Residents, What do you not like about your specialty?

[Bugpie]

OK....I get it...joke, joke...ha ha! Sorry!

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[Old MD]

Its important to read ALL of the chart, before jumping to conclusions.

 

[Febrifuge]

Please refer to post of Dr. Boris which said: 'EM docs, what DO you like about your specialty'...

Yeah, I went and checked as well. But I'm afraid DrBoris said, "...what don't you like." I see no edits on his post...

However, Roja did a fine job of answering that question already on June 20, and so there's a certain amount of confusion about why Boris would ask for info that was already out there. Perhaps he meant, "let's have some more EM people add to what Roja has said about what's not to like in EM."

Me, I think it's the "fishbowl effect." Everything that docs do in EM winds up being scrutinized later by others, and seldom if ever does EM deliver anything but a 'working' diagnosis. So there's bound to be endless re-hashing of stuff that often just isn't that important.

 

[Bugpie]

So there's bound to be endless re-hashing of stuff that often just isn't that important.

 

[Leukocyte]

Its important to read ALL of the chart, before jumping to conclusions.

07-01-2004 11:16 PM
drboris "EM residents, what things D'ONT you like about your specialty"


Sooooooo, who's the one who needs to read that "chart" now?

Anywhoooo, Thank you Dr. Roja for your post. As always, it was helpful and informative.

 

[roja]

I blame it on posting at work. To many kids with fevers.

 

[Febrifuge]

I was hoping the needlessly-worried moms and drug-seekers would take a day off in honor of the holiday. Turns out, no, not so much.

 

[IdiotBoxen]

Currently doing a tour with ob/gyn.

Things I hate:
- Incredibly stupid patients. Yes, taking Marvelon can interfere with your ability to get pregnant...
- Asshat private docs who don't listen to the midwives. The chief midwife has done 10,000+ deliveries, when she makes a suggestion, DO IT!!
- Patients being very hostile towards me because i'm male.
- Litigation.

But, i've gotta say this is the best rotation in history. Pure ****ing magic.

 

[MoosePilot]

Currently doing a tour with ob/gyn.

Things I hate:
- Asshat private docs who don't listen to the midwives. The chief midwife has done 10,000+ deliveries, when she makes a suggestion, DO IT!!

If the doc just automatically takes the chief midwife's suggestions, then why not just let her do the delivery instead of putting their license on the line only to be a sort of go-between?

I really am asking vs. just arguing, because I've seen this sort of thing in flying and am curious if it's pretty similar in medicine. In flying I'm the main one liable if there are any violations of aviation regulations, yet I have to coordinate a team, some of which have more experience in certain aspects of what we're doing than I do. At the end of the day, though, I'm in charge for a reason and I'm always more comfortable losing my professional credentials through my own action and not through just doing what someone else thought best.

 

[IdiotBoxen]

If the doc just automatically takes the chief midwife's suggestions, then why not just let her do the delivery instead of putting their license on the line only to be a sort of go-between?

What I was saying is that private docs come in and think they know everything, they take no advice from the very knowledgable midwifes. When what they should be doing is listening to them, they *do* know what they are doing. The chief midwife here *does* know practically everything, and it is a very good idea to do what she advises. Just my experience thusfar.

 

[The White Coat Investor]

What I was saying is that private docs come in and think they know everything, they take no advice from the very knowledgable midwifes. When what they should be doing is listening to them, they *do* know what they are doing. The chief midwife here *does* know practically everything, and it is a very good idea to do what she advises. Just my experience thusfar.

Its like an EM intern listening to an oldhat ER nurse. Yea, you should listen, cause they're usually right. But don't forget who's getting paid to make the decisions, and where that responsibility lies.

 

[fourthyear]

Who's getting paid to make the decisions??? Certainly not the ER intern!!! The nurse definitely makes more money than an intern on a per-hour basis. Actually, the humor probably lies in the idea that ANYONE is collecting any money for an ER visit these days, so many ER patients are there for the simple fact that they have no access to a primary doctor b/c they have no insurance or ability to pay for medical care.

You are right about the responsibilty thing though. Nurses can help you a lot, but occassionally if you listen to them and do everything they say without trusting your own medical knowlege, you could get yourself into trouble once in a while if he/she's wrong.

 

[emdoc21]

Fourth year,

As most residents will attest, responsibility in making decisions has little to do with the salary you earn.

As an emergency resident, I value the input of emergency nurses. But, rarely are the nurses in a position where they will be the ones making important decisions on the patients, besides routine but important tasks such as starting IVs, giving fluids, drawing blood, or putting in for an EKG.

During my intern year, I would certainly write at least 100 orders a shift, typically with attending input only for major decisions or when I had a question. So, yes, the emergency intern is being paid to make the decisions.

Perhaps you'll have a better perspective after you've spent some time as a resident.

 

[roja]

Nicely put. And we are also the ones that will get called into court for our decisions.

 

[fourthyear]

Its like an EM intern listening to an oldhat ER nurse. Yea, you should listen, cause they're usually right. But don't forget who's getting paid to make the decisions, and where that responsibility lies.

For those who can't read past the last post....I was responding to the comment made just above mine that says the intern is "getting paid to make the decisions"...I DID comment that I agreed with residents having the ultimate responsibility for thier decisions regardless of who they are listening to when they make them...and by the way, I AM a resident and have made plenty of decisions I was fully responsibile for - fourthyear was a name I began using two years ago when I was a fourthyear.

 

[trapper john]

Anesthesiology residency: From a PGY-4

Ups: Call ends at 24 hours sharp, and when it's a weekday call, it means a day off is really a day off if it was a quiet night.
As previously mentioned, don't have to spend much time on the floor other than for codes. Post-ops are usually 30 seconds.
Like the invasive aspects: Lines of all kinds, fiberoptics, bronchoscopy, neuraxial, regional.
Plenty of intellectual challenge ala IM, but without any issue of compliance. If your BP is too high, it's going down, end of story.
The pot of gold at the end of the rainbow ain't bad either. I have so many wanting my CV, or offering jobs, it's almost mind blowing.

Downs: When a call is bad, it's REALLY bad. Recently on peds, worked 20/24hrs straight!
Stress: Don't kid yourself, anesthesiology is a very stressful specialty. The routine can become life and death in seconds. Also peds was really sad at times, cranies on kids with brain tumors are very depressing.
Hate OB call: wait: HATE OB CALL!!!! Epidurals all night, sections at 2 am, and pulling the damn catheters in the middle of the night.
Hate the fact that different attendings want things done their way.
Most all, hate the fact that I got stuck with two more months of CCM in my supposedly elective senior year. If I wanted to be a unit doc, I would have just done IM.

 

[Mr_Money]

hate the fact that I got stuck with two more months of CCM in my supposedly elective senior year. If I wanted to be a unit doc, I would have just done IM.

Amen to that brother! I got similarly hosed my PGY-3 year.

 

[Lonestar]

Thats nothing; now, our program is instituting 4 months CCM (intern year), 2 months each year thereafter. Tell me this doesn't suck. Better thank your luck stars that you got out before $hit like this hits your program.