I wish patients knew what the ER was for

[smq123]

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How much of these inappropriate ER visits are due to inadequate access to decent primary care? I bet that a lot of these patients would vanish if there was such access.

At my first job out of residency, one of the receptionists at the front desk told me that a woman came in with several young children. The children had some mild cold symptoms, and the mom asked if they could be seen today as walk-in sick patients. The mom mentioned that they were uninsured.

Just to check, the receptionist checked the kids in the state Medicaid database. She informed the mom that, actually, the kids DID have Medicaid insurance.

The mom said, "Oh, ok," and then turned to leave.

The receptionist asked her where she was going - "we can see you today; we have appointment slots available. You won't even have to wait very long."

The mom said, "Oh, we have Medicaid, so it's free to go to the ER. It's faster too."

<facepalm>

 

[FlaminHotER]

I've never bought the "increased access to primary care will decrease ER visits" argument. I can see this only happening in rural critical access areas.

The entitled nonsense presentations will come to the ED regardless of what outpatient resources are available to them.

And always at 3am

 

[Apollyon]

KIDS, STOP FIGHTING, OR I SWEAR I AM TURNING THIS CAR AROUND.

(My husband jokes that 90% of the reason that he wanted to have kids is so that he could say this.).

But in all seriousness - can we stop lecturing the posters here on what they should, or should not, be doing in their professional lives? And can we stop making assumptions about the experience level of people posting here?

If we can't get this thread back on track, it will be closed.

The site is not for patients. We're not the ones derailing (and I, literally, wrote the book chapter on derailments). <--- Not a joke

 

[Rekt]

KIDS, STOP FIGHTING, OR I SWEAR I AM TURNING THIS CAR AROUND.

(My husband jokes that 90% of the reason that he wanted to have kids is so that he could say this.).

But in all seriousness - can we stop lecturing the posters here on what they should, or should not, be doing in their professional lives? And can we stop making assumptions about the experience level of people posting here?

If we can't get this thread back on track, it will be closed.

Can we stop locking threads when people’s tiny little feelings may be hurt?

Some people just need to tighten the **** up. It’s just sad

 

[hoot504]

KIDS, STOP FIGHTING, OR I SWEAR I AM TURNING THIS CAR AROUND.

(My husband jokes that 90% of the reason that he wanted to have kids is so that he could say this.).

But in all seriousness - can we stop lecturing the posters here on what they should, or should not, be doing in their professional lives? And can we stop making assumptions about the experience level of people posting here?

If we can't get this thread back on track, it will be closed.

Except one is possibly actually a kid, a pre-med at best... while the others are board certified EM physicians who were having a conversation amongst themselves before this person inserted themselves into the thread.

Maybe you should direct that person to a more appropriate part of the forum. Perhaps a thread about how to get into medical school?

 

[GonnaBeADoc2222]

KIDS, STOP FIGHTING, OR I SWEAR I AM TURNING THIS CAR AROUND.

(My husband jokes that 90% of the reason that he wanted to have kids is so that he could say this.).

But in all seriousness - can we stop lecturing the posters here on what they should, or should not, be doing in their professional lives? And can we stop making assumptions about the experience level of people posting here?

If we can't get this thread back on track, it will be closed.

What a feather brained post.

Correct the problem MOD. Stop lecturing attending physicians.

 

[VA Hopeful Dr]

What a feather brained post.

Correct the problem MOD. Stop lecturing attending physicians.

No.

Seriously though, seems like every few months y'all get someone stumbling in here spouting nonsense - disgruntled patient, naive student, or angry specialist. I can promise if you just ignore them they will go away. Or let one of us know and we can deal with it.

 

[Zebra Hunter]

Now back to the original topic.

I still maintain that my happiest time on the job was that 3 month period between March - May 2020 when people started using the ER appropriately, we had yet to have a COVID surge, I was only having to see 1.2 pts/hr, got to leave shifts sometimes 2-3 hrs early, family members could not come back with patients, and patients were much kinder to our profession.

I’d happily take a 30% pay cut to get back to that kinda practice again. I could practice for decades like that and be satisfied, rather than planning to bail on the profession as soon as I feel financially able.

 

[AW125]

I don't think anything I said was nonsense but if you feel that way I guess it highlights a disconnect that some of you might have with the realities of medicine today and issues with access to care; and I would suggest you read up on those issues because the solution to what you are describing is a public health problem where the populations that are entering the ED are doing so because they have no where else to go. I just don't see how you are blaming the patient for that.

You can check out countyhealthrankings.com to uncover where patients in your geographical location are going to receive care when they feel sick and some locations have primary care provider to patient ratios of 5000:1 or higher and if that's you then your ED will get flooded with the cases that you are complaining about but again the blame is not on the patient, it's on the way the system is set up.

 

[dozitgetchahi]

I've never bought the "increased access to primary care will decrease ER visits" argument. I can see this only happening in rural critical access areas.

The entitled nonsense presentations will come to the ED regardless of what outpatient resources are available to them.

The “entitled nonsense” patients are also the ones who don’t actually go to PCPs, or if they do they go once every 5 years and then no show repeatedly…

Interestingly, these people come into the rheumatology clinic too (usually these are followup patients). My first question when I hear this stuff: “is your PCP aware of this? Have you talked to them about it?” Usually there is a long, weird pause, as if the patient has never even considered this might be something you should do.

I think a lot of the problem is that PCPs are overworked - and also some of them are basically just going through the motions, and not trying very hard for their patients - but a lot of patients also aren’t even giving them the chance to see if they can help.

 

[AW125]

The “entitled nonsense” patients are also the ones who don’t actually go to PCPs, or if they do they go once every 5 years and then no show repeatedly…

Interestingly, these people come into the rheumatology clinic too (usually these are followup patients). My first question when I hear this stuff: “is your PCP aware of this? Have you talked to them about it?” Usually there is a long, weird pause, as if the patient has never even considered this might be something you should do.

I think a lot of the problem is that PCPs are overworked - and also some of them are basically just going through the motions, and not trying very hard for their patients - but a lot of patients also aren’t even giving them the chance to see if they can help.

The issue is not just access to better primary care. The provider also has to be "good" at what they do and well, nobody really wants to go into primary care these days so if you want good quality primary care, you also have to pay those doctors well.

So you can see how this is a circular problem.

The patient is not going out of their way to clog the system up; they really are not well taken care of to begin with and also not educated about health and disease.

Again, there is a solution for all of this but it involves money and resources and this is where doctors don't have much of a say unless they avoid some of these areas of medicine altogether.

 

[GonnaBeADoc2222]

I don't think anything I said was nonsense but if you feel that way I guess it highlights a disconnect that some of you might have with the realities of medicine today and issues with access to care; and I would suggest you read up on those issues because the solution to what you are describing is a public health problem where the populations that are entering the ED are doing so because they have no where else to go. I just don't see how you are blaming the patient for that.

You can check out countyhealthrankings.com to uncover where patients in your geographical location are going to receive care when they feel sick and some locations have primary care provider to patient ratios of 5000:1 or higher and if that's you then your ED will get flooded with the cases that you are complaining about but again the blame is not on the patient, it's on the way the system is set up.

Lol.

According to this dataset, my county has a better ratio of PCPs to patients than the US on average, and less uninsured, yet they still come to the ED in droves.

I'm fine with it as this = revenue for my group, but stop trying to paint this picture of terrible primary care access as being ubiquitous throughout the country.

 

[AW125]

Lol.

According to this dataset, my county has a better ratio of PCPs to patients than the US on average, and less uninsured, yet they still come to the ED in droves.

I'm fine with it as this = revenue for my group, but stop trying to paint this picture of terrible primary care access as being ubiquitous throughout the country.

Do you have a public health background?

 

[skougess]

Do you have a public health background?

What is your malfunction? It’s really bizarre as a lay person to go onto a practicing physician forum and tell us that we just “don’t get” the flaws of the medical system when we live and breathe it every day. Like, personality disorder bizarre.

 

[AW125]

What is your malfunction? It’s really bizarre as a lay person to go onto a practicing physician forum and tell us that we just “don’t get” the flaws of the medical system when we live and breathe it every day. Like, personality disorder bizarre.

You find it bizarre because I'm right.

Keep in mind that the patient is the customer in the business of medicine. You get Press Ganey's right?

So don't preach to me when I'm merely telling you to look beyond your frustrations.

 

[Apollyon]

Please stop. Please. The moderator said to stop. This applies to you, too. Please stop. Stop.

 

[GonnaBeADoc2222]

You find it bizarre because I'm right.

Keep in mind that the patient is the customer in the business of medicine. You get Press Ganey's right?

So don't preach to me when I'm merely telling you to look beyond your frustrations.

Touts a public health background (a field highly reliant on pure data and statistical analysis) then throws the Press Gainey card, which we know generates poor data with a low n, and leads to worse patient outcomes.

Take your "business" elsewhere.

 

[AW125]

Touts a public health background (a field highly reliant on pure data and statistical analysis) then throws the Press Gainey card, which we know generates poor data with a low n, and leads to worse patient outcomes.

Take your "business" elsewhere.

Every physician, future and present, should have a background in public health. It helps you to understand who you are taking care of exactly. Are you familiar with the Social Determinants of Health? You have to understand those factors to understand your patient population and their behaviors.

My point with the Press Ganey is that at the end of the day, you have to make that patient happy or else it's your job on the line. So instead of criticizing the behaviors of your patient, try and figure out how to change their behavior. And like I said, that's a primary care problem. My point being is that what you are complaining about right now will not change any time soon.

 

[Boatswain2PA]

Do you have a public health background?

I have an MPH. And after practicing EM for 12 years I can tell you that the vast majority of the soft "science" that you learned in your public health classes is utter bull$hit.

Do we know what "social determinants of health are".....yeah, we live it. And thanks to recent changes, we have to document them.

I predict you work in government....

 

[AW125]

I have an MPH. And after practicing EM for 12 years I can tell you that the vast majority of the soft "science" that you learned in your public health classes is utter bull$hit.

Do we know what "social determinants of health are".....yeah, we live it. And thanks to recent changes, we have to document them.

I predict you work in government....

And how exactly is it not useful?

Why are you saying I work in government? I'm a student. Should I take this as a compliment?

 

[Apollyon]

Stop. Stop. Stop. Stop.

 

[gro2001]

Should I take this as a compliment?

No.

 

[Boatswain2PA]

And how exactly is it not useful?

Why are you saying I work in government? I'm a student. Should I take this as a compliment?

Public Health probably peaked in usefulness in the 1960s with the near eradication of polio. From John Snow to then, public health was generally always improving mankind's life. Since then there have been a few wins (unleaded gas), but mostly it has gone off the rails into unscientific sociological insanity that only seeks power and the almighty(tax) dollar.

Now it is used as a cudgel to impose exclusively political goals on segments of society. The worst of which was a recent pandemic which resulted in utterly asinine and useless new requirements (with brutal enforcement) for almost everyone.

And no....other than military, most people in the real world do not use the descriptor of "working in government" as a compliment.

 

[Boatswain2PA]

Mods - conversations go on tangents in real life and on internet. Nobody is flaming, and the original post can still be discussed. I ask that you allow our young public health student get a little more real life education.

 

[RustedFox]

This poster PM'ed me last night and asked some honest questions. I gave him honest answers. He asked more, but I was on shift. Everything was cool.

He's naive, yes. But he's playing by the rules.

Let him ask his questions. He's gotta learn too. Some of the answers will be impolite. That's fine.

 

[RustedFox]

And how exactly is it not useful?

Why are you saying I work in government? I'm a student. Should I take this as a compliment?

It's not useful because the short-sighted findings and recommendations that public health related "sciences" come up with commonly result in unfunded mandates that exacerbate the problem they're trying to solve, and are written by people who don't actually work seeing patients, boots-on-the-ground.

"Rules for thee, not for me."

 

[AW125]

Public Health probably peaked in usefulness in the 1960s with the near eradication of polio. From John Snow to then, public health was generally always improving mankind's life. Since then there have been a few wins (unleaded gas), but mostly it has gone off the rails into unscientific sociological insanity that only seeks power and the almighty(tax) dollar.

Now it is used as a cudgel to impose exclusively political goals on segments of society. The worst of which was a recent pandemic which resulted in utterly asinine and useless new requirements (with brutal enforcement) for almost everyone.

And no....other than military, most people in the real world do not use the descriptor of "working in government" as a compliment.

Well then going back to the topic of discussion, what solution do you propose for patients using services that they don't need?

My understanding of public health is different from yours in that I see it as public education and awareness...not politics.

At my school we are taught that fixing the problems in medicine today starts with primary care and I believe that if the patient is self-aware, they will know when to visit an ED, when to start taking care of themselves, and when to get a second opinion. Why do you feel that is an unreasonable goal to work towards?

I even said I agree that patients end up in the ED when they shouldn't be there but I'm saying it's not their fault.

 

[RustedFox]

Every physician, future and present, should have a background in public health. It helps you to understand who you are taking care of exactly. Are you familiar with the Social Determinants of Health? You have to understand those factors to understand your patient population and their behaviors.

We're all painfully aware of SDH. Radically, we can do nothing about it.
Their "behavior" is often entitled, abusive, and dangerous. These are the patients who will assault staff, complain to admin, and endanger our jobs.

My point with the Press Ganey is that at the end of the day, you have to make that patient happy or else it's your job on the line. So instead of criticizing the behaviors of your patient, try and figure out how to change their behavior. And like I said, that's a primary care problem. My point being is that what you are complaining about right now will not change any time soon.

Bro. Listen to me.
Press Ganey doesn't work the way you think it does. You've also never been Press-Ganey'ed.

@Rekt - remember your neurocritical peds resus where you saved the day, but it counted as a negative? Tell that story to the kid.

 

[RustedFox]

Well then going back to the topic of discussion, what solution do you propose for patients using services that they don't need?

My understanding of public health is different from yours in that I see it as public education and awareness...not politics.

At my school we are taught that fixing the problems in medicine today starts with primary care and I believe that if the patient is self-aware, they will know when to visit an ED, when to start taking care of themselves, and when to get a second opinion. Why do you feel that is an unreasonable goal to work towards?

I even said I agree that patients end up in the ED when they shouldn't be there but I'm saying it's not their fault.

Right here. There's your mistake.
The average ED user isn't self aware.
John Everyman fallacy.

I know, it's unpleasant to hear it - so you reject it as false. The average person can't possibly be that dumb and irresponsible, right?

You're wrong. They're far dumber and more irresponsible than you could imagine.

And now that irresponsibility is our liability.

 

[Boatswain2PA]

To come up with a solution means you have to identify the ACTUAL cause of the problem, which is the disconnect between the "customer" and the "payor". The further away the customer and the payor get, the worse the problem. This ties in with how health care is rationed (and it is ALWAYS rationed in some way), etc.

Want to fix the problem of inappropriate ED usage? Close the gap between the customer and payer. Insurance companies try to do this by imposing pre-authorizations, denials, etc. But then there is EMTALA, and other government forces that widen that gap.

Public education and awareness is only a small part of public health. And if you don't see how PUBLIC health is intertwined with politics then your professors have failed. The first thing Jon Snow did was implore the government to shut down the Broad Street well....that's public health.

Fixing the problems in medicine today goes much deeper than primary care. Entitlement, disassociation between patients & payors, generalized lack of education (not only of when to go to ED or PCM). A large percentage of our patients don't even understand that they should perhaps take tylenol if something hurts, or their kid has a fever, instead of running to the ED. There is a gross lack of coping skills in many patients who routinely use the ED.

Biggest problem is nobody places any responsibility, and therefore fault, on individuals anymore.

 

[AlmostAnMD]

I know, it's unpleasant to hear it - so you reject it as false. The average person can't possibly be that dumb and irresponsible, right?

You're wrong. They're far dumber and more irresponsible than you could imagine.

And now that irresponsibility is our liability.

That probably reads as really callous but this is a 100% true and irrefutable statement. I, too, entered medical school with the idea that people are reasonable like me and use the ED if there is an emergency. This could not have been further from the truth.

The average person is terrifyingly stupid. Given a list of choices for a good outcome or a simple path for success they'll stumble off it and make the worst possible decisions simply because they have the freedom to do so.

There is no real consequence to stupidity in this country. Lose your lob, lose your house, lose your spouse, but you will never be denied care in the ED for your bad decisions. And we will be 100% accountable when things go wrong despite the real problem starting often decades before our point of contact.

 

[AW125]

To come up with a solution means you have to identify the ACTUAL cause of the problem, which is the disconnect between the "customer" and the "payor". The further away the customer and the payor get, the worse the problem. This ties in with how health care is rationed (and it is ALWAYS rationed in some way), etc.

Want to fix the problem of inappropriate ED usage? Close the gap between the customer and payer. Insurance companies try to do this by imposing pre-authorizations, denials, etc. But then there is EMTALA, and other government forces that widen that gap.

Public education and awareness is only a small part of public health. And if you don't see how PUBLIC health is intertwined with politics then your professors have failed. The first thing Jon Snow did was implore the government to shut down the Broad Street well....that's public health.

Fixing the problems in medicine today goes much deeper than primary care. Entitlement, disassociation between patients & payors, generalized lack of education (not only of when to go to ED or PCM). A large percentage of our patients don't even understand that they should perhaps take tylenol if something hurts, or their kid has a fever, instead of running to the ED. There is a gross lack of coping skills in many patients who routinely use the ED.

Biggest problem is nobody places any responsibility, and therefore fault, on individuals anymore.

OK, I'll even agree with you that the average person is stupid and has the "education level of a 4th grader." (That's a professor quote)

I also get the politics behind this argument but I'd like to think that medicine and healthcare transcends politics in the end.

I just don't understand why you don't feel that the solution to this is at the source? The source being the first heatlhcare encounter that any patient has and that is with some type of primary care provider. I'm arguing it is their responsibility to help the patient "navigate" through the healthcare system.

If you don't educate that patient today, they will continue doing what they are doing. For example, if the primary care provider does not want to listen to each concern the patient has, the patient will see them for 1 concern and then go to the ED for the other. And that is what you are saying is the problem with your work.

 

[Boatswain2PA]

Nothing transcends politics when there is massive amounts of money involved. Money = power, and power corrupts. Just look at the debacle with the recent pandemic where OUR TAX MONEY likely created the little bug. Crazy.

The source of the solution is our poorly educated patient population. How do we fix that? Throw more money at schools? Doesn't seem to work.

As to giving patients "education" in the ED - that typically results in poor Press Ganey scores, which idjits in administration/government/public health place so much credence in.

I can (and do) tell patients to stop doing meth all day long. They won't stop what they are doing.

The problem with PCMs seeing patients for only ONE complaint at a time goes back to the disconnect between patients and payors. CMS/insurance pays PCMs poorly per visit, so PCMs only have TIME for one complaint.

 

[AW125]

That probably reads as really callous but this is a 100% true and irrefutable statement. I, too, entered medical school with the idea that people are reasonable like me and use the ED if there is an emergency. This could not have been further from the truth.

The average person is terrifyingly stupid. Given a list of choices for a good outcome or a simple path for success they'll stumble off it and make the worst possible decisions simply because they have the freedom to do so.

There is no real consequence to stupidity in this country. Lose your lob, lose your house, lose your spouse, but you will never be denied care in the ED for your bad decisions. And we will be 100% accountable when things go wrong despite the real problem starting often decades before our point of contact.

Are you talking about patient compliance or life decisions?

I can understand frustrations with patient compliance but how can you have any control over the patients that you choose to see?

If you raise healthcare prices then maybe you can filter out the frequent fliers but is that ethical? I'm not really political but we did study the healthcare is a privilege/choice debate and our program made the convincing argument that it is indeed a privilege but at the same time the ED doors have to be open to everyone and it is accepted that everyone in our society has their own story.

 

[RustedFox]

OK, I'll even agree with you that the average person is stupid and has the "education level of a 4th grader." (That's a professor quote)

Yes. (Insert chadface meme here).

I also get the politics behind this argument but I'd like to think that medicine and healthcare transcends politics in the end.

This statement shows that you know nothing.

I just don't understand why you don't feel that the solution to this is at the source? The source being the first heatlhcare encounter that any patient has and that is with some type of primary care provider. I'm arguing it is their responsibility to help the patient "navigate" through the healthcare system.

Why go thru the trouble of finding a PCP, making an appointment, getting to that appointment, waiting for the doc, and being disappointed when you don't get what you want immediately when you can just show up at the ER anytime for free and demand things.

If you don't educate that patient today, they will continue doing what they are doing. For example, if the primary care provider does not want to listen to each concern the patient has, the patient will see them for 1 concern and then go to the ED for the other. And that is what you are saying is the problem with your work.

Patient: "Thanks for the education. I'll listen to and understand none of it because I'm a child. I'm off to the ER to make unreasonable demands and break that system next."

 

[hoot504]

Honestly guys, this person is not worth anyone's time. I'm all for educating the youngins but this person is so hugely removed from most of ours typical day-to-day that I think a conversation is pretty much pointless.

 

[AW125]

Yes. (Insert chadface meme here).



This statement shows that you know nothing.



Why go thru the trouble of finding a PCP, making an appointment, getting to that appointment, waiting for the doc, and being disappointed when you don't get what you want immediately when you can just show up at the ER anytime for free and demand things.



Patient: "Thanks for the education. I'll listen to and understand none of it because I'm a child. I'm off to the ER to make unreasonable demands and break that system next."

I don't think it's that bad. If it were, somebody in the higher ups would do something.

I've worked in an ED and I've observed what you are saying but not to the degree that you are describing.

You make it seem like patients want to be in the ED. Who wants to be anywhere near a hospital if they don't need to be?

 

[gruemd]

I don't think it's that bad. If it were, somebody in the higher ups would do something.

I've worked in an ED and I've observed what you are saying but not to the degree that you are describing.

You make it seem like patients want to be in the ED. Who wants to be anywhere near a hospital if they don't need to be?

If you've worked in an ED it isn't for long enough, or directly enough with patients. There are many patients who absolutely want to be here/in the hospital. I have one right now I'm trying to discharge.

I can sense from your questions that your intentions seem pure enough. But I can also tell that you are still at the point in your education where your thoughts are not fully your own, they are an amalgam of your professors and your limited life experience. Consider this: If all of these problems were simply solved by "More PCPs!" or "Higher ups would fix this if it was that bad!" then those things wouldn't be problems because they would be fixed by now. Your ideas aren't unique or special, and I say that without any ire, it's a hard lesson to learn in the transition from theory to practice. Books are easy, lectures are easy, and ideas there seem simple, and make sense. Real life is messy and complicated and absolutely entirely entwined with politics and money and greed and laziness. Sure, shoot for the stars with pie in the sky ideas, someone has to do it, but going about it this way with those that are boots on the ground is not the way, even just as an academic discussion.

 

[RustedFox]

I don't think it's that bad. If it were, somebody in the higher ups would do something.

I've worked in an ED and I've observed what you are saying but not to the degree that you are describing.

You make it seem like patients want to be in the ED. Who wants to be anywhere near a hospital if they don't need to be?

1. (Bolded). Oh my God, bro. The higher ups have done and will do absolutely nothing. Hard stop. 15 years I've been an ER doc. It has gotten worse every year, and the "higher ups" only make the problems worse.

2. You're worked in an ED? Cute. You were a tourist. I spent a week in Spain. Let me tell them what they need to do to fix what I didn't understand.

3. BWAHAHA. Who wants to be in a hospital if they don't need to be? Let's see...

Seniors who don't like their nursing home.

Nursing homes who don't like their seniors.

The homeless that have gotten kicked out of every shelter for being asshats.

People who want work notes.

People who want narcotics.

People who want turkey sandwiches.

People who can't cope with simple life stressors.

People avoiding obligations.

People who want validation and attention for their psychiatric or non-existent conditions.

People who don't want to wait for a PCP appointment.

People that have been fired by their PCPs and subspecialists.

People that have been fired by several PCPs and subspecialists.


The list goes on.

These people are dangerous. They're the ones who will imperil your career.

Get. Out. Of. My. ER.

 

[hoot504]

I don't think it's that bad. If it were, somebody in the higher ups would do something.

I've worked in an ED and I've observed what you are saying but not to the degree that you are describing.

You make it seem like patients want to be in the ED. Who wants to be anywhere near a hospital if they don't need to be?

This may be the funniest post I've ever seen on this forum.

 

[RustedFox]

I don't think it's that bad. If it were, somebody in the higher ups would do something.

I've worked in an ED and I've observed what you are saying but not to the degree that you are describing.

You make it seem like patients want to be in the ED. Who wants to be anywhere near a hospital if they don't need to be?

Your PM reply to mine last night was thoughtful and revealing. I'll get back to you tonight on shift.

@ everyone else. He's misguided, but he's trying to understand. Mods; let us cook.

 

[RustedFox]

Honestly guys, this person is not worth anyone's time. I'm all for educating the youngins but this person is so hugely removed from most of ours typical day-to-day that I think a conversation is pretty much pointless.

No, no, no.. let him cook.
His PM to me last night was rather thoughtful. He's struggling to learn a few things right now and (like we did) is inclined to reject the unpleasant parts.

 

[gruemd]

No, no, no.. let him cook.
His PM to me last night was rather thoughtful. He's struggling to learn a few things right now and (like we did) is inclined to reject the unpleasant parts.

Have you been watching more Breaking Bad recently or something? 😆

 

[Apollyon]

No, no, no.. let him cook.
His PM to me last night was rather thoughtful. He's struggling to learn a few things right now and (like we did) is inclined to reject the unpleasant parts.

You've mentioned the PM 3 times.

In any case, dude is outie.

 

[hoot504]

No, no, no.. let him cook.
His PM to me last night was rather thoughtful. He's struggling to learn a few things right now and (like we did) is inclined to reject the unpleasant parts.

Arguing with people who clearly have far more experience and knowledge than you isn't thoughtful. I didn't wander over here when I was a pre-med. Like someone earlier said, it speaks to more of a personality issue.

 

[RustedFox]

Arguing with people who clearly have far more experience and knowledge than you isn't thoughtful. I didn't wander over here when I was a pre-med. Like someone earlier said, it speaks to more of a personality issue.

Bro. Did you argue with your attending when you didn't understand something and didn't like it as a student or resident? Most of us did.

 

[smq123]

Arguing with people who clearly have far more experience and knowledge than you isn't thoughtful. I didn't wander over here when I was a pre-med. Like someone earlier said, it speaks to more of a personality issue.

I was the perfect mom before I actually had kids, and I was also the perfect physician before I started med school. I agree it's not thoughtful to argue with someone who has more experience, but I think it's incredibly common - maybe it's human nature? The internet letting us all think that we know more than we really do?

(P.S. I had nothing to do with him being banned, so don't come at me.)

 

[greatnt249]

Why go thru the trouble of finding a PCP, making an appointment, getting to that appointment, waiting for the doc, and being disappointed when you don't get what you want immediately when you can just show up at the ER anytime for free and demand things.

Apparently we have a whole generation who won't go out to restaurants because they're too anxious to call and make a reservation, so it might not actually be very far off that people go to the ED because it's "less hassle" than having a phone conversation.

 

[hoot504]

Bro. Did you argue with your attending when you didn't understand something and didn't like it as a student or resident? Most of us did.

Much smaller gap there homie.

 

[HemorrhagicShock]

TING, OR I SWEAR I AM TURNING THIS CAR AROUND.

(My husband jokes that 90% of the reason that he wanted to have kids is so that he could say this.).

But in all seriousness - can we stop lecturing the posters here on what they should, or should not, be doing in their professional lives? And can we stop making assumptions about the experience level of people posting here?

Agreed fully!

I routinely tell people that time during the pandemic was the peak joy of my career. Our reputation amongst lay people skyrocketed, the rest of the house of medicine actually respected us for once, the patient load was truly only emergencies, and being on shift was chill AF. No visitors made patient interactions very fruitful and meaningful. And they were ALWAYS appreciative.

I miss those days dearly (despite at the time also having that lingering thought that I might die from an unknown virus... which speaks volumes about how bad EM has gotten now that I desire to go back to the days when I potentially had a real increased chance of dying on shift)