Incorrect statements about EM

[cooldreams]

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Of course. But that has nothing to do with the manner in which people were posting in here. But what do I know? The ED docs are CLEARLY mature.

the first post that you replied to does not seem to be outlandish to me. could you be more specific than this :

Intellectually challenging is relative.
Ask a general surgeon to reduce a shoulder...painlessly.
Ask a internest to run a trauma.
Ask a pediatrician to treat a 20 year old.
Ask a trauma doc to treat heart failure.

I do all of that.

What I want in my profession is to make money, enjoy life, enjoy my family, and WANT to come back to work.
If I wanted that was "intellectually challenging" EVERY SINGLE DAY and never got easier I would be a professional crossword puzzler. Now that can be some hard ****e.

to which you replied:

If you knew how to "treat" all that stuff, you wouldn't be calling so many frickin' consults, now, would you?

he didnt say he completely over saw the entire "treatment" of these... if he did, he wouldnt have time to do them all.

also consider, the point of his post was not really even about what ED docs do, but rather about what someone wanted in their profession.

this is the post you started in on this thread with. what is your specific gripe?


further to the point i believe, surgeons do not perform anethis, rehab, self image issues. heart surgeon doesnt perform brain surgery, etc etc. we all do different parts. what is the problem??

 

[kinetic]

Really? You see nothing wrong with that post? Oh, well! He should try going up to any of those physicians and saying it.

 

[questionguy]

the first post that you replied to does not seem to be outlandish to me. could you be more specific than this :

to which you replied:

he didnt say he completely over saw the entire "treatment" of these... if he did, he wouldnt have time to do them all.

also consider, the point of his post was not really even about what ED docs do, but rather about what someone wanted in their profession.

this is the post you started in on this thread with. what is your specific gripe?


further to the point i believe, surgeons do not perform anethis, rehab, self image issues. heart surgeon doesnt perform brain surgery, etc etc. we all do different parts. what is the problem??

Don't you see that you are being entirely too reasonable? He was unable to reply with this with more than just 1 line and the standard ( ) b/c he has no intentions of actually debating the merits of what was said in this thread; instead he is demonstrating his beleaguered ignorance with every flame-inducing post. It is pointless to attempt to reason with an individual whose modus operandi is solely to incite a negative reaction to his irritating banalities.

 

[cooldreams]

Really? You see nothing wrong with that post? Oh, well! He should try going up to any of those physicians and saying it.

i dont think he was saying they couldnt do those things, just that the way they would treat would be intellectually stimulating to them.

say you are a programmer. you are told to program this genetic algorithm, and make it look nice, gui and all... no prob... a few hrs l8r you are done. whats next?

well the program was for an rf engineer trying to develop a new sophisticated band pass filter to use with brain waves or something. in getting the program, the rf engineer may think about the coding in great detail, different ways to get the computer to perform various functions to get the greatest possible output most exactly precisely what he wants. an art.

the programmer was happy with the work he did, but to him was pretty routine. to the rf it was something he would later base research off of.

a similar end point was reached by both, but to one it was an art, that they would devote a great deal of concentration to while the other would work to get the task done and move on to something else. what docwagner stated above seems perfectly reasonable to me....

 

[kinetic]

Summary of questionguy's post: I don't like the way reality gets in the way of my imagination.

 

[questionguy]

Summary of questionguy's post: I don't like the way reality gets in the way of my imagination.

This proves what I was attempting to demonstrate very nicely I do believe.

 

[kinetic]

This proves what I was attempting to demonstrate very nicely I do believe.

Same here.

 

[cooldreams]

Summary of questionguy's post: I don't like the way reality gets in the way of my imagination.

well i guess you are trying to develop a quoted quote for yourself here. but you are protraying you, yourself, to be quite unreasonable and wrong. i thought even trolls had more sense than that?... i guess you just enjoy in trying to make everyone look bad, including yourself?? 😕

i take my leave of this conversation with you.... it has dead ended.... im sure you will get the last word in though, so, congrats......... 🙄

 

[kinetic]

but you are protraying you, yourself, to be quite unreasonable and wrong. i thought even trolls had more sense than that?... i guess you just enjoy in trying to make everyone look bad, including yourself?? 😕

Actually, I believe the title of this thread is quite precise.

 

[questionguy]

What Kinetic has contributed to this thread---->

If you knew how to "treat" all that stuff, you wouldn't be calling so many frickin' consults, now, would you?

I know; and the cleverly done incomplete workups are also for the same purpose.

OMG! Wow, let's get rid of the cardiologists! Make way for you!

Wow, so you mean ED docs CAN'T take care of all patients, unlike the other specialties?! OMG!! Thanks for reaching the same conclusion as me, but like ten posts too late!!

P.S. I don't know why you're so proud about "activating" a cath lab that you wanted to explicitly mention it twice.

Yes, that's right: the ED knows the diagnosis and how to treat said diagnosis; the other teams are basically just there to enact their plans for the patient, which, did I mention, they already knew. You guys crack me up.

WAH HA HA HA! "Oh, man, why won't everyone recognize that I know and do it all as an ED doc? They must be too busy writing "cardiac diet" on the order sheet!" Please post more!

And yet it accomplished the task at hand.

How were they out of context? Because you didn't like the way they sounded? Also, note that I provided a link to the thread. SUCKAHS!

OMG! You're right! I'm immature ...so that caused YOU guys to say all those things! Now I've seen the light!

WAH HA HA HA! Now come the rips on post count! Aw, don't like how bad you guys sound, so the answer is to start talking about post count. Aww.

PWNAGE!

Of course. But that has nothing to do with the manner in which people were posting in here. But what do I know? The ED docs are CLEARLY mature.

Actually, I believe the title of this thread is quite precise

There are a whole ton of missing.

So now that we see he has posted not 1 thing of substance, can we please not feed the very unemployed troll?

 

[kinetic]

No, no, please continue demonstrating what maturity is all about! That plus ringing your own bells.

 

[Uncle Rico]

Why does anyone care what some residency fail-out has to say? Let's leave him alone, and maybe we'll hire him as one of our nurses in the coming years.

 

[questionguy]

Why does anyone care what some residency fail-out has to say? Let's leave him alone, and maybe we'll hire him as one of our nurses in the coming years.

👍

 

[kinetic]

Why does anyone care what some residency fail-out has to say? Let's leave him alone, and maybe we'll hire him as one of our nurses in the coming years.

WAH HA HA HA! That'd be great in the Nursing forums! Oh, wait ...I caused you to post that, right? HA HA HA!

 

[kinetic]

👍

After ripping on smileys ... So smart! 👍

 

[ERMudPhud]

Slightly less than a year ago Kinetic appeared here with this his very first post.

http://forums.studentdoctor.net/showthread.php?t=110312

Thus establishing his somewhat biased view of EM

It appeared that he had recently been fired from his residency because of conflicts with the emergency department. This despite the fact that most EM departments don't even have the power to get a janitor fired much less another departments residents. Judging from his behaivior here you have to wonder if his firing had more to do with a general inability to get along with anyone.

He now appears to be applying for the surgical match and come match day will hopefully match somewhere and become too busy for SDN. In the meantime he has kept busy accumulating something in excess of 10,000 posts despite being repeatedly banned or on probation. He mostly lives in the lounge forum but sometimes surfaces in the rest of SDN to cause trouble (look at his recent spamming ban as an example)

http://forums.studentdoctor.net/showthread.php?t=176974

His post count would be even higher if not for long periods when he is denied access to what appears to be his only means of social interaction-SDN.

Despite all this he is sometimes good for a laugh if for nothing else just to see what he has done recently to get banned or who he is currently pissing off. Just don't bother taking anything he says seriously or trying to debate with him. It is often easier to add him to you kill file and then just go looking for his posts when you need a laugh.

 

[kinetic]

I never claimed I had an unbiased view of the ED; however, it's pathetic that you're hiding behind that, since it had nothing to do with the posts coming from you awesome awesome ED docs. But nobody accused you of being logical.

 

[Jeff698]

His post count would be even higher if not for long periods when he is denied access to what appears to be his only means of social interaction-SDN.

Don't they have 900 numbers or web sites for that?

Actually, he's a pretty good troll. I mean, if you're gonna go through the trouble of doing something, ya might as well do it right.

Take care,
Jeff

 

[kinetic]

Absolutely. 👍

 

[Febrifuge]

... It is often easier to add him to you kill file and then just go looking for his posts when you need a laugh.

That's a good question: how does one put a particular user on "Ignore" on SDN?

 

[Siggy]

User cp (top right of any page on the tool bar) - Buddy / Ignore Lists (2nd to last on the right menu in Miscellaneous) - add name - hit ignore

 

[DrMom]

That's a good question: how does one put a particular user on "Ignore" on SDN?

click on the username & then view public profile. When you get to the new page, there's a an option to add user to your ignore list...kinda in the middle of the page.

 

[cooldreams]

That's a good question: how does one put a particular user on "Ignore" on SDN?

r u a gurl? for some reason i always pictured you as a guy hahaha

 

[docB]

Holy cow! What a degenerated mess. This was a good thread until this morning. Hmm.... what happened this morning?

 

[Febrifuge]

click on the username & then view public profile. When you get to the new page, there's a an option to add user to your ignore list...kinda in the middle of the page.

Thank you; very handy info.

Here's an EM-related thought: the 'Ignore' list is sort of like the message-board version of a hip full o' Haldol for those "challenging" patients.

 

[sydney_ne]

Holy cow! What a degenerated mess. This was a good thread until this morning. Hmm.... what happened this morning?

As the OP of this thread, I definitely agree. Thanks to ERMudPhud, roja, jazz, DocB, NinerNiner999, and a few others for the great replies.

To some of the others (both EM supporters and detractors), I'm sure that a lot of what you have to say is valid. But I'd appreciate it if you stick to the OP and to please be considerate of what I said in my OP.

My post is not meant to troll. And my comments are limited by the fact that I'm a medical student, and still learning. I just wanted to play devil's advocate and vet some of these statements. Please don't flame me or anyone else who replies.

I'd like to restate 2 issues from the beginning of this thread, in the hope that they will stimulate more comments.

1. There's more flexibility in EM because of shift work. But it seems to come at a price that isn't always considered. The same system that provides you with flexibility also limits your autonomy. The EM doc working in an ER is an employee where corporate profit, seniority, shift equity, and political issues can all be abused. Also, the EM doc has to work with staff that he/she did not hire, can not evaluate, and can not fire. To some extent, this is true of other specialties (surgeons work with OR staff they did not hire), and any doc can work as an employee (such as for Kaiser). But it seems to be more of an issue in EM, because you don't have a choice of practice options. Any thoughts about this problem or about alternative practice options outside the ED?
   
2. I'd love to hear from other residents or attendings about research opportunities they have had in EM.

Thanks!

 

[jazz]

my goal is not to feed the ridiculousness that kinetic started but ....

i saw that you posted my response in the different forums. my point was to explain to the OP why we (EM physicians) like our field and find it challenging and cerebral. i fully realize that there is a need for every speciality as i would not enjoy being an internist, pediatrician, surgeon, dermatologist, etc. as emergency physicians, we value the services of our subspecialists and admitting services.

i don't know what field you are in kinetic. but i assume that one day you will be done with training and will actually have to work with emergency physicians and rely on your emergency attendings as well as internists and primary care physicians to refer patients and cases to you. i can tell you that if i had to deal with you in the community and there was another specialist in the same field, i would refer to the other individual.

to sydney_ne, i'm glad that you found our viewpoints helpful and hope that we were able to demonstrate how challenging and exciting emergency medicine is. unfortunately, as you can tell by how this forum has degenerated, that we are often an underappreciated field and you're right to realize that there are often incorrect statements made about emergency medicine

 

[ERMudPhud]

The same system that provides you with flexibility also limits your autonomy.

[*]I'd love to hear from other residents or attendings about research opportunities they have had in EM.[/list]

Thanks!

As I said before the practice opportunities for EM are much like any other specialty with the exception of solo private practice-a vanishing model anyway. I know of a number of small groups that staff single EDs. They essentlally have a small group practice that owns the contract for their hospital.The politics of such a group are no different than they would be for a group of FP's or surgeons or whatever. You can be a hospital or HMO employee like all the other physicians in the HMO. You can be an employee of an academic medical center and be no different from the surgeons, internist etc.. employed by that center. You can also be employed be a big corporation that staffs hundreds of ED's. It up to you and depends on what you want and where you want to live.

Research in EM is wide open since the field touches on so many aspects of medicine and has so few established researchers. To see examples of really good clinical research look at the recent Rivers article on goal directed therapy in sepsis in NEJM. For basic science it is mostly either toxicology or ischemia/reperfusion injury. There is good work being done at Wayne State, Thomas Jefferson, U Penn and a few others. As an alternative you can decide like I did that the basic science that interests you has no real clinical correlation and wander off doing whatever interests you while still working part time in the ED doing the clinical work you enjoy. I work 4 nights a month in the ED and spend the rest at the bench.

 

[kungfufishing]

[[*]There's more flexibility in EM because of shift work. But it seems to come at a price that isn't always considered. The same system that provides you with flexibility also limits your autonomy. [/QUOTE]

I actually perceive this "lack of autonomy" as an opportunity. One of the many perks to EM is that I dont have to be involved as much with the small business/practice building/management aspects of medicine. I dont want to mess with any of that stuff, or at least not more than I have to. The idea that within EM there are jobs available where I show up, doctor for 8-9 hours, and go home is at least presently very appealing.

 

[Jeff698]

No joke, Febrifuge!

Wouldn't it be great if you could just order a bolus of "ignore the fool", STAT?

Take care,
Jeff

 

[roja]

There are definately lots of research opportunities. I am not into bench research but I have already done one clinical research project (retrospective) and am working on two research projects (working on the IRB's) of my own, plus I am working on two other prospective randomized trials.

Residents here have also done research, clinical and bench.

You can also do research fellowship which usually is two years and involves getting an MPH.

In regards to your other point, The day is gone when an MD Although my father is in a solo practice as a surgeon, he has to deal with not just OR staff but hospital privlages etc. There is almost no job in medicine where someone has control over you. There are definately negatives to this but there are also positives.

Its wise to be aware of the practice environ that you are going into. As has been said before, you can go corporate, you can go into a democratic group or you can go academic. There is a lot of flexibility in how you structure your career.

Best of luck to you.