Is IM really like this?

[Raryn]

What does all this have to do with Parkinson's Syndrome?

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[evilbooyaa]

You can get frustrated and rant/vent at times; the difference to me is having a fundamental level of respect for the various fields and their responsibilities.

But even though in the minute I hang up the phone I want to strangle the idiotic medicine/surgery/ortho/ER/derm/peds intern...when I take a step back I can recognize the difficulty of their job and respect them for doing it.

Thank you for supporting my argument from a resident perspective. This was literally the only point that I was trying to make. This and the fact that physicians' inability to do the above is getting us reamed in the political arena.

As to Instatewaiter - EP can be electrophysiologist or emergency physician, just as acronyms can stand for multiple things, as people have noted for the past 5-6 posts. Context and all that.

 

[notbobtrustme]

Sliding scale lantus?? I'm doing something wrong...

err i think that was the joke.

 

[Instatewaiter]

classy argument about acronyms.

PS: EP can mean either electrophysiologist or emergency physician.

letters, words, english, communication, etc..

No.

 

[Instatewaiter]

err i think that was the joke.

Yeah

 

[e30ftw]

No.

Yes.

 

[Instatewaiter]

Yes.

Perhaps to a pgy2 em resident.

 

[e30ftw]

Perhaps to a pgy2 em resident.

I love this.

We have come full circle in this thread. It began as a question: "What is IM like?"

Now 8 pages later an IM-trained resident/fellow makes an argument in absolute terms that the acronym "EP" *cannot* refer to the phrase "Emergency Physician."

Arguments in absolutes are nearly always poor form in discussion because they are so easily proven untrue.

See exhibit A:

http://www.epmonthly.com/

I freely admit that in cardiology and inpatient medicine consulting electrophysiology, an EP means electrophysiologist. This is obvious and easily understood.

Rather than concede the slight possibility that at some point in time somewhere in the world an ER doc could be correctly referred to as an Emergency Physician through the acronym 'EP' Instatewaiter continues to state it is absolutely incorrect and impossible. Then he kind of creepily looks through my past posts to see that I am a PGY-2 EM resident, which btw, is a f$@%ing awesome job, and makes a statement inferring that, to my ignorant worldview, the acronym EP could refer to an ER doc but to anyone enlightened it could only possibly mean 'electrophysiologist'.

What is IM like?

Behold, this is Internal Medicine.

 

[Anastomoses]

There's no accounting for personality defects.

 

[DermViser]

There's no accounting for personality defects.

Don't you know it.

 

[The Buff OP]

Damn! SMH All I hear from this thread is money, money, and more money.
Whatever happen to people wanting to become a medical doctor to help people and they could careless how much they make? After all, even the low salary specialties pay more than most jobs out there.

 

[HopefulReapp]

Damn! SMH All I hear from this thread is money, money, and more money.
Whatever happen to people wanting to become a medical doctor to help people and they could careless how much they make? After all, even the low salary specialties pay more than most jobs out there.

The money replies are a small minority of posts. I think you need more dirty and gritty patient exposure before you'll get off the high horse. Please notice that every single attending who has posted in this thread agrees with the general sentiment of frustrating patients and the need for a true passion in specifically IM to deal with it. If all you hear are pointless complaints, again it just seems that you haven't really seen anything with the inpatient population.

 

[DermViser]

Damn! SMH All I hear from this thread is money, money, and more money.
Whatever happen to people wanting to become a medical doctor to help people and they could careless how much they make? After all, even the low salary specialties pay more than most jobs out there.

You're kidding right? Whose talking about liking medicine only for the money? I was talking about Hospitalists. But that's bc the job description is a huge cluster*, that would be nowhere near gratifying to me, no matter how much it paid.

 

[DermViser]

The money replies are a small minority of posts. I think you need more dirty and gritty patient exposure before you'll get off the high horse. Please notice that every single attending who has posted in this thread agrees with the general sentiment of frustrating patients and the need for a true passion in specifically IM to deal with it. If all you hear are pointless complaints, again it just seems that you haven't really seen anything with the inpatient population.

He's premed, so real patient exposure probably lacking.

 

[The Buff OP]

You're kidding right? Whose talking about liking medicine only for the money? I was talking about Hospitalists. But that's bc the job description is a huge cluster*, that would be nowhere near gratifying to me, no matter how much it paid.

I only read the first page. But tell if I'm wrong most kids want to always go for the high paying specialties or specialties with great lifestyles.
The whole cluster thing, that's on them its not like they didn't know about that.

 

[The Buff OP]

The money replies are a small minority of posts. I think you need more dirty and gritty patient exposure before you'll get off the high horse. Please notice that every single attending who has posted in this thread agrees with the general sentiment of frustrating patients and the need for a true passion in specifically IM to deal with it. If all you hear are pointless complaints, again it just seems that you haven't really seen anything with the inpatient population.

I don't know what you are talking about, buddy. If anything I'm down to earth and I never try to look down at anybody.
I have had some bullcrap patients when I did my emergency room clinical's, I feel yah.

 

[DermViser]

I only read the first page. But tell if I'm wrong most kids want to always go for the high paying specialties or specialties with great lifestyles.
The whole cluster thing, that's on them its not like they didn't know about that.

1) No, certain specialties are not cluster****, where 50 things are going on at once, while you have to do your job.

 

[username456789]

Every time I see this thread title pop up, all I can think of is

 

[Instatewaiter]

I love this.

We have come full circle in this thread. It began as a question: "What is IM like?"

Now 8 pages later an IM-trained resident/fellow makes an argument in absolute terms that the acronym "EP" *cannot* refer to the phrase "Emergency Physician."

Arguments in absolutes are nearly always poor form in discussion because they are so easily proven untrue.

See exhibit A:

http://www.epmonthly.com/

I freely admit that in cardiology and inpatient medicine consulting electrophysiology, an EP means electrophysiologist. This is obvious and easily understood.

Rather than concede the slight possibility that at some point in time somewhere in the world an ER doc could be correctly referred to as an Emergency Physician through the acronym 'EP' Instatewaiter continues to state it is absolutely incorrect and impossible. Then he kind of creepily looks through my past posts to see that I am a PGY-2 EM resident, which btw, is a f$@%ing awesome job, and makes a statement inferring that, to my ignorant worldview, the acronym EP could refer to an ER doc but to anyone enlightened it could only possibly mean 'electrophysiologist'.

So some throwaway journal/website is your proof? Come on.

It was never absolute terms I spoke in. It's not that EP can't refer to emergency physicians, it's that in the clinical setting it just doesn't. When someone says, get EP involved, they don't mean go talk to the Emergency Room. Go talk to the EP... never means let's see what the emergency physician thinks. I'm going to send you to EP doesn't mean you're getting admitted through the triage station.

 

[VisionaryTics]

So some throwaway journal/website is your proof? Come on.

http://www.acep.org/

Dude, just give up.

Yes, EP usually refers to electrophysiology. You've probably heard it a ton in IM (and I think you're a cards fellow?).

However, some people occasionally refer to emergency medicine docs as EPs.

 

[The Buff OP]

U mad @DermViser?

 

[WillburCobb]

I only read the first page.

You're really missing out

 

[The Buff OP]

You're really missing out

 

[Instatewaiter]

http://www.acep.org/

Dude, just give up.

Yes, EP usually refers to electrophysiology. You've probably heard it a ton in IM (and I think you're a cards fellow?).

However, some people occasionally refer to emergency medicine docs as EPs.

ACEP is an acronym. I'm not arguing people call people who graduated from an emergency medicine residency, emergency physicians... I'm arguing that people don't call them EPs... cause they don't

 

[jdh71]

ACEP is an acronym. I'm not arguing people call people who graduated from an emergency medicine residency, emergency physicians... I'm arguing that people don't call them EPs... cause they don't

Agreed. No one out "there" refers to emergency docs as "EP's". I guess maybe emergency docs call themselves that?? Never heard anyone in the out-patient or in-patient side of medicine use the acronym to mean anything other than electrophysiology.

Of course, this thread is evidence to the contrary. Heh.

The one thing you can say about the "allo" forum . . . "Hey, at least it's NOT pre-med"

 

[Venko]

So some throwaway journal/website is your proof? Come on.

It was never absolute terms I spoke in. It's not that EP can't refer to emergency physicians, it's that in the clinical setting it just doesn't. When someone says, get EP involved, they don't mean go talk to the Emergency Room. Go talk to the EP... never means let's see what the emergency physician thinks. I'm going to send you to EP doesn't mean you're getting admitted through the triage station.

Okay.

Let me just say as an EP (Emergency Physician)... Who really cares what instate waiter is serving up.

In some clinical settings, EP refers to emergency physicians most often. Whether you wish to agree with it or not it is there.

Similarly, US can mean ultrasound but also certainly refers to the United States (by the way, both are correct in any clinical setting).

As for EP, I use it both ways. My colleagues use it both ways in clinical settings.

Lets all return what this waiter served up and move on with our lives.

 

[FIREitUP]

Okay.

Let me just say as an EP (Emergency Physician)... Who really cares what instate waiter is serving up.

In some clinical settings, EP only refers to emergency physicians. Whether you wish to agree with it or not it is there.

Similarly, US can mean ultrasound but also certainly refers to the United States (by the way, both are correct in any clinical setting).

As for EP, I use it both ways. My colleagues use it both ways in clinical settings.

Lets all return what this waiter served up and move on with our lives.

yeah except EP according to you can describe two different types of physicians. i think it's pretty easy to determine by context whether or not someone is talking about an ultrasound or the united states of america

 

[Venko]

yeah except EP according to you can describe two different types of physicians. i think it's pretty easy to determine by context whether or not someone is talking about an ultrasound or the united states of america

If the trauma surgeon in the trauma bay says, "go grab the EP for intubation," which happens the context will guide to the emergency physician. If the inpatient attending says, "consult EP for this arrhythmia," again context will guide you.

Context is everything, the acronym is not exclusive and not guaranteed in any clinical setting to be used a single way. Both are acceptable and are in use in patient care areas, in conferences, in the literature, and in the board room.

 

[FIREitUP]

If the trauma surgeon in the trauma bay says, "go grab the EP for intubation," which happens the context will guide to the emergency physician. If the inpatient attending says, "consult EP for this arrhythmia," again context will guide you.

Context is everything, the acronym is not exclusive and not guaranteed in any clinical setting to be used a single way. Both are acceptable and are in use in patient care areas, in conferences, in the literature, and in the board room.

i think it might be possible that one would confuse two physicians for another rather than the united states vs ultrasound.

 

[notbobtrustme]

did we seriously just have 20+ posts on acronyms?

 

[DermViser]

did we seriously just have 20+ posts on acronyms?

IM = intramuscular

 

[Brain Bucket]

did we seriously just have 20+ posts on acronyms?

By the time we finish our fellowships, we will be REALLY fun at parties.

 

[colbgw02]

Because apparently we're doing this...I'll just add that the semantic creep between abbreviation and acronym annoys me.

 

[Otto of the Silver-Hand]

GI= soldier in the army
FM= frequency modulation
GS = Goldman Sachs
SDN = software-defined networking

 

[Winged Scapula]

If the trauma surgeon in the trauma bay says, "go grab the EP for intubation," which happens the context will guide to the emergency physician. If the inpatient attending says, "consult EP for this arrhythmia," again context will guide

Trauma surgeons are calling someone else to do the intubation?

 

[DermViser]

Trauma surgeons are calling someone else to do the intubation?

Yeah, that almost never happens. Most trauma surgeons if anything don't want to delegate to someone else, esp. if it's an EM doc, on their patient.

 

[e30ftw]

How often are dermatology residents in the bay again?

in ~50 trauma tubes I've never seen a trauma surgeon intubate or have any interest in obtaining a non-surgical airway.

 

[Raryn]

I love the absolutes.

"No one out "there" refers to emergency docs as "EP's"."

You know, if we find even one person who does it, you're automatically wrong.

Do I normally just refer to them as "ED doc"s? Yes. Have I ever referred to them as EPs? Yup.

This discussion is getting ridiculous.

 

[DermViser]

How often are dermatology residents in the bay again?

in ~50 trauma tubes I've never seen a trauma surgeon intubate or have any interest in obtaining a non-surgical airway.

Yes, bc it's not like I haven't done required clinical rotations in med school. You really think a trauma surgeon is going to let an EM doc handle things on his patients (which he then has to deal with)

 

[e30ftw]

Yes, bc it's not like I haven't done required clinical rotations in med school. You really think a trauma surgeon is going to let an EM doc handle things on his patients (which he then has to deal with)

This thread is amazing.

Derm resident telling ER resident how trauma airways work based on medical school experience.

I know EM manages the airway in trauma patients at my lvl 1 center because that is what I do everyday... for my residency.

Like I said, in my experience, trauma surgeons have no interest in non-surgical airways.

 

[Winged Scapula]

This thread is amazing.

Derm resident telling ER resident how trauma airways work based on medical school experience.

I know EM manages the airway in trauma patients at my lvl 1 center because that is what I do everyday... for my residency.

Like I said, in my experience, trauma surgeons have no interest in non-surgical airways.

That's what so ridiculous about this thread. We all come from different environments and experiences yet we seem so hell bent on absolutes.

Like others I'm more familiar with EP referring to Electrophysiology but in context, I have heard it refer to Emergency Physician. In my world FMD refers to Fibromuscular Dysplasia but in the FM forums, I've seen it used to refer to those practitioners.

In e30ftw's world EM does the airway. In my residency and fellowships, at Level 1 Trauma Centers and now practicing at one, the trauma bay airways belong to either the Anesthesia or Surgery residents. Trauma was very unpopular with our EM residents because the bay was really run by surgery. Different worlds, different cultures and different experiences: it doesn't mean one is right and the other wrong.

 

[Venko]

i think it might be possible that one would confuse two physicians for another rather than the united states vs ultrasound.

It's possible even likely.

Still doesn't change the fact that EP refers to both specialties in different contextual settings.

US is taking over the world

 

[Raryn]

That's what so ridiculous about this thread. We all come from different environments and experiences yet we seem so hell bent on absolutes.

Like others I'm more familiar with EP referring to Electrophysiology but in context, I have heard it refer to Emergency Physician. In my world FMD refers to Fibromuscular Dysplasia but in the FM forums, I've seen it used to refer to those practitioners.

In e30ftw's world EM does the airway. In my residency and fellowships, at Level 1 Trauma Centers and now practicing at one, the trauma bay airways belong to either the Anesthesia or Surgery residents. Trauma was very unpopular with our EM residents because the bay was really run by surgery. Different worlds, different cultures and different experiences: it doesn't mean one is right and the other wrong.

Every place is different. At my medical school, the surgical and EM departments set up a calendar of alternating weeks for who ran trauma activations (and thus got the head of the bed).

 

[SouthernSurgeon]

This thread is amazing.

Derm resident telling ER resident how trauma airways work based on medical school experience.

I know EM manages the airway in trauma patients at my lvl 1 center because that is what I do everyday... for my residency.

Like I said, in my experience, trauma surgeons have no interest in non-surgical airways.

Yeah I mean I'd give the airway a shot if no one else was around? But to be honest my comfort level with a surgical airway is probably higher than with a difficult intubation ( given that my number of trachs/neck cases outnumber my intubations > 10:1)

 

[Venko]

Yes, bc it's not like I haven't done required clinical rotations in med school. You really think a trauma surgeon is going to let an EM doc handle things on his patients (which he then has to deal with)

Dermviser...why are you commenting on my specialty? Are you so bored with derm conversations that you feel the need and feel qualified to speak on the global landscape of trauma airways?

Please leave your opinion if you feel you must but please don't speak in absolutes nor try and correct those who actually work routinely in emergency departments.

After all, you would not want me talking in absolutes about dermatology?

It's only fair to those who read these threads, and shows a healthy sense of ones limits.

Our trauma attendings and EP attendings are friends and colleagues. We have a healthy respect for each other routinely and appreciate each others help.

Thank you for your one month of medical school experience. It is NOT globally applicable.

 

[FIREitUP]

It's possible even likely.

Still doesn't change the fact that EP refers to both specialties in different contextual settings.

US is taking over the world

i've never heard it used, but i believe ya. either way, i'm just trying to bug you because i'm bored on the internet, haha

 

[DermViser]

Dermviser...why are you commenting on my specialty? Are you so bored with derm conversations that you feel the need and feel qualified to speak on the global landscape of trauma airways?

Please leave your opinion if you feel you must but please don't speak in absolutes nor try and correct those who actually work routinely in emergency departments.

After all, you would not want me talking in absolutes about dermatology?

It's only fair to those who read these threads, and shows a healthy sense of ones limits.

Our trauma attendings and EP attendings are friends and colleagues. We have a healthy respect for each other routinely and appreciate each others help.

Thank you for your one month of medical school experience. It is NOT globally applicable.

My comment was more on Surgeons (esp. General Surgeons) not EM docs. You have to understand your specialty is quite young. Up until 1979, EM was not even it's own specialty. Surgeons and IM were the ones who did all those things that EM docs do now.

 

[Venko]

My comment was more on Surgeons (esp. General Surgeons) not EM docs. You have to understand your specialty is quite young. Up until 1979, EM was not even it's own specialty. Surgeons and IM were the ones who did all those things that EM docs do now.

Since once again you are not a general surgeon, trauma surgeon, emergency physician, not even an attending physician, and were not practicing in 1979....

I will once again tell you to not speak in absolutes.

It's funny that you would lecture me on the history of my specialty

Your point was, no surgeon would let an EM doc care for their patients.

It's just wrong.

Stick to your expertise...derm residency. It's only fair to others who are your senior in every respect in the topic at hand...in this case, trauma airways.

 

[DermViser]

Since once again you are not a general surgeon, trauma surgeon, emergency physician, not even an attending physician, and were not practicing in 1979....

I will once again tell you to not speak in absolutes.

It's funny that you would lecture me on the history of my specialty

Your point was, no surgeon would let an EM doc care for their patients.

It's just wrong.

Stick to your expertise...derm residency. It's only fair to others who are your senior in every respect in the topic at hand...in this case, trauma airways.

Yeah, just like getting an "H" vs. an "HP" in Biochemistry, is a good indictator of residency performance.

 

[Instatewaiter]

Yeah, just like getting an "H" vs. an "HP" in Biochemistry, is a good indictator of residency performance.

?