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AlmostAnMD said:
Completely true and self-inflicted wound. Look back at this forum 10 years ago. Filled with "I can just clock in/clock out", "work wherever I want", "i just see patients and don't worry about meetings or education"

What that attitude actually translates to is, "we don't want a seat at the decision making table" and while docs are just clocking in and out major policy shifts were happening, leaving Ed docs on an island no one cares about and is slowly sinking.

In this respect, nurses had a better play than docs, but they had a better incentive. An ed nurse makes pennies compared to ed docs (exaggerating). Thus, ed docs were not incentivized to go an administrative route since that would definitely decrease or laterally move pay.

For nurses it significantly increased their revenue stream. Nursing directors/administrators make significantly more than floor nurses AND influence policy.

A few decades of this, and you'll see why every administrative position in a hospital is a nurse with a few docs peppered in.

Thus, even the nursing lobbying on a national level is infinitely more organized and effective than dickless cmg shells like ACEP.

This is one of a myriad of reasons I left clinical practice. I enjoy working on the policy side, prioritizing revenue increases to hospital and applying pressure to insurance companies. I'm trying to streamline things for floor docs so they can get paid more and do less work with fewer epic workflow stops.
Click to expand...

The argument is always doctors are to lazy even though we have to excel in college and do a **** ton of crap in residency we are at the whims of the hospital due to ERs being attached to the hospital.

Some of EM downfall is based on EMTLA and insurance company lobbying. We were able to recover some of it from freestanding EDs.

We spend so much time studying and away from family who can blame doctors for clock in/clock out mentality especially since the prospect of ownership is gone.

Doctors are trained not to work as a team with others and just bare responsibility and take it like a good boy in residency. Why do people think it will change as an attending.

Look at anesthesia they are subservient to surgeons and yet they are making more than ever and hospitals are breaking their necks to accommodate them even though patients don't travel or choose based on anesthesia.

EM downfall is mostly based on EM wanting more admin in the form of residencies. If EM was just clock in and clock out you wouldn't see all these new residencies pop out of nowhere because EM sucks and thus so many want to do academics or do community.

CMG own ED groups now so nurse admin which is the hospital have the power for admin since CMG and large SDG want to keep the hospital contract.
 
AlmostAnMD said:
Completely true and self-inflicted wound. Look back at this forum 10 years ago. Filled with "I can just clock in/clock out", "work wherever I want", "i just see patients and don't worry about meetings or education"
Click to expand...

I agree with you that physician leadership is lacking in general, but I disagree that this is the reason why EM is on fire. On the contrary, I would say EM sucks specifically because of decisions made by physician leaders.

As just two examples:
- CMGs got big because SDG physician owners cashed out, future EM physicians be damned.
- Midlevel scope creep got on a roll because physicians trained them so they could pocket the extra revenue.

It's obviously a lot more complicated than that, but saying lack of physician leadership led us to where we are is letting a lot of physicians off way too easy.
 
Sure docs take some responsibility for the slow downfall, but let's not be blinded by the fact that many do not have any say in decision making. When CMGs take over, there typically are 4 reasons.

1. SDG leaders are tired of the constant billing/admin fight and finally decide it is better to just sell out to get out of the game
2. SDGs have their contract taken away from them without cause
3. SDGs do a terrible job and get replaced
4. SDGs are given an ultimatum to do the impossible or a CMG will do the impossible.

Our Stable SDG was #4 and our choice was either to have a CMG come in or do the impossible. So we sold out to a CMG. We had no choice.

I would day #2 and 4 are much more common. Those who think SDGs sell out because they want an overlord is sorely mistaken. The economics of medicine, billing, increased responsibilities eventually become too much to stay a SDG. This is no only happening to EM, it is happening to almost all specialties in the house of medicine. Surgeons, Anesth, Cards, GI, primary. Most would love to stay as SDGs but I bet most on here would sell out too given the economics/politics of medicine.
 
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emergentmd said:
I would day #2 and 4 are much more common. Those who think SDGs sell out because they want an overlord is sorely mistaken. The economics of medicine, billing, increased responsibilities eventually become too much to stay a SDG. This is no only happening to EM, it is happening to almost all specialties in the house of medicine. Surgeons, Anesth, Cards, GI, primary. Most would love to stay as SDGs but I bet most on here would sell out too given the economics/politics of medicine.
Click to expand...
These words are incredibly true. It's tough and getting tougher to remain an SDG but the benefits of remaining an SDG are still so incredibly worth it. If you've got enough docs who are business savvy and able/willing to do the work on the business side then your SDG has a good chance to remain in good shape and continue on. If you don't have the docs to do that, you're in trouble.
 
emergentmd said:
Sure docs take some responsibility for the slow downfall, but let's not be blinded by the fact that many do not have any say in decision making. When CMGs take over, there typically are 4 reasons.

1. SDG leaders are tired of the constant billing/admin fight and finally decide it is better to just sell out to get out of the game
2. SDGs have their contract taken away from them without cause
3. SDGs do a terrible job and get replaced
4. SDGs are given an ultimatum to do the impossible or a CMG will do the impossible.

Our Stable SDG was #4 and our choice was either to have a CMG come in or do the impossible. So we sold out to a CMG. We had no choice.

I would day #2 and 4 are much more common. Those who think SDGs sell out because they want an overlord is sorely mistaken. The economics of medicine, billing, increased responsibilities eventually become too much to stay a SDG. This is no only happening to EM, it is happening to almost all specialties in the house of medicine. Surgeons, Anesth, Cards, GI, primary. Most would love to stay as SDGs but I bet most on here would sell out too given the economics/politics of medicine.
Click to expand...

The same could be said for scope creep. The power that physicians have in "supervising" midlevels is very different now than it was decades ago. But these conditions didn't arise in a vacuum out of nowhere. We are here because of many decisions taken by physicians leaders in the past--usually long before most of us were practicing medicine.

Anyways, my point wasn't "if you sell your SDG or supervise midlevels in 2026 you are bad". I just wanted to push back on this idea that if only we had physician interested in leadership back in the day, then the field wouldn't be where it is.
 
JacobMcCandles said:
These words are incredibly true. It's tough and getting tougher to remain an SDG but the benefits of remaining an SDG are still so incredibly worth it. If you've got enough docs who are business savvy and able/willing to do the work on the business side then your SDG has a good chance to remain in good shape and continue on. If you don't have the docs to do that, you're in trouble.
Click to expand...
I applaud those who can hold out but it is harder and harder to do. Let's take our successful SDG 25 yrs ago.

Democratic, lots of say in how the dept is run, made around $250-275/hr seeing 1.7pph, we had respect, and admin left us alone. No one left, very few job openings. Very little CMG/VC money. Great job. Hospital is efficient, pts get admitted quickly.

Hurdles
#1 - insurance payments go down, cost of admin/billing goes up. now we are making $200-$225/hr seeing 1.8pph. We suck it up b/c it is still a good job
#2 - Volume goes up across the system. Now We are seeing 2.5pph. We suck it up, job still decent
#3 - Acuity goes up, everyone getting older, nursing homes popping up all over the place. Still seeing 2.5pph. Job starting to suck, docs beginning to leave, hard to recruit good docs.
#4 - Volume continues to go up, now pushing 3pph, still making $225/hr and complaints happening everywhere. Our choice is to hire more EM docs and drop everyone's pay to around $200/hr vs hiring APCs which would push doc volume back to 2.25pph and income bumps up back up to about $250/hr.
#5 - Volume continues to go up, we are forced to hire EM docs and pay back to $225hr. We heard CMG want to enter the market and we have been solicited for a buyout but we relent.
#6 - Chronically no beds. Job really suck now. Holds everywhere. Pts hate it, admin hates it, staff hates it. Experienced staff leaves and only choice is hire neg grads. Admin starting metrics, door to doc time, protocols, Stemis/trauma/sepsis/stroke alert program that chastise us for missing any metric. We feel like protocol simps rather than EM docs.
#7 - EM group, our OB/Cards group wants to stop in house call. Can you read all the EKGs and be first to Emergent OB stuff til OB comes from home. Hey, can you be on the trauma team also as we are starting to increase our trauma designation. Yeah, no new $$$.... that is just part of your job now.
#8 - Hospital taking over crappy outlying contracts 1 hr away, opening a new FSER every year. Admin wants us to staff every new site with EM docs. Crap, mass hiring starts. These new sites makes about $125/hr, guess what.... hospitals will not give stipends. We have supplement these new sites with income from the more profitable sites. now everyone's pay is $190/hr.
#9 - Hospital wants to stop giving out hospitalist stipends. Legacy and strong hospitalist group balks b/c stipends are required to keep their quality. 1 yr into negotiations, hospitalist threaten to leave unless they increase the stipends. Hospital balks and wants to terminate stipends. Hey EM Doc group, Can you run the hospitalist program for us and you are not getting a stipend. Did we tell you that the hospitalist stipends across the system is about $5M. That is literally 25%+ of our EM billing going to support the hospitalist. Guess what, if you can't TH is ready to do EM+Hospitalist without stipend.

You are the board of the SDG, at which point are you selling out to the CMG that wants to buy you out? We sold out at #9. Our 2 choices were
#1 - Run the hospitalist group and drop the EM doc pay to $150/hr..... yeah you heard it right. No EM DOC is going to join our group and there will be mass exodus.
#2 - Sell the TH and you guys get a small golden parachute to keep us as employees for 2 yrs so not disrupt a well run EM system.

There is NO other choice. I didn't want to point out the other 100 smaller issues along the way. SDGs are a small cog in the wheel and many times have zero choice in the matter. Those that think the older docs all sold out are sorely mistaken. It is easy to bag on the older docs and lament that you guys inherited a crappier job but whoever has the money controls the process. CMGs/VCs/Hospitals have the money and we are just small roaches to them.
 
The gradual, largely unavoidable erosion from insurance companies would be impressive if it wasn't so scummy. These people definitely know what they are doing.

My two favorite scams run this year so far

1) the (mostly) end of the inpatient only procedure list

2) aetna limiting billing if MA plans don't meet mcg but still allowing ip status approval to prevent ALJ disputes

Every year, a slow and gradual erosion. People make fun of frogs for not noticing a 1 degree at a time difference boiling them but what happened to medicine is really no different.

Physicians are expensive capital. They definitely won't give up on ensuring full midlevel freedom. Too much money to save by dumping expensive doctors.

And, as I've previously said, we're a ripe group to target because we are so poorly organzied/infiltrated with CMGs that largely align their vision with insurance companies across too many domains
 
emergentmd said:
I applaud those who can hold out but it is harder and harder to do. Let's take our successful SDG 25 yrs ago.

Democratic, lots of say in how the dept is run, made around $250-275/hr seeing 1.7pph, we had respect, and admin left us alone. No one left, very few job openings. Very little CMG/VC money. Great job. Hospital is efficient, pts get admitted quickly.

Hurdles
#1 - insurance payments go down, cost of admin/billing goes up. now we are making $200-$225/hr seeing 1.8pph. We suck it up b/c it is still a good job
#2 - Volume goes up across the system. Now We are seeing 2.5pph. We suck it up, job still decent
#3 - Acuity goes up, everyone getting older, nursing homes popping up all over the place. Still seeing 2.5pph. Job starting to suck, docs beginning to leave, hard to recruit good docs.
#4 - Volume continues to go up, now pushing 3pph, still making $225/hr and complaints happening everywhere. Our choice is to hire more EM docs and drop everyone's pay to around $200/hr vs hiring APCs which would push doc volume back to 2.25pph and income bumps up back up to about $250/hr.
#5 - Volume continues to go up, we are forced to hire EM docs and pay back to $225hr. We heard CMG want to enter the market and we have been solicited for a buyout but we relent.
#6 - Chronically no beds. Job really suck now. Holds everywhere. Pts hate it, admin hates it, staff hates it. Experienced staff leaves and only choice is hire neg grads. Admin starting metrics, door to doc time, protocols, Stemis/trauma/sepsis/stroke alert program that chastise us for missing any metric. We feel like protocol simps rather than EM docs.
#7 - EM group, our OB/Cards group wants to stop in house call. Can you read all the EKGs and be first to Emergent OB stuff til OB comes from home. Hey, can you be on the trauma team also as we are starting to increase our trauma designation. Yeah, no new $$$.... that is just part of your job now.
#8 - Hospital taking over crappy outlying contracts 1 hr away, opening a new FSER every year. Admin wants us to staff every new site with EM docs. Crap, mass hiring starts. These new sites makes about $125/hr, guess what.... hospitals will not give stipends. We have supplement these new sites with income from the more profitable sites. now everyone's pay is $190/hr.
#9 - Hospital wants to stop giving out hospitalist stipends. Legacy and strong hospitalist group balks b/c stipends are required to keep their quality. 1 yr into negotiations, hospitalist threaten to leave unless they increase the stipends. Hospital balks and wants to terminate stipends. Hey EM Doc group, Can you run the hospitalist program for us and you are not getting a stipend. Did we tell you that the hospitalist stipends across the system is about $5M. That is literally 25%+ of our EM billing going to support the hospitalist. Guess what, if you can't TH is ready to do EM+Hospitalist without stipend.

You are the board of the SDG, at which point are you selling out to the CMG that wants to buy you out? We sold out at #9. Our 2 choices were
#1 - Run the hospitalist group and drop the EM doc pay to $150/hr..... yeah you heard it right. No EM DOC is going to join our group and there will be mass exodus.
#2 - Sell the TH and you guys get a small golden parachute to keep us as employees for 2 yrs so not disrupt a well run EM system.

There is NO other choice. I didn't want to point out the other 100 smaller issues along the way. SDGs are a small cog in the wheel and many times have zero choice in the matter. Those that think the older docs all sold out are sorely mistaken. It is easy to bag on the older docs and lament that you guys inherited a crappier job but whoever has the money controls the process. CMGs/VCs/Hospitals have the money and we are just small roaches to them.
Click to expand...

I think the problem you had was a bad hospital admin. It sounds like it spiraled out of control until it eventually burned your group. Sorry that happened and yes buyout was likely the best solution for your group at that time. Just sad to see it lead to that. How is the hospital now with TH?

Interesting that your OBGYN/Cards group had the power to say “no,” but not the EM group.
 
Porfirio said:
I think the problem you had was a bad hospital admin. It sounds like it spiraled out of control until it eventually burned your group. Sorry that happened and yes buyout was likely the best solution for your group at that time. Just sad to see it lead to that. How is the hospital now with TH?

Interesting that your OBGYN/Cards group had the power to say “no,” but not the EM group.
Click to expand...
If you are in far from a major city, there likely will still be "good" hospital Admins because they sometimes grew up in the area, still care about the community and know that the contract will not attract many bidders/CMGs. But in large cities, their really are not any good admin because they will choose profit over almost anything else. They care about profit, which increases their bonuses and their chance to move up. I was Chair of our EM dept for 7 years and Vice before. I have seen how little they care about any specialty less EM.

Hospital system 7 years since I left is a shell of itself. Revolving door of EM docs, shortage of EM docs, staff turnover increased and this is from a very sought after city to work in where 20 yrs ago you could not find an EM job.

Specialists wanted more stipends and hospital balked so wanted to have EM cover. They don't care about OB/Cards and only care about dropping stipends. Our group balked and I am sure they just paid the stipend.

Some on here think that they crap on EM but trust me, they crap on all specialists. From my years at the executive meeting level, they tried to cut hospitalist, ENT, Surg, plastics stipend. All of them complained. No one was happy.
 
emergentmd said:
If you are in far from a major city, there likely will still be "good" hospital Admins because they sometimes grew up in the area, still care about the community and know that the contract will not attract many bidders/CMGs. But in large cities, their really are not any good admin because they will choose profit over almost anything else. They care about profit, which increases their bonuses and their chance to move up. I was Chair of our EM dept for 7 years and Vice before. I have seen how little they care about any specialty less EM.

Hospital system 7 years since I left is a shell of itself. Revolving door of EM docs, shortage of EM docs, staff turnover increased and this is from a very sought after city to work in where 20 yrs ago you could not find an EM job.

Specialists wanted more stipends and hospital balked so wanted to have EM cover. They don't care about OB/Cards and only care about dropping stipends. Our group balked and I am sure they just paid the stipend.

Some on here think that they crap on EM but trust me, they crap on all specialists. From my years at the executive meeting level, they tried to cut hospitalist, ENT, Surg, plastics stipend. All of them complained. No one was happy.
Click to expand...
The problem is mostly financial. You guys likely had levers to pull to get your per patient reimbursement (and therefore your hourly) up. Many of those problems wont change (all the financial stuff) and therefore younger docs are stuck. Just a different perspective. Also if the parachute was small then you missed out. Things got much better in EM for SDGs.
 
EctopicFetus said:
The problem is mostly financial. You guys likely had levers to pull to get your per patient reimbursement (and therefore your hourly) up. Many of those problems wont change (all the financial stuff) and therefore younger docs are stuck. Just a different perspective. Also if the parachute was small then you missed out. Things got much better in EM for SDGs.
Click to expand...
Reimbursement and practice of medicine continually change. Economics of today is not the same 10 yrs ago. Reimbursement changes in a heartbeat. It is hard being a SDG battling new headwinds every few years.

Did we have levers to increase reimbursement/income? We had bare bone admin costs. We changed billers a few time and ended up with a strong billing group by almost all metrics. We continue to pull levers throughout our 15+ year run with every headwinds. The only big lever we had was hiring APCs; if you have a big magical lever, I would love to hear it. Its a binary situation for SDG governed essentially by income in. We had zero control over reimbursement, we have zero leverage with carriers, we were already out of network.

But there is no lever that we could pull to overcome a $5M hospitalist stipend that would keep on growing. I am confident in saying that 100% of those demonizing "old docs" who sold out would have done the same with a $5M headwind.

Lets be honest, if we sold out to a SDG of young docs, they would have immediately turned around and sold it to TH.

You say that things got better for EM SDGs which I am not sure is true, but when we were faced with the decision there were no way we would know what the future held.

Sure there were SDGs that sold out and "screwed" younger docs, but lets be honest. Everyone has a number and you (general) would sell too if the number is right. It is easy to demonize those who took the risk to start a SDG and then cashed out but until you start a SDG with all of the work/risks, you will never understand the headwinds SDGs had/have.
 
emergentmd said:
Reimbursement and practice of medicine continually change. Economics of today is not the same 10 yrs ago. Reimbursement changes in a heartbeat. It is hard being a SDG battling new headwinds every few years.

Did we have levers to increase reimbursement/income? We had bare bone admin costs. We changed billers a few time and ended up with a strong billing group by almost all metrics. We continue to pull levers throughout our 15+ year run with every headwinds. The only big lever we had was hiring APCs; if you have a big magical lever, I would love to hear it. Its a binary situation for SDG governed essentially by income in. We had zero control over reimbursement, we have zero leverage with carriers, we were already out of network.

But there is no lever that we could pull to overcome a $5M hospitalist stipend that would keep on growing. I am confident in saying that 100% of those demonizing "old docs" who sold out would have done the same with a $5M headwind.

Lets be honest, if we sold out to a SDG of young docs, they would have immediately turned around and sold it to TH.

You say that things got better for EM SDGs which I am not sure is true, but when we were faced with the decision there were no way we would know what the future held.

Sure there were SDGs that sold out and "screwed" younger docs, but lets be honest. Everyone has a number and you (general) would sell too if the number is right. It is easy to demonize those who took the risk to start a SDG and then cashed out but until you start a SDG with all of the work/risks, you will never understand the headwinds SDGs had/have.
Click to expand...
Been there is all im saying. Every group has its challenges but truly what could TH do that you couldnt. We both know they dont take these contracts to lose money. Heck at the time you sold (I assume) PE money was flowing in.. It wasnt so they would not get a return on their money. Im not vilifying you. It’s what it is. I also totally agree that many young docs would bail if the money was there and 95% of those who complain do absolutely nothing when it comes to changing their circumstances and really just want to ride the coattails and again 95% dont want to do anything extra at all.
 
EctopicFetus said:
Been there is all im saying. Every group has its challenges but truly what could TH do that you couldnt. We both know they dont take these contracts to lose money. Heck at the time you sold (I assume) PE money was flowing in.. It wasnt so they would not get a return on their money. Im not vilifying you. It’s what it is. I also totally agree that many young docs would bail if the money was there and 95% of those who complain do absolutely nothing when it comes to changing their circumstances and really just want to ride the coattails and again 95% dont want to do anything extra at all.
Click to expand...
You know the answer to this.
1. They can negotiate better rates.
2. They can hire/money whip coverage when we could not.
3. They have connections to the C suite of HCA
4. They can afford to lose money in order to enter the market especially if they took over the $5M hospitalist stipend
5. They are big enough to threaten HCA if they needed a hospitalist Stipend. They are big enough to lose the contract and not care. Our SDG have roots in the city and would be hard to leave. TH could care less if they lost the contract.
6. TH has a hospitalist section and have some levers to increase billing/charges. We have no idea how to run a hospitalist group so have no levers


I can go on and on, but TH lost money for the first few years. I can tell you with certainty they were not profitable but penetrating a "valuable" market was worth it.
 
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New EM Residency: Lahey Clinic (Burlington, MA), Inaugural Class July 2027

Hi all, PD here for a brand-new EM program I'm excited to share.

Lahey Clinic Emergency Medicine Residency
  • 4-year categorical, ACGME-accredited
  • 6 residents in our inaugural class (July 2027 start)
  • Home site: Lahey Clinic — Level I Trauma Center, tertiary academic medical center
  • Rotations across community, pediatric, and critical care sites
  • Affiliated with UMass Chan Lahey Regional Medical Campus and Beth Israel Lahey Health — full access to research, scholarship, and mentorship across that network
Being a new program means the founding class gets a real hand in shaping curriculum and culture from day one. Not something you get walking into a program with decades of institutional momentum already set.

Full welcome letter and more info on our site: Lahey Clinic EM Residency

Happy to answer questions here, about the trauma center, the rotation structure, or what founding-class life looks like. You can also reach me directly at [email protected].

— Katerina Papa, DO, Program Director

Please reach out to me directly at [email protected] if you have any questions. We look forward to seeing your application soon.

Warmly,
Katerina Papa, DO
Program Director, Emergency Medicine Residency

MOD ACTION: This thread and all replies were merged into the Residency Programs: Announcements and Advertisements thread. -southerndoc
 
Last edited by a moderator:
Interest Reaction GIF
 
Its unfortunate than EM is just used for labor this is an academic program but after doing 4 years what fellowships are available? Just a basic CC fellowship and since its harvard affiliated you will be a second class fellow to Pulm and Anesthesiology.
 
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[from the peanut gallery]

They are a hospital employed group; technically they aren't Harvard-affiliated, they are UMass affiliated. Parts of the larger BILH network are Harvard affiliated, and I'm sure some of the mentorship and research and such will cross-pollinate...
 
carbonizedeyesockets said:
Urgent care and telemedicine rotation!? 🤮

As if we don't already do enough urgent care in the actual emergency department - just more watering down of EM.

This is just another health system using underpaid residents to cut costs.
Click to expand...

It’s 4 years and what’s worse by the PD post this here she either doesn’t even look at this forum.
 
carbonizedeyesockets said:
Urgent care and telemedicine rotation!? 🤮

As if we don't already do enough urgent care in the actual emergency department - just more watering down of EM.

This is just another health system using underpaid residents to cut costs.
Click to expand...
Not EM but I wonder if an urgent care rotation might be useful for the different setting. Urgent care in an urgent care is different from urgent care in the ED, if nothing else based on available resources.
 
LaheyClinicEM said:
New EM Residency: Lahey Clinic (Burlington, MA), Inaugural Class July 2027

Hi all, PD here for a brand-new EM program I'm excited to share.

Lahey Clinic Emergency Medicine Residency
  • 4-year categorical, ACGME-accredited
  • 6 residents in our inaugural class (July 2027 start)
  • Home site: Lahey Clinic — Level I Trauma Center, tertiary academic medical center
  • Rotations across community, pediatric, and critical care sites
  • Affiliated with UMass Chan Lahey Regional Medical Campus and Beth Israel Lahey Health — full access to research, scholarship, and mentorship across that network
Being a new program means the founding class gets a real hand in shaping curriculum and culture from day one. Not something you get walking into a program with decades of institutional momentum already set.

Full welcome letter and more info on our site: Lahey Clinic EM Residency

Happy to answer questions here, about the trauma center, the rotation structure, or what founding-class life looks like. You can also reach me directly at [email protected].

— Katerina Papa, DO, Program Director

Please reach out to me directly at [email protected] if you have any questions. We look forward to seeing your application soon.

Warmly,
Katerina Papa, DO
Program Director, Emergency Medicine Residency
Click to expand...
How long is the residency? The attendings are employed by whom?
 
I'll at least try and give them credit for small classes with 6 residents.

At the same time Boston has 3 residencies with 100+ residents.

I'd be very suspicious however about their claims on the website to include all the crazy high acuity patients and no competition for procedures.
The hospital already has multiple established programs to include anesthesiology and general surgery which currently manage the critical traumas and
based on their website they only see 1500 trauma admissions which is at the bare minimum for level 1 trauma certification.

The residents even have to do rotations at shock trauma since they get so few trauma cases in the emergency department.
 
carbonizedeyesockets said:
Urgent care and telemedicine rotation!? 🤮

As if we don't already do enough urgent care in the actual emergency department - just more watering down of EM.

This is just another health system using underpaid residents to cut costs.
Click to expand...

Lmao what a joke. A rotation in something midlevels do unsupervised from day one.

VA Hopeful Dr said:
Not EM but I wonder if an urgent care rotation might be useful for the different setting. Urgent care in an urgent care is different from urgent care in the ED, if
nothing else based on available resources.
Click to expand...

No.
 
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I'll add that as far as I can tell from the website the PD has zero previous residency faculty experience and has literally just worked at Lahey Hospital.
 
Furthermore on the website there are no aPDs listed on the residency faculty for the residency program.
 
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