Oy strike a nerve there?
I was going to pick this apart (Calling RVUs a strawman then immediately pretending that RN compensation has any relation to MD??) but I realized at the "tremendous value I bring the hospital" bit that you might be a tad delusional. I have seen a slow but growing use of telemedicine to do the work of a nocturnist (hospital loses less money to just miss the admit charge and have a telemed consult if its before midnight)--the 'tremendous value' a nocturnist brings (and this is from an admin perspective) is admits people from ER, doesnt get sued, doesnt piss off the staff, doesnt transfer people. Literally anyone with training in IM, FM (and probably EM) could be a nocturnist....
Look man it's great that you have a unicorn SDN job but the lurkers who might be reading this should know there are harsh realities out there before deciding that making 750k/yr doing 10 nights a month is a realistic expectation.
Don't forget including watching a couple hours of Netflix a night and googling some 990s to that list of not getting sued!😘
I think you're correct that telemedicine is expanding, we use it in the form of remote cross coverage so I can focus on admitting and saving lives overnight rather than prescribing nystatin powders. But as far as losing my job to a computer, my shop went from 1 nocturnist to 4 on at night over the past 5 years. Each year I've made more than the last. Can you name a single nocturnist or hospitalist program that has been shrinking? No? I'll wait.
And yes- not just 'literally', but *quite literally* anyone with training in IM or FM can be a nocturnist/hospitalist. Just like any of them can pull 500k+ if they just want to work hard enough. No unicorn job required. How badass is that? All it takes is an undergraduate degree, 4 years of medical school, 3 years of residency and board eligibility/certification. Literally any of us could also be cards or GI, if we were just masochistic enough to want to put our lives off for another 3-4 years...but we had different passions and priorities.
That part about not getting sued also requires a little competence. Not pissing anyone off? Some communication skills. Add to that some time management, organization, stamina, multitasking, thriving under pressure, the ability to work with and educate housestaff, the distillation of as much of the medicine I love with as little of the BS (rounding, GOC discussions, discharge planning), the intellectual stimulation of making the diagnosis and setting the patient on the right course (but never seeing them again!), not having consultants managing my patients, and the excitement or rapid responses and codes.
There's probably a couple ER docs I'd trust to do my job, but based on the florid chf the ER just sold me as a UTI, or the ACE they continued on the guy with the k of 6.8, I think I'll let them stay in their lane for now while I stay in mine. Despite their best intentions and all their training, studies have long established a clear and direct relationship between ER boarding times and mortality.
But you already knew that.
But you still chose to put us all down.
After all this, I still have no idea what you even do for a living. So remind me what value you add to this discusion other than negativity disguised as some reality check?
I didnt come here to put down any perceived mind numbing mundaneness of all the consults for demand ischemia or FOBT positive stools. I'm not here to **** on anyone else career choice, just to share my n=1 incase it helps others make a decision. Notice I've done this without trashing any specialty. Not even a single time. And yet it took you like 6 hours to do what I've avoided in all my years on SDN- Because it doesnt validate my life choice anymore than being truly passionate about and satisfied with my career already does. I dont know how truly bitter about your career choice you need to be, but consider taking it out on something else.
I get to dial in exactly how much I want to work/make, the flexibility to be abroad each month, or move to another part of the country on a dime. I feel grateful and happy to go to work every day, and satisfied when I go to sleep for the lives I've bettered and the difference I've made. I'm confident and proud in the value I bring, have zero worries about job security, or any regrets- and as it happens, my income, net worth, respect i get from patients/colleagues/family/community, and job satisfaction confirm it more and more each week. I dont need external validation, nor is any of your mud slinging sticking.
From where I'm standing, I'm living the dream.
It may not be your dream, and that's ok.
I never said it was for everyone, I never even said it was typical. But I do believe it is within reach for most if it's what they seek and willing to work a little for it.
And if that's delusional.. 🤷🏻♂️
Peace ✌
