Volunteer Emergency Physician?

[BJJVP]

So I have left emergency medicine. I still miss SOME aspects of it. I am also worried about skill erosion because there may come a time in the future when I may have to pull shifts in the pit again. Anyone volunteer in a department as a physician? I am thinking I would basically go in for 4-6 hours, maybe once a month, pick up whatever charts I want, then leave. I would think that there's a department out there that would take any help they could get.

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[Groove]

Care to tell us your details? Early retirement or something else?

 

[BoardingDoc]

So I have left emergency medicine. I still miss SOME aspects of it. I am also worried about skill erosion because there may come a time in the future when I may have to pull shifts in the pit again. Anyone volunteer in a department as a physician? I am thinking I would basically go in for 4-6 hours, maybe once a month, pick up whatever charts I want, then leave. I would think that there's a department out there that would take any help they could get.

I think you will have a very hard time finding a place to hire you for this role. You probably see it as you're offering your services for free. In reality:

-You're offering to work less than 1 shift/month, so they can't put you on the schedule as a regular doc.
-Having a random doc show up to cherry pick charts during the other doc's shift probably isn't something they want
-The hospital needs to pay malpractice for you, which at 1 shift/month may not be worth it as they generally pay a fixed rate, not one based on hours worked.
-At 4-6 hours / month at a hospital it's unlikely you will ever learn the nuances of the hospital well enough to ever be anything except "that guy who doesn't know how to page a consultant / admit patients / fix orders / insert quirk here"

If you wanted to work 1-2 full shifts a month somewhere, I suspect that would be doable.

 

[BJJVP]

Care to tell us your details? Early retirement or something else?

Urgent care. Don't judge

 

[BJJVP]

I think you will have a very hard time finding a place to hire you for this role. You probably see it as you're offering your services for free. In reality:

-You're offering to work less than 1 shift/month, so they can't put you on the schedule as a regular doc.
-Having a random doc show up to cherry pick charts during the other doc's shift probably isn't something they want
-The hospital needs to pay malpractice for you, which at 1 shift/month may not be worth it as they generally pay a fixed rate, not one based on hours worked.
-At 4-6 hours / month at a hospital it's unlikely you will ever learn the nuances of the hospital well enough to ever be anything except "that guy who doesn't know how to page a consultant / admit patients / fix orders / insert quirk here"

If you wanted to work 1-2 full shifts a month somewhere, I suspect that would be doable.

I suspected this to be the case. Thanks for your response.

 

[CoolDoc1729]

I think you will have a very hard time finding a place to hire you for this role. You probably see it as you're offering your services for free. In reality:

-You're offering to work less than 1 shift/month, so they can't put you on the schedule as a regular doc.
-Having a random doc show up to cherry pick charts during the other doc's shift probably isn't something they want
-The hospital needs to pay malpractice for you, which at 1 shift/month may not be worth it as they generally pay a fixed rate, not one based on hours worked.
-At 4-6 hours / month at a hospital it's unlikely you will ever learn the nuances of the hospital well enough to ever be anything except "that guy who doesn't know how to page a consultant / admit patients / fix orders / insert quirk here"

If you wanted to work 1-2 full shifts a month somewhere, I suspect that would be doable.

I also don’t think it would maintain your skills to cherry pick charts for 10 hours a month as an extra, any more than doing whatever you’re currently doing.

 

[bravotwozero]

Urgent care. Don't judge

Enjoy your normal circadian rhythm.

 

[Angry Birds]

So I have left emergency medicine. I still miss SOME aspects of it. I am also worried about skill erosion because there may come a time in the future when I may have to pull shifts in the pit again. Anyone volunteer in a department as a physician? I am thinking I would basically go in for 4-6 hours, maybe once a month, pick up whatever charts I want, then leave. I would think that there's a department out there that would take any help they could get.

I am moving in a similar direction although I’m almost out of medicine altogether. However, my goal will be to get it down to 3 shifts/mo. I don’t mind doing those on a weekend and I think that is sellable to a hospital.

I’m close to this goal but not yet there…

 

[Franzd'Epinay]

I am moving in a similar direction although I’m almost out of medicine altogether. However, my goal will be to get it down to 3 shifts/mo. I don’t mind doing those on a weekend and I think that is sellable to a hospital.

I’m close to this goal but not yet there…

What’s stopping you from fully leaving medicine behind?

Is the new gig that low-paying? Or are you just hesitant to no longer consider yourself an Emergency Physician?

 

[alpinism]

Yeah I'd find a low stress ED that allows 1-2 PRN shifts a month.

 

[RustedFox]

Who the Christ is going to work in the ER for free as a volunteer?

The HELL is WRONG with you?!

 

[RustedFox]

I think you will have a very hard time finding a place to hire you for this role. You probably see it as you're offering your services for free. In reality:

-You're offering to work less than 1 shift/month, so they can't put you on the schedule as a regular doc.
-Having a random doc show up to cherry pick charts during the other doc's shift probably isn't something they want
-The hospital needs to pay malpractice for you, which at 1 shift/month may not be worth it as they generally pay a fixed rate, not one based on hours worked.
-At 4-6 hours / month at a hospital it's unlikely you will ever learn the nuances of the hospital well enough to ever be anything except "that guy who doesn't know how to page a consultant / admit patients / fix orders / insert quirk here"

If you wanted to work 1-2 full shifts a month somewhere, I suspect that would be doable.

Yeah, this.
If you did this, I would be like:
"Dude, GTFO of my way."

 

[thegenius]

So I have left emergency medicine. I still miss SOME aspects of it. I am also worried about skill erosion because there may come a time in the future when I may have to pull shifts in the pit again. Anyone volunteer in a department as a physician? I am thinking I would basically go in for 4-6 hours, maybe once a month, pick up whatever charts I want, then leave. I would think that there's a department out there that would take any help they could get.

??

Why not just work a few shifts a month

 

[RustedFox]

"Hey guys, I think what I want to do with my career is run my FM clinic and then pick up 1-2 days a week in the ER because I like the ER but I want continuity of care and this should be easy to do because like most ER stuff is FM anyways and I want to avoid burnout so I won't do nights or weekends so there's robble dee dobble da robble."

Remember these mouthbreathers?

 

[BJJVP]

I get it. It's an unusual thought and probably not realistic or practical. I was just curious if anyone had pulled it off.

I may have to work in the emergency dept at some point in the future. Therefore, I wanted to keep that option available. I have heard that after 2 years away, malpractice companies see you as potentially uninsurable (this may or may not be true...it's just what another EP told me). Groups/employers will probably also question your skills if away for too long. It would be nice if I could say it hasn't been 5 years since I intubated someone, put in a chest tube, performed an LP or reduction, etc. I could just work a couple of shifts a month but then I would have to deal with all of the other ED problems...charge nurse asking what to do because the waiting room is full, sitting through meetings about metrics and fallouts, working nights, accepting terrible signouts, etc. In addition, I would likely have to make more of a commitment timewise with less control. And to be honest, I just kind of miss seeing/treating some of those emergent conditions. I thought it be possible to do so while possibly even helping out an understaffed department. No offense intended guys.

 

[Angry Birds]

What’s stopping you from fully leaving medicine behind?

Is the new gig that low-paying? Or are you just hesitant to no longer consider yourself an Emergency Physician?

I wouldn’t word it as “that low paying,” but yes, it’s not doctor money. I’m hopefully gonna build on it and progress so that I no longer require EM at all… but not quite there yet. Close though.

But even if I no longer rely on EM to supplement my income, I want to keep it as a fall back in case things go south in my new career, which is fickle.

 

[Franzd'Epinay]

It would be nice if I could say it hasn't been 5 years since I intubated someone, put in a chest tube, performed an LP or reduction, etc.

What are the odds you get these during your 4-6 hour visits once a month? Also, on the off-chance that one of these patients does come during that limited time-frame, why should you get priority over the doc who is working that shift?

This just seems very one-sided, especially if you say you don't want to care about things like the busy waiting room.

 

[BoardingDoc]

What are the odds you get these during your 4-6 hour visits once a month? Also, on the off-chance that one of these patients does come during that limited time-frame, why should you get priority over the doc who is working that shift?

This just seems very one-sided, especially if you say you don't want to care about things like the busy waiting room.

Even if the other doc doesn't want to do the CT/intubation/whatever, it's likely that the patient is sick enough that it's going to take considerable time to dispo them. In that case, you're either staying past your 4-6 hour window (making you unhappy), or you're doing all the fun crap and then signing the disaster patient out to another doc (winning you no friends whatsoever.)

That said, @BJJVP, if you do plan on working in the ED again someday, you may want to consider doing the 1-2 shifts/mo that I and others suggested. While I'm sure there are EDs out there that will take any warm body, this will geographically limit you significantly. I can definitively say that I would not bother reviewing an application from a doc who wanted to work in our ED but who hadn't practiced in the ED for >1 year.

 

[Rekt]

Surprised. I would not consider 1-2 shifts a month "keeping up skills". I personally don't think that's enough.

I don't do hiring, but if I did, I would not even consider someone who did 1-2 shifts over a normal applicant.

 

[CoolDoc1729]

Surprised. I would not consider 1-2 shifts a month "keeping up skills". I personally don't think that's enough.

I don't do hiring, but if I did, I would not even consider someone who did 1-2 shifts over a normal applicant.

We had a doc working 1-2 shifts a month. Her husband was an specialist surgeon and she didn’t need to work. This went on for like 5 years and she still didn’t know how to get anything done, who to call for x and y, she couldn’t work midnights (not that she wanted to) because she truly couldn’t be left alone.

 

[thegenius]

I get it. It's an unusual thought and probably not realistic or practical. I was just curious if anyone had pulled it off.

I may have to work in the emergency dept at some point in the future. Therefore, I wanted to keep that option available. I have heard that after 2 years away, malpractice companies see you as potentially uninsurable (this may or may not be true...it's just what another EP told me). Groups/employers will probably also question your skills if away for too long. It would be nice if I could say it hasn't been 5 years since I intubated someone, put in a chest tube, performed an LP or reduction, etc. I could just work a couple of shifts a month but then I would have to deal with all of the other ED problems...charge nurse asking what to do because the waiting room is full, sitting through meetings about metrics and fallouts, working nights, accepting terrible signouts, etc. In addition, I would likely have to make more of a commitment timewise with less control. And to be honest, I just kind of miss seeing/treating some of those emergent conditions. I thought it be possible to do so while possibly even helping out an understaffed department. No offense intended guys.

Just work 2-4 shifts a month. The fact is most of Emergency Medicine is rather easy and mundane, and most days it's just a job like every single other job on this planet. You go to work, put in your time, leave work, get paid.

 

[bravotwozero]

"Hey guys, I think what I want to do with my career is run my FM clinic and then pick up 1-2 days a week in the ER because I like the ER but I want continuity of care and this should be easy to do because like most ER stuff is FM anyways and I want to avoid burnout so I won't do nights or weekends so there's robble dee dobble da robble."

Remember these mouthbreathers?

The OP is like someone who was on the titanic, actually able to get a spot on the lifeboat, but keeps asking if he can go back ‘just to get a looky loo’…

 

[thegenius]

The OP is like someone who was on the titanic, actually able to get a spot on the lifeboat, but keeps asking if he can go back ‘just to get a looky loo’…

“But save my spot in the lifeboat at all costs!”

 

[Tenk]

The OP is like someone who was on the titanic, actually able to get a spot on the lifeboat, but keeps asking if he can go back ‘just to get a looky loo’…

Meanwhile, the rest of us are all like:

 

[BoardingDoc]

Surprised. I would not consider 1-2 shifts a month "keeping up skills". I personally don't think that's enough.

I don't do hiring, but if I did, I would not even consider someone who did 1-2 shifts over a normal applicant.

To be clear, someone doing 1-2 a month would not get hired at my shop either. I suspect it would open up doors at some CMG sweatshop however.

 

[RustedFox]

@Lynx zwo drei vier

Read this thread. The titanic analogy is hard truth.

 

[RustedFox]

Surprised. I would not consider 1-2 shifts a month "keeping up skills". I personally don't think that's enough.

I don't do hiring, but if I did, I would not even consider someone who did 1-2 shifts over a normal applicant.

I didn't work in the ER for a year.
It took a few phone calls from the right people in the right places who know me for me to get hired again.

That's the other thing about EM that students don't realize; it's a one-way street. There is no "coming back after a few years". This adds a whole new level of pressure to your career.

 

[Lynx zwo drei vier]

@Lynx zwo drei vier

Read this thread. The titanic analogy is hard truth.

I appreciate the tough love. Not being a smartаss.

 

[RustedFox]

I appreciate the tough love. Not being a smartаss.

Cautus metuit foveam vulpes.

 

[Angry Birds]

Surprised. I would not consider 1-2 shifts a month "keeping up skills". I personally don't think that's enough.

I don't do hiring, but if I did, I would not even consider someone who did 1-2 shifts over a normal applicant.

We had a doc working 1-2 shifts a month. Her husband was an specialist surgeon and she didn’t need to work. This went on for like 5 years and she still didn’t know how to get anything done, who to call for x and y, she couldn’t work midnights (not that she wanted to) because she truly couldn’t be left alone.

To be clear, someone doing 1-2 a month would not get hired at my shop either. I suspect it would open up doors at some CMG sweatshop however.

Well, in response to all of the above comments, I would simply ask to look at this from the perspective of those who are looking to exit EM while still keeping EM as a potential back-up option if the exit option fails.

First, I would say that not all ER docs are the same. If you've been doing EM long enough and are good enough, then I think you can actually reduce your clinical hours significantly and still retain your skills better than the example of the specialist surgeon's wife above. My chief resident went onto do a tox fellowship and was only working in the ER once a week during this time... and he still was the man, with no difference between him and those who went into full time attendingship. Some people got it, other don't. Some people have worked in the ER for decades and are clueless...

Second, it might not be a jump right back into a high acuity ER... Rather, it would be a gradual return to play in a low volume, low acuity ER and then you can slowly work your way back over a year or so...

From that perspective, doing a couple shifts a month will at least keep this option alive whereas a cold turkey stop will not.

 

[Lynx zwo drei vier]

Cautus metuit foveam vulpes.

Catholic high school?

 

[RustedFox]

Catholic high school?

Public

 

[Lynx zwo drei vier]

Public

Ah. I just assumed that you'd been forced to learn Latin somewhere.