Residency search- all HCAs bad?

[DrZoster]

I'm aware of the general reputation HCA/CMG residencies have as being awful, corporate pervisions to the concept of clinical education that should be avoided at all cost. I'm aware that they are expanding by creating brand new residency programs or buying up previously independent programs or merging with university affiliated programs. I am not completely aware of the complexities of ED and GME management so I'm unsure how recent mergers or buyouts would affect the quality of education over the next 3-4 years. I'm thinking of the Detroit Medical Center- Sinai Grace and Detroit Receiving that seem to have good reputations but have been owned by Tenet for the past several years.

When searching for programs, should the HCA label on a program lead to immediately filling the row in red on my spreadsheet or are there any that are worth digging into further? Any of these CMG programs with redeemable qualities or minimal corporate influence despite the label?


Thanks for the input

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[EctopicFetus]

Yes. All HCA is bad. Its a terrible place to work and the indoctrination will make you a broken stockholm syndrome suffering fool. Do not rank. Tenet isnt HCA. In general find the well established good reputation programs. Avoid the new ones or about to be established cause anyone with a brain will be annoyed. Now there are plenty of brainless *****s out there so you will find some 4th tier job for sure. If you hope to do better stick with legit stuff.

 

[sylvanthus]

Yes.

 

[alpinism]

The biggest problem with HCA residencies is that most do not follow evidenced based medicine.

Do you really want to go to a program where viral illnesses are treated with antibiotics and fluid boluses?

 

[bravotwozero]

I think the bigger question is, do you really want to go into a field where employment prospects and earning potential are inevitably declining every year?

 

[Rekt]

Blood cultures. Lactic. 30mL/kg bolus. 1g Rocephin. Head to toe CT. Everything is a level 5. PAs and NPs are your equal or better than you.


Congrats on finishing your HCA residency.

 

[NYEMMED]

Avoid.

I would go to an established residency.
This is the training you need for the rest of your career. I would not allow a residency started just for the secondary gain of the system to be trusted

 

[RoyBasch]

Yes, these programs suck. They don’t need a devils advocate.

I presume the reason you are giving them a second look is because they have a program in a geography you favor.

Think again, this training is crucial for the rest of your career. Get the best you can. If the beach, mountains, big city, etc. is important to you, you can seek that out later (you will trade a lot of salary, but that’s a different thread).

 

[DrZoster]

I hear you guys. I'm planning on applying far and wide to well-established programs. I was curious if anybody had an opinion on whether or not the CMG residencies deserve a second look

 

[NYEMMED]

I hear you guys. I'm planning on applying far and wide to well-established programs. I was curious if anybody had an opinion on whether or not the CMG residencies deserve a second look

Nope. Any CMG residency should have zero looks

 

[EctopicFetus]

I hear you guys. I'm planning on applying far and wide to well-established programs. I was curious if anybody had an opinion on whether or not the CMG residencies deserve a second look

All cancer is bad. All CMG residencies are bad.
-Fin
Roll credits

 

[Rendar5]

All CMG residencies are suspect. Tenet is not a CMG. HCA is because it’s directly partnered with Envision.

 

[Siggy]

All cancer is bad. All CMG residencies are bad.
-Fin
Roll credits

Unlike CMGs, cancer starts to grow on you after a while.

 

[benem]

I'm unsure how recent mergers or buyouts would affect the quality of education over the next 3-4 years. I'm thinking of the Detroit Medical Center- Sinai Grace and Detroit Receiving that seem to have good reputations but have been owned by Tenet for the past several years.

I’d be careful with for-profit teaching hospitals of all stripes. Remember that Tenet was more than willing to sell Hahnemann, Creighton, and Atlanta Medical Center to organizations that shut them down. DMC’s two residencies historically were very strong but I can’t see Tenet wanting to keep DMC. DMC recently shut down their neurosurgery residency and transplant program. Tenet has sold most of their non-core hospitals and is focusing on its surgery center business. Do you want to end up working for a hospital that could be sold at any moment to someone that may have no experience in running a hospital?

 

[southerndoc]

Nope. Any CMG residency should have zero looks

USF/Tampa General is a pretty good program ran by CMGs. My program is staffed by a CMG (ApolloMD). We're both busy programs that I think train residents pretty well. I'm biased about my own program, but USF/Tampa General seems to be a respected program.

 

[Trousseau]

Not EM, but I did an HCA residency in IM. Been an attending hospitalist for over a year now (at a non-HCA, non-CMG place).

I felt I was trained well and had faculty that cared about how we were doing and learning. Of course I know there is a stigma to coming from an HCA place, which made my initial job search harder, but I think I will be on to brighter places in the future.

I think it’s site-dependent, I’m sure there are many HCA sites that are dumpster fires.

 

[EctopicFetus]

Not EM, but I did an HCA residency in IM. Been an attending hospitalist for over a year now (at a non-HCA, non-CMG place).

I felt I was trained well and had faculty that cared about how we were doing and learning. Of course I know there is a stigma to coming from an HCA place, which made my initial job search harder, but I think I will be on to brighter places in the future.

I think it’s site-dependent, I’m sure there are many HCA sites that are dumpster fires.

I dont know you or where you trained but no one thinks they are poorly trained. Im not saying you are. The key is the line where you say there is a stigma and made your initial job search harder.

For the residents and med students on here. That is 2 strikes in an ever more competetive market. Eventually it doesnt matter. You could go to a crappy med school and a crappy residency (in any field) and eventually like your SAT score it doesnt matter anymore.

I was a chief resident and went to a fancy undergrad. No one cares right now. Its all about my recent work experience and what i have done. Same for you @Trousseau Its all about how good of a hospitalist you are now.

 

[kumatie]

I'm aware of the general reputation HCA/CMG residencies have as being awful, corporate pervisions to the concept of clinical education that should be avoided at all cost. I'm aware that they are expanding by creating brand new residency programs or buying up previously independent programs or merging with university affiliated programs. I am not completely aware of the complexities of ED and GME management so I'm unsure how recent mergers or buyouts would affect the quality of education over the next 3-4 years. I'm thinking of the Detroit Medical Center- Sinai Grace and Detroit Receiving that seem to have good reputations but have been owned by Tenet for the past several years.

When searching for programs, should the HCA label on a program lead to immediately filling the row in red on my spreadsheet or are there any that are worth digging into further? Any of these CMG programs with redeemable qualities or minimal corporate influence despite the label?


Thanks for the input

I will not hire anyone from an HCA. Ever. The last graduate from a HCA left his shift for 2 hrs for a lunch break. Someone came in with a STEMI and died. The other could not intubate or do any procedures. I am talking like didn’t even know how to hold the glidescope or know what RSI is. I remember the nurse manger bringing me in and having me watch him. The guy was trying to intubate a “combative” patient. The patient was awake and talking and he tried to stick the glidescope down his throat. I remember the patient pushing the docs hands away and then asking “why are you putting that down my throat”. I can’t make this **** up. I thought I was hallucinating.

If I see or hear anything related to a applicant being from an HCA I burn the application and then **** on it. That how much I despise the HCA. I would even go as far to say if you can only match at an HCA residency, you probably should not be practicing emergency medicine at all. Do something else that doesn’t involve life or death situations. It is utterly embarrassing to EM the quality of graduates that come from these programs.

I consider graduates from HCA serial killers. They are utterly dangerous and harm and kill patients. It makes my stomach sick thinking about this crap.

 

[EctopicFetus]

I will not hire anyone from an HCA. Ever. The last graduate from a HCA left his shift for 2 hrs for a lunch break. Someone came in with a STEMI and died. The other could not intubate or do any procedures. I am talking like didn’t even know how to hold the glidescope or know what RSI is. I remember the nurse manger bringing me in and having me watch him. The guy was trying to intubate a “combative” patient. The patient was awake and talking and he tried to stick the glidescope down his throat. I remember the patient pushing the docs hands away and then asking “why are you putting that down my throat”. I can’t make this **** up. I thought I was hallucinating.

If I see or hear anything related to a applicant being from an HCA I burn the application and then **** on it. That how much I despise the HCA. I would even go as far to say if you can only match at an HCA residency, you probably should not be practicing emergency medicine at all. Do something else that doesn’t involve life or death situations. It is utterly embarrassing to EM the quality of graduates that come from these programs.

I consider graduates from HCA serial killers. They are utterly dangerous and harm and kill patients. It makes my stomach sick thinking about this crap.

Yowza. I’ll admit I won’t hire an hca grad but these stories have me worried. With hca opening up residencies left and right we will all be patients eventually.

 

[RustedFox]

Yowza. I’ll admit I won’t hire an hca grad but these stories have me worried. With hca opening up residencies left and right we will all be patients eventually.

Yeah, I've worked with an HCA grad. He's a complete ostrich.

 

[Old_Mil]

When searching for programs, should the HCA label on a program lead to immediately filling the row in red on my spreadsheet or are there any that are worth digging into further? Any of these CMG programs with redeemable qualities or minimal corporate influence despite the label?

HCA is so bad, HCA programs should automatically be DNR (do not rank). Do a different kind of residency if that's all you can manage.

 

[Rendar5]

HCA will just end up hiring their own and they won’t be upset about lack of quality care as that is never their focus

 

[thegenius]

I will not hire anyone from an HCA. Ever. The last graduate from a HCA left his shift for 2 hrs for a lunch break. Someone came in with a STEMI and died. The other could not intubate or do any procedures. I am talking like didn’t even know how to hold the glidescope or know what RSI is. I remember the nurse manger bringing me in and having me watch him. The guy was trying to intubate a “combative” patient. The patient was awake and talking and he tried to stick the glidescope down his throat. I remember the patient pushing the docs hands away and then asking “why are you putting that down my throat”. I can’t make this **** up. I thought I was hallucinating.

If I see or hear anything related to a applicant being from an HCA I burn the application and then **** on it. That how much I despise the HCA. I would even go as far to say if you can only match at an HCA residency, you probably should not be practicing emergency medicine at all. Do something else that doesn’t involve life or death situations. It is utterly embarrassing to EM the quality of graduates that come from these programs.

I consider graduates from HCA serial killers. They are utterly dangerous and harm and kill patients. It makes my stomach sick thinking about this crap.

is it possible that particular doctor from HCA was just terrible?

 

[thegenius]

Yeah, I've worked with an HCA grad. He's a complete ostrich.

 

[Trousseau]

HCA is so bad, HCA programs should automatically be DNR (do not rank). Do a different kind of residency if that's all you can manage.

Sometimes the Match doesn’t go your way, and it’s where you gotta go. Doesn’t mean your life is ruined or you’ll be a terrible doctor. We all have to make the best of the circumstances we get.

 

[Rekt]

Sometimes the Match doesn’t go your way, and it’s where you gotta go. Doesn’t mean your life is ruined or you’ll be a terrible doctor. We all have to make the best of the circumstances we get.

This is a bad take. Those circumstances you "get" are suboptimal and dangerous. If you can look past patient safety, then at least look at yourself being open to litigation more so than people adequately trained.

Also, we should change all the HCA in this thread to CMGs (or my preference CMCompanies since there is nothing group like about them).

 

[kumatie]

This is a bad take. Those circumstances you "get" are suboptimal and dangerous. If you can look past patient safety, then at least look at yourself being open to litigation more so than people adequately trained.

Also, we should change all the HCA in this thread to CMGs (or my preference CMCompanies since there is nothing group like about them).

I wholeheartedly agree with this statement. There is a upcoming generation of doctors who have never been told no. Have never been told that they shouldn’t become a doctor. They’ve gone through medical schools who will except anyone and have no absolutely no standards. And then they go on to a residency where they push through the system to make financial gain. Or worse, “it’s the only place they matched”.

The system is such that if you want to become a doctor you can. That is the only requirement. Never mind the skill set, intelligence and resilience and other attributes needed to be a successful physician. There’s no weeding out. The Everyone one gets a trophy, everyone gets a price sentiment has reached medical training and it is terrifying. People are finding out after going to residency and medical school and decades of “training” that they don’t have what it takes to be a doctor in the real world.

I live in a flyover state (because of my husband) and work for private democratic group. It is hard recruiting and we usually get applicants that are bottom of the barrel. Many HCA candidates. One I just interviewed openly admitted he didn’t like doing procedures because “he faints at the sight of blood”. WTF?!
I’m sorry if this offends any HCA graduates, but anyone matching into one of these programs should think long and hard about whether they truely should be an ER physician.

 

[RustedFox]

I wholeheartedly agree with this statement. There is a upcoming generation of doctors who have never been told no. Have never been told that they shouldn’t become a doctor. They’ve gone through medical schools who will except anyone and have no absolutely no standards. And then they go on to a residency where they push through the system to make financial gain. Or worse, “it’s the only place they matched”.

The system is such that if you want to become a doctor you can. That is the only requirement. Never mind the skill set, intelligence and resilience and other attributes needed to be a successful physician. There’s no weeding out. The Everyone one gets a trophy, everyone gets a price sentiment has reached medical training and it is terrifying. People are finding out after going to residency and medical school and decades of “training” that they don’t have what it takes to be a doctor in the real world.

I live in a flyover state (because of my husband) and work for private democratic group. It is hard recruiting and we usually get applicants that are bottom of the barrel. Many HCA candidates. One I just interviewed openly admitted he didn’t like doing procedures because “he faints at the sight of blood”. WTF?!
I’m sorry if this offends any HCA graduates, but anyone matching into one of these programs should think long and hard about whether they truely should be an ER physician.

Right?! RIGHT!!?

It's like: I want to be a strongman, and compete in strongman competitions, but I don't like the idea of hitting the gym hard every day. I just want to go do it; I don't want to EARN it.

Similar situation with the "body positivity" ostriches. You want a beach bod? It takes work. You're not "fatphobic" if you want to better yourself.

America needs to get a grip.

 

[VA Hopeful Dr]

I wholeheartedly agree with this statement. There is a upcoming generation of doctors who have never been told no. Have never been told that they shouldn’t become a doctor. They’ve gone through medical schools who will except anyone and have no absolutely no standards. And then they go on to a residency where they push through the system to make financial gain. Or worse, “it’s the only place they matched”.

The system is such that if you want to become a doctor you can. That is the only requirement. Never mind the skill set, intelligence and resilience and other attributes needed to be a successful physician. There’s no weeding out. The Everyone one gets a trophy, everyone gets a price sentiment has reached medical training and it is terrifying. People are finding out after going to residency and medical school and decades of “training” that they don’t have what it takes to be a doctor in the real world.

I live in a flyover state (because of my husband) and work for private democratic group. It is hard recruiting and we usually get applicants that are bottom of the barrel. Many HCA candidates. One I just interviewed openly admitted he didn’t like doing procedures because “he faints at the sight of blood”. WTF?!
I’m sorry if this offends any HCA graduates, but anyone matching into one of these programs should think long and hard about whether they truely should be an ER physician.

Head over to the pre-med forums, the first bold part isn't at all true outside of Caribbean schools and the match rate from those schools is abysmal.

That said, the second bold part is just stupid on that person's part. I had a classmate who fainted during our first anatomy lab and her first day in the OR on surgery as a 3rd year so she is now a radiologist. That's what you do in those circumstances. I'm that way with suctioning respiratory secretions so I knew anything inpatient based wasn't going to work for me long term. My wife is that way with any eye procedures so ophthalmology was the first thing she crossed off her list.

 

[thegenius]

Right?! RIGHT!!?

It's like: I want to be a strongman, and compete in strongman competitions, but I don't like the idea of hitting the gym hard every day. I just want to go do it; I don't want to EARN it.

Similar situation with the "body positivity" ostriches. You want a beach bod? It takes work. You're not "fatphobic" if you want to better yourself.

America needs to get a grip.

You really have something against ostriches.

 

[RustedFox]

You really have something against ostriches.

You're catching on.

 

[clibby]

This is a bad take. Those circumstances you "get" are suboptimal and dangerous. If you can look past patient safety, then at least look at yourself being open to litigation more so than people adequately trained.

Also, we should change all the HCA in this thread to CMGs (or my preference CMCompanies since there is nothing group like about them).

That starts to get complicated. Some HCA hospitals with residencies have the ED staffed by SDGs and some non-profit hospitals have residencies staffed by CMGs. I agree that the profit motive of the ED group is more influential than who owns the hospital, but this is a whole mess that EPs over the past 20 years have allowed our specialty to develop into.

While I get the vitriol towards the for profit motives of places like HCA, blanket judgment of people does nothing other than make someone seem bitter, elitist, and unpleasant. All types of hospitals have been doing the same thing with residencies, not just HCA. I mean we have South Alabama, Abrazzo, multiple UHS hospitals, multiple Dignity hospitals, multiple non HCA FL hospitals, multiple Ascension and Spectrum hospitals in MI, and the list goes on and on. I have yet to see objective data that any one residency produces EPs that are better than another or that any one residency produces EPs that have less malpractice claims. We need to raise the standards of EM training all around for public accountability and training opportunities per resident which means that many new and some established programs need to cut spots or close.

That said, my advice to the OP would be to rank HCA programs lower not because you will not necessarily get good training (each program is different and I would recommend a couple HCA over some established programs for clinical skills), but there seems to be enough angry EPs that will try to brush you off early in your career that it isn't worth the headache unless you want to be in a specific area. If you want to do academia, I suspect they are even more anti-HCA, so reputation and academic niche matters even more than competency. In the end, if you can help it, it isn't worth the headache for the rest of your career.

 

[Trousseau]

I wholeheartedly agree with this statement. There is a upcoming generation of doctors who have never been told no. Have never been told that they shouldn’t become a doctor. They’ve gone through medical schools who will except anyone and have no absolutely no standards. And then they go on to a residency where they push through the system to make financial gain. Or worse, “it’s the only place they matched”.

The system is such that if you want to become a doctor you can. That is the only requirement. Never mind the skill set, intelligence and resilience and other attributes needed to be a successful physician. There’s no weeding out. The Everyone one gets a trophy, everyone gets a price sentiment has reached medical training and it is terrifying. People are finding out after going to residency and medical school and decades of “training” that they don’t have what it takes to be a doctor in the real world.

I live in a flyover state (because of my husband) and work for private democratic group. It is hard recruiting and we usually get applicants that are bottom of the barrel. Many HCA candidates. One I just interviewed openly admitted he didn’t like doing procedures because “he faints at the sight of blood”. WTF?!
I’m sorry if this offends any HCA graduates, but anyone matching into one of these programs should think long and hard about whether they truely should be an ER physician.

But all this is the opposite of truth. The med schools that admit everybody (Caribbean) have horrifically bad attrition and match rates. And anyone who has the skillset to pass this profession’s exam gauntlet and do the 80 (sometimes 100) hr weeks has proven their intelligence and resilience many times over.

The HCA guys are here to stay. And medical students these days seem to be very demanding about where they want to live, so in less desirable parts of the country, HCA grads might be all you have to look at lol. Eventually there will be more and more, the sky won’t fall, and I think the stigma will lessen.

For the OP, again I would not deliberately seek out an HCA program, it’s not worth the crappy first job search. But if it’s what you land in for whatever reason, I would not listen to the doomsayers either.

 

[Franzd'Epinay]

The system is such that if you want to become a doctor you can. That is the only requirement. Never mind the skill set, intelligence and resilience and other attributes needed to be a successful physician. There’s no weeding out.

Applicants to MD schools

• 1980-1981: 36,083
• 2000-2001: 37,088
• 2020-2021: 53,030

Matriculants to MD schools.

• 1980-1981: 16,587
• 2000-2001: 16,301
• 2020-2021: 22,239

Matriculants/Applicants:

• 1980-1981: 16,587/36,083 = 45.97%
• 2000-2001: 16,301/37,088 = 43.95%
• 2020-2021: 22,239/53,030 = 41.94%

Total Bachelor's degrees awarded:

• 1980-1981: 935,140
• 2000-2001: 1,244,171
• 2019-2020: 2,038,431 (No 2020-2021 data)

Matriculants/Graduating seniors:

• 1980-1981: 16,587/935,140 = 1.77%
• 2000-2001: 16,301/1,244,171 = 1.31%
• 2019-2020: 21,869/2,038,431 = 1.07% (No 2020-2021 data)

Sources:

Bachelor's degrees conferred by postsecondary institutions, by field of study: Selected years, 1970-71 through 2019-20

The primary purpose of the Digest of Education Statistics is to provide a compilation of statistical information covering the broad field of American education from prekindergarten through graduate school. The Digest includes a selection of data from many sources, both government and private...

nces.ed.gov

https://www.aamc.org/media/37701/download?attachment

https://www.aamc.org/media/37706/download?attachment

Someone else can do the math with DO schools, but I doubt it'll get us anywhere closer to the boomerific statement that anyone can become a physician nowadays.

 

[southerndoc]

You really have something against ostriches.

This reminds me of DrMom who had an ostrich as her avatar. I miss seeing her posts on here.

 

[thegenius]

You're catching on.

That ostrich is breathing out smoke. It swallowed a cigar.

 

[RustedFox]

That ostrich is breathing out smoke. It swallowed a cigar.

Is my brain making this up, or do I remember an old-timey, black-and-white cartoon involving an ostrich that swallowed a cigar, Groucho Marx-style?

 

[kumatie]

What does it mean when one is called an ostrich? I am unfamiliar with this term. I just called call a boomer. I know that’s not a compliment, but this ostrich talked alludes me.

 

[RustedFox]

What does it mean when one is called an ostrich? I am unfamiliar with this term. I just called call a boomer. I know that’s not a compliment, but this ostrich talked alludes me.

You can be an ostrich.
You can act ostriched.

 

[sylvanthus]

Right?! RIGHT!!?

It's like: I want to be a strongman, and compete in strongman competitions, but I don't like the idea of hitting the gym hard every day. I just want to go do it; I don't want to EARN it.

Similar situation with the "body positivity" ostriches. You want a beach bod? It takes work. You're not "fatphobic" if you want to better yourself.

America needs to get a grip.

This could be said of all the jenny mcjennerson or whatevs the name is. Everyone wants to be a doctor, noone wants to put in the work. ‘murica fuk ya!

Edited to add: Were hosed when we get old and need healthcare. May have to channel my inner american indian and just be left behind on the prarie.

 

[thegenius]

What does it mean when one is called an ostrich? I am unfamiliar with this term. I just called call a boomer. I know that’s not a compliment, but this ostrich talked alludes me.

he's just making up stuff.

Next year it will be "platypus" and "platypussied"

 

[Tenk]

Ostriches suck. Everyone knows it’s all about being an eagle.

 

[GonnaBeADoc2222]

Sometimes the Match doesn’t go your way, and it’s where you gotta go. Doesn’t mean your life is ruined or you’ll be a terrible doctor. We all have to make the best of the circumstances we get.

Nah.

You don't gotta be a genius to get into a respectable US allopathic (or even osteopathic) medical school and respectable EM residency. 30 on the MCAT (or whatever the equivalent is these days), 3.6 GPA, 220/230 on step 1 or thereabouts.

Takes hard work and resiliency but not really the highest bar.

 

[RustedFox]

Nah.

You don't gotta be a genius to get into a respectable US allopathic (or even osteopathic) medical school and respectable EM residency. 30 on the MCAT (or whatever the equivalent is these days), 3.6 GPA, 220/230 on step 1 or thereabouts.

Takes hard work and resiliency but not really the highest bar.

I had a 3.6 and a 34 on the MCAT.
They passed on me.
SGU for the win.

 

[GonnaBeADoc2222]

I had a 3.6 and a 34 on the MCAT.
They passed on me.
SGU for the win.

That was years ago when there were less medical schools. Im talking 2022.

 

[RustedFox]

That was years ago when there were less medical schools. Im talking 2022.

Ouch. You called me old. Lol.

 

[GonnaBeADoc2222]

Ouch. You called me old. Lol.

Lol. Im not that far behind you!

 

[Franzd'Epinay]

That was years ago when there were less medical schools. Im talking 2022.

There are more medical schools now, but there are also a lot more kids applying.

I think we’re just lying to ourselves if we think we’re hot **** and the peak of Med school competitiveness just so happened to coincide with when we applied. I’m getting some real "Coach woulda put me in fourth quarter, we would've been state champions" delusional vibes from a lot of these posts.

 

[VA Hopeful Dr]

There are more medical schools now, but there are also a lot more kids applying.

I think we’re just lying to ourselves if we think we’re hot **** and the peak of Med school competitiveness just so happened to coincide with when we applied. I’m getting some real "Coach woulda put me in fourth quarter, we would've been state champions" delusional vibes from a lot of these posts.

Ehhh, it's some of both. You can look at admissions for incoming classes at various schools and see this. Newer schools are easier than when most of us came through while older schools are harder. This is based just on GPA and MCAT of course and that's not all there is to admissions.

 

[RustedFox]

he's just making up stuff.

Next year it will be "platypus" and "platypussied"

Disclosure:

I was told that I had to clean up my language, because a patient in the hall bed (where there isn't supposed to be a bed at all) overheard me say something to RN staff along the lines of:

"No. We need to do this now before (the patient) gets up there because the OSTRICHES on the floor don't know what they're doing."

According to some, this "doesn't inspire confidence in patient care".

I meant what I said, too. No way in hell would I want a family member to be cared for at my shop, under certain services.

I also recall declaring that: "the ICU is full of ostriches."