Is There Dignity and Honor in Hospitalist Work?

[BillBill1219]

Is there dignity and honor in hospitalist work? Do you feel like your work is meaningful or do you feel more like a pawn being used by whatever corporate entity happens to be your employer? Is it "just a job" or does this role fulfill a calling you may have had prior to entering the medical profession? Why do so many hospitalists frequently change jobs and can this field offer long-term stability in terms of living/working in one area for extended periods of time (i.e., long enough to plant roots and raise a family.) I realize there are a lot of variables but thank you for any thoughts/insights you can share.


Foot note: These are serious questions that I have been pondering. No matter how balanced, mature, and sincere people are in their posting, there always seems to be a handful of users (usually attendings) who respond with unnecessarily bitter, curmudgeonly, condescending, and snide remarks. If these feelings are welling up inside of you as you read this post, please reconsider responding to the thread. And again, thanks for any genuine thoughts/remarks.

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[timpview]

I’ve come to the conclusion that any specialty that is dependent on hospital employment is facing an uphill battle in feeling they are appreciated/valued and not a cog in the wheel.

 

[dieABRdie]

Is there dignity and honor in hospitalist work? Do you feel like your work is meaningful or do you feel more like a pawn being used by whatever corporate entity happens to be your employer? Is it "just a job" or does this role fulfill a calling you may have had prior to entering the medical profession? Why do so many hospitalists frequently change jobs and can this field offer long-term stability in terms of living/working in one area for extended periods of time (i.e., long enough to plant roots and raise a family.) I realize there are a lot of variables but thank you for any thoughts/insights you can share.


Foot note: These are serious questions that I have been pondering. No matter how balanced, mature, and sincere people are in their posting, there always seems to be a handful of users (usually attendings) who respond with unnecessarily bitter, curmudgeonly, condescending, and snide remarks. If these feelings are welling up inside of you as you read this post, please reconsider responding to the thread. And again, thanks for any genuine thoughts/remarks.

I feel bad for the hospitalists in our town. They do practice inpatient medicine... but often are serving as the baby sitters for the specialists. Our med oncs actually rarely round at the hospital. Patients get admitted to hospitalist, they see the patient once and coordinate from their clinic.

We have a few truly "private" internists in town. Yes... they have to go back and forth from their clinic to the hospital to see their patients. But I'd do that any day of the year to not answer to the hospital administration.

 

[NewYorkDoctors]

6 things wrong with hospital medicine

A perfect example of how administrative and market forces in health care can largely extinguish the incredible potential of a new specialty.

www.kevinmd.com

It would seem the inevitable corporatization and "overuse" of the physician by corporations is what makes hospital medicine so uninspiring and unfulfilling.

However, I have a few colleagues who are part of a large IM practice in NY and go to one of two hospitals. They rotate GIM and do one week of inpatient private hospitalist for just their own patients. This doctor sits around in the physicians lounge and then just rounds around all day and does admissions for their own patients. This physician pulls up their outpatient EMR and gets a full story and full workup continuation. They call their specialist private friends. The patients are like "hey it's you Dr so and so. nice to see you." I'm sure that is a more fulfilling setup.

 

[Prehealth1011]

Is there dignity and honor in hospitalist work? Do you feel like your work is meaningful or do you feel more like a pawn being used by whatever corporate entity happens to be your employer? Is it "just a job" or does this role fulfill a calling you may have had prior to entering the medical profession? Why do so many hospitalists frequently change jobs and can this field offer long-term stability in terms of living/working in one area for extended periods of time (i.e., long enough to plant roots and raise a family.) I realize there are a lot of variables but thank you for any thoughts/insights you can share.

Forget other specialties, they get screwed and dumped on by the hospital itself

Our private hospitalists job offer states “procedures optional, open icu with excellent sub speciality support” word for word. Neither are true. The game always seems to be how much you can squeeze out of them. You get excited when you see upto 300k comp on practicelink until you read the fine prints and realize they want you to not sleep at night and/or be an intensivist in the Midwest

 

[Zendo]

IM PCP is starting to sound better than Hospitalist these days.

 

[BillBill1219]

Forget other specialties, they get screwed and dumped on by the hospital itself

Our private hospitalists job offer states “procedures optional, open icu with excellent sub speciality support” word for word. Neither are true. The game always seems to be how much you can squeeze out of them. You get excited when you see upto 300k comp on practicelink until you read the fine prints and realize they want you to not sleep at night and/or be an intensivist in the Midwest

Yeah, this is what makes me hesitant to pursue hospitalist work. They will promise you the world, and in reality it’s just becomes a game of cat and mouse between you and the hospital. Which is insane to me, because I would think facilities would want to retain as many people as they can, considering how onerous it is to onboard/credential/license a doc.

 

[gutonc]

Yeah, this is what makes me hesitant to pursue hospitalist work. They will promise you the world, and in reality it’s just becomes a game of cat and mouse between you and the hospital. Which is insane to me, because I would think facilities would want to retain as many people as they can, considering how onerous it is to onboard/credential/license a doc.

I would just like to point out that this is pretty much universal (at least in medicine, likely most other industries) and not in any way limited to hospitalist work.

You are absolutely correct that it's cheaper to retain physicians than to hire them, but most organizations don't really do that math correctly.

 

[dgdg]

I used to be a hospitalist early in my career, now independent outpt private practice. Everything has it's pros and cons.
You can't have it all - independence, maximal salary, limited admin work, etc.
Certainly healthcare providers continue to feel stress and I read about depression, suicide rates.

I see two sides of it, if one can try to make it that simple. The satisfaction of the doctor patient relationship vs. dealing with the potential headaches of corporate/administrative pressures. We all can do well for our patients and make a positive difference in their lives, sometimes that can get lost with all the external pressures faced.

 

[VA Hopeful Dr]

IM PCP is starting to sound better than Hospitalist these days.

Advantages to both. Continuity of care is definitely not for everyone which is the main complain many people have about primary care medicine. Even those of us that like it, have patients that make us regret it from time to time.

 

[mumixam]

Is there dignity and honor in being a practicing physician?
I'd say so

 

[FutureInternist]

Is there dignity and honor in hospitalist work? Do you feel like your work is meaningful or do you feel more like a pawn being used by whatever corporate entity happens to be your employer? Is it "just a job" or does this role fulfill a calling you may have had prior to entering the medical profession? Why do so many hospitalists frequently change jobs and can this field offer long-term stability in terms of living/working in one area for extended periods of time (i.e., long enough to plant roots and raise a family.) I realize there are a lot of variables but thank you for any thoughts/insights you can share.


Foot note: These are serious questions that I have been pondering. No matter how balanced, mature, and sincere people are in their posting, there always seems to be a handful of users (usually attendings) who respond with unnecessarily bitter, curmudgeonly, condescending, and snide remarks. If these feelings are welling up inside of you as you read this post, please reconsider responding to the thread. And again, thanks for any genuine thoughts/remarks.

Who cares…
I get there at 630
Home by 2… noon on weekends
Get paid till 7

Good money
Good work-life balance
Can hang out with kiddo even on my on week
Base salary + RVU so high volume (even when baby-sitting) is $ for me

As long as its “round & go” its the best

If I had to do clinic for the rest of my life, I would shoot myself in the head …😏

 

[dgdg]

Who cares…
I get there at 630
Home by 2… noon on weekends
Get paid till 7

Good money
Good work-life balance
Can hang out with kiddo even on my on week
Base salary + RVU so high volume (even when baby-sitting) is $ for me

As long as its “round & go” its the best

If I had to do clinic for the rest of my life, I would shoot myself in the head …😏

Who cares for your patients after 2, and any admissions? I assume the night shift doesn't start until around 7pm

 

[BillBill1219]

Who cares…
I get there at 630
Home by 2… noon on weekends
Get paid till 7

Good money
Good work-life balance
Can hang out with kiddo even on my on week
Base salary + RVU so high volume (even when baby-sitting) is $ for me

As long as its “round & go” its the best

If I had to do clinic for the rest of my life, I would shoot myself in the head …😏

I'm glad you have a good gig but how long can you expect this to last? My understanding is that things are pretty sweet for the first 2-3 years, then the administration starts to squeeze more and more out of you, cut your pay etc.

 

[NewYorkDoctors]

If I had to do clinic for the rest of my life, I would shoot myself in the head …😏

I would agree with you on this point if the caveat were
... while working as a salaried employed PCP for a hospital system in which the administrators are stealing my productivity and feeding me RVUs.

in a private practice setting (in which opening PCP is not too hard at all), these "extra work" tasks are all compensated either indirectly (doing a PA, doing some paper work forms, etc... which necessitates patient follow up and another office visit later) or directly (use the chart review and telehealth codes). hence if you are paid to do this extra work, that salve really is soothing

 

[FutureInternist]

Who cares for your patients after 2, and any admissions? I assume the night shift doesn't start until around 7pm

I don’t leave if there is anything major happening or pending.
For unforeseen issues, we have Rapid Response who can then call us & get recs.
In 12 years, I have had to go back maybe 5 times for unexpected issues

 

[FutureInternist]

I'm glad you have a good gig but how long can you expect this to last? My understanding is that things are pretty sweet for the first 2-3 years, then the administration starts to squeeze more and more out of you, cut your pay etc.

13 years 😏… and going.

Helps to be efficient and I take 30 mins the night before to prepare for the next day.

All pts seen, all orders in, all notes done by noon-ish… then just hang out cos leaving at noon is a little too “in your face” for the old timers who are slow 😏

 

[Drrrrrr. Celty]

It depends entirely on what your concept of dignity entails and what you do and how you sleep at night knowing what you do.

I had great disdain for my time as a resident doing hospital admission/rounding rotations - i.e "hospitalist with training wheels". albeit I was on for 4 weeks straight by myself seeing 15 patients as opposed to 1 week on 1 week off. It just felt like it was medicine without the human element. I couldn't help people, know them, and also do my job well. And by the end half the time even if the patients were nice I wasn't emotionally available enough to engage for longer than 5 minutes. I was berated by rude patients who just wanted pain medicines, people who needed to frankly stay another week but had hit their hospital allotted time, and I half the time I felt cowardly because instead of engaging in hard conversations I avoided it and moved on.

I don't know how hospitalists do it without losing everything that frankly matters.

 

[VA Hopeful Dr]

I would agree with you on this point if the caveat were
... while working as a salaried employed PCP for a hospital system in which the administrators are stealing my productivity and feeding me RVUs.

in a private practice setting (in which opening PCP is not too hard at all), these "extra work" tasks are all compensated either indirectly (doing a PA, doing some paper work forms, etc... which necessitates patient follow up and another office visit later) or directly (use the chart review and telehealth codes). hence if you are paid to do this extra work, that salve really is soothing

Being on salary for the vast majority of non-academic medicine is a scam outside of the first 1-2 years while building a practice.

RVUs aren't too bad overall. Could I do PP and make more than I do now? Maybe. But I like being able to see Medicaid/hospital charity patients and knowing I won't take an income hit for it.

I do the same as you do (minus telehealth codes) in terms of paperwork, or just have my staff do it whichever is more efficient.

 

[dozitgetchahi]

Is there dignity and honor in hospitalist work? Do you feel like your work is meaningful or do you feel more like a pawn being used by whatever corporate entity happens to be your employer? Is it "just a job" or does this role fulfill a calling you may have had prior to entering the medical profession? Why do so many hospitalists frequently change jobs and can this field offer long-term stability in terms of living/working in one area for extended periods of time (i.e., long enough to plant roots and raise a family.) I realize there are a lot of variables but thank you for any thoughts/insights you can share.


Foot note: These are serious questions that I have been pondering. No matter how balanced, mature, and sincere people are in their posting, there always seems to be a handful of users (usually attendings) who respond with unnecessarily bitter, curmudgeonly, condescending, and snide remarks. If these feelings are welling up inside of you as you read this post, please reconsider responding to the thread. And again, thanks for any genuine thoughts/remarks.

I didn’t read the rest of the posts.

However…remember that any job, fundamentally, is an economic contract for labor in exchange for compensation. The longer I’m in medicine, the less I see this is a “calling” and the more I see it as a job - with all the pros and cons associated with that. Do your job well, and go home. Look for meaning and satisfaction elsewhere. Not everything we do is some sort of august thing. You are not the POTUS (and even that is just a job also, and one that sucks in a lot of ways).

 

[NewYorkDoctors]

I didn’t read the rest of the posts.

However…remember that any job, fundamentally, is an economic contract for labor in exchange for compensation. The longer I’m in medicine, the less I see this is a “calling” and the more I see it as a job - with all the pros and cons associated with that. Do your job well, and go home. Look for meaning and satisfaction elsewhere. Not everything we do is some sort of august thing. You are not the POTUS (and even that is just a job also, and one that sucks in a lot of ways).

Yep. Medicine is "an art based on a science but practiced like a business."

Although I've becoming ever more cynical as the years pass (I am more cynical about human behavior but not about what we do as a profession. It takes so much cajoling and "art of medicining" a patient to get the patient to be adherent or at least change up lifestyle it's just grating. I feel like a salesperson sometimes with how I negotiate and "art of medicine" the patients), I just know that if I just do things by the book (and document things) and take no short cuts (unless the patients are nonadherent and force me to take a shortcut) when it comes to my patients, then I'll know I did did the proper (standard of) care for the patient and can rest easily at night.

Taking a "short cut" to me means "not doing what the academic doctors would do because I'm too lazy to jump through the hoops."
Granted the academic doctors have fellows/residents and also a whole army of support staff, but i'm still going to try to do that level of care for the "hard cases."

 

[Crayola227]

I feel bad just coming in to say that when I read the thread title I just sort of lol'd as my immediate response

 

[dozitgetchahi]

Yep. Medicine is "an art based on a science but practiced like a business."

Although I've becoming ever more cynical as the years pass (I am more cynical about human behavior but not about what we do as a profession. It takes so much cajoling and "art of medicining" a patient to get the patient to be adherent or at least change up lifestyle it's just grating. I feel like a salesperson sometimes with how I negotiate and "art of medicine" the patients), I just know that if I just do things by the book (and document things) and take no short cuts (unless the patients are nonadherent and force me to take a shortcut) when it comes to my patients, then I'll know I did did the proper (standard of) care for the patient and can rest easily at night.

Taking a "short cut" to me means "not doing what the academic doctors would do because I'm too lazy to jump through the hoops."
Granted the academic doctors have fellows/residents and also a whole army of support staff, but i'm still going to try to do that level of care for the "hard cases."

It is remarkable how much long-term advantage people like us have gotten by trying to be consistently not stupid, instead of trying to be very intelligent.

Charlie Munger

One of my favorite quotes - from the right hand man to Warren Buffet. It’s amazing how much good you can do as a doctor just by consistently going by the book (and it’s surprising how many of your colleagues around you won’t be doing that).

 

[DrMetal]

On a scale of 1 to 10 (10 being I absolutely love it) . . .I'm about a 7. And I think that's ok.

My only concern about the hospitalist track, is that I don't think it's financially sustainable for the hospitals. I see them trying to replace us with mid-levels and AI. We'll see what happens, I'll be retired by then likely.

 

[BillBill1219]

I don’t leave if there is anything major happening or pending.
For unforeseen issues, we have Rapid Response who can then call us & get recs.
In 12 years, I have had to go back maybe 5 times for unexpected issues

How many patients do you carry routinely? What about admission days?

 

[FutureInternist]

How many patients do you carry routinely? What about admission days?

16-18.

We have a dedicated admitter but sometimes if its busy, they will give rounders some of them.

We have base + RVU so any “extra” work is also extra $

 

[Osteoth]

On a scale of 1 to 10 (10 being I absolutely love it) . . .I'm about a 7. And I think that's ok.

My only concern about the hospitalist track, is that I don't think it's financially sustainable for the hospitals. I see them trying to replace us with mid-levels and AI. We'll see what happens, I'll be retired by then likely.

I mean they basically pay nurses and hospitalists the same at this point…

 

[gutonc]

I mean they basically pay nurses and hospitalists the same at this point…

It's funny, because it's true.

My former academic hospital system is basically run by the nurses union at this point. Other hospital systems in the area (one of which I now work for), complain that the academic system is setting the bar so high on nursing pay that nobody else can keep up.

The sad part is that this same academic hospital is losing physicians (including me) at a rapid clip to the other local systems because their physician compensation is s***. I predict that in 5 years, there won't be any physicians around to give the nurses orders and the whole place will be a giant nursing circle jerk.

 

[Fpg1245]

It's funny, because it's true.

My former academic hospital system is basically run by the nurses union at this point. Other hospital systems in the area (one of which I now work for), complain that the academic system is setting the bar so high on nursing pay that nobody else can keep up.

The sad part is that this same academic hospital is losing physicians (including me) at a rapid clip to the other local systems because their physician compensation is s***. I predict that in 5 years, there won't be any physicians around to give the nurses orders and the whole place will be a giant nursing circle jerk.

I still remember reading a 10 paragraph admission HP from an NP about the patients fatigue.

buried at paragraph 8 was the fact that his BS was 500 and his pressure was 200 systolic

Enjoy using nursing theory to figure out and then actually get patients out of the hospital in anything other than a body bag

 

[FutureInternist]

The Moral Crisis of America’s Doctors

 

[Fpg1245]

The Moral Crisis of America’s Doctors

View attachment 373439

The realities are simple. People don’t really want to pay for health care either through taxes or out of their own pocket. As a result the bottom line will be the only thing hospital systems focus on. The softer stuff like caring and listening and spending time with patients the things that make medicine enjoyable and even fun will get brushed aside.

I’m so tired of readying articles bemoaning this stuff because pain is largely self inflicted.

 

[dozitgetchahi]

The realities are simple. People don’t really want to pay for health care either through taxes or out of their own pocket. As a result the bottom line will be the only thing hospital systems focus on. The softer stuff like caring and listening and spending time with patients the things that make medicine enjoyable and even fun will get brushed aside.

I’m so tired of readying articles bemoaning this stuff because pain is largely self inflicted.

What bothers me even more than that is the newfangled practice of describing burnout in ever more flowery and confounding terms, like “moral injury”.

Fact: whenever I’ve felt burned out, the fundamental issue was that there was too much **** to do and too little time to do it, without enough time to recover. “Moral injury” may have been some small part of that, but it wasn’t all of it (or even most of it).

What bothers me even more about these articles featuring new squirrelly ways of describing burnout is that there’s usually some sort of weird disclaimer that goes something like “studies show people can work really hard and not burn out, if they really like what they’re doing”. Poppycock. That’s one of the most bull**** things I’ve ever heard, up there with “oxycodone isn’t addictive when used for chronic pain” and “if you like your doctor, you can keep them”. The implication is that, as a doctor, you must not like what you’re doing enough to not burn out. Or your morality is getting in the way, leading to “moral injury”. Either way, the problem is apparently you, doctor. If you fixed your morals and/or just learned to love the grind more, your sense of burnout would magically evaporate.

Bull****. The system expects too much out of us in too little time. Period. That’s the simple equation. Leave my morality and motivation out of it.

 

[FutureInternist]

What bothers me even more than that is the newfangled practice of describing burnout in ever more flowery and confounding terms, like “moral injury”.

Fact: whenever I’ve felt burned out, the fundamental issue was that there was too much **** to do and too little time to do it, without enough time to recover. “Moral injury” may have been some small part of that, but it wasn’t all of it (or even most of it).

What bothers me even more about these articles featuring new squirrelly ways of describing burnout is that there’s usually some sort of weird disclaimer that goes something like “studies show people can work really hard and not burn out, if they really like what they’re doing”. Poppycock. That’s one of the most bull**** things I’ve ever heard, up there with “oxycodone isn’t addictive when used for chronic pain” and “if you like your doctor, you can keep them”. The implication is that, as a doctor, you must not like what you’re doing enough to not burn out. Or your morality is getting in the way, leading to “moral injury”. Either way, the problem is apparently you, doctor. If you fixed your morals and/or just learned to love the grind more, your sense of burnout would magically evaporate.

Bull****. The system expects too much out of us in too little time. Period. That’s the simple equation. Leave my morality and motivation out of it.

Its always framed as “How can YOU deal with the 💩 we throw at you?” … and never “How can we stop throwing so much 💩?”

😡

 

[sloh]

What bothers me even more than that is the newfangled practice of describing burnout in ever more flowery and confounding terms, like “moral injury”.

Fact: whenever I’ve felt burned out, the fundamental issue was that there was too much **** to do and too little time to do it, without enough time to recover. “Moral injury” may have been some small part of that, but it wasn’t all of it (or even most of it).

What bothers me even more about these articles featuring new squirrelly ways of describing burnout is that there’s usually some sort of weird disclaimer that goes something like “studies show people can work really hard and not burn out, if they really like what they’re doing”. Poppycock.

Ya get that fuzzy language out of here. We want hard numbers and returns. In other words, FYPM.

 

[BillBill1219]

My mental health improves drastically simply by working less.

 

[collegestud2013]

Yeah, this is what makes me hesitant to pursue hospitalist work. They will promise you the world, and in reality it’s just becomes a game of cat and mouse between you and the hospital. Which is insane to me, because I would think facilities would want to retain as many people as they can, considering how onerous it is to onboard/credential/license a doc.

Is there dignity and honor in hospitalist work? Do you feel like your work is meaningful or do you feel more like a pawn being used by whatever corporate entity happens to be your employer? Is it "just a job" or does this role fulfill a calling you may have had prior to entering the medical profession? Why do so many hospitalists frequently change jobs and can this field offer long-term stability in terms of living/working in one area for extended periods of time (i.e., long enough to plant roots and raise a family.) I realize there are a lot of variables but thank you for any thoughts/insights you can share.


Foot note: These are serious questions that I have been pondering. No matter how balanced, mature, and sincere people are in their posting, there always seems to be a handful of users (usually attendings) who respond with unnecessarily bitter, curmudgeonly, condescending, and snide remarks. If these feelings are welling up inside of you as you read this post, please reconsider responding to the thread. And again, thanks for any genuine thoughts/remarks.

A lot of it has do with nearly all hospitalists jobs being employed (rather than being practice owners, which you see a lot more of in some other specialties), and the issues that come with being an employee.

Some of it also has to do with finding the right job or work environment. There are some good ones out there but also a good share of not so good ones. It seems like the top reasons hospitalists end up switching jobs include having too high of a patient census than they are comfortable with, low pay relative to workload, having to work night shifts, or being micro-managed on your metrics by admin.

Also the hospitalist job market is also getting more saturated lately. In the past few years there doesn't seem to be a lot of interest in primary care among new grads and pay per hour tended to be higher doing hospitalist work than primary care, so the IM grads who don't go on to fellowship have been more likely to do hospitalist. It also is an attractive option for many new grads due to the flexibility it offers, you can get started right away without the issues of having to ramp up volume in an outpatient practice, and it is easier to leave in a few years compared to doing outpatient as well if your personal or career plans change. Also, any IM or FM grad can go into it, and these are the 2 largest specialties with most residency grads. There's also been increased use of midlevels in hospital medicine which in turn reduces demand for physicians. This plus stagnant CMS reimbursements will all tend to drive pay down.

Also, any shift based-specialty in which you don't own the patients (this also includes specialties like EM, intensivist, radiology, anesthesiology) is generally less costly to re-hire when someone leaves, since there's no issue of lost patient continuity. It's a lot more expensive to replace a PCP or outpatient specialist with a full panel than a hospitalist. In some cases, it's possible that that hospital thinks it's less costly to re-hire than to pay more to retain them if the market is getting saturated.

 

[Splenda88]

Who cares…
I get there at 630
Home by 2… noon on weekends
Get paid till 7

Good money
Good work-life balance
Can hang out with kiddo even on my on week
Base salary + RVU so high volume (even when baby-sitting) is $ for me

As long as its “round & go” its the best

If I had to do clinic for the rest of my life, I would shoot myself in the head …😏

Your gig is better than mine.

I got there ~ 7:15 am and be home ~4:25 pm... by my program rule, we can't leave the hospital before 4:15 pm.

I am not aware of that many FT jobs in medicine that beat HM flexibility.

One truly work 7-8 hrs on most days. Almost everyone finishes their work between 1-3 pm.

The fact that one can sit down and watch a 2-hr soccer game while at work and not be bothered by BS, make HM very appealing.

 

[FutureInternist]

Your gig is better than mine.

I got there ~ 7:15 am and be home ~4:25 pm... by my program rule, we can't leave the hospital before 4:15 pm.

I am not aware of that many FT jobs in medicine that beat HM flexibility.

One truly work 7-8 hrs on most days. Almost everyone finishes their work between 1-3 pm.

The fact that one can sit down and watch a 2-hr soccer game while at work and not be bothered by BS, make HM very appealing.

My family still likes me so I try to go home early 😏

 

[aafisahar]

Bull****. The system expects too much out of us in too little time. Period. That’s the simple equation. Leave my morality and motivation out of it.

you literally just described moral injury lol

 

[tantacles]

My mental health improves drastically simply by working less.

SAME

 

[GonnaBeADoc2222]

As an EM doc, i feel for you guys.

We only have about a 15 to 20% admit rate, but out of what we admit, half of it is just junk.

At least in EM, the pay is still there (kinda).

Being hospital employed sucks, and I warn anyone reading this to persue fields where you can avoid this.

 

[dozitgetchahi]

you literally just described moral injury lol

It’s not. There’s a difference between burnout and what the media describes as “moral injury”. It’s subtle, but important.

Imagine a single mom working three jobs to put food on the table for her family. That person is quite likely “burnt out”, but I don’t think anyone is worried about “moral injury” there. She’s not having some sort of moral crisis because she’s not able to optimally serve customers at McDonalds, or something. She is exhausted. She has too much **** to deal with in too little time, and not enough time to recover.

The “moral injury” bit is frustrating to me because in the realm of doctors, it recasts that fundamental issue into some sort of physicians’ “moral crisis”. But in most patient situations when I’ve felt burnt out, I simply don’t feel some sort of “moral crisis”. (I was able to deliver good care. I was just exhausted.) Aside from this, the bigger issue with it is that outside of the medical profession, it trivializes the issue and makes it look like our problem is some sort of bougie “existential/moral crisis” rather than us simply being run into the ground. People in America are already unsympathetic to doctors - who IMO at this point they largely see as rich and whiny, and even exploitative - and this just compounds the issue. “Dr. Jones, how quaint of you to bitch about your “moral injury” while you make $300k a year.” Joe 6 Pack may well be working as many hours as we are per week, perhaps in the trades or something, but he’s not making nearly what we do in most cases. And so he doesn’t get what we’re complaining about, and maybe even thinks it’s much ado about nothing.

It’s not a good look. And “moral injury” doesn’t even accurately describe a lot of the trouble we’re dealing with.