Jet's Random Thoughts About Today At Work

[jetproppilot]

---

Members don't see this ad.

A dedicated holding room nurse would drastically increase my efficiency.

I love working with orthopedists who appreciate a motivated physician consultant (me) who enables them to leave the hospital two hours earlier than normal after a busy day of total joints.

Combined spinal/epidurals are the bomb for total joints.

An efficient, motivated circulating RN is worth her weight in gold.

Conflict that is addressed with concern, humor, and enthusiasm goes away quickly.

Even though she's 5'2" and about a buck-five, my S.O. is a badass surgeon. Fifteen minute lap appys? Twenty-five minute lap-hernias? Forty-five minute colon resections? She does this. Routinely. WOW. She rates as a rokkstar.

The neurosurgeons at my facility are rokkstars. Had I to do it all over again, I would consider enduring the grueling neurosurgery residency in order to enjoy a seven figure salary doing an exclusive spine practice.

I am a part of an anesthesia group that, as a whole, is great. We have no weak-link physicians.

I like working with all of our CRNAs.

Of the few whining surgeons I work with, I could easily kick their ass. Blindfolded. With one hand tied behind my back. The whiney ones are below average in their specialty. All but one.....an older heart surgeon......who is a dick.....but knows how to operate.....but I could still kick his ass. Somehow that stupid, meaningless, totally irrelevant fact that they are out of shape with protruding stomachs and biceps the size of my four-year-olds helps me accept their whineyness. Stupid? Yes. Helpful? Yes. I'd love to invite them to the squat rack with four plates on each side when they start with their whineyness someday....and tell them yes, I'm concerned about what you are whining about, but unless your scrotum hits the floor with that 405 on your back it doesnt count.....

I work in an OR where, as a whole, everyone gets along and humor amongst everyone makes the day go by quicker.

I eat alotta food, albeit healthy food. Today I brought four packages of fat free turkey and four yogurts. It amuses my peers. They make fun of me. It makes me, and them, laugh.

Being able to have fun at work is a commodity without a price tag.

GEEZ! Just looked at the direct deposit into my account. Even though I took a
one third paycut from previous gig, I'm still very well compensated. I have no monetary complaints.

I was on late call today and therefore worked my ass off. I still left the hospital in a good mood.

I enjoy a great relationship with many non-surgical colleagues who are eager to help me with problems, both personal and professional.

Being responsible for all central lines in the hospital sucks. But then again, I think back to the rather large direct deposit....

I'm on second call tonite. I have my kids. I have no babysitter to call if I get called in. I have a colleague who said to call her if I need her to watch my kids if I get called in. I am grateful for that.

The friendly relationship between MDs and CRNAs in my group, free of political
agendas, is priceless.

The Chief of my department is not afraid to stand up under pressure. For that I am grateful.

I am the neurosurgery anesthesia liason (sp?). I invest some time in communicating with the chief of neurosurgery at our hospital. He's a big dude who has intimidated many. Its amazing how a little active listening and alotta anesthesia deftness can go a long way at satisfying our surgical colleagues. Dude invited me to a Hornets game. To sit in his club-level seats. Drinks are served.

It was 45 degrees and raining when I got to work today at 0620. I wish my monster truck fit into the covered doctors parking lot.

Overall, I am grateful. I've been doing this gig eleven years now. I still wake up before the alarm goes off. And I'm having fun at work.

 

[Gimlet]

I could have used your S.O. the other day during the 2.5 hour lap chole I was stuck in with a notoriously slow attending.

It's nice that you get along with your non-surgical staff and the circulating RNs. I hope I'm in an environment someday where all the scrub techs and circulating nurses aren't total douchebag bitches.

When I got in my truck this morning at 0600, it was -4 and snowing. Definitely wishing the the hospital would give us med students access to the parking garage instead of making us park over at school and walk the half-mile to the hospital.

 

[coprolalia]

A very wise attending, who was a recovered addict still practicing anesthesia, once told me that the key to having a good life - absolutely requisite - can be found in only four things:

(1) having someone to love (emotional purpose, physical, intimacy, security)
(2) having a meaningful job (daily purpose, financial, professional fulfillment)
(3) having hope for the future (lifelong purpose, meaning)
(4) having ability to remain circumspect (humor, "big picture", not taking self too seriously)

I think people get depressed because, like missing one of the four corners of a solid foundation, things fall down when one of these isn't there. People turn to something else, less wholesome and fulfilling and even potentially dangerous (like drugs, extramarital affairs, etc.) to make up for one of these things when they are missing.

I asked this mentor about (1), which can be hard to find. He told me that it doesn't matter if the person loves you back the same way. What's important is that you love them and show it, that's enough.

-copro

 

[Planktonmd]

Great post Jet, Thank you.

 

[cfdavid]

Hey Jet, you said you're responsible (i assume your group) for all central lines.

Is this becoming more common? That is, having "proceduralists" do this stuff?

I've heard talk about a new specialty of proceduralists (NO idea how far along this is, if at all), but if anes is filling this gap, perhaps this is another little niche service that anes could do (and in your case, are doing) to fullfill a need. This seems like an overall positive from that perspective.

Thought?

 

[jetproppilot]

Hey Jet, you said you're responsible (i assume your group) for all central lines.

Is this becoming more common? That is, having "proceduralists" do this stuff?

I've heard talk about a new specialty of proceduralists (NO idea how far along this is, if at all), but if anes is filling this gap, perhaps this is another little niche service that anes could do (and in your case, are doing) to fullfill a need. This seems like an overall positive from that perspective.

Thought?

This is my 3rd pp gig in 11 years, CF. And the first one where anesthesia does most or all central lines. I dont know how widespread it is. I know the reimbursement doesnt justify the time if you are being called in only to place the line.

Like I said above, though, I'm happy at work and happy with my reimbursement. So being unhappy about line placement is a small issue I dont worry about. I just do it.

 

[jetproppilot]

A very wise attending, who was a recovered addict still practicing anesthesia, once told me that the key to having a good life - absolutely requisite - can be found in only four things:

(1) having someone to love (emotional purpose, physical, intimacy, security)
(2) having a meaningful job (daily purpose, financial, professional fulfillment)
(3) having hope for the future (lifelong purpose, meaning)
(4) having ability to remain circumspect (humor, "big picture", not taking self too seriously)

I think people get depressed because, like missing one of the four corners of a solid foundation, things fall down when one of these isn't there. People turn to something else, less wholesome and fulfilling and even potentially dangerous (like drugs, extramarital affairs, etc.) to make up for one of these things when they are missing.

I asked this mentor about (1), which can be hard to find. He told me that it doesn't matter if the person loves you back the same way. What's important is that you love them and show it, that's enough.

-copro

Thanks for sharing this very wise info, Cop.

 

[coprolalia]

I've heard talk about a new specialty of proceduralists (NO idea how far along this is, if at all), but if anes is filling this gap, perhaps this is another little niche service that anes could do (and in your case, are doing) to fullfill a need.

Yeah, I've heard about this too. Basically, from the reports I've heard where this job is offered, you are employed by the hospital, it is shift work, and you don't get a whole lot of cash (like $150-180K). The upside is that it is shift work and you are indemnified by the hospital. The job I heard about includes things like placing central lines, intubations, bedside changing of VAC dressings, bronchoscopies for BAL, etc. and it's not a fee-for-service but instead a salaried position. So, there's no real incentive to be efficient.

But, this is just one job description. I'm sure there are others. It seems like, based on our skill set, we're the ideal profession to fulfill this type of job.

-copro

 

[Planktonmd]

Yeah, I've heard about this too. Basically, from the reports I've heard where this job is offered, you are employed by the hospital, it is shift work, and you don't get a whole lot of cash (like $150-180K). The upside is that it is shift work and you are indemnified by the hospital. The job I heard about includes things like placing central lines, intubations, bedside changing of VAC dressings, bronchoscopies for BAL, etc. and it's not a fee-for-service but instead a salaried position. So, there's no real incentive to be efficient.

But, this is just one job description. I'm sure there are others. It seems like, based on our skill set, we're the ideal profession to fulfill this type of job.

-copro

This sounds more like a job for a PA not a Physician.

 

[cfdavid]

This sounds more like a job for a PA not a Physician.

Yeah, I honestly can't remember where I read about this proposed specialty, but it seems that it wouldn't be something many would want to do all day, unless there was more clinical skill/knowledge required in the job description. I think the arguement was to have specialists do some of the higher risk procedures to limit liability, which in and of itself is not a bad idea. Who knows.

 

[johankriek]

A dedicated holding room nurse would drastically increase my efficiency.

I love working with orthopedists who appreciate a motivated physician consultant (me) who enables them to leave the hospital two hours earlier than normal after a busy day of total joints.

Combined spinal/epidurals are the bomb for total joints.

An efficient, motivated circulating RN is worth her weight in gold.

Conflict that is addressed with concern, humor, and enthusiasm goes away quickly.

Even though she's 5'2" and about a buck-five, my S.O. is a badass surgeon. Fifteen minute lap appys? Twenty-five minute lap-hernias? Forty-five minute colon resections? She does this. Routinely. WOW. She rates as a rokkstar.

The neurosurgeons at my facility are rokkstars. Had I to do it all over again, I would consider enduring the grueling neurosurgery residency in order to enjoy a seven figure salary doing an exclusive spine practice.

I am a part of an anesthesia group that, as a whole, is great. We have no weak-link physicians.

I like working with all of our CRNAs.

Of the few whining surgeons I work with, I could easily kick their ass. Blindfolded. With one hand tied behind my back. The whiney ones are below average in their specialty. All but one.....an older heart surgeon......who is a dick.....but knows how to operate.....but I could still kick his ass. Somehow that stupid, meaningless, totally irrelevant fact that they are out of shape with protruding stomachs and biceps the size of my four-year-olds helps me accept their whineyness. Stupid? Yes. Helpful? Yes. I'd love to invite them to the squat rack with four plates on each side when they start with their whineyness someday....and tell them yes, I'm concerned about what you are whining about, but unless your scrotum hits the floor with that 405 on your back it doesnt count.....

I work in an OR where, as a whole, everyone gets along and humor amongst everyone makes the day go by quicker.

I eat alotta food, albeit healthy food. Today I brought four packages of fat free turkey and four yogurts. It amuses my peers. They make fun of me. It makes me, and them, laugh.

Being able to have fun at work is a commodity without a price tag.

GEEZ! Just looked at the direct deposit into my account. Even though I took a
one third paycut from previous gig, I'm still very well compensated. I have no monetary complaints.

I was on late call today and therefore worked my ass off. I still left the hospital in a good mood.

I enjoy a great relationship with many non-surgical colleagues who are eager to help me with problems, both personal and professional.

Being responsible for all central lines in the hospital sucks. But then again, I think back to the rather large direct deposit....

I'm on second call tonite. I have my kids. I have no babysitter to call if I get called in. I have a colleague who said to call her if I need her to watch my kids if I get called in. I am grateful for that.

The friendly relationship between MDs and CRNAs in my group, free of political
agendas, is priceless.

The Chief of my department is not afraid to stand up under pressure. For that I am grateful.

I am the neurosurgery anesthesia liason (sp?). I invest some time in communicating with the chief of neurosurgery at our hospital. He's a big dude who has intimidated many. Its amazing how a little active listening and alotta anesthesia deftness can go a long way at satisfying our surgical colleagues. Dude invited me to a Hornets game. To sit in his club-level seats. Drinks are served.

It was 45 degrees and raining when I got to work today at 0620. I wish my monster truck fit into the covered doctors parking lot.

Overall, I am grateful. I've been doing this gig eleven years now. I still wake up before the alarm goes off. And I'm having fun at work.

sounds like you are gettin chumped out if you are not making at least half a mil.. minimum for ajob like this.. no hornet tickets or me banging any nurse in the or will make up for this.

 

[jetproppilot]

sounds like you are gettin chumped out if you are not making at least half a mil.. minimum for ajob like this.. no hornet tickets or me banging any nurse in the or will make up for this.

Nah, Johan, no chump here.

Money isnt my primary driving force.

Usta be.

I don't have to make a half mil anymore.

I've gotta f u k you account, remember?

So I'll take my job with the good income, comfortable environment, plenty of vacation, plenty early days so I'm involved in my kids lives.

As long as I feel comfortable with my reimbursement and job position, it doesnt really matter what you think.

 

[coprolalia]

Nah, Johan, no chump here.

Money isnt my primary driving force.

Usta be.

I don't have to make a half mil anymore.

I've gotta f u k you account, remember?

So I'll take my job with the good income, comfortable environment, plenty of vacation, plenty early days so I'm involved in my kids lives.

As long as I feel comfortable with my reimbursement and job position, it doesnt really matter what you think.

👍🙂

-copro

 

[johankriek]

Nah, Johan, no chump here.

Money isnt my primary driving force.

Usta be.

I don't have to make a half mil anymore.

I've gotta f u k you account, remember?

So I'll take my job with the good income, comfortable environment, plenty of vacation, plenty early days so I'm involved in my kids lives.

As long as I feel comfortable with my reimbursement and job position, it doesnt really matter what you think.

you can have what you have now.. and be fairly compensated ... just have to look and be willing to man up and make it happen.. but everyone wants security... a paycheck everyweek... blah blah blah.. thats why we are in the amc mess that we are in...

 

[cfdavid]

Nah, Johan, no chump here.

Money isnt my primary driving force.

Usta be.

I don't have to make a half mil anymore.

I've gotta f u k you account, remember?

So I'll take my job with the good income, comfortable environment, plenty of vacation, plenty early days so I'm involved in my kids lives.

As long as I feel comfortable with my reimbursement and job position, it doesnt really matter what you think.

Very wise, brother. It's hard to place a value on those things you've mentioned.

And once you've built up that fu.ck you account, it's all the more possible...lol
That's freedom that few people will know.

 

[Noyac]

Yep, money ain't everything. As long as it is enough and the situation is good for you, then you will be happy. I also took a 30% pay cut to be in my dream job/location. I have never regretted it. I just spent the last weekend in a hut in the backcountry with snow nuken down on us skiing/snowboarding our asses off. Nobody around for miles. Nearly had to spend the rest of the week there since the passes are closed now from avalanches. I couldn't do that in my last location and would have spent a lot of money getting to this type of activity. Get your priorities straight early on and your life will be full. In my opinion, if you go for the highest paying job right off the bat you will soon find out why it pays so well. Cause it sucks. 😱 Once you get accustom to the salary then you will have a very difficult time going down from there. You will then feel stuck in a rut. Just my opinion.

 

[supercut]

I've gotta f u k you account, remember?

I LOVE it! I'm working on such an account but I never thought to call it that. Now I will.

Just curious...is it more like an emergency fund to cover x month's expenses while you look for another position, or is it enough to live off the interest? Did I understand that you've been in private practice for 11 years, meaning that you finished residency only 11 years ago? Cuz I'm pretty impressed that you are in such a good position that short a time after residency!

 

[militarymd]

Jet,

I'm gonna have to adopt that name for my account.... F U K you account.

I actually feel fortunate to actually have it....because my wife is ALSO a doctor...and who did NOT feel the need to live the life of a DOCTOR's wife.

I think the MOST frequent road block to most of us haveing F U K you accounts is the "doctor's wife".

 

[cfdavid]

Jet,

I'm gonna have to adopt that name for my account.... F U K you account.

I actually feel fortunate to actually have it....because my wife is ALSO a doctor...and who did NOT feel the need to live the life of a DOCTOR's wife.

I think the MOST frequent road block to most of us haveing F U K you accounts is the "doctor's wife".

That and simply living beyond ones means... This is obvious, but so many people do it. Then, one little hiccup occurs and they're losing their homes..

The crazy thing is that our entire economy revolves around "consumerism". Look at what the Fed wants us to do with this stimulus package (if it passes)... SPEND IT. Save? Hell no, the worlds economy would go to hell in a handbasket if Americans actually SAVED. It's ludicrous. The entire economy (arguably global) is resting on Americans continuing to SPEND, and it's the stated objective of what we're supposed to do with this tax rebate in the spring.

Sorry for the little rant. I've just been pretty bearish lately because our fundamentals are SO out of wack. We'll see what happens here over the next year. I think it's going to get messy. I personally think defensive positions may be in order here. What do you guys think?

 

[militarymd]

That and simply living beyond ones means... This is obvious, but so many people do it. Then, one little hiccup occurs and they're losing their homes..

The crazy thing is that our entire economy revolves around "consumerism". Look at what the Fed wants us to do with this stimulus package (if it passes)... SPEND IT. Save? Hell no, the worlds economy would go to hell in a handbasket if Americans actually SAVED. It's ludicrous. The entire economy (arguably global) is resting on Americans continuing to SPEND, and it's the stated objective of what we're supposed to do with this tax rebate in the spring.

Sorry for the little rant. I've just been pretty bearish lately because our fundamentals are SO out of wack. We'll see what happens here over the next year. I think it's going to get messy. I personally think defensive positions may be in order here. What do you guys think?

You are SPOT on, my friend.....and because you are....we're all going to be SCREWED down the road.

 

[cfdavid]

You are SPOT on, my friend.....and because you are....we're all going to be SCREWED down the road.

Yeah, I agree. The only question is how far down the road. It's a super precarious situation we teeter on.

If things come to what they may, there are ways to protect yourself and even profit from a MAJOR, prolonged recession. If only I had a crytal ball.

I have mixed emotions. If confidence in the U.S. goes to total hell (not super likely, but not impossible), then even U.S. treasuries (traditional safe havens)won't be any good. And going to cash (i.e. dollars) would be a no no given very real inflationary possibilities. Gold, or other precious metals, perhaps. Other currencies that have more solid fundamentals behind them (Swiss Francs?). Not sure. Certainly those would be better than getting slaughtered in the stock market.

It's a tough one though. Because if we enter a prolonged, deep recession, there's a very real possibility that it goes global. But, money will always be running for safety under such circumstances. Money won't disappear, it'll just go to different places as well as change hands.....

 

[jetproppilot]

That and simply living beyond ones means... This is obvious, but so many people do it. Then, one little hiccup occurs and they're losing their homes..

The crazy thing is that our entire economy revolves around "consumerism". Look at what the Fed wants us to do with this stimulus package (if it passes)... SPEND IT. Save? Hell no, the worlds economy would go to hell in a handbasket if Americans actually SAVED. It's ludicrous. The entire economy (arguably global) is resting on Americans continuing to SPEND, and it's the stated objective of what we're supposed to do with this tax rebate in the spring.

Sorry for the little rant. I've just been pretty bearish lately because our fundamentals are SO out of wack. We'll see what happens here over the next year. I think it's going to get messy. I personally think defensive positions may be in order here. What do you guys think?

You're very wise and intuitive for a med student, my friend.

I've never been a defensive player.....hell, I play no limit hold'em for fun for chrissakes....but I believe you are right.

Regardless, I've made a few contrarian purchases lately....now have a pretty large position in Delphi whose stock is in shambles right now since they are bankrupt....but I'm a bettin' dude, and I'm bettin' they emerge and become healthy again (remember Kmart, anyone?)

If I'm right, it could be a seven figure gain.

If I'm wrong, oh well. My screw around Schwab account will take a hit.

Won't affect the overall picture.

It's just not my style to put all my money where it is "safe".

And lets face it....if you are an equity investor, your money isnt really safe.

Even blue chip stocks are up for corrections (remember when PG took a 50% hit?)

But alotta times, the higher the risk, the higher the reward.

BTW, already have airline tickets for WSOP 2008!!!!! YAY!!!!!!!

As you recall, I got knocked out of an event last year an hour into the tournament with a great hand....by a pro who went all in on a drawing hand....and he hit the one-in-five chance that he'd win.

Can't help that.

And can't dwell on the past.

So I'm gonna give it another shot...

I'm all in. 😍

 

[cfdavid]

You're very wise and intuitive for a med student, my friend.

I've never been a defensive player.....hell, I play no limit hold'em for fun for chrissakes....but I believe you are right.

Regardless, I've made a few contrarian purchases lately....now have a pretty large position in Delphi whose stock is in shambles right now since they are bankrupt....but I'm a bettin' dude, and I'm bettin' they emerge and become healthy again (remember Kmart, anyone?)

If I'm right, it could be a seven figure gain.

If I'm wrong, oh well. My screw around Schwab account will take a hit.

Won't affect the overall picture.

It's just not my style to put all my money where it is "safe".

And lets face it....if you are an equity investor, your money isnt really safe.

Even blue chip stocks are up for corrections (remember when PG took a 50% hit?)

But alotta times, the higher the risk, the higher the reward.

BTW, already have airline tickets for WSOP 2008!!!!! YAY!!!!!!!

As you recall, I got knocked out of an event last year an hour into the tournament with a great hand....by a pro who went all in on a drawing hand....and he hit the one-in-five chance that he'd win.

Can't help that.

And can't dwell on the past.

So I'm gonna give it another shot...

I'm all in. 😍

Jet, I haven't really been following too many individual stocks. But, I'm behind Delphi 100% being from Detroit. GM is looking relatively strong lately, and improving fundamentally. Being Delphi's largest customer, this would bode well. Not sure about the extent of their exports, but potentially the weak dollar would help.

I'll keep an eye on it. I'd love to see them succeed and get back on their feet. They employ a lot of people. Also, I'm always rooting for my SDN buddies! 👍

 

[VentdependenT]

How is activision doing (I think they made Rockband and Guitar hero)?

Everyone is talking about those games. I looked out of my hi-rise window the other day into someone else's apt in another hi-rise, and there were like 6 dudes in there singen, strummen, playen air drums, and gyrating to Rock Band.

Hilarious.

 

[Dr Serenity]

That and simply living beyond ones means... This is obvious, but so many people do it. Then, one little hiccup occurs and they're losing their homes..

The crazy thing is that our entire economy revolves around "consumerism". Look at what the Fed wants us to do with this stimulus package (if it passes)... SPEND IT. Save? Hell no, the worlds economy would go to hell in a handbasket if Americans actually SAVED. It's ludicrous. The entire economy (arguably global) is resting on Americans continuing to SPEND, and it's the stated objective of what we're supposed to do with this tax rebate in the spring.

Sorry for the little rant. I've just been pretty bearish lately because our fundamentals are SO out of wack. We'll see what happens here over the next year. I think it's going to get messy. I personally think defensive positions may be in order here. What do you guys think?

👍👍👍👍👍👍👍

Couldn't have said it better. Would much rather have a modest (but nice enough) home, a used late-model Ford/Chevy/whatever, a nice retirement fund and F you account, and sleep comfortably at night rather than a mansion, $200000 luxury car, and debt up to my eyeballs.

 

[cfdavid]

👍👍👍👍👍👍👍

Couldn't have said it better. Would much rather have a modest (but nice enough) home, a used late-model Ford/Chevy/whatever, a nice retirement fund and F you account, and sleep comfortably at night rather than a mansion, $200000 luxury car, and debt up to my eyeballs.

Man, me too. That f.ck you account (Jet, you've officially coined a new term...lol) and the FREEDOM that comes with it, is hard to overstate.

 

[supercut]

The crazy thing is that our entire economy revolves around "consumerism". Look at what the Fed wants us to do with this stimulus package (if it passes)... SPEND IT. Save? Hell no, the worlds economy would go to hell in a handbasket if Americans actually SAVED. It's ludicrous. The entire economy (arguably global) is resting on Americans continuing to SPEND, and it's the stated objective of what we're supposed to do with this tax rebate in the spring.

Yeah, and part of the stated reason that "high income" people aren't getting the rebate is because they are the most likely to *gasp* SAVE the money instead of spending it! I'm sorry to say that it seems like the economy is an increasingly fragile house of cards. People can't keep spending more than they make forever, governement handouts or not.