NYC: High acuity, non-academic EDs?

[DeadCactus]

I don't know anything about NYC. Are there any high-volume, high-acuity EDs that either don't have residents or where attendings are seeing sick patients on their own a significant amount of time?

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[Lexdiamondz]

I don't know anything about NYC. Are there any high-volume, high-acuity EDs that either don't have residents or where attendings are seeing sick patients on their own a significant amount of time?

There are, but the tradeoff is that those are shops that are pretty dysfunctional


Harlem Hospital has Metropolitan residents occasionally rotate through but many attendings do their own tubes, lines, reductions etc

Bronx lebanon has decent acuity but also had that shooting last year

NYU Lutheran doesn't have resident coverage 24/7 so attendings will often tube and line overnight and in the early AM.

HHC Queens has decent acuity but alot gets siphoned off to Elmhurst and NYP Queens

Jamaica has no EM residents but is wild AF. Acuity is pretty high there though.



Other spots like Brookdale and Wykoff recently opened EM residencies. For what reason IDK.

 

[GeneralVeers]

NYC hospital WITHOUT residents? Sounds like hell. Who's going to start all the IVs and transport patients for imaging?

 

[RustedFox]

NYC hospital WITHOUT residents? Sounds like hell. Who's going to start all the IVs and transport patients for imaging?

Reason #239 why NYC sucks. Standby later for elaboration. Too tired right now.

 

[Groove]

Ah, good ol NYC. I still remember all the tolls I would have to pay to get downtown and back along with the cops who would stand on the street corner waiting for those of us in bumper to bumper traffic who would get caught by the yellow light and have our bumpers hanging just barely out into the intersection. I've never seen someone give a ticket so fast. They'd run over, spit it out of some little hand held machine, whip it at you and run back to the corner.

In hindsight, I have no idea what I was thinking by taking my car there. Big mistake.

The best part of NYC was the hour or two north I'd drive to go hiking. Cool little town called Cold Spring... Breakneck ridge trail if memory serves. I'd hike up there on countless weekends. Pretty views of the Hudson. I don't miss NYC at all though.

 

[BoardingDoc]

Ah, good ol NYC. I still remember all the tolls I would have to pay to get downtown and back along with the cops who would stand on the street corner waiting for those of us in bumper to bumper traffic who would get caught by the yellow light and have our bumpers hanging just barely out into the intersection. I've never seen someone give a ticket so fast. They'd run over, spit it out of some little hand held machine, whip it at you and run back to the corner.

Did you live in NYC? As someone who is visiting, I can see how that behavior from the ticket cops would seem terrible. As someone who used to live there, that behavior is 100% necessary. The gridlock that would (and used to) happen without significant fines and enforcement for blocking the box is abysmal. If you aren't going to be able to clear the intersection before the light changes, stay out of the damn intersection. If you can't tell, don't go.

 

[GonnaBeADoc2222]

Don't know answer to OPs question but I did a sub I in NYC back in the day and couldn't be happier that I didn't match there.

 

[Apollyon]

People from the city can't wait to come back. People not from the city can't wait to leave.

 

[miacomet]

If you work in NYC, you, for the most part, want residents. The hospitals are INSANELY dysfunctional. Well, the ERs are. All the hospitals are high acuity. Here's my take on a few of the community sites. Almost all of them will have off-service rotators, students etc.

Bronx Lebanon (aka Bleb)- pays well, people seem happy, well-staffed with attendings, ED has a lot of respect in the hospital, good chair. I'd look here first if you are absolutely not interested in residents. Shootings happen everywhere. They've had a couple, though.

St John's Queens- Can't keep it staffed. Insanely dysfunctional. On third staffing group in three years. Nursing homes everywhere. They were offering great locums rates awhile back. Impossible commute.

Jamaica- they want (and need) residents and are planning on starting a residency in the next few years. Level I trauma, which means in some ways it's more functional. Cornell surgery residents, off service residents. Good department chair and assistant chair. Patients from all over the world and perhaps beyond. Busy. Crazy AF. Lots of stuff from JFK. Good EMR. Long commute but good subway access from NYC. Decent salary by NYC standards. Phasing out their non EM docs and putting them out to pasture in their new urgent care. FWIW, you might as well work and live in LI and save on city tax while earning more.

Lutheran- Now an NYU affiliate. Very popular place to work for recent Kings County grads, who seem to really like it, so rarely many job openings. Admin seems to really want and like KC grads.

Lenox Hill- Run by Northwell. Rich patients. Northwell pays well and has great benefits.

Weiler- Insanely busy and understaffed.

Flushing- Insanely busy and high acuity. Pay is crap.

Harlem Hospital- HHC, thus terrible salary. Good medmal coverage. I vaguely know people there who seem happy. I think they are nuts. YMMV. Terrible EMR. This is par for HHC hospitals. You want residents!!!

Beth Israel- residency closing, hospital sort of closing, but not the ER, exactly. Word is Mount Sinai EM residents will rotate.

NYC Downtown/Beekman, or whatever it is called these days: Cornell affiliate, lots of Chinese patients, Wall Streeters, and dignitaries. Not sure if there are any residents. They put a lot of money into it recently.

NYP-Allen- Columbia affiliate, but no residents. Busy. Lots of Dominican patients.

 

[GonnaBeADoc2222]

What is aporoximate average NYC hourly pay and what is "good" NYC hourly pay, just out of curiosity?

 

[miacomet]

Highly variable. Unless you are per diem, most jobs pay annually, not hourly, and they expect a lot of hours for the pay, and if you stay late, you don't get paid for the extra hours IME. Worked out to less than $200 at all jobs I looked at. PAGNY was offering per diems $140-$230 (latter being weekend nights) last I checked.

There seem to be more openings in PEM than EM in NYC lately if that's an interest.

 

[Groove]

People from the city can't wait to come back. People not from the city can't wait to leave.

Too true. I did clinicals in NYC and this OB attending pulled me into his office one day to ask me questions about TN. He commuted 1.5 hours to and from work every day and had some colleagues that had moved to a city outside Nashville and were trying to talk him into it coming down to join their practice and he couldn't wrap his brain around how cheap everything was (land, real estate, etc..) and kept asking me about life in TN. He then made me swear to secrecy that I wouldn't tell anyone. I wonder if he's still in NY. Sometimes, I wonder if New Yorkers know just how good life can be outside the Big Apple.

 

[gro2001]

If you work in NYC, you, for the most part, want residents. The hospitals are INSANELY dysfunctional. Well, the ERs are. All the hospitals are high acuity. Here's my take on a few of the community sites. Almost all of them will have off-service rotators, students etc.

Bronx Lebanon (aka Bleb)- pays well, people seem happy, well-staffed with attendings, ED has a lot of respect in the hospital, good chair. I'd look here first if you are absolutely not interested in residents. Shootings happen everywhere. They've had a couple, though.

St John's Queens- Can't keep it staffed. Insanely dysfunctional. On third staffing group in three years. Nursing homes everywhere. They were offering great locums rates awhile back. Impossible commute.

Jamaica- they want (and need) residents and are planning on starting a residency in the next few years. Level I trauma, which means in some ways it's more functional. Cornell surgery residents, off service residents. Good department chair and assistant chair. Patients from all over the world and perhaps beyond. Busy. Crazy AF. Lots of stuff from JFK. Good EMR. Long commute but good subway access from NYC. Decent salary by NYC standards. Phasing out their non EM docs and putting them out to pasture in their new urgent care. FWIW, you might as well work and live in LI and save on city tax while earning more.

Lutheran- Now an NYU affiliate. Very popular place to work for recent Kings County grads, who seem to really like it, so rarely many job openings. Admin seems to really want and like KC grads.

Lenox Hill- Run by Northwell. Rich patients. Northwell pays well and has great benefits.

Weiler- Insanely busy and understaffed.

Flushing- Insanely busy and high acuity. Pay is crap.

Harlem Hospital- HHC, thus terrible salary. Good medmal coverage. I vaguely know people there who seem happy. I think they are nuts. YMMV. Terrible EMR. This is par for HHC hospitals. You want residents!!!

Beth Israel- residency closing, hospital sort of closing, but not the ER, exactly. Word is Mount Sinai EM residents will rotate.

NYC Downtown/Beekman, or whatever it is called these days: Cornell affiliate, lots of Chinese patients, Wall Streeters, and dignitaries. Not sure if there are any residents. They put a lot of money into it recently.

NYP-Allen- Columbia affiliate, but no residents. Busy. Lots of Dominican patients.

I thought it was the opposite with BI: residency and ER closing, but hospital saying open (sort of) in the form of like an outpatient surgical center or something?

 

[InternistDO]

I thought it was the opposite with BI: residency and ER closing, but hospital saying open (sort of) in the form of like an outpatient surgical center or something?

ED will remain open as a semi freestanding, most inpatient beds are closing. The BI EM residency is done though.

 

[miacomet]

Oh. Update. Some sort of exodus at Lutheran. Couldn't get the whole scoop.