Kaiser Mid Atlantic

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boo2

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Hey Gang!

Several months ago I posted about being unhappy in my community EM job and feeling like I was working to make money for the partners, not to mention the metrics, RVU/pt per hour stress, and bad schedule. Thanks for your replies and PMs. I don't post a lot, but I check in on SDN daily.

I made a change to the Kaiser Mid Atlantic group- and its been a good choice for me. 🙂 I just wanted to give a review of the gig in case any one is wondering.

I'm at one of the new Clinical Decision Units(being launched actively and over the past 2 years)- essentially free standing EDs with 23hr obs capabilities, but no ambulances. I have seen people on SDN comment that the CDU is not Emergency Medicine. I don't know about other regions, but we definitely get sick people and non sick people- that is the point of staffing with EM, and there is a great mix of pathology. I don't feel like I have left the ED, except that I don't get as much of the critical care patient(which in the big picture I am totally ok with).

For me the best parts are:
1)amazing follow-up: I can help facilitate appointments and learn from my consultants (meaning Derm and ENT the next day if needed! I can schedule a kid for followup the next day without having to make phone calls). What a huge relief knowing patients will get the care they need...
2)The weight of metrics being tied to money and the rat race to promotion off of my shoulders
3)The supportive environment of the company with competitive salary and awesome benefits package
4) Observing those borderline patients, with a hospitalist evaluating them if necessary. That with the great follow-up takes such a mental burden off of me, as well as a reduced fear of malpractice. Chest painers get three sets and cards dispo in AM. No justifying anything to anyone.
5)Most importantly....not feeling exhausted even after a busy shift....🙂 and being able to focus on my personal life.

In terms of practicing EM as a pit doc I have come to accept that you can't get away from the shift work, weekends, or holidays, but you can minimize a lot of other garbage! So far, so good!

We are recruiting- DC, suburban MD, Baltimore. There has been little turnover since the start and thus we want awesome candidates that we will enjoy working with for the next 20 years.

PM me for questions, or if you want the recruiters info. There will be a booth at ACEP as well.

Well thats my 2 cents!
 
Intubations, resuscitations, trauma? Any of that at your shop? Not trying to challenge you, just my ignorance.
 
You are right- definitely less critical care traffic, but it does trickle through. Treat it the same way you would do in many community ED's- stabilize and transport out. We've had head bleeds, GI bleeds, strokes, stemi's, sepsis, codes, intubations. I've had to reduce joints, reduce hernias, do LP's, splint fractures, give adenosine etc. We manage a pretty sick population, and I quickly learned that just because you have insurance and follow up doesn't mean you take care of yourself.

Top dx in the ED are the top dx we see as well. Pretty much bread and butter community EM.

If doing the stuff you mentioned on a daily basis floats your boat and you need it to be happy in your career then this is not the job for you. So far its kept me mentally stimulated and I do not feel bored.

Its also kinda cool to actually see patients get better and go home after a short stay as well.

Go Hoos!
 
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