New attending advice

[Matia03]

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Fresh attending here.


Recently started my first attending job and I am about 10 shifts in.

I am getting told to practice a certain way considerably by the other "older" attendings (35-45 years of age) in my group. Every shift I am being told " you should of admitted this patient, should of d/c this patient, or should of flown this patient". I have not had a bad outcome in any of these cases, and there pretty bread n butter patient's which dispo's tend to be up to personal preference.


When this usually happens I usually just say "Oh, thanks for the feedback" and smile not making a big fuss.

But I am getting tired of being questioned on every run of the mill case.


Is this normal for new attendings? Any advice on how to say politely "mind your own F'n business "

 

[ERDude]

Little bit hard to say without specifics of the cases but in general it's hugely important to be practicing in line with your group's patterns. The first year out of residency is a steep curve and it's good to get feedback even if the ego resists (I can be the same way). Also it takes up to 1 year at a job (in my experience of 2 SDGs) to really get a feel for the practice patterns/politics and having a good handle on those aspects makes everything smoother.

In short: yes, it's normal for new attendings.

I would advise against saying "mind your own F'n business" in any way, polite or not. Just take the advice at face value and move forward. You're literally 2 weeks into attending-hood. Don't sweat it.

 

[Tiger26]

They're just trying to look out for you (and the reputation of the group ...)--this is a really risky time period with you having just finished training. I'd politely take their advice for a while

 

[emergentmd]

Fresh attending here.


Recently started my first attending job and I am about 10 shifts in.

I am getting told to practice a certain way considerably by the other "older" attendings (35-45 years of age) in my group. Every shift I am being told " you should of admitted this patient, should of d/c this patient, or should of flown this patient". I have not had a bad outcome in any of these cases, and there pretty bread n butter patient's which dispo's tend to be up to personal preference.


When this usually happens I usually just say "Oh, thanks for the feedback" and smile not making a big fuss.

But I am getting tired of being questioned on every run of the mill case.


Is this normal for new attendings? Any advice on how to say politely "mind your own F'n business "

Take in Advice, read up. If you are still uncertain, talk to other attendings. Some attendings are very conservative, order everything known to man, keep pts in the ED for ever, clog the ED down. DONT be someone like this.

Don't take things personally, your first year is learning what the community standard of care is.

I have worked in alot of places and workups/admissions can vary greatly.

Its funny that most places I work at, you can barely even get any advice unless you ask directly. You could be discharging an 80 YO guy with anginal CP and many could care less. I guess you should feel lucky

 

[Birdstrike]

Fresh attending here.


Recently started my first attending job and I am about 10 shifts in.

I am getting told to practice a certain way considerably by the other "older" attendings (35-45 years of age) in my group. Every shift I am being told " you should of admitted this patient, should of d/c this patient, or should of flown this patient". I have not had a bad outcome in any of these cases, and there pretty bread n butter patient's which dispo's tend to be up to personal preference.


When this usually happens I usually just say "Oh, thanks for the feedback" and smile not making a big fuss.

But I am getting tired of being questioned on every run of the mill case.


Is this normal for new attendings? Any advice on how to say politely "mind your own F'n business "

This will go away in about 6 weeks. You're new. You're on everyone's radar. They're reviewing your charts. After a few weeks of not having any unexpectedly bad outcomes they'll get tried of doing it and move on to other issues once they have a comfort level that whatever you're doing, you're not killing anyone. Part of it goes with the territory of being a newbie. Yes, after all these years of training and being done, you're a newbie again. That will pass. The other thing is what others alluded to. There can be a massive gap between the rainbows and unicorn world of how medicine is practiced in a training/tertiary center and the "real world." Some of their advice likely is legit, real world advice, along the lines of how things are done differently anywhere but residency programs.

Whatever you do, don't say, "mind your own F'n business." Absorb any advice that seems good. Ignore that which seems bad. Some of what you know as a newbie will be better than the old farts think they know, because it's more up to date. Some of what you think you know will not be as good as what they know, due to the experience gap. The first 6 months after residency is some of the hardest months of all of you medical career. But after that it gets better, permanently. Finally.

You'll be fine.

 

[Groove]

You'll be fine. Learn the patterns but stick to your guns with the things you feel strongly about. It's easy to adopt cavalier patterns like d/c'ing high risk cardiac patients because the hospital is resistant to admissions for acs rule outs. Just because "everyone else does it" doesn't mean it's o.k. in some instances.

 

[Docinthetrenches]

Yes that is normal. I was second guessed a lot my first year. I was not even super confident myself so usually I appreciated the feedback. It depends if they are harping on you or trying to be constructive. As you work more you will find out if you are a big worker-upper/admitter, or a discharger. Or maybe in between. I think as you work more you get more confident and better at comfortably discharging more people but style is very individualised. Ideally we all gravitate towards practising safe and responsible medicine where pt safety is not put at risk but we are also not wasting health care dollars and just being defensive.