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Coronavirus: Residents being told to work in DIFFERENT specialty
- Thread starter calvinhobbes
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Starting? Homeboy has been a Grade A troll from post 1.I’m a Xennial. And I’ve been out of training less than a year.And I’m starting to think this guy is just being an ass for the fun of it now.
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As long as we're not talking about this fancy-shmancy version that came out later!Oregon Trail Generation, please
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This thread is getting to be like boomer facebook but replace millennial with resident
I'll make it easier for you guys; yes, I will be ordering an almond-milk latte as I refuse to care for your patients.
Millennial here, out of training less than a year. Stop acting like a snot-nosed entitled kid who give the rest of us millennials a bad name.
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I wish I could believe that but I read through the thread in the RadOnc forum that was reference earlier in this thread. Truly appalling. He is clearly not a lone wolf on this subject.
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This thread is getting to be like boomer facebook but replace millennial with resident
I'll make it easier for you guys; yes, I will be ordering an almond-milk latte as I refuse to care for your patients.
Ok, resident.
Someone posted somewhere (elsewhere on SDN? Facebook? Instagram? Don't remember) that they were heartened by the good things that they see the quarantine/COVID pandemic bringing out.
I don't know what they're seeing, but that has not been my experience.
- Non-HCWs hoarding PPE (that they don't even know how to correctly use).
- Patients lying about being afebrile and asymptomatic just to get through the door.
- Patients lying about having fever, just so that they can get tested, when it is widely known that there are few tests available.
- Celebrities, even fellow physicians (cough cough, Rand Paul) who manage to use their pull and influence to get tested despite being asymptomatic.
- Completely oblivious patients showing up with symptoms highly suspicious for COVID, who act shocked when you tell them to self quarantine for 2 weeks. "But I can still go to the grocery store now, right? Because I don't have any food at home."
- Boomers saying that they don't care if they get COVID 19 because "You can't live your life in fear. If I die, I die," and don't realize that they could take down a doctor, a nurse, or a respiratory therapist down with them.
And now, whining from residents (i.e. PHYSICIANS) in a field that has historically self-congratulated itself on being able to attract the "best and the brightest." The best and the brightest, maybe, but clearly not the bravest and certainly not the most civic-minded. And those "best and brightest" are now apparently devoting their mental energies to finding loopholes in their residency contract to ensure that THEY won't have to be on the front lines if they are asked.
The sentiment amongst rad oncs seems to have been "we take care of cancer patients; our patients are really complicated and really sick." Well, now the tables are turned and the patients flooding the ER and the ICUs are the sickest of the sick, and the most complicated. And now you still don't want to help? Please.
For the record, I'm <40 and graduated from residency <10 years ago, so this is not an age thing.
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"...from 8-4, M-F. If it's SVC syndrome, you'll have to ask nicely."
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If it's SVC syndrome, consider stent or chemotherapy first. If these don't apply, please give steroids and wait until 8 AM the next weekday.
Just kidding. Sort of.
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No, I think he’s been an ass for a while now...I’m a Xennial. And I’ve been out of training less than a year.
And genXer here and we made being lazy an art form...but the doctor counterparts are still going to do what they need to do, to do the best for their patients.
Though frankly I don’t think he represents the millennial faction either...as it has been noted here, many of the millennials here are doing what’s right for pt care...I think he’s a guy that went into medicine for the money and now is pissed that he actually may have to doctor...
Think all you want dude, if you are not doing what all your other co-residents are doing , it will come back to bite you... even if you think you’re the PDs pet. No one here has said you CAN’T do it, but there will be consequences to your actions...and while you probably didn’t have consequences growing up for the things you did, you will have to accept them in this case...and that consequence could be as severe as dismissal ...people get dismissed for a lot less( and are always surprised by it....).
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I mean, I'm a resident and I strongly feel that we can and should be asked to help where it is necessary (though I'm EM so maybe it is more of a DGAF mind set).
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$5 says there's a similar thread in the derm forum.
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I'll take that bet.
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That’s sad that is what you have had for attendings...most of mine led by example...in a good and inspiring way.
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Aren't you a radiology resident? Unless your attendings have been redeployed elsewhere, not sure how they would "hide" behind the residents as they can do a lot of work remotely. Plus if they were being repurposed, they would likely not be running an IM teaching service, but would be with a random assortment of people of various specialties similarly re-assigned.
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Nope. But it’s happening in Michigan and New York already where derm residents are being pulled to help out.
As a derm resident, I certainly wouldn’t volunteer, but I also wouldn’t refuse to help out either if needed, availability of appropriate PPE notwithstanding. I don’t think that’s unreasonable, especially for specialties that don’t manage inpatients. Fortunately, my area of the country still has relatively few cases... for now.
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Some of us are residents too.
I’m a Xennial. And I’ve been out of training less than a year.
Xennial here as well. Dragging in boomers and millennials into this thread confirms the bolded.
Our attendings were the first ones to step up and add extra shifts to triage. They've tried to shield us as much as possible, but it's becoming obvious that's not going to be possible for very long. Fortunately, many of us have been asking to help from the get-go. This is getting worse long before it gets better...
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Also a rads resident. I doubt they're going to redeploy my attendings (who are already just running a skeleton crew) - not just because of their averge age, and distance from doing clinical medicine, but because they *do* have full home workstations. The residents don't, which is why we're in ready-reserve to be cross-assigned.
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at my institution we have rehab attendings on the floor who has been doing rehab for 40+ years now asked to manage 2 internal medicine residents and 20 vented patients. is that really ideal or even adequate i dare say
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Clearly not, but what is your proposed alternative?
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Still, they are attendings with the experience and common sense that should bear. And they're managing IM residents who live and breath floor medicine, each of which only has the 10 patients an intern would be expected to carry on July 1st. My hope is that they're babysitting a bunch of rocks or dispo issues. Not great, not terrible. I think it's going to get terrible soon.
Edit: I apparently skipped across the 'vented' portion. I assumed floor patients.
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When we have tent hospitals in Central Park and convention centers, adequate and ideal are pipedreams.
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I don’t disagree with you guys but it’s just coming in terms with the harsh reality and the fact some patients if not all are not receiving optimal care
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When the largest health care system in NYS (and largest private employer in NYS) sends their various Attendings to the ER (or stay home with no pay) you know things are dire.
www.nytimes.com
“One of the largest hospital networks in New York has given its doctors an ultimatum: either help deal with the coronavirus crush, or stay home without pay.
At other hospitals, too, all hands are being called to deck. Neurosurgeons and cardiologists, orthopedic, dermatology and plastic surgery residents — all have been pulled into emergency rooms and intensive care wards. Receptionists who normally deal with billing are also being told they will be reassigned, to emergency rooms to help screen Covid-19 patients.”
With Virus Surge, Dermatologists and Orthopedists Are Drafted for the E.R. (Published 2020)
Specialists who haven’t worked an intensive care shift in years are being pressed into duty as coronavirus cases overwhelm New York’s hospitals.
“One of the largest hospital networks in New York has given its doctors an ultimatum: either help deal with the coronavirus crush, or stay home without pay.
At other hospitals, too, all hands are being called to deck. Neurosurgeons and cardiologists, orthopedic, dermatology and plastic surgery residents — all have been pulled into emergency rooms and intensive care wards. Receptionists who normally deal with billing are also being told they will be reassigned, to emergency rooms to help screen Covid-19 patients.”
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While I'd argue that perhaps some IM subspecialists should get pulled in to thelp, rehab patients are quite complex--especially in an academic setting, where it is rare to have hospitalists manage the patients. We were the hospitalist for all of our rehab patients (though out in the community hospitalists often manage medical issues). So there probably aren't a whole lot of better attendings to step up to hospitalist medicine than an academic rehab physician.
How many other specialists actually truly run their own unit these days? Everyone else co-manages with hospitalists. Rehab in the academic setting typically doesn't. Now that there are only so many hospitalists to go around, you go for the next best thing. Better to be intubated by a PM&R doc than a psychiatrist, right? Maybe not, we'd both be terrible at it, lol... But we do actually run rapids, codes (until code team arrives), and know how to manage inpatient medical issues.
Rehab MDs are likely more competent than most to manage a vented patient. Outside the ICU, the only unit that allows vented patients is rehab (for SCI). Obviously that's for a stable ventilated patient, but we also work with pulmonology to wean our patients off the vent while they're in the ICU. It's nothing compared to managing ARDS and the stuff pulmonology does, but at least we're not freaking out near a ventillator and know how to change the settings. Well, most of us would freak out, but the rehab attendings at SCI units won't.
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2 resident docs DIED in NYC today (IM and anesthesia from Elmhurst and Mt Sinai).
And yet they (admin) are telling us that we need to wear rain ponchos and garbage bags. Like come on! Really scared here, seriously. Feds get your **** together, we’re literally walking into fires without the ability to put them out!!
And yet they (admin) are telling us that we need to wear rain ponchos and garbage bags. Like come on! Really scared here, seriously. Feds get your **** together, we’re literally walking into fires without the ability to put them out!!
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Theyre not going to stop treating you like cannon fodder unless you do something about it.
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You need your attendings to walk out. Done. Out. All of you - as a group - walk out of the hospital. One or two residents doing this won't end well. Only residents doing it won't end well. Attendings walking out on their own won't end well. Everyone needs to be in this together and the few stragglers who refuse can stay behind and take over 100% of physician patient care.
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Is that not being reported in the news because it just happened? I haven't seen anything in the news about that. I have to imagine it will make headlines when it becomes public.
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I've been seeing it on social media. An OMFS resident in Detroit also died from Covid-19. 3 residents total this last week. One was in their 20s, Detroit one was in their 30s, and I'm unsure about the other one from NYC.
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I guess that’s my question. I’ve also seen references here and on social media, wondering why it’s not been reported in the news media.
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I heard it from friends at these hospitals.
Here’s another article: Doctors In Training Are Dying, And We Are Letting Them Down
We are fighting an uphill battle without PPE and without any hazard pay and ACGME duty hours have gone out the window (pretty much).
Here’s another article: Doctors In Training Are Dying, And We Are Letting Them Down
We are fighting an uphill battle without PPE and without any hazard pay and ACGME duty hours have gone out the window (pretty much).
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I'm a peds attending who completed a med/peds intern year, so I have 6 months experience in internal medicine (ICU x 2, general floor x 2, ER x 2)
However that was about 10 years ago. I could probably function at an intern level but certainly not confident enough to be a senior resident or attending.
I don't understand why DeBlasio and Cuomo keep going on TV saying they need doctors. From what I've heard, that's not true. They certainly need ICU and ER docs (and the nursing staff that goes with it) but that's about it. They certainly dont need pediatricians masquerading as internists.
Also I heard that New York has an 80,000 strong medical reserve corps on standby that is full of doctors and nurses willing to help out, and I've heard that so far that reserve corps has largely gone un-activated and they are just waiting around doing nothing.
There's some kind of miscommunication going on up there in terms of what kind of doctors are needed and where they are needed at.
Upstate New York is not that busy. Instead of using med students or residents out of their specialty, a far better idea is to take the ER and hospitalist IM docs in upstate New York and recruit them to work in NYC. Of course they need to fix the PPE problem before asking people to help out.
However that was about 10 years ago. I could probably function at an intern level but certainly not confident enough to be a senior resident or attending.
I don't understand why DeBlasio and Cuomo keep going on TV saying they need doctors. From what I've heard, that's not true. They certainly need ICU and ER docs (and the nursing staff that goes with it) but that's about it. They certainly dont need pediatricians masquerading as internists.
Also I heard that New York has an 80,000 strong medical reserve corps on standby that is full of doctors and nurses willing to help out, and I've heard that so far that reserve corps has largely gone un-activated and they are just waiting around doing nothing.
There's some kind of miscommunication going on up there in terms of what kind of doctors are needed and where they are needed at.
Upstate New York is not that busy. Instead of using med students or residents out of their specialty, a far better idea is to take the ER and hospitalist IM docs in upstate New York and recruit them to work in NYC. Of course they need to fix the PPE problem before asking people to help out.
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Perhaps consider that what you've heard is inaccurate?
Pretty sure they need a number of docs. A number of specialists can work non-COVID IM wards, freeing up the IM docs. No one's going to go to a press conference and list unwelcomed specialists at this time. They need docs -- a number of different types of docs.
Except that upstate NY has its share of COVID patients and they haven't yet spiked.
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Fine, then let's hear it from actual doctors on the front lines. The articles I've read written by real medical professionals in New York state that they need ER/ICU/IM hospitalist docs, not every doctor imaginable coming to help out and fit in wherever.
The people screaming on TV about drafting doctors and needing every doctor to come to NYC so far are politicians who understand very little about medicine or the medical profession and think that all doctors are interchangeable. They probably watch Grey's Anatomy and have come away with the mistaken impression that the same doctor that delivers babies can also do brain surgery or treat patients with cancer.
Also, it's not so easy to separate the non-COVID from the COVID patients coming in. The tests have a huge lag time. You need to assume that every single person coming into the hospital with cough/congestion has COVID. There's actually been a huge decrease (even in New York) in the number of patients hospitalized for non respiratory complaints, and that includes stuff like myocardial infarctions.
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I’m now wondering if this is a hoax or a bad game of telephone of some kind. This has been circulating on social media for a week. I’m finding it increasingly implausible that the actual news media wouldn’t write about young trainee docs dying, when other HCW who have died have been making headlines. The Forbes article quotes a tweet as its only source, written by a Texas ER resident who seems to be reporting the same uncorroborated rumor we’ve all heard. There was an OMFS resident in Detroit who died recently but not confirmed that Covid19 was the cause. Things are tough out there but we don’t do ourselves any favors by spreading rumors.
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Politicians are screaming about getting docs because front liners are screaming about lack of PPE and amount of HCWs who are sick. I doubt any of them know what the physician shortage city-wide is and I haven't really heard any of them speaking out about needing ER/ICU/IM docs. Given that people from other specialties have already been recruited to work, I find it hard to believe they're screaming specifically for ER/ICU/IM. Where are you seeing that? Can you provide a link? Also ER/ICU/IM docs in every single state is on standby for their own communities
With Virus Surge, Dermatologists and Orthopedists Are Drafted for the E.R. (Published 2020)
Specialists who haven’t worked an intensive care shift in years are being pressed into duty as coronavirus cases overwhelm New York’s hospitals.
Hospitals redeploy specialists to COVID-19 front lines
Specialists like anesthesiologists, orthopedic surgeons and cardiologists, who don't typically treat infectious disease patients, are heeding calls from overwhelmed hospitals to help treat the rising number of COVID-19 patients.
www.modernhealthcare.com
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I understand the confusion. I practice pediatrics just outside Detroit, which is definitely a hotspot. I’m also an Air Force reservist. I’m NOT ER/ICU/anesthesia. I have put myself on every volunteer list put out by Detroit and my local large suburban hospital system, to help when needed. I’ve also heard our governor go on TV asking for doctors to come help Michigan. So far... nothing. Local, Detroit, Air Force... I can only assume they don’t need me? I’ve been working at a drive through testing site but even those shifts are hard to get because we have so many idle docs, nurses, and MAs looking for something to do.
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In most of the country, hospitals and medical practices are actually pretty slow. My hospital is currently at about 50-60% capacity. Hospitalists, anesthesiologists and ED docs are having their hours cut, despite being "front-line." Almost every private practice doctor is struggling now and reducing staff hours. This mirrors what is going on in the larger economy. In some hot spots, they can probably use help in ICU, ED, etc, but I'm skeptical that even New York needs tens of thousands of people from every field right now.
