PEM vs urgent care

[Julietcf14]

Hey guys,
I am a second year resident trying to decide what to do with the rest of my life. I LOVE my ED rotations but its not the traumas I care much for, it's the coughs and colds + suturing and splinting and abscess draining that really make my world go round. I am trying to figure out if my best option is to apply PEM (with 3 years fellowship and limited jobs) or are there urgent cares out there where I could still do minor procedure like splinting, suturing, and abscess draining!!?! I just don't know enough about urgent cares that are not attached to a pediatric ER to know if that option even exists. If it does, then I am pretty sure that would be my happy place but if not then I think my best option is PEM. Thoughts?

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[Rutgers06]

Hey guys,
I am a second year resident trying to decide what to do with the rest of my life. I LOVE my ED rotations but its not the traumas I care much for, it's the coughs and colds + suturing and splinting and abscess draining that really make my world go round. I am trying to figure out if my best option is to apply PEM (with 3 years fellowship and limited jobs) or are there urgent cares out there where I could still do minor procedure like splinting, suturing, and abscess draining!!?! I just don't know enough about urgent cares that are not attached to a pediatric ER to know if that option even exists. If it does, then I am pretty sure that would be my happy place but if not then I think my best option is PEM. Thoughts?

There are definitely urgent care centers that do minor procedures like suturing and abscess draining. In general, urgent care is all about churning people out, so it would be a good idea to talk to someone who is currently in urgent care around you to get an idea of what exactly they do. Another option is to do ED "fast track", which is similar, but just attached to a peds ED.

 

[Cuthbert]

I would agree with Rutgers. There are many urgent care centers that will fit exactly what your looking for. The "fast track" ER option is where a general pediatrician (no further training required) is employed by a pediatric ER to hand the lower acuity patients.

 

[Julietcf14]

I really appreciate the advice and I am still weighing my options. I was wondering if the fast tracks at other people's hospitals allow gen Peds docs to suture lacs, drain abscesses and splint? It seems like all of that goes to te ER and fast track just sees the ear aches, sore throats and fevers. Anything that requires more than 15-20 min goes to te PEM ppl at my institution. Is that not universal?

 

[Cuthbert]

I really appreciate the advice and I am still weighing my options. I was wondering if the fast tracks at other people's hospitals allow gen Peds docs to suture lacs, drain abscesses and splint? It seems like all of that goes to te ER and fast track just sees the ear aches, sore throats and fevers. Anything that requires more than 15-20 min goes to te PEM ppl at my institution. Is that not universal?

Not where I was. However, I cannot say that I have enough experience in other places to know what the "norm" is.

 

[Stitch]

I really appreciate the advice and I am still weighing my options. I was wondering if the fast tracks at other people's hospitals allow gen Peds docs to suture lacs, drain abscesses and splint? It seems like all of that goes to te ER and fast track just sees the ear aches, sore throats and fevers. Anything that requires more than 15-20 min goes to te PEM ppl at my institution. Is that not universal?

There are a number of jobs that let gen peds trained people do those things, but those jobs are disappearing as more and more peds EM people enter the workforce. It's all hospital and location dependent.

 

[ifailedmcat]

I am a generalist who works Pedi Urgent Care full-time. Most of us are not EM trained. You can msg me for more info if you like.

 

[bjackrian]

A lot of the subsites of my hospital hire general pediatricians for just this kind of work (i.e., we have the big main hospital where most of the suturing/abscesses/etc would be seen by PEM docs, but we also have several satellite sites that are sometimes staffed by a general pediatrician). At those subsites, the pediatrician does all the minor procedures him/herself until they reach a point where he/she is not confident/competent to perform them (which obviously has some variation from person to person). I imaging that other hospitals have similar setups.