an area where my most likely option will be employment since most PP in our field do not do CCM.

 

[chocomorsel]

@dannyboy1, let me tell you about work-life balance:

Scenario 1: You're an employee. You work happily 45-50 hours/week, get paid X and retire at 65.
Scenario 2: You're an owner. You work 65 hours/week, make 2*X, stash a ton in retirement accounts, retire at 50. Or, even better, go part-time at 45, work even happier 30 hours/week for X, still stash a ton in retirement accounts.
No brainer.

Tomorrow is not promised. People die young, all the time. And groups sell out or get kicked out frequently enough. Some groups don't necessarily make more than employed people. Being in PP does not guarantee a higher paycheck although often times it does.

And like Danny, working 65 hours a week doesn't sit well for many people.

 

[chocomorsel]

The second case is tough. Unless the resident tested positive for opiates, I don't see the reason for firing him. That was cruel and unusual punishment.

Completely agree. This sounds like total BS. Who found the syringe at his house anyway and tattled? I can say I have gone home and found used empty syringes in my pocket. I have gone home and found a vial of fentanyl and had to double back to the hospital.

Can someone at least provide a urine test in this day and age? There has to be more to the story than that. Someone didn't like he/she and had already built a case. Total and utter BS. I hope they sue and get a s hit ton of money should it be just an accidental syringe.

 

[chocomorsel]

I dunno. I'm not sure how I could get an empty syringe from my scrubs into my street clothes accidentally. Much, much, much higher chance that the syringe ends up in the laundry with a blunt needle attached and the hospital gets fined $50,000 but can't trace it back to anyone.

Not everyone changes in and out of clothes at the hospital. Plenty of folks take a bunch of scrubs home and wear the same pair in and out of the hospital. Have you never seen this?

 

[chocomorsel]

Wasn't a particularly popular resident, somewhat annoying. I feel if this happened to any of the golden boys/girls at the department, the program would have gone all out in their defence.

The chief resident in the year before me lost a whole case of Opiates/Benzos.
This was back before the Pyxis and we would check out a giant case of drugs for call. Something like 6 vials of 5cc Fentanyl and 4 Vials of 2cc Versed plus some Dilaudid and Morphine mixed up in there. He lost the whole thing. Nothing bad happened to him, and he wasn't even investigated. Needless to say, he was well liked and connected and this was before his chief year. I liked him a whole lot myself, but when I saw how others were treated for suspected drug abuse, I knew the system was not fair. We all don't play by the same rules.

 

[abolt18]

The chief resident in the year before me lost a whole case of Opiates/Benzos.
This was back before the Pyxis and we would check out a giant case of drugs for call. Something like 6 vials of 5cc Fentanyl and 4 Vials of 2cc Versed plus some Dilaudid and Morphine mixed up in there. He lost the whole thing. Nothing bad happened to him, and he wasn't even investigated. Needless to say, he was well liked and connected and this was before his chief year. I liked him a whole lot myself, but when I saw how others were treated for suspected drug abuse, I knew the system was not fair. We all don't play by the same rules.

I've been told by the pharmacists at my hospital that 1 mistake with the controlled substances gets noted but they do nothing about it. 2nd mistake, you get drug tested, looked into, and whatever else they feel necessary to do.