Working at a critical access hospital?

[gro2001]

Has anyone here worked at a small (25 beds-ish, 10k visits/year) critical access hospital? What's it like? Is it great or horrible? What are the pros/cons (especially for a first job out of residency)?

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[Doctor Bob]

I worked at one... it was... ummm... a good time to get a lot of reading done. I think we saw somewhere between 10-15 patients a day in the "ER". And the vast majority of them didn't need to be there.
I saw one almost-sick person in all of my shifts. The rest would have been just fine if the whole building had been replaced with a Walgreens. But this facility really wanted to have a BC/BE emergency physician there... and they were willing to pay for it.

Pro: lots of down time, easy job,
Con: you don't see much acuity and so fresh out of residency you don't get a chance to see what you really know

 

[gro2001]

I worked at one... it was... ummm... a good time to get a lot of reading done. I think we saw somewhere between 10-15 patients a day in the "ER". And the vast majority of them didn't need to be there.
I saw one almost-sick person in all of my shifts. The rest would have been just fine if the whole building had been replaced with a Walgreens. But this facility really wanted to have a BC/BE emergency physician there... and they were willing to pay for it.

Pro: lots of down time, easy job,
Con: you don't see much acuity and so fresh out of residency you don't get a chance to see what you really know

Thanks so much for the reply!

Sounds like you would not recommend it as first job?

 

[Doctor Bob]

Sounds like you would not recommend it as first job?

Depends on what your long term goals are. The first year out from residency is when you solidify a lot of your practice style, your pace, etc. And a critical access hospital isn't a good place to do it. Sure it can give you confidence in dealing with patients on your own, but you're not really seeing the sick ones or high acuity ones anyway (it's a possibility, but if it occurred with any frequency out there, they'd build a full hospital). So you'll still have the same hurdle of "can I deal with this really really sick patient all by myself" eventually when you move on to a bigger facility.

So, no, unless there's a community reason that brings you to a critical access facility, I wouldn't recommend it.