Specialities for lazy people wanting relaxed 8-5 job (serious)

[Dharma]

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Definitely open to interpretation but I would venture that your interpretation is one that represents a very small minority.

Most of my surgical colleagues are very happy with our choice of field but no one would say it's a lifestyle specialty.

I dint think they would. But good luck to those looking for lifestyle working a job they dread.

 

[Mass Effect]

Thinking that psych is for the lazy or a guaranteed means to a laid-back lifestyle? If that's so, you may find yourself walking the path of misery. Psych is for those whose primary motivation is a passion for treating those with mental illness.

Psych does guarantee a laid-back lifestyle if that's what you shoot for. Not sure how you can debate that.

+ social work (e.g. finding placement, helping extending utility bill deadlines), law enforcement (e.g parole/probation officers), lawyers (e.g hearings, court, 303's, 304's, etc)… and these play a significant role during one's day, not just a here and there kind of thing, but rather quite regularly. So, a lot of stuff outside of what one may see as being within the realm of medicine. Yes, there is ancillary staff to help with this things, but the psychiatrist is very much involved, often at the lead and doing some of the dirty work him/herself.

It's not a lifestyle speciality… unless you have some passion for it. Just tolerating it, won't be enough.

It's a lifestyle specialty in that you have plenty of opportunities for an 8-5 or 9-5 job with weekends off, which is rare in medicine. And as for everything else you mentioned, it depends entirely on where you are. Where I did my third year rotations, the attendings on medicine spent more time talking to social work than the psychiatrists did. Here in residency, the psych attendings interact with social work, law enforcement, and do go to court now and then, but it sure isn't a "significant" part of one's day as you say. Not even close. Also, that's entirely dependent on what branch of psychiatry you decide to practice. In emergency psych, C/L, reproductive psych, transplant psych, or a number of others, you don't have to deal with court regularly, if at all, and in most of ones I just mentioned (with the exception of emergency psych), you have nothing to do with social work either.

Let's be honest though, I bet most people gunning for psych are aiming for those cash-pay purely outpatient gigs.

Spoken by someone with limited exposure to psychiatrists or aspiring psychiatrists. "Most" want to treat the mentally ill and don't aspire to run a cash-only practice.

 

[Dharma]

Psych does guarantee a laid-back lifestyle if that's what you shoot for. Not sure how you can debate .

My point is very simple: if you choose psych bc of the lifestyle first and foremost, you're likely not going to be very happy, regardless of lifestyle and you may (MAY) be doing your patients a disservice as well. That's it.

 

[Winged Scapula]

My point is very simple: if you choose psych bc of the lifestyle first and foremost, you're likely not going to be very happy, regardless of lifestyle and you may (MAY) be doing your patients a disservice as well. That's it.

You weren't very clear about that point.

Instead you focused on defining "lifestyle" as enjoying one's profession which is why most of us questioned you.

NO ONE is arguing that the OP (or any one) should choose a specialty that they didn't actually enjoy or at least tolerate, good lifestyle or not.

 

[Dharma]

You weren't very clear about that point.

Instead you focused on defining "lifestyle" as enjoying one's profession which is why most of us questioned you.

NO ONE is arguing that the OP (or any one) should choose a specialty that they didn't actually enjoy or at least tolerate, good lifestyle or not.

One can attempt to make a point without debate and simply present another prospective instead. My apologies for lack of clarity at onset. Think it's clear now.

 

[Dr. USMLE]

The OP defined himself or herself as "lazy" looking for a "relaxed" job. Radiology has no need for these people. Those people do very poorly both in terms of performance and personal happiness.

1. Volumes are only going to go up in the next nine years. Radiologists are only going to become more integrated into clinical teams. Radiology is moving toward 24 hour service with decreasing teleradiology reliance. The OP's goals are not compatible with the future of radiology.

2. If you count the outside reading and studying (which is not optional), I put in more hours per week as a radiology resident than as an IM intern (with the exception of 4th year)... and you're correct, the workload goes up an attending.

3. People who go into radiology thinking that it will cater to an 8-5, checking-the-email-all-day kind of job are the ones who feel they got "tricked". With a few exceptions, that lifestyle is gone.

4. Agree, but one cannot get a good feel for radiology or the radiology life by shadowing a radiologist.

Don't get me wrong, I love my job, and I would do it again in a heartbeat. But I also like the challenge of reading quickly and accurately, and I don't mind taking the extra steps to make sure patients' imaging is taken care of... which is not infrequently before 8 or after 5. It's not as much work as surgery, and it has different a different kind of stress than something like EM or an IM speciality, but rads has its own type of stress and requires effort to be decent.

Just to add another perspective, I disagree almost completely with the above post. I understand that people in any field do not want to encourage "lazy" people to enter it. However, I am not sure I agree that someone who wants a relaxed, controllable schedule after many years of training is "lazy." To me, that person understands the importance of work-life balance.

Having said that, radiology is a relaxed specialty relative to nearly every other specialty in medicine. As a radiology resident, I work 40-50 hours per week on average, have all major holidays off, get extra conference/academic time off, and have large chunks of protected research and study time. I rarely read more than 30 minutes a day when I come home and that can be said about most of my co-residents. My derm, rad onc, ophtho, and anesthesia friends actually work more than me. Some of my derm friends at "good programs" are even required to share call with plastics and ENT. Some other derm friends work around the same hours without nights or weekends, which I do envy, but make up for it during the week with extremely busy clinic with charting that often extends beyond clinic hours.

Within radiology, mammography and nuclear medicine would be good fits for you. There are also cush outpatient musculoskeletal positions and no-call fully outpatient IR positions (for example in dialysis clinics). VA and academic jobs may also provide you with your desired relaxed day job - residents do most of the work and cover the nights/weekends. VA also offers immunity. Another option would be to build or join a cosmetic IR practice - these are more common than I originally thought and cosmetic IR is a growing area.

Few important caveats:
This only works if you are quick. The pace of work can be quite fast, but to me that's part of the excitement - ability to see very interesting cases every shift. If you are slow, you will likely be less happy because it will extend your work hours. This is similarly applicable to derm and ophtho. The visual nature of the specialities allow for split-second diagnosis and little documentation.

The "lazy genius" stereotype definitely applies to rads residents I know - their laziness is supported by their innate talents and the nature of the speciality (visual nature and elimination of inefficiencies involved in direct patient contact).

Some of these more desirable positions will be moderately competitive.

 

[VisionaryTics]

Some of my derm friends at "good programs" are even required to share call with plastics and ENT.

Can you explain this more? Why would derm share call?

 

[Kahreek]

...

 

[drkristy85]

This gets to the main issue that MadJack and just about any medical student I've ever talk to about the issue seems to fail to understand. When you join a group practice (and the vast majority of graduating dermatology residents do) to a large extent you're at the mercy of what the group expects of you. Even if you are fortunate enough to get a contract that only requires you to work four days or even less, you will be working at anything but a "leisurely pace" (which is precisely what the OP is looking for). Seeing 5-10 patients an hour is not uncommon in many Derm practices. This is in no way compatible with what the OP says he is looking for.

that sounds terrible. why would anyone even bother to become a dermatologist?

 

[drkristy85]

The people who see fewer patients are the ones who work fewer days/week. When at work, the pace is absolutely not "leisurely", which is evidently very important to the OP. Were he willing to sacrifice this stipulation, many other aspects of Dermatology practice lend itself to a a good lifestyle as we all know.

Most psychiatrists in private practice also have a fast pace, often seeing 5-6 patients per hr. I remember seeing that during my Psych rotation. It's disturbing how no one is able to work at a leisurely pace, no matter what field we are in. We should be able to spend more time with patients, not run around like crazy everyday and stay late to finish notes.....

 

[TorMed]

Rheum

 

[Mass Effect]

Most psychiatrists in private practice also have a fast pace, often seeing 5-6 patients per hr. I remember seeing that during my Psych rotation. It's disturbing how no one is able to work at a leisurely pace, no matter what field we are in. We should be able to spend more time with patients, not run around like crazy everyday and stay late to finish notes.....

Why do so many people take their own experience, then apply it to "most" in the field?

 

[IlDestriero]

Most psychiatrists in private practice also have a fast pace, often seeing 5-6 patients per hr. I remember seeing that during my Psych rotation. It's disturbing how no one is able to work at a leisurely pace, no matter what field we are in. We should be able to spend more time with patients, not run around like crazy everyday and stay late to finish notes.....

The two private psychiatrists I know well work 8-4 and 9-5 m-f. One is a solo cash only in a wealthy suburb and will schedule patients up to 6pm when he wants. He bills at ~300/hr and never takes call, etc at a hospital. If his service calls about an acute incident he says call 911 or go to the ED. His shortest med management appt is 30 min. Routine f/u is 45 or 60m and new patients are 2 hours. He has a lot of free time and often blocks an hour for lunch with his wife, 1/2 days for golf, etc.
The other one manages a small group affiliated with a charity. He has another 2 psychiatrists and several PhDs. He can field calls from his bed at home, or from Hawaii. He only takes call at a local psych hospital when he wants to make some extra money working per diem and to keep some skills up. His appointments are 40 min new patient and 20 min f/u. I think most psychiatrists would not be able to see more than 3 patients an hour, and if they wanted to set up shorter med management appointments, they could probably just hire an NP to see 4-5 patients an hour and screen for issues that need physician input. He is always home for dinner by 5.
Both of these guys have an outstanding lifestyle.

 

[Mad Jack]

Psych does guarantee a laid-back lifestyle if that's what you shoot for. Not sure how you can debate that.



It's a lifestyle specialty in that you have plenty of opportunities for an 8-5 or 9-5 job with weekends off, which is rare in medicine. And as for everything else you mentioned, it depends entirely on where you are. Where I did my third year rotations, the attendings on medicine spent more time talking to social work than the psychiatrists did. Here in residency, the psych attendings interact with social work, law enforcement, and do go to court now and then, but it sure isn't a "significant" part of one's day as you say. Not even close. Also, that's entirely dependent on what branch of psychiatry you decide to practice. In emergency psych, C/L, reproductive psych, transplant psych, or a number of others, you don't have to deal with court regularly, if at all, and in most of ones I just mentioned (with the exception of emergency psych), you have nothing to do with social work either.



Spoken by someone with limited exposure to psychiatrists or aspiring psychiatrists. "Most" want to treat the mentally ill and don't aspire to run a cash-only practice.

Statistically, most psychiatrists do not accept insurance.

 

[Silent Cool]

What does PM&R do?

 

[Gadofosveset]

Just to add another perspective, I disagree almost completely with the above post. I understand that people in any field do not want to encourage "lazy" people to enter it. However, I am not sure I agree that someone who wants a relaxed, controllable schedule after many years of training is "lazy." To me, that person understands the importance of work-life balance.

Having said that, radiology is a relaxed specialty relative to nearly every other specialty in medicine. As a radiology resident, I work 40-50 hours per week on average, have all major holidays off, get extra conference/academic time off, and have large chunks of protected research and study time. I rarely read more than 30 minutes a day when I come home and that can be said about most of my co-residents. My derm, rad onc, ophtho, and anesthesia friends actually work more than me. Some of my derm friends at "good programs" are even required to share call with plastics and ENT. Some other derm friends work around the same hours without nights or weekends, which I do envy, but make up for it during the week with extremely busy clinic with charting that often extends beyond clinic hours.

Within radiology, mammography and nuclear medicine would be good fits for you. There are also cush outpatient musculoskeletal positions and no-call fully outpatient IR positions (for example in dialysis clinics). VA and academic jobs may also provide you with your desired relaxed day job - residents do most of the work and cover the nights/weekends. VA also offers immunity. Another option would be to build or join a cosmetic IR practice - these are more common than I originally thought and cosmetic IR is a growing area.

Few important caveats:
This only works if you are quick. The pace of work can be quite fast, but to me that's part of the excitement - ability to see very interesting cases every shift. If you are slow, you will likely be less happy because it will extend your work hours. This is similarly applicable to derm and ophtho. The visual nature of the specialities allow for split-second diagnosis and little documentation.

The "lazy genius" stereotype definitely applies to rads residents I know - their laziness is supported by their innate talents and the nature of the speciality (visual nature and elimination of inefficiencies involved in direct patient contact).

Some of these more desirable positions will be moderately competitive.

As someone who is on the resident admissions board for my institution, "lazy" is not someone we are looking for. "Relaxed" in the sense of chill and friendly is something we are looking for... but someone who doesn't do a good amount of reading off the clock and someone who won't go the extra mile is not someone we are looking for. These people do not tend to do well. The "lazy genius" frequently turns out to be just "lazy" and a poor team player.

In the real radiology work world, no one cares about your Step 1, 2, and 3 scores. No one. What they care about is if you get your work done quickly, go the extra mile, and are a good team player. "Lazy geniuses" are not usually good team players... because they're lazy. If they're good team players... then they're not lazy 'cause that requires more than the minimal effort. Many PP jobs have hidden unpaid expenditures of time. Bosses and team members like the hard worker.

Mammography has traditionally fit the requirements that the OP is interested in. NM has too, but the job outlook there is dim at best. Don't bank your future on "cush" MSK-only OP practice. These positions are kind of a fantasy... if a few of them do exist, you're going to need connections to get them. In general, PP rads work very hard. It's exhausting work. Vein clinic work is going to look different in nine years. "Cush" academic MSK is more likely, but "lazy" academicans are a stereotype and are decreasing as academic volume goes up and tenure-track positions disappear. There's a fair amount of tension between the lazier senior academics with the old mentality and the junior academics who are expected to pick up the volume for them.

Radiology residency is easier in some respects than other residencies, but if a person thinks he or she can put in minimal effort after residency... he or she has a surprise a comin'.

Also, PS... the "lazy genius" tends to get poor recommendations for the PP job search. "Cush" OP practices are not going to take a bottom of the barrel fellowship grad and since there's no objective criteria of quality, faculty recommendations are critical. The lazy senior resident and fellow is not fooling anyone. PPs are looking for someone to work hard for them so they can work less hard. A new grad is not going to jump into a partner position. You may get into a more comfortable PP job 3-5+ years out, but you're gonna work to get there.

The idea of coasting through rads residency and then landing a lucrative minimal-effort PP job is obsolete. Don't say you weren't warned.

 

[drkristy85]

With the exception of mammography in some centers/groups, radiology does not satisfy 1, 2, or 3. No radiology job satisfies 4.
6 and 7 are somewhat misleading.

Please do not consider radiology: radiologists with the OP's goals now spew endlessly on Aunt Minnie (and elsewhere) about how radiology tricked them and now they're forced to be real doctors.

The OP wants PMNR.

yea radiologists frequently work nights/weekends....there is always at least one on-call radiologist at all times. During the day, they all work like crazy. They have way too much to do and too little time, if you ask me

 

[awared2]

The family medicine physician I've been rotating with for the past week gets to the office at 8ish and her last patient is at 3:30 or 4pm. Appointments are scheduled for 30 mins each and are generally hospital follow-ups or sinus sick visits. The office is owned by a hospital system and seems pretty relaxed.

 

[Guero]

Pm&r

And as far as I'm concerned having finished interviewing at Pmr programs, most of the time on call you still get at least 5 hours of sleep. There are a couple exceptions with SOME programs to that rule

This is from a post by scironmike from the pain forums. This is an example of what's possible position if you go through Pmr residency and acquire a pain fellowship

http://www.forums.studentdoctor.net...r-vs.-Private-Practice.1117713/#post-16117136

"I left my academic practice at USC back in 2011 and joined Southern California Permanente Medical Group. I just made partner. For PM&R / pain, the current 4th year physician salary is about $290,000 / year (the pain stipend for finish a fellowshp is $42,000 / year). There is also a draw at the end of the year which is profit sharing with the group. This is generally another $10,000 to $20,000 depending on how the group does. The salary continues to go up every year until a max at year 12. After that, it is just adjustments based on market changes and also based on cost of living increases.

The benefits package is very nice. I pay $32 / month for $1,500,000 term life insurance (as I get older and the price goes up, the med group pays a larger percentage). Long term specialty specific disability is completely paid for. I'm able to invest $51,000 / year tax deferred in a 401K and a Keogh plan. I also have the option of a Roth 401k if I opt for it. Health, dental, and vision are completely covered for the family. I don't pay any premiums for health and dental insurance. I have no copays for any medical care. I will retire with 53% of my salary as a pension. My understanding is tha the pension plan is very well funded.

I work 4.5 days a week. I get a half day off every week for my own academic time. I'm only on call 1 in 10 weeks, and it is all from home. I've never been called after 7:30 PM. If I have to come in on the weekend to do a consult, I get paid for call-back. Currently I get 23 vacation days per year wtih another 5 days for conferences. Partners here for 10 years get something like 33 vacation days per year + 5 days for educational leave. We can acrue vacation up to 90 days, then we get cashed out at our typical hourly rate.

The practice of pain is pretty different at each Kaiser medical center. I've been VERY happy with my practice here at Kaiser Permanente Downey. My colleagues in PM&R, PM&R pain, and Anesthesia / pain management are REALLY great people and are excellent physicians. We have a lot of autonomy in patient care. In my department, we are seeing patients within 3-4 days of a referral. Patient satisfaction is high. I just got authorization to start performing PRP injections. Patients will be able to get PRP for their regular office co-pay. I get two half days a week of fluoro time. I also get to perform electrodiagnostic studies on a regular basis."

I'm speechless. I never would've expected such a well compensated, laid back, contented description from any specialty. I always anticipate some frank negatives. Did the OP you quoted perhaps leave any of those out? I'll go shoot a PM just out of pure curiosity if s/he still has an active account.

Anyways, thanks for sharing.

 

[sloh]

I'm speechless. I never would've expected such a well compensated, laid back, contented description from any specialty. I always anticipate some frank negatives. Did the OP you quoted perhaps leave any of those out? I'll go shoot a PM just out of pure curiosity if s/he still has an active account.

Anyways, thanks for sharing.

I'm a 4th year medical student and during 3rd year, I rotated with a PM&R physician licensed in pain management as well who worked for Kaiser in San Diego. I can attest to the fact that he worked 4.5 days a week. First patient was in around 8:30 and he often times finished around 4-5 pm with an hour for lunch. I remember asking him what he did with his "half day". He said "spend time with my kids." He also went on to say "Work is great.....but not that great." He had so many hobbies outside of work, I couldn't even keep track. Hands down one of the happiest physicians I've ever met.

 

[Guero]

I'm a 4th year medical student and during 3rd year, I rotated with a PM&R physician licensed in pain management as well who worked for Kaiser in San Diego. I can attest to the fact that he worked 4.5 days a week. First patient was in around 8:30 and he often times finished around 4-5 pm with an hour for lunch. I remember asking him what he did with his "half day". He said "spend time with my kids." He also went on to say "Work is great.....but not that great." He had so many hobbies outside of work, I couldn't even keep track. Hands down one of the happiest physicians I've ever met.

I totally understand and believe it all. But what I really want to know is, what comprise the ". . . Not that great" components? What are the downsides, boredom/routine? I'm infinitesimally curious.

 

[sloh]

I totally understand and believe it all. But what I really want to know is, what comprise the ". . . Not that great" components? What are the downsides, boredom/routine? I'm infinitesimally curious.

One off the top of my head is prestige and I think it plays much more of a role in med students' decisions than we want to openly admit

 

[drkristy85]

Pediatric Neurosurgery.

Really? Neurosurgeons work long hours and long cases

 

[colbgw02]

Really? Neurosurgeons work long hours and long cases

Are you new to the internet?

 

[TheWorldWarrior]

palliative care (1 year fellowship after medicine/peds/neuro/other residency)

Problem is, no matter what specialty you choose, there will likely be some amount of weekend/night responsibilities, even if minimal.

I'm doing palliative care after internal medicine [hopefully]. Based on you just making this topic and leaving out the most important factor [whether or not you will do what you like] i'd say this would be a bad choice for you. People will see through your BS; that's really true for family members of dying patients/critically ill patients [though not always]. Rotating through palliative care for 1 month as an elective during 4th year was easily the best rotation/experience of my medical school career. EVERYONE should rotate through palliative care; it gets your empathy back.

 

[Lord_Vader]

Rheum

 

[DermatoFIGHT]

Radiology has some call and weekend shifts. Using RadiHoliday to describe radiology isn't applicable these days.

Radiology is not lifestyle specialty, it is very demanding and difficult. I do not know where people had the impression radiology was easy. There is call and the amount of readings you have to do is exhausting. You work like an animal doing readings.

 

[Biochemist21]

To the OP: I would discourage you from Anesthesia. One, it's not going to meet half your criteria. And two, I don't want someone with your attitude as my co-worker. Sorry but I had to say it. I want someone who is willing to bust their tail when they're at work and not complain about it. I need to be able to trust that my colleague is going to be there if I need an extra hand, not staring at the clock and meandering down when they feel like it. Perhaps some other specialties are more amenable to that mentality. I'm happy to cover your shift if you have an event, or stay a little late if you need some help, but I have to believe that you're going to do the same for me. I don't plan on working 80+ hrs a week as an attending, nor do I expect that of others. Only want to work three days a week? That's fine with me (assuming you're compensated accordingly). But I do expect that when you're at work, you're going to work (and be fun to be around, haha).

I'm not targeting you as an individual, merely your attitude towards work. I hope that you find your dream job/specialty, whatever that may be.

 

[Baller MD]

To the OP: I would discourage you from Anesthesia. One, it's not going to meet half your criteria. And two, I don't want someone with your attitude as my co-worker. Sorry but I had to say it. I want someone who is willing to bust their tail when they're at work and not complain about it. I need to be able to trust that my colleague is going to be there if I need an extra hand, not staring at the clock and meandering down when they feel like it. Perhaps some other specialties are more amenable to that mentality. I'm happy to cover your shift if you have an event, or stay a little late if you need some help, but I have to believe that you're going to do the same for me. I don't plan on working 80+ hrs a week as an attending, nor do I expect that of others. Only want to work three days a week? That's fine with me (assuming you're compensated accordingly). But I do expect that when you're at work, you're going to work (and be fun to be around, haha).

I'm not targeting you as an individual, merely your attitude towards work. I hope that you find your dream job/specialty, whatever that may be.

If CRNAs can get paid stool sit, I don't see why OP shouldn't go into anesthesia.

 

[Biochemist21]

If CRNAs can get paid stool sit, I don't see why OP shouldn't go into anesthesia.

I don't see your logic here?

 

[Kaustikos]

does minute clinic even hire MD's? I thought they just hired nurse practitioners because its cheaper....anyone know of physicians working at minute clinic?

Probably not. But it doesn't hurt to try given the amazing lifestyle.

The other option I've heard is great is "Floater Physicians" that basically go where they're needed in the US. You can (I've heard) choose the hours and place you want to go. Doubt any field but FM/Hospitalist could do it, but it's a nice gig. Minus the traveling, but you can also call it a vacation and/or chance to see different places that might suit you better.


Also, I actually loved Psych when I did it.

 

[drchik4life]

FM wouldn't be realistic based on your criteria.

1. You won't be working at a leisurely/relaxed pace. You'll be seeing as many patients as possible crammed into 15-20min blocks with most having multiple complex medical issues and complaints.
2. Nearly every FM doc I've worked with ends up spending 2-3 hrs every night/weekend doing charting and answering messages/phone calls.
3. You'll also have to keep up to date on the current medical guidelines and CME requirements. That means studying and attending conferences after normal business hours.

Psych will be the same or a little better lifestyle wise but will usually require night/weekend call responsibilities if you're affiliated with a hospital system.

What are you going to do if your patient attempts suicide on a Saturday night?

"Sorry bro I'm not coming in to the ED, its after normal business hours..."

You could go private practice, but then you'll have to deal with all the paperwork and administrative issues involved with running your own business.

Basically you're SOL.

Why would the family doctor come into the ED if their patient is trying to commit suicide? Would they be seen by the ED doc and talk to social work then transferred to a mental health floor and admitted under a psychiatrist? Just curious

 

[Mass Effect]

Why would the family doctor come into the ED if their patient is trying to commit suicide? Would they be seen by the ED doc and talk to social work then transferred to a mental health floor and admitted under a psychiatrist? Just curious

No doctor is going to come in to the ED if their patient is trying to commit suicide. The doctors already there will handle it.

 

[Mass Effect]

Because they were talking about psych?

Not going to happen in psych either.

 

[drchik4life]

No doctor is going to come in to the ED if their patient is trying to commit suicide. The doctors already there will handle it.

Thats what i figured I work in the ED as a scribe and have never seen a family doc come in, just makin sure 🙂

 

[Guero]

No doctor is going to come in to the ED if their patient is trying to commit suicide. The doctors already there will handle it.

Despite that being the case in the vast majority of situations, there are always exceptions. While conducting clinical research before med school, I caught my own former PCP in the ED checking up on her pt being admitted 2/2 SI w/psychosis. It happens, but under the perfect storm: She was the teaching attending on medicine service and got a call from an ED resident notifying her that her pt was being admitted. If you're already there and rounding, why wouldn't you comfort your own pt? I sure as heck would.

 

[Kaustikos]

No doctor is going to come in to the ED if their patient is trying to commit suicide. The doctors already there will handle it.

You mean one shouldn't do that? I guess it'd be stupid to ask if that same physician should not only do that, but start putting orders in by him/herself without talking to the ED team? And also formulating all plans... and doing any procedures necessary?

 

[Mass Effect]

If you're the admitting physician, there is no chance you would have to physically see the patient?

This has been talked about numerous times in this very thread. If the OP is wanting a specialty where he does not have to come into the hospital in the middle of the night, psych fits the bill. Unless a psychiatrist is in a group practice that requires them to come in for admissions or is working in an inpatient psych facility that requires attendings to take in-house call, no the outpatient psychiatrist would not come in to see the patient unless they wanted to (and they most likely would not be the admitting physician). Would every outpatient FM doc come in to the ED in the middle of the night because their patient has a COPD exacerbation?

Despite that being the case in the vast majority of situations, there are always exceptions. While conducting clinical research before med school, I caught my own former PCP in the ED checking up on her pt being admitted 2/2 SI w/psychosis. It happens, but under the perfect storm: She was the teaching attending on medicine service and got a call from an ED resident notifying her that her pt was being admitted. If you're already there and rounding, why wouldn't you comfort your own pt? I sure as heck would.

Well now, don't change the goal post, then accuse someone of not meeting it. Your PCP was an attending on the medicine service and was already there at the hospital. That is NOT the same as a doctor getting out of bed and coming into the ED in the middle of the night because his/her patient attempted suicide. Apples and oranges.

You mean one shouldn't do that? I guess it'd be stupid to ask if that same physician should not only do that, but start putting orders in by him/herself without talking to the ED team? And also formulating all plans... and doing any procedures necessary?

What are you talking about??? What procedures? What orders? You guys can't change a post to mean what you want it to mean, then bitch when others reply to the post as is. The original post was talking about a psychiatrist coming in in the middle of the night because their patient attempted suicide. I'm telling you from real-life experience as a psych resident (and numerous people in this thread have backed me up) that most psych attendings -- especially the outpatient ones, which is what the OP we've all quoted was talking about -- do NOT come in to the hospital because their patient attempted suicide. You can twist the posts to mean anything you want, but the bottom line is what I said, not what you try to make it mean.

 

[Mass Effect]

I wasn't responding to the OP, I was responding to the confusion over alpinism's very specific scenario. The poster was asking why a FP would come in for a suicidal patient, when that's not what alpinism was referring to - he was referring to an on-call psychiatrist getting called about a new admission.

But that's just it. Alpinism was not referring to an on-call psychiatrist. If you go back to alpinism's original post, he/she was referring to ANY psychiatrist. This point in alpinism's post was debated for pages.

 

[Guero]

. . .
Well now, don't change the goal post, then accuse someone of not meeting it. Your PCP was an attending on the medicine service and was already there at the hospital. That is NOT the same as a doctor getting out of bed and coming into the ED in the middle of the night because his/her patient attempted suicide. Apples and oranges.
. . .

I was fairly certain I distinguished my my orange; though I am certain it was devoid of "accusations." Nevertheless, as always, interpretation abounds and you proved me wrong. ::tips hat:: Good day, sir.

 

[Mass Effect]

Alpinisms post wasn't the center of that debate. His post was pretty clear - "if you're affiliated with a hospital system" - ie on call.

Alpinism's post triggered the debate. This is a fact. And since when does affiliation with a hospital system mean you're on call? What memo did I miss?

 

[Mass Effect]

You missed the memo about reading basic context

Failed attempt at a save. Speaking of reading skills, might want to brush up on yours.

 

[Mass Effect]

He was clearly describing a scenario in which a psychiatrist has admitting and inpatient responsibilities. Why is this so hard?

He was talking about outpatient psychiatrists who, for some reason, had to go admit the patient in the middle of the night just because that patient was their patient in the outpatient clinic. He pretty much admitted this in later posts and frankly, the info was wrong.

Do at least some psychiatrists not ever admit patients or care for inpatients?

I have yet to meet an attending psychiatrist who comes into the hospital to admit patients overnight. And if you bother to read the thread, you will see several others say the same.

 

[Mass Effect]

He was describing an on call psychiatrist who needed to admit a patient. Something that in some cases may require physical presence and not a phone conversation.

I have yet to see it requiring physical presence by an attending.

 

[Mass Effect]

You have never seen nor can imagine a scenario in which an on-call psychiatrist is required to physically see the patient they are admitting?

I've never seen an on-call attending psychiatrist come in to the hospital in the middle of the night to see a patient being admitted. Ever.

So, to answer the OP's question (if you're done hijacking), psychiatry is a field that fits all his needs. If he's an attending who wants to come in in the middle of the night to admit, I'm sure he can find a job that allows that, but more often than not, he will not have to.

 

[Chipster.]

I've never seen an on-call attending psychiatrist come in to the hospital in the middle of the night to see a patient being admitted. Ever.

So, to answer the OP's question (if you're done hijacking), psychiatry is a field that fits all his needs. If he's an attending who wants to come in in the middle of the night to admit, I'm sure he can find a job that allows that, but more often than not, he will not have to.

Wake up on the wrong side of the bed this morning? You've been a d*ck all over these forums today.

Or maybe every day and I've had the good fortune of overlooking you until now.

 

[Mass Effect]

Wake up on the wrong side of the bed this morning? You've been a d*ck all over these forums today

If you call it being a dick that I called out posters for being jackasses to Caribbean students and people who had to SOAP into residency, then I'm happy to be a dick. I don't consider a dick move any more than I consider anything I've said in this thread a dick move. A little advice for you, there's an ignore button, use it.

 

[michaelrack]

Inpatient psychiatrists (or psychiatrists on call for an inpt unit) don't come in in the middle of the night to the ER to admit a patient. They discuss the patient with either the ER doc and/or the social worker, and admit the pt over the phone.

 

[PL198]

yeah I don't really get what the psych is going to do in that situation that the ER doc can't.....

from a theoretical perspective it makes no sense why they'd have to come in.

 

[JimmyB123]

Pretty sure everybody knows about psych since everybody rotates through it. Psych is a unique field which requires a certain personality. If you feel you can thrive in it then definitely do it, but picking it solely for "lifestyle" reasons would easily lead to frustration.

How would you describe this"certain" personality unique to psych? Curious to know