How will you handle possible stop to elective surgery?

[siliso]

Stay home and let people die and your colleagues sweat without your help even though you could help - regardless of payment or nonpayment, for now - yes you’re a pariah and a toilet seat that smokes a cigar. Forever that is what you are. You’ll be remembered.

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[chocomorsel]

Your contract says they can’t fire you??
They will try to do something in order to survive. These AMC’s will fall like a house of cards in a few weeks if they have to pay out full salaries with no/minimal collections.

I sure am hoping and praying that they do!
But I got no dog in the fight!

 

[chocomorsel]

Stay home and let people die and your colleagues sweat without your help even though you could help - regardless of payment or nonpayment, for now - yes you’re a pariah and a toilet seat that smokes a cigar. Forever that is what you are. You’ll be remembered.

WTF? Who are you and where did you come from with this comedic line?

 

[siliso]

Who knows, man. The angel on your shoulder or the devil.

 

[chocomorsel]

Who knows, man. The angel on your shoulder or the devil.

I ain’t never heard of a toilet seat that smokes a cigar. And I grew up on the South!
That’s some funny ****!!!

 

[siliso]

Can’t take credit, it’s Chris Onstad from above. But apropos x1000.

 

[dannyboy1]

If people are dying and the hospital is broke and can’t pay you and you decide you won’t come in to help because you aren’t getting paid, that is your right as an American but you are not someone I want as a physician or colleague and would not wish u well once the storm is over. Sorry not sorry.

If you’re not coming in because you’re quarantined, sick, other obligations, or maybe even you’re scared, that is fine. But purely for financial reasons? Shame! Shame! Shame!

If the work is so vital for society then society can pay for it....

 

[NicMouse64]

I’m going to agree with you on something.

We’re hearing talk about the government bailing out the cruise ship or airline industry, but folks are entertaining the idea of having to go “all hands on deck” without pay. I will personally lead a riot in the streets if the cruise ship industry gets a billion dollar bail out and I am working an overwhelmed healthcare system without compensation.

Trillion dollar*

 

[siliso]

If you’re alive and have where to live and what to eat, wear, and get around, And have no sincere fear that your dependents won’t have their basic needs, already society is paying you fairly.

 

[siliso]

But I am fully in support of direct action on behalf of the vulnerable. Do it and take care of ppl too.

 

[dannyboy1]

If people are dying and the hospital is broke and can’t pay you and you decide you won’t come in to help because you aren’t getting paid, that is your right as an American but you are not someone I want as a physician or colleague and would not wish u well once the storm is over. Sorry not sorry.

If you’re not coming in because you’re quarantined, sick, other obligations, or maybe even you’re scared, that is fine. But purely for financial reasons? Shame! Shame! Shame!

Let’s see if I understand this. I work as an anesthesiologist at a busy tertiary care center. I’m considered clinically competent, do my job quietly and efficiently, get along well with surgeons and patients, never show up late or cause any trouble. But god forbid I don’t want to work for free and out come the knives. Take away his license! Make sure he never works again! Are you fu(king kidding me!!! License revocation should be reserved for physicians who are a clear and present danger to their patients......

 

[dannyboy1]

If you’re alive and have where to live and what to eat, wear, and get around, And have no sincere fear that your dependents won’t have their basic needs, already society is paying you fairly.

Why is Bernie Sanders posting on our forum ??

 

[siliso]

Here’s what I’m saying: for now! Go back to making whatever bux you ethically can, after national emergency is resolved. If you have no worries for your family’s ability to live and eat, you and I are fortunate beyond fortunate in a crisis. And the crisis will end and then we can go back to arguing politics and holding out for the big money and etc.

 

[deleted480308]

Here’s what I’m saying: for now! Go back to making whatever bux you ethically can, after national emergency is resolved. If you have no worries for your family’s ability to live and eat, you and I are fortunate beyond fortunate in a crisis. And the crisis will end and then we can go back to arguing politics and holding out for the big money and etc.

a demand that anyone assume liability and risk for no pay is not logical. They may choose to out of charity but it should never be an expectation

 

[MoMoGesiologist]

Let’s see if I understand this. I work as an anesthesiologist at a busy tertiary care center. I’m considered clinically competent, do my job quietly and efficiently, get along well with surgeons and patients, never show up late or cause any trouble. But god forbid I don’t want to work for free and out come the knives. Take away his license! Make sure he never works again! Are you fu(king kidding me!!! License revocation should be reserved for physicians who are a clear and present danger to their patients......

I agree it’s an extreme statement. And you have the right to not show up to work if you are not being paid.

But if the stories coming out of Italy are real and materialize here (not enough beds, ORs turned into ICUs), and the hospital can’t do elective surgery and is losing money and asks you to volunteer, you really wouldn’t help? This isn’t asking you to work for free because hospital wants to take advantage of you, this is if it’s a national crisis and all hands on deck situation. What does being a physician mean in this situation?

 

[Justice4all]

All hands on deck! I am all for it . But if your institution is acting like business as usual with no cancellation of elective cases or non essential outpatient clinic, my participation will be limited. We need to flatten the curve and not make physicians vectors in this pandemic.

 

[siliso]

a demand that anyone assume liability and risk for no pay is not logical. They may choose to out of charity but it should never be an expectation

I don’t know. We made certain promises and agreements with society once upon a time in exchange for the right to cut on, temporarily poison and etc our neighbors. When a once in a gen crisis arises, everyone might justly expect to be conscripted to some kind of civic duty. If there’s a salient one you’re already capable for, so much the more. To be absolved of liability and risk for good-faith action is a reasonable expectation in return I agree.

 

[deleted480308]

I don’t know. We made certain promises and agreements with society once upon a time in exchange for the right to cut on, temporarily poison and etc our neighbors. When a once in a gen crisis arises, everyone might justly expect to be conscripted to some kind of civic duty. If there’s a salient one you’re already capable for, so much the more. To be absolved of liability and risk for good-faith action is a reasonable expectation in return I agree.

and paid. Society has literally no right to expect work without payment

 

[deleted171991]

a demand that anyone assume liability and risk for no pay is not logical. They may choose to out of charity but it should never be an expectation

No jury will vote against a physician who was working his butt off in the trenches.

 

[siliso]

and paid. Society has literally no right to expect work without payment

Sure man, 2LT pay if you’ve no other source of income, I’m on board. We all gotta eat.

 

[GravelRider]

Sure man, 2LT pay if you’ve no other source of income, I’m on board. We all gotta eat.

So you’d be fine with a few billion dollar bailout of a cruise ship company, while doctors and nurses make sacrifices for the good of others? If this gets as bad as it could, the government is going to be throwing a lot of money around, but the doctors and nurses should just be grateful for what they have?

 

[deleted480308]

Sure man, 2LT pay if you’ve no other source of income, I’m on board. We all gotta eat.

Not even an army doc works for LT pay, and they chose to sign up for their terms voluntarily. You simply don’t have a right to demand labor out of people without offering them pay that voluntarily choose to show up for.

 

[deleted171991]

Not even an army doc works for LT pay, and they chose to sign up for their terms voluntarily. You simply don’t have a right to demand labor out of people without offering them pay that voluntarily choose to show up for.

Friendly advice (for oral boards and life): be flexible. AKA pick your battles.

 

[siliso]

No man, you’ve got me all wrong. I literally am Bernie Sanders. I think your student debt should be suspended or canceled. I think we should expropriate cruise line CEOs, not prop them up, and support them and their dishwashers at about the same rate. But that’s outside our scope here.

 

[MoMoGesiologist]

Definitely agree that if we are bailing out industries, doctors should be at the top of the list. We should get CEO level bonus checks for exposing ourselves to this level of risk

 

[siliso]

You’d be surprised what the government is able to require of you in times of crisis (see WWI/II jurisprudence). Better to be a human and not to test the limits.

 

[MoMoGesiologist]

No man, you’ve got me all wrong. I literally am Bernie Sanders. I think your student debt should be suspended or canceled. I think we should expropriate cruise line CEOs, not prop them up, and support them and their dishwashers at about the same rate. But that’s outside our scope here.

Good luck on the debates tonight!

 

[deleted480308]

Friendly advice (for oral boards and life): be flexible. AKA pick your battles.

I’m a resident, my whole life is a string of “yes sir, I happen to love jumping, how high would you like to see me?”

But watching “physician leaders” justify that my attendings subject themselves to slavery or they will ruin them is actually a battle worth choosing

You’d be surprised what the government is able to require of you in times of crisis (see WWI/II jurisprudence). Better to be a human and not to test the limits.

I’m not at all surprised at what govt will do (slavery, trail of tears, japanese internment) to people. Unlike you however, I think the appropriate response is to tell the govt to back the hell off and leave people alone

 

[VA Hopeful Dr]

Friendly advice (for oral boards and life): be flexible. AKA pick your battles.

This came up in another thread and my take it on was this:

If the hospital essentially runs out of money and tells me "we need to not pay you for a time but we'll promise, in writing, to pay you for this work when we're able", I would be fine with that.

But working for free with no promise of ever getting paid for the work: well I'll be honest there's a good chance I'd still help out but it would be when I chose to.

 

[Morzh]

Good to know. Maybe one of those fancy Japanese toilets with the bidets and heated seats is the answer then.

I bought a $30 bidet attachment for my toilet off Amazon 4 years ago... it's been life changing!

 

[chocomorsel]

and paid. Society has literally no right to expect work without payment

Wow. You know, this could be your family that needs help.
Spoken like a true Capitalist. All about the money. Who caress how many people need help?

 

[chocomorsel]

I bought a $30 bidet attachment for my toilet off Amazon 4 years ago... it's been life changing!

Been there. Done that. Awesome product.

 

[siliso]

Your rights are only as good as your ability to assert them (with violence if it comes to it). The wiser course may be to bend and not to break, and better for your soul and country too. If you’re a voluntarist then max volunteerism might be your strongest choice. If you’ve got no frame of reference except muh rights vs the evil gubmint this will be hard to grasp but I believe in our intelligence. And I sincerely hope that none of these contingencies come to pass for all of our good.

 

[deleted480308]

Wow. You know, this could be your family that needs help.
Spoken like a true Capitalist. All about the money. Who caress how many people need help?

large difference between charity and assuming ownership over someone, one is awesome and the other is never acceptable

Your rights are only as good as your ability to assert them (with violence if it comes to it). The wiser course may be to bend and not to break, and better for your soul and country too. If you’re a voluntarist then max volunteerism might be your strongest choice. If you’ve got no frame of reference except muh rights vs the evil gubmint this will be hard to grasp but I believe in our intelligence. And I sincerely hope that none of these contingencies come to pass for all of our good.

Do you believe it is ever acceptable for the govt to exert the force you have been describing here in this thread?

 

[siliso]

I do. See Aquinas, Hobbes, for a few examples, as to why. Even American constitution and jurisprudence have always acknowledged and incorporated the police power.

 

[deleted480308]

I do. See Aquinas, Hobbes, for a few examples, as to why. Even American constitution and jurisprudence have always acknowledged and incorporated the police power.

then we fundamentally disagree on the premise of liberty

 

[vector2]

I do. See Aquinas, Hobbes, for a few examples, as to why. Even American constitution and jurisprudence have always acknowledged and incorporated the police power.

I don't know if you follow any of the other threads here but sb247 is a person who has literally said he would give away his own dying child for adoption before taking money from the taxpayer to pay for healthcare. That should give you an idea as to the fruitfulness of any planned future discussion.

 

[deleted171991]

I don't know if you follow any of the other threads here but sb247 is a person who has literally said he would give away his own dying child for adoption before taking money from the taxpayer to pay for healthcare. That should give you an idea as to the fruitfulness of any planned future discussion.

The absolutism of the young and inexperienced. The relativism of the old and... wise (?).

Fifty Shades of Grey should have been a book about life and wisdom.

 

[siliso]

I hereby resign then
Godspeed sb247 and get your ass to work
Even maximum liberty allows your colleagues the liberty to hate and shun you forever if you don’t

 

[deleted480308]

The absolutism of the young and inexperienced. The relativism of the old and... wise (?).

Fifty Shades of Grey should have been a book about life and wisdom.

I’m old too unfortunately

 

[mmag]

We employ salaried CRNAs at an outpatient surgery center. I’m not sure what we will do if surgeries are canceled for a prolonged period of time. There would be no way we would be able to continue to pay with no money coming in.

Can you subcontract them out to the local hospital as ICU RNs? Definitely gonna have a shortage and aren't CRNAs always touting their ICU nursing experience?

 

[chocomorsel]

Can you subcontract them out to the local hospital as ICU RNs? Definitely gonna have a shortage and aren't CRNAs always tout their ICU nursing experience?

I have a feeling they would do it only if they could run the show. And tell the bedside nurses what to do. Not function as bedside nurses.

 

[pgg]

No jury will vote against a physician who was working his butt off in the trenches.

I'm not sure I share that confidence. Even if you're right, the time, expense, and emotional pain of merely being sued is substantial, and it all happens before the jury even enters the picture.

There are plenty of people who will be happy to sue. They will sue. They will sue over an unavoidable outcome. They will sue over the triage decision that denied treatment to their dead family member. They will sue if their dead family member didn't get a particular treatment because supplies were short or unavailable. They will sue because they are entitled, obnoxious, selfish people ... or perhaps just because they in pain, and naive and genuinely believe that unlimited healthcare on demand at no cost under all circumstances is a human right, and a physician that doesn't or can't do that, is either criminally negligent or a profiteering war criminal.

If the US public hadn't consistently been waging a campaign of denigration and marginalization of physician "providers" for the entirety of my ~20 year career, I'd have a little more faith in that jury. So I don't think it's unreasonable for people to be concerned about the medicolegal risk associated with practicing medicine outside of areas for which they are trained, credentialed, and insured.

If our government would take a moment, while bailing out airlines and cruise ships (!), and explicitly augment Good Samaritan laws in order to make physicians immune to lawsuits stemming from practicing outside their area of expertise when caring for COVID-19 patients, that'd be nice. But they won't - see the line above about two+ decades of denigration and marginalization. They hate us because, unlike nurses, we haven't been waging a self-aggrandizing propaganda public relations campaign about how compassionately selflessly great we are while punching a clock for shift work.

All that said - despite the validity of these concerns and these risks, I would absolutely think less of a physician who refused to work during a crisis like this. I would remember it. It would influence any reference or hiring decision I was later asked to give or make. This is more than just a job. We have a duty to care for the sick and injured, and to be of service to our country in its time and need. Yes, they're free to stay home if the billing slows. I'm free to remember their absence and later act on this new knowledge of their character.

 

[Mman]

I file the potential for having to chip in without getting paid in a national emergency under professionalism. I would suspect people that bailed and didn't help out if they were able to could be reported to state medical boards for sanctioning and license suspension.

Nobody is waving a flag saying "hey I will work for free". But if there is critical work to be done, we must do it and figure out the payment later.

 

[dannyboy1]

I file the potential for having to chip in without getting paid in a national emergency under professionalism. I would suspect people that bailed and didn't help out if they were able to could be reported to state medical boards for sanctioning and license suspension.

Nobody is waving a flag saying "hey I will work for free". But if there is critical work to be done, we must do it and figure out the payment later.

Practically, how would this work? Many of us are credentialed at multiple hospitals, quite a few of us are even licensed in multiple states. Who would claim the “right” to our (unpaid) labor. Would there be a physician draft? Would it apply to all physicians? Would all outpatient practices shut down as their physicians are conscripted??

 

[Mman]

Practically, how would this work? Many of us are credentialed at multiple hospitals, quite a few of us are even licensed in multiple states. Who would claim the “right” to our (unpaid) labor. Would there be a physician draft? Would it apply to all physicians? Would all outpatient practices shut down as their physicians are conscripted??

I will just assume that you have a regular work schedule and hospitals would expect people to show up as they regularly do. I will also assume the locum gig you did out of state 4 years ago will not be requiring you to show up for work.

 

[Mikkel]

I will just assume that you have a regular work schedule and hospitals would expect people to show up as they regularly do. I will also assume the locum gig you did out of state 4 years ago will not be requiring you to show up for work.

In these stressful times, I will still show up, but only if I get to bring my emotional support animals.

 

[Mman]

In these stressful times, I will still show up, but only if I get to bring my emotional support animals.

as long as it isn't a llama. their spitting is frowned upon in these secretion sensitive times

 

[deleted697535]

I'm not sure I share that confidence. Even if you're right, the time, expense, and emotional pain of merely being sued is substantial, and it all happens before the jury even enters the picture.

There are plenty of people who will be happy to sue. They will sue. They will sue over an unavoidable outcome. They will sue over the triage decision that denied treatment to their dead family member. They will sue if their dead family member didn't get a particular treatment because supplies were short or unavailable. They will sue because they are entitled, obnoxious, selfish people ... or perhaps just because they in pain, and naive and genuinely believe that unlimited healthcare on demand at no cost under all circumstances is a human right, and a physician that doesn't or can't do that, is either criminally negligent or a profiteering war criminal.

If the US public hadn't consistently been waging a campaign of denigration and marginalization of physician "providers" for the entirety of my ~20 year career, I'd have a little more faith in that jury. So I don't think it's unreasonable for people to be concerned about the medicolegal risk associated with practicing medicine outside of areas for which they are trained, credentialed, and insured.

If our government would take a moment, while bailing out airlines and cruise ships (!), and explicitly augment Good Samaritan laws in order to make physicians immune to lawsuits stemming from practicing outside their area of expertise when caring for COVID-19 patients, that'd be nice. But they won't - see the line above about two+ decades of denigration and marginalization. They hate us because, unlike nurses, we haven't been waging a self-aggrandizing propaganda public relations campaign about how compassionately selflessly great we are while punching a clock for shift work.

All that said - despite the validity of these concerns and these risks, I would absolutely think less of a physician who refused to work during a crisis like this. I would remember it. It would influence any reference or hiring decision I was later asked to give or make. This is more than just a job. We have a duty to care for the sick and injured, and to be of service to our country in its time and need. Yes, they're free stay home if the billing slows. I'm free to remember their absence and later act on this new knowledge of their character.

I understand what you mean. I understand b

I file the potential for having to chip in without getting paid in a national emergency under professionalism. I would suspect people that bailed and didn't help out if they were able to could be reported to state medical boards for sanctioning and license suspension.

Nobody is waving a flag saying "hey I will work for free". But if there is critical work to be done, we must do it and figure out the payment later.

Look I'm going to work.

But this just isn't true. No one's going to know or remember or care.

The real ppl we should be flogging to death working are the virologists and scientists that will eventually create the vaccine and treatment for this. Not us.

All we do is tube ppl. That's all anyone does anyway cause there is no treatment yet. We can do pocus and start epi.

Were not saving the world anytime soon.

 

[Mman]

Look I'm going to work.

But this just isn't true. No one's going to know or remember or care.

They will remember and they will care. Our field is based on service.