Too Smart for EM?

Discussion in 'Emergency Medicine' started by teeayejay, Aug 2, 2018.

  1. VA Hopeful Dr

    VA Hopeful Dr Senior Member
    Physician 10+ Year Member

    Joined:
    Jul 28, 2004
    Messages:
    18,274
    Likes Received:
    20,274
    Status:
    Attending Physician
    Its why salaried work is for suckers most of the time. If each admission means $200 into that hospitalist's pocket, the bitching will go away pretty damned quick. In fact, those easy CP admits become just fantastic.

    If its any consolation, my 68 year old FP uncle routinely talks about how great life has been for him since hospitalists came to town in the mid 90s.
     
    Birdstrike and Redrox like this.
  2. Redrox

    10+ Year Member

    Joined:
    Oct 28, 2008
    Messages:
    286
    Likes Received:
    71
    Let me chuck in another way of looking at this beyond the whole making bank and having time off schtick ( which don't get me wrong, I absolutely f*cking love these parts of it)

    Had me a lot of attendings and fellow med students tell me I was too smart for EM, but they said this for kind reasons. Thought I'd get bored not dealing with super "complex" stuff.

    Just wanna reassure the original poster that I don't feel intellectually stunted not at all. See plenty of rare things often, still am learning something on a monthly if not weekly basis, kinda cool to be able to call up a specialist in their field and hear how they do stuff. Everything and everybody comes through the ER, you gonna see some zebras no worries. Gonna see some unusual complications. You gonna **** yourself from time to time, even in a community shop debating what to do. Cocktail party stories for years.

    More importantly, ER is good for the social brain. Even if the bread and butter diseases and presentations get routine, the people always gonna be different. Each room, each family a different dynamic. Who needs a friendly doc and how to be funny if they need that, who needs a walking text book with facts and figures. Why are they really here? What's the one thing they're most afraid of?

    Challenge for me at this point is anticipating questions the family is afraid to ask, phrasing things the way they needed to be phrased, being the kind of doc they need me to be. It's hard and it's fun.

    Same with nursing staff. Fun and a challenge to pick out who's having a hard day and how to get them brighter bout it. Pick up on who's pissed, who's distracted, having a hard day, who's feeling left out of the camaraderie and gonnna be a pill later if not in on the jokes. Who's irredeemable today and needs to be dodged.

    Ya gonna have the bank to make up for the years of training, days off to enjoy that bank cash money, and a job worth spending a buncha years on.
     
    #52 Redrox, Aug 6, 2018
    Last edited: Aug 6, 2018
  3. TheComebacKid

    7+ Year Member

    Joined:
    Feb 10, 2011
    Messages:
    253
    Likes Received:
    316
    You know, I never stated that I could do the work of a hospitalist or a specialist. I sure as hell can't, and I'm glad to death that there are people out there who are better than me at many of things that I can't manage i.e. starting chemotherapy or repairing a ruptured AAA. If anyone appreciates the work that the physicians do upstairs, it's me, trust me, I'm married to one of them.

    That being said, I promise you, an IM doc cannot practice bread and butter emergency medicine better than a board certified EM trained physician. I stand by what I said, AKA nobody can do what we can do. As a senior EM resident, one of my favorite things to do is push an off service IM resident rotating through the ED to their limit. The other day I pushed a second year IM resident to manage a patient in hemorrhagic shock from a massive GI bleed. After his shift was over, he said "Don't let any of the other residents ever talk down to you. This place is absolutely insane."

    I think pretty much every single person in emergency medicine in this forum has a great appreciation for the work that other physicians in other specialties put in. It's time other specialties do the same with regards to the ED docs that are busting ass and saving lives everyday. Are some of us terrible at what we do? Sure. But as a whole, I really think EM docs play a critical role in the house of medicine.
     
    VA Hopeful Dr and Perrin like this.
  4. Perrin

    Perrin sittin in the morning sun
    10+ Year Member

    Joined:
    Apr 6, 2004
    Messages:
    3,290
    Likes Received:
    1,260
    Status:
    Attending Physician
    He was a good attending. He'd occasionally crack jokes with us on rounds and took an interest in each of us students that were on his team. It helped that we had good residents with us and one was doing a prelim year before starting EM. We had a good team that rotation. There was another student interested in EM and I think the rest were a mix of IM and primary care.
     
  5. Veil

    Veil EM Attending
    Physician Faculty

    Joined:
    Jun 20, 2017
    Messages:
    331
    Likes Received:
    498
    Status:
    Attending Physician
    Highly underrated portion of what we do. I routinely point out to medical students that you must always know your audience.

    Some people benefit from an attending who doubles as a stand-up comedian -- as a result, they benefit from it, they feel better about things, and you feel better about things as a more enjoyable interaction. The patient/significant other the next room over might file a complaint about the very same thing.

    Know your audience. Happily, EM is excellent training for "reading the room" and the people in it.
     
  6. gro2001

    gro2001 SOCMOB
    Physician Faculty 10+ Year Member

    Joined:
    Jul 4, 2006
    Messages:
    912
    Likes Received:
    596
    Status:
    Attending Physician
    It gets me just a little angrier every time I hear the phrase that ER docs create work for other specialties. It would be like me blaming EMS for bringing me patients. They signed up to take consults and admissions just like I signed up to take shifts in the ER. Nowhere in my contract does it say how many patients EMS is allowed to bring to me on my shifts, and no where in theirs does it say how many consults they are supposed to do.
     
  7. Brorthopedic

    2+ Year Member

    Joined:
    Oct 6, 2015
    Messages:
    787
    Likes Received:
    2,666
    Status:
    Medical Student
    mo' money, mo' problems
     
  8. GonnaBeADoc2222

    10+ Year Member

    Joined:
    Oct 31, 2008
    Messages:
    417
    Likes Received:
    486
    Status:
    Attending Physician
    I think the smart ones realize this and are good partners to work with.

    To the dumb ones I say: Remember that hip I reduced / PTA I drained / Pigtail I placed / horrible facial laceration I repaired at 3am and sent home? Yeah you don't cause I didn't call you about it.
     
  9. VA Hopeful Dr

    VA Hopeful Dr Senior Member
    Physician 10+ Year Member

    Joined:
    Jul 28, 2004
    Messages:
    18,274
    Likes Received:
    20,274
    Status:
    Attending Physician
    You've never seen an EP get mad at EMS for bringing in patients?
     
  10. Hercules

    Hercules Son of Zeus
    10+ Year Member

    Joined:
    Jul 25, 2000
    Messages:
    1,212
    Likes Received:
    199
    Status:
    Attending Physician
    Yes. I have seen that at virtually every non-academic non-productivity based shop I’ve been at. For many of the same reasons detailed above about specialists getting mad at the ED doc.


    Sent from my iPhone using SDN mobile
     
    #60 Hercules, Aug 7, 2018
    Last edited: Aug 7, 2018
    sunshinefl and VA Hopeful Dr like this.
  11. TheComebacKid

    7+ Year Member

    Joined:
    Feb 10, 2011
    Messages:
    253
    Likes Received:
    316
    What gets me equally upset is when a cardiologist sends me their asymptomatic hypertension patient from clinic, then gets upset at me for calling them in the middle of the night to evaluate a patient.

    This idea that EM is the sole culprit when it comes to dumping on other services is the biggest fallacy. Whenever any patient has any problem that a specialist is remotely unfamiliar with, their response is always "Go to the nearest ED". I'm not saying that this is never appropriate (in fact a lot of times it is), but a lot of times, the ED is a convenient way for other physicians to not have to deal with their patients and get a good nights sleep.

    To all the specialists/consultants out there, I'm happy to see your patients in the middle of the night so you can get a good night's sleep. But please think twice before calling me out for "dumping" on you, or "soft" admits.
     
    #61 TheComebacKid, Aug 7, 2018
    Last edited: Aug 7, 2018
  12. VA Hopeful Dr

    VA Hopeful Dr Senior Member
    Physician 10+ Year Member

    Joined:
    Jul 28, 2004
    Messages:
    18,274
    Likes Received:
    20,274
    Status:
    Attending Physician
    The nice thing, as many people here have pointed out, is that out in practice the vast majority of us from various specialties get along very well.

    It really does seem to be academics (and occasional Axis 2 jerks out in practice) that overshadow that fact that most of us do just fine day in and day out.

    I mean, I've been out of my FM residency for 5 years. In that time, I've only had a problem with a single EM doc. And after talking to multiple other people in the area, that particular guy is just a POS. The other 3 dozen of so EPs I've talked to in that time were very pleasant, professional, and quite understanding even if I admitted it was a dump and I was sorry about it.
     
  13. EmergDO

    2+ Year Member

    Joined:
    Sep 7, 2016
    Messages:
    139
    Likes Received:
    146
    Status:
    Medical Student
    I've never had a doctor get mad at me for bringing them EMS patients, but I've definitely had a lot of nurses and techs get grumpy about it.
     
  14. Perrin

    Perrin sittin in the morning sun
    10+ Year Member

    Joined:
    Apr 6, 2004
    Messages:
    3,290
    Likes Received:
    1,260
    Status:
    Attending Physician
    I've jokingly reminded them that we aren't the only ED in town when there's 5 crews waiting to unload a patient. The only time I get irritated is when they bring the pt to the wrong hospital. Family requested the hospital across town where the pt's specialists are at. Now I have to apologize and calm down an irate family.
     
    theseeker4 likes this.
  15. The White Coat Investor

    The White Coat Investor Practicing Doc and Blogger
    Physician Partner Organization 10+ Year Member

    Joined:
    Nov 18, 2002
    Messages:
    5,160
    Likes Received:
    2,249
    Status:
    Attending Physician
    Clearly that doc doesn't own his job. That would be like a restaurant owner getting mad that so many people want to eat in his restaurant. #residentmentality
     
  16. VA Hopeful Dr

    VA Hopeful Dr Senior Member
    Physician 10+ Year Member

    Joined:
    Jul 28, 2004
    Messages:
    18,274
    Likes Received:
    20,274
    Status:
    Attending Physician
    Goes back to the original point of "salaries are for suckers"
     
  17. Perrotfish

    Perrotfish Has an MD in Horribleness
    Physician 10+ Year Member

    Joined:
    May 26, 2007
    Messages:
    8,007
    Likes Received:
    3,739
    Status:
    Attending Physician
    EMS isn't really a fair comparison, they work on protocols and don't really have a choice about what they do. A better comparison is the primary care doctor sending a patient to the ER. That's when I've seen ER docs get angry (reasonably or not) because they think the other doc should have been able to handle the patient's problem
     
  18. gro2001

    gro2001 SOCMOB
    Physician Faculty 10+ Year Member

    Joined:
    Jul 4, 2006
    Messages:
    912
    Likes Received:
    596
    Status:
    Attending Physician
    Yes, you are right. That's probably a better comparison. I've seen both (ER docs getting mad at EMS and primary care docs). Both reactions are stupid.

    When I was comparing the EMS to the ED doc experience, I was thinking more of the typical situation where the hospitalist sees that a certain patient can't go home because of reasons, and doesn't have any particular reason to go to another service (surgical issue, stroke, badness warranting ICU), but yet gives me a hard time for admitting them. In that sense, it's very similar to the EMS thing: I am passing on the care to the person who is supposed to take over from that point but for some reason they think its worthwhile to complain about it.

    The ER docs complaining about primary care docs sending in a patient is also stupid. Like when they send in someone with asymptomatic hypertension. If you really think that it was super straight forward and should not have been sent to the ER, its the easiest dispo in the world. If it isn't super easy to dispo them or you feel you are stuck doing a workup, then maybe it wasn't all that straight forward after all and therefore not a completely inappropriate referral. Basically, ER docs should see a patient sent in from the clinic as a consult. Before getting mad, think about how you would want someone you are consulting to respond.
     
  19. RustedFox

    RustedFox We're all stars now. In the GOAT RODEO.
    10+ Year Member

    Joined:
    Aug 21, 2007
    Messages:
    3,649
    Likes Received:
    2,731
    Status:
    Attending Physician
    I used to feel this way until it became so common for every physician, NP, and PA in this county and the next to send the patient to the ER at 5:30 PM (Quittin' time! Yabba Dabba Doo!) with their 170/69 pressure and a warning that they'll "have a stroke" if they don't go. First off, I don't want the lie perpetuated that they'll "have a stroke!" as I work in the United States Capital of Old People. The force is already strong with that myth here. Second, when the halls are three deep with snowbirds, the patient would actually be better off chilling out in a cool room at their PMD's office with a dose of that dreaded Clonidine, seeing their pressure go down, and going home - rather than walking into the circus tent that is the ER and waiting for another hour or so just to be told "okay; its down - go home."
     
    GonnaBeADoc2222 likes this.
  20. BoardingDoc

    BoardingDoc Don't worry. I've got my towel.
    Physician 7+ Year Member

    Joined:
    Feb 23, 2010
    Messages:
    1,007
    Likes Received:
    1,407
    Status:
    Attending Physician
    Are you actually bothering to lower these people's BP? If they're truly asymptomatic, I'm just doing an exam and discharging them. If they are symptomatic, they get labs/CT/whatever and then they go home (I still don't lower their BP). If they have signs of end organ dysfunction, that's a different story.
     
  21. RustedFox

    RustedFox We're all stars now. In the GOAT RODEO.
    10+ Year Member

    Joined:
    Aug 21, 2007
    Messages:
    3,649
    Likes Received:
    2,731
    Status:
    Attending Physician
    I don't bother to do anything to lower their BP. My point (politely, in response to gro2001's post), is that this particular bit of PMD/PA/NP behavior is:

    1. Lazy (Doctor/NP dipsh!t just wants to go home).
    2. Dishonest (the patient won't have a stroke).
    3. Harmful (the ancient Ones and Jennie McJennyson the ER-NP just love that clonidine dose).
    4. More costly (both to patient, and to the healthcare system at large).
    5. Fully unnecessary (and jams up my already short-staffed and over-capacity ER).

    If it were just one or two a week, I'd be more understanding. But here, its at least 3-5 visits every day during tourist/snowbird season that I deal with alone.
     
  22. GonnaBeADoc2222

    10+ Year Member

    Joined:
    Oct 31, 2008
    Messages:
    417
    Likes Received:
    486
    Status:
    Attending Physician
    A consult is: "I've thought about this issue to the best of my ability and believe it needs some kind of expertise that is beyond my scope of practice." If "consulting" the ER, it SHOULD involve an attending to attending conversation to discuss the concerns of the person making the referral and best steps forward. I really like these conversations when they happen.

    A consult is not: "Oh damn it's closing time or it's 2pm on a Saturday and I don't feel like dealing with this (or don't have the basic knowledge and thus, shouldn't be in practice) and taking the 2 minutes to reassure my patient and schedule them for follow up, so I'm gonna scare my patient into going to the ED ("Your BP of 180/100 is going to make your head fall off!"), oh and I'm not even going to bother to call the ER doc."

    This is akin to me wheeling an ankle sprain up to the OR, without bothering to get imaging, and not calling the orthopedic surgeon.

    Plain and simple it is lazy, uneducated and dangerous medicine (what else are you mismanaging in your office?). It is bad for the "system," frustrates patients and costs them real financial dollars (a $200 ED co-pay may not seem like much to you or me, but might be a lot for that 75 yo on a fixed budget), and contributes to burnout of ED staff and physicians.
     
    Redrox and theseeker4 like this.
  23. VA Hopeful Dr

    VA Hopeful Dr Senior Member
    Physician 10+ Year Member

    Joined:
    Jul 28, 2004
    Messages:
    18,274
    Likes Received:
    20,274
    Status:
    Attending Physician
    Admittedly there are lots of ****ty doctors in all of medicine.
     
    OccupyTheED, Redrox and racerwad like this.
  24. fahimaz7

    10+ Year Member

    Joined:
    Jul 18, 2004
    Messages:
    3,276
    Likes Received:
    208
    Status:
    Attending Physician
    MCG.
     
  25. sum dude

    Physician 7+ Year Member

    Joined:
    Jun 16, 2009
    Messages:
    152
    Likes Received:
    102
    Status:
    Attending Physician
    I had a similar problem. I thought I was too awesome for EM. Everybody was like, you're awesome, don't go into EM, that's lame. I decided if I went into EM, I could make it less lame, b/c I'm that awesome. Turns out, EM already was awesome. Everybody won--we're like synergentically awesomer.

    Turns out I just had too much pride to acknowledge no one is really TOO awesome for EM. Or smart. For any specialty.
     
  26. MechEDoc

    MechEDoc maybe minor rocket surgery...
    2+ Year Member

    Joined:
    Sep 17, 2015
    Messages:
    127
    Likes Received:
    104
    Status:
    Resident [Any Field]
    What we have here is a modern day example of the Will Rogers phenomenon ("When the Okies left Oklahoma and moved to California, they raised the average intelligence level in both states").

    Welcome to emergency medicine!
     
    GonnaBeADoc2222 and 24GaugeEJ like this.
  27. acadianvoyager

    2+ Year Member

    Joined:
    May 31, 2016
    Messages:
    14
    Likes Received:
    6
    I spent too much energy listening to the haters in med school, and it almost talked me out of EM. I LOVE my job and would never want to work anywhere else in the hospital. If EM gets you going, don't let anyone take you off that train.
     
    gamerEMdoc likes this.
  28. slz1900

    7+ Year Member

    Joined:
    Nov 10, 2011
    Messages:
    311
    Likes Received:
    47
    Status:
    Resident [Any Field]
    EM is just as intellectual as any specialty, there’s just a lot less pontification and if a patient is admitted another doc will look over everything you did. Look over everything the PGY10 pediatric neurosurgeon does and you’ll probably find stuff to pick at too. If talking about whether 5 or 10 of hydralazine is better for 55 year old diabetic Scandinavians seems ‘intellectual’ then yeah, you’re not going to get much of that. The only reason those discussions don’t happen in EM is because of time constraints and inability to have hour long conferences in the middle of the day. Likewise comb over any specialties’ decision making and you’ll find tons of stuff that seems questionable. If you want to do something truly intellectual do a postdoc or medical genetics research or something. Otherwise clinical medicine in all specialties is about repetition repetition repetition with some reading sprinkled in until you gain competence.
     
    #78 slz1900, Oct 10, 2018
    Last edited: Oct 10, 2018
    rjdiii and teeayejay like this.
  29. Brigade4Radiant

    10+ Year Member

    Joined:
    Dec 13, 2006
    Messages:
    908
    Likes Received:
    143
    Status:
    Attending Physician
    The problem is a lot of PCP's say that you will need to be admitted. So when I try to discharge them family throws a fit even if I do lab work to satisfy them. My blood pressure is still high my PCP told me I need to be admitted for my bp of 180!
     
  30. gamerEMdoc

    gamerEMdoc Associate PD; EM Clerkship Director
    Physician Faculty Gold Donor Classifieds Approved 2+ Year Member

    Joined:
    Feb 10, 2016
    Messages:
    1,504
    Likes Received:
    2,576
    Status:
    Attending Physician
    PCPs always say to patients that they need admitted, until you call them to admit the patient.
     
    LChristmas likes this.
  31. BoardingDoc

    BoardingDoc Don't worry. I've got my towel.
    Physician 7+ Year Member

    Joined:
    Feb 23, 2010
    Messages:
    1,007
    Likes Received:
    1,407
    Status:
    Attending Physician
    In an asymptomatic HTN patient, if the family throws a fit, I take a couple of minutes to explain why this isn't an emergency and why they don't need to be admitted. If they persist, I also have no issue throwing the PCP under the bus in this scenario and explain that even being sent to the ED for an evaluation without any symptoms was grossly inappropriate. If they're still throwing a fit at that point I just say sorry, then leave the room and click discharge.
     
  32. Apollyon

    Apollyon Screw the GST
    Physician Lifetime Donor Classifieds Approved 10+ Year Member

    Joined:
    Nov 24, 2002
    Messages:
    19,450
    Likes Received:
    3,928
    Haha, you did it again!!

    "Need admitted"

    Haha, Pennsy hick! (As I do my charts in "the icebox of PA"!)
     
    gamerEMdoc likes this.
  33. thegenius

    thegenius Senior Wharf Rat
    10+ Year Member

    Joined:
    Jul 12, 2004
    Messages:
    1,108
    Likes Received:
    215
    Status:
    Attending Physician
    100% true! Hear that all the time.
     
    miacomet likes this.
  34. miacomet

    Joined:
    Apr 2, 2018
    Messages:
    627
    Likes Received:
    309
    Status:
    Attending Physician
    There are many ways to think about this. EM requires a very specific personality- confident but not arrogant, with good leadership skills and great people skills to deal with everyone from VIPs to hospital staff to cranky consultants, and it also requires the ability to multitask, take care of multiple sick patients, and a vast fund of knowledge. These are, of course, all forms of intelligence. I don't think anyone is saying (and if they are, well, no point in arguing with a fool) that EM doesn't take a very high level of skill.

    EM, however, doesn't necessarily take book smarts (although I would argue much of medicine doesn't), and when people say this what they may mean is that if you get off on discussing the citric acid cycle, this isn't the best way to use your specific form of intelligence and it may not be the field for you if you want really cerebral discussions and cutting-edge basic science research.
     
    pencilcase, Redrox and gamerEMdoc like this.
  35. thegenius

    thegenius Senior Wharf Rat
    10+ Year Member

    Joined:
    Jul 12, 2004
    Messages:
    1,108
    Likes Received:
    215
    Status:
    Attending Physician
    Yea most of medicine, these days, is written up in textbooks and algorithmic. And when the algorithm doesn't exist, there sure is lots of guessing in medicine.

    I think good ER docs feel very comfortable acting first and then getting information second. Kind of the antithesis of every specialty in health care, where they do a thorough H&P and then act.

    Of course the problem arises when they act first prior to getting information, when they have time to get the information. Some ER docs, for instance, are intubate BOOM just like that (thus getting a history much more difficult) when in fact they have time to gather information. Anyway a separate topic.
     
  36. OccupyTheED

    OccupyTheED Attending Physician
    5+ Year Member

    Joined:
    Feb 8, 2012
    Messages:
    120
    Likes Received:
    69
    Status:
    Attending Physician
    I think lots of other specialties don't quite understand what we do and quite frankly I don't care. I make my own schedule, work about 12-13 days a month on average and I'll pull in about 480K this year. I'm quite confident they're even less qualified to do my job than I am to do theirs and most are pretty bad judges of how good we are/aren't in performing our duties.
     
    Redrox likes this.
  37. VA Hopeful Dr

    VA Hopeful Dr Senior Member
    Physician 10+ Year Member

    Joined:
    Jul 28, 2004
    Messages:
    18,274
    Likes Received:
    20,274
    Status:
    Attending Physician
    Do keep in mind that patients often misrepresent what we (doctors as a whole) tell them
     
    Redrox and sunshinefl like this.
  38. gamerEMdoc

    gamerEMdoc Associate PD; EM Clerkship Director
    Physician Faculty Gold Donor Classifieds Approved 2+ Year Member

    Joined:
    Feb 10, 2016
    Messages:
    1,504
    Likes Received:
    2,576
    Status:
    Attending Physician
    Oh yeah, no doubt. Most of the time the "my PCP told me to come in to be admitted" means they spoke to a nurse on the on call line who tells every person that calls to go to the ED.
     
    Redrox and sunshinefl like this.
  39. latinclubimperatus

    latinclubimperatus Don't get snarky, I'm better at it than you.
    Account on Hold 2+ Year Member

    Joined:
    Jul 6, 2014
    Messages:
    634
    Likes Received:
    382
    Status:
    Medical Student
    Dunces? Is that really the reputation ED docs get?


    Sent from my iPad using Tapatalk
     
  40. Veil

    Veil EM Attending
    Physician Faculty

    Joined:
    Jun 20, 2017
    Messages:
    331
    Likes Received:
    498
    Status:
    Attending Physician
    Basically just from the people who are too clueless to know better.
     
  41. miacomet

    Joined:
    Apr 2, 2018
    Messages:
    627
    Likes Received:
    309
    Status:
    Attending Physician
    I would add that if respect within the house of medicine is really important to people, EM may also not be the right field for them. While our more forward-thinking colleagues may give the ED its due, older colleagues and more traditional areas of the country (hello, NYC and Northeast) continue to malign the specialty, with EM not even having departmental status in many areas.

    I'm not knocking people for wanting respect- we deserve it, and sadly we are still one of the newer specialties, and ACEP sure isn't doing much to help our case.
     
  42. The Knife & Gun Club

    2+ Year Member

    Joined:
    Nov 6, 2015
    Messages:
    2,035
    Likes Received:
    3,832
    Status:
    Medical Student
    Same thing happened to me today.

    Attending said “oh you want to do EM? Enjoy being the hospital secretary. Why not do surgery? You can do everything the ER people do but also learn how to be a doctor”

    The table of surgery residents and fellows had a good laugh.

    Now I know he’s probably just a jackass but damn it sucks to know that’s how some people in academics view EM.
     
  43. VA Hopeful Dr

    VA Hopeful Dr Senior Member
    Physician 10+ Year Member

    Joined:
    Jul 28, 2004
    Messages:
    18,274
    Likes Received:
    20,274
    Status:
    Attending Physician
    FTFY
     
  44. gamerEMdoc

    gamerEMdoc Associate PD; EM Clerkship Director
    Physician Faculty Gold Donor Classifieds Approved 2+ Year Member

    Joined:
    Feb 10, 2016
    Messages:
    1,504
    Likes Received:
    2,576
    Status:
    Attending Physician
    Hahaha. I love that a surgeon said that. For doctors that can do anything, it sure is odd that they try to admit everything to medicine.
     
  45. Veil

    Veil EM Attending
    Physician Faculty

    Joined:
    Jun 20, 2017
    Messages:
    331
    Likes Received:
    498
    Status:
    Attending Physician
    Both true. Happily, most of our surgeons here get that EM is its own thing.

    It's all bull**** in the end. Pick what you think will keep you happiest.
     
  46. Mr. Hat

    10+ Year Member

    Joined:
    Dec 20, 2006
    Messages:
    926
    Likes Received:
    863
    Status:
    Attending Physician
    And once again I’m so offended and angry at this garbage that I can’t even.... oops hold on.... the cash truck is backing up to my house again, and the UPS guy is delivering the snorkel I ordered for those beach resort trips this winter.

    Ok sorry what were we talking about? Crud I forgot. Anyway heading to the gym now and then going out to dinner. I may catch a movie too since I get to sleep in tomorrow, being on a run of days off and all. Ah well, if it comes back to me I’ll let you know.
     
  47. The Knife & Gun Club

    2+ Year Member

    Joined:
    Nov 6, 2015
    Messages:
    2,035
    Likes Received:
    3,832
    Status:
    Medical Student
    10/10 quality post. Much appreciated.
     
  48. VA Hopeful Dr

    VA Hopeful Dr Senior Member
    Physician 10+ Year Member

    Joined:
    Jul 28, 2004
    Messages:
    18,274
    Likes Received:
    20,274
    Status:
    Attending Physician
    It really is amazing how much of this goes away as soon as you leave academics.
     
  49. Paperman

    Joined:
    Nov 26, 2018
    Messages:
    30
    Likes Received:
    34
    100% agree.

    Too smart for EM? Haha, maybe 30 years ago but game has changed. I had friends at other programs tell me about surgeons saying this kind of bulls*t but the average board scores for my EM class were higher than nearly every other specialty, significantly so for our general surgery residency. In fact, our PD alluded to our class having second highest average board scores amongst all residencies in hospital (hospital had every residency possible I believe). Not a measure of intelligence per say, but allows comparison of apples to apples for medical students/residents.....

    General surgeons at every academic center I rotated at or did residency at seemed extremely unhappy with their career choice. This seemed to have profound 'trickle down' effect to their residents. Was actually kind of sad to witness close-up....

    At my current hospital all of our surgical specialists LOVE us. They know we do everything we can to minimize BS work for them and they go out of their way to advocate for us and support us.

    As alluded to above, if you care what people think of your specialty or allow such comments to influence your potential career choice your setting yourself up for possible lifetime of unhappiness......

    TPM
     
    Blackdogue and gamerEMdoc like this.
  50. TheComebacKid

    7+ Year Member

    Joined:
    Feb 10, 2011
    Messages:
    253
    Likes Received:
    316
    I had the exact same comments. One of the CT surgery attendings in the OR referred to me as a triage nurse when he found out I wanted to do EM and had a great laugh about it with the fellow and OR staff.

    In that moment, it became abundantly clear to me. While I'm sure there are "nice" surgeons, why would I want to associate myself with the culture of a specialty that talks that way about other specialties? You have to be a pretty unhappy/miserable person.

    At least the dermatologists in med school said "Wow! I could never do that, congrats to you for being so motivated and pursuing EM".

    It's amazing how much nicer people are if they are allowed to sleep and spend time with their families.
     
    Birdstrike and gamerEMdoc like this.

Share This Page