tag:blogger.com,1999:blog-24021163.post4490380219381689049..comments2024-02-18T01:56:38.508-06:00Comments on M.D.O.D.: My Favorite Year911DOChttp://www.blogger.com/profile/06466669111561150174noreply@blogger.comBlogger56125tag:blogger.com,1999:blog-24021163.post-55763341548625555422010-07-08T17:48:53.096-05:002010-07-08T17:48:53.096-05:00I don't complain of what you accuse.
I compl...I don't complain of what you accuse. <br /><br />I complain of these people: <br /><br />a) "I stubbed my toe an hour ago" (no mark on them and they are not limping )<br />b)"I got shot at"<br />c)"I felt dizzy headed last week"<br />d)"I vomited yesterday and I need a work excuse"<br />e)the patients who walk in, hop onto the stretcher then writhe with back pain wanting drugs<br />f)the patients that we see over and over with STD's who REFUSE to go to the health dept and won't use condoms. The health dept charges $10.<br /><br />These are actual cases. The last 3 are frequent, the last one is multiple times a day.<br /><br />These people feel no responsibility to pay and don't care if the hospital goes bankrupt (which ours did, we're operating under Chapter 11 and have fired all of the people who stock our supplies. We’re working with a skeleton crew of nurses, housekeepers, and care providers).<br /><br />These are the same patients who DEMAND that the doctor hurry and see them. They complain when they don't get what they WANT and their ER visit is over 2 hours.<br /><br />I complain about these patients because they do not pay to keep the lights on, the scanners running, the staff working, and the rooms stocked with supplies (which frequently they steal), and yes, my salary too. I complain about them because they take my time away from seeing patients that really need my time and services.<br /><br />We complain because all of our education is being turned into checklists by non-practicing "academics", some with health care degrees who justify their existence by expanding policies year after year. They only add to an already burdensome load of rules, regulations and paperwork which HINDERS us.<br /><br />I resent politicians who don't understand the first thing about healthcare delivery in the "real world" who make laws and lay down regulations which are not practical while ignoring practicing physicians and instead find academicians and researchers to parade in front of the cameras.<br /><br />I resent politicians who want to promise the ignorant public "pie in the sky" then blame the health care system when their impractical ideas do not work; then pass more laws and regulations which make the situation worse.<br /><br />I resent the burdensome load of paperwork and the fact that it takes me longer to complete the paperwork than it does to see and care for the patient.<br /><br />I abhor the "logic" that people FEEL as if it is reasonable and just to FORCE me to provide my knowledge and labor for free to people whose only goal in life is to take from society as much as they can. They sanction this behavior by a ridiculous notion that I have more, thus it is my DUTY to give to people who demand and do not give back. If I complain, they try to guilt me by saying that I went into medicine just for money. I complain because I am tired of people who loot my intellectual property and my labor because they feel as if they have a right to it merely because they exist.<br /><br />There is a difference between freely giving something and being forced to give something because someone demands it. One makes you feel good. The other makes you feel resentful.<br /><br />I am not talking about the truly needy. I am talking about the smokers with cell phones & expensive clothes who want Rx's for Tylenol and refuse to pay a dime for medical care or see a PCP or walk-in clinic for minor issues.<br /><br />I am talking about the lady I saw this week who complained that the Gub'ment would only give her $800 a month to feed her 5 kids...and they went through 5 boxes of oatmeal a week. (When I asked why she didn't buy the cheap tub of generic quick oats, then add some sugar and brown sugar like I do, she scoffed that it takes too much time).<br /><br />I would like for people who don't understand our jobs, to recognize our difficulties, and realize that government will never improve anything with rules & regulations. <br /><br />I apologize in advance that this is way over your impacted cranium.erdoc85https://www.blogger.com/profile/06373340227068589953noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-37028571348085537292010-07-08T10:01:13.464-05:002010-07-08T10:01:13.464-05:00yet another brilliant post by an anonymi...
we all...yet another brilliant post by an anonymi...<br />we all just woke up one day in our current jobs... boy were we lucky to spin the wheel and hit on ER doctor. we have no right to complain. the things we complain about are purely self serving and have nothing to do with a crumbling system that is already making high quality medical care nearly impossible for people like you sister.911DOChttps://www.blogger.com/profile/06466669111561150174noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-39502682659561046972010-07-07T20:18:57.145-05:002010-07-07T20:18:57.145-05:00There are hundreds of thousands of people who woul...There are hundreds of thousands of people who would jump for the chance to make $150+ an hour doing the job you describe. It's too easy for you? Boo hoo. Patients get angry? Boo hoo. My sister gets abused in retail for $8 an hour every single day of the week.<br /><br />The real question is, would you take a pay cut to see only high acuity patients? Probably not. Yet you complain that the hospital wants to make money to pay your salary, in turn delivering you easier patients that make your job much simpler than patients with actual emergencies.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-90147447059099883972010-05-29T23:07:11.557-05:002010-05-29T23:07:11.557-05:00Panda:
You need to remember....this is a job. Yes ...Panda:<br />You need to remember....this is a job. Yes an important job, but a job nonetheless. I am also your age and this is also my second career. At the end of the day (when not on call) I go home, spend time with those I love and what I love to do. I am sure you probably make more than I given you are a private ER doc, but I am also rather sure my quality of life is better than yours. In the end is it more important to make a bunch of dough or spend time with those you love? Maybe it is time to take a good long hard look at how you want to spend the next 20-25 years. <br />Just a thought....Good luck.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-9981557585581580362010-05-21T17:39:09.747-05:002010-05-21T17:39:09.747-05:00I have read Panda's posts on and off over the ...I have read Panda's posts on and off over the past several years through random people linking his blogs. Someone just linked me to this site and now here I am again. I just wanted to say that I really appreciate your posts, as well as all the other doctors on this blog (okay so I just started reading this an hour ago, but so far, it's great!). I'm currently studying for step 1 and this has made for an interesting break. :)MedStudentStudyingForBoardsnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-34686535393744716222010-05-21T04:29:40.712-05:002010-05-21T04:29:40.712-05:00welcome back pb ! it was such a nice surprise to f...welcome back pb ! it was such a nice surprise to find you here !! i guess i owe you big time - your blog did carry me through the exams ..:) and a lot of rough patches here n there !Anitha Vaidhyanathan https://www.blogger.com/profile/08819943296848338396noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-69604501537851208272010-05-21T01:45:52.524-05:002010-05-21T01:45:52.524-05:00That would be a good stand-alone post actuallyThat would be a good stand-alone post actuallyjnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-32565729904528699532010-05-19T22:03:57.163-05:002010-05-19T22:03:57.163-05:00Great post PB.
Sadly, over my time I have seen t...Great post PB. <br /><br />Sadly, over my time I have seen the ER transform from a place to deal with urgencies and emergencies into the "safety net" of American Medicine, always patrolled by trial lawyers looking for anything they can turn into a payday.<br /><br />In residency, they teach you science. You spend time in Journal Clubs and debating evidence based medicine. You learn indications for tests and studies, and WHEN you’re expected to pull the trigger on such things. Then you enter the world and find that no one gives a whit about such things. Most patients with a stubbed toe demand an X-ray. Parents of little kids who bonk their head on the coffee table believe Junior “must” have a CT. <br /><br />Beyond taking excellent care of patients, our specialty has transformed into one of "meeting customer's expectations". The emphasis on our knowledge and background has taken a back seat to our "bedside manner".<br /><br />Many in ACEP push us toward a public health mission which the pinheads at the CDC just love. Sure, pap smears in the ER…(over my dead body). ACEP is rapidly becoming our version of the AMA dominated by the panty-waste-touchy-feely in our specialty who don’t actually PRACTICE medicine.<br /><br />Mathematicians have tried to turn much of clinical medicine into formulas and decision trees. These have been adopted by Government bureaucrats and nurses with clip boards who second-guess too many of our decisions (not based on clinical grounds, but based on checklists).<br /><br />How well we adhere to these "checklists" is viewed by the Joint Commission as "quality" and soon will be used to reimburse us (or as we all know...used to decrease our reimbursement).<br /><br />Coders & billers have co opted the patient's medical record and turned it into a billing document. (Last shift, I had the chart Nazi track me down for not completing the Review of Systems, Past Medical History, & Family History on a lady who just wanted a tetanus shot after she pricked her finger on some barbed wire). <br /><br />In short, being a physician in the ER isn't about being a physician taking of patients with emergencies. There are many days where I don't see an "emergency". <br /><br />I still enjoy taking care of patients. I just abhor the other BS that goes along with it. I still believe that the majority of patients are appreciative.<br /><br />Still, all in all, I consider myself fortunate to be doing what I am doing.erdoc85https://www.blogger.com/profile/06373340227068589953noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-52622135147028330422010-05-19T19:37:20.242-05:002010-05-19T19:37:20.242-05:00Hi Amy! Yeah, just too busy cutting fingernails to...Hi Amy! Yeah, just too busy cutting fingernails to participate regularly. Today a 6 yr. old threw chairs and tried to push a bookcase over on my partner. Gotta go!Devorrahhttps://www.blogger.com/profile/14542045173559671539noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-404388647118614622010-05-19T14:14:03.935-05:002010-05-19T14:14:03.935-05:00Dev! You're alive!Dev! You're alive!Amelia Ameshttps://www.blogger.com/profile/17296224743117560163noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-32765564366582823852010-05-19T13:09:40.840-05:002010-05-19T13:09:40.840-05:00Nice to hear from you Panda. You da man.Nice to hear from you Panda. You da man.Danzmannoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-6593304119988475822010-05-19T09:37:19.097-05:002010-05-19T09:37:19.097-05:00Panda--welcome! Short bio--I used to be an attorne...Panda--welcome! Short bio--I used to be an attorney, now I'm a kindergarten teacher, and there have been plenty of shocks along the way re: what "teaching" entails these days (do they really expect me to cut their kids' fingernails?)<br /> Best advice, in all seriousness: Remarry well and invest emotionally in a hobby/sport/activity that you love. Takes the edge off. Best wishes!Devorrahhttps://www.blogger.com/profile/14542045173559671539noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-50959007208445366882010-05-19T06:58:17.349-05:002010-05-19T06:58:17.349-05:00Panda, sorry to hear about your plight and your di...Panda, sorry to hear about your plight and your divorce. I'm running out of money here also as I finish up my psych NP program. Damn sure glad I went that route though, along with my shamanic training. I'm such a happy man!Randall Sextonhttps://www.blogger.com/profile/08942283223874316290noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-20077941417519974532010-05-19T06:11:32.384-05:002010-05-19T06:11:32.384-05:00ER Doc, are you for real?
Don't come to my ER...ER Doc, are you for real? <br />Don't come to my ER.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-70713912208747944822010-05-19T05:05:06.632-05:002010-05-19T05:05:06.632-05:00Its one of those "The Grass is Greener on the...Its one of those "The Grass is Greener on the other side of the Fence" things...<br />Like how my sister bitches about how hard her Air Traffic Controller job is, makin 150K/yr for basically playin video games 20 hrs/week, which is more like 10 when you account for lunch, smoke breaks etc etc.. <br />Then I remind her how she was turnin tricks for $20/pop a few yrs ago and she won't bitch for a few days...<br /><br />FrankAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-86681150364826340252010-05-18T23:23:44.387-05:002010-05-18T23:23:44.387-05:00okay, we are now at 100% mobidity.okay, <a href="http://online.wsj.com/article/SB10001424052748703957904575252263501070290.html?mod=WSJ_hpp_MIDDLENexttoWhatsNewsForth" rel="nofollow">we are now at 100% mobidity</a>.911DOChttps://www.blogger.com/profile/06466669111561150174noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-5263004205654289292010-05-18T22:16:54.555-05:002010-05-18T22:16:54.555-05:00Relax, Panda, you have a diagnosis. I heard about ...Relax, Panda, you have a diagnosis. I heard about <a href="http://www.compassionfatigue.org/" rel="nofollow">compassion fatigue</a> from a military officer today. Psychiatry is bunk. Neuroplasticity rules. Haters step off, we are approaching 100% morbidity in America. Is everyone equally miserable yet? I'm sorry for venting, I have compassion fatigue and am 100% service-connected.911DOChttps://www.blogger.com/profile/06466669111561150174noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-24047095791348841812010-05-18T22:16:24.101-05:002010-05-18T22:16:24.101-05:00Dr. Pheidippides runs in vain. Greece is lost. Th...Dr. Pheidippides runs in vain. Greece is lost. The American Spartans, it seems, are anything but.<br /><br />It's fairly terrible to hear some of these stories. Panda has no incentive to lie, little to exaggerate. I can only assume that he culls little sympathy because he's been busy grinding his heels on the world-view that keeps personal responsibility, common sense, and humility as far from the zeitgeist as is politically expedient/psychosocially soothing. <br /><br />Dr. Bear, thank you for the narrative. Your writing has likely done much more good than will ever come to light. Keep it up. You Greeks seem to have a thing for competence in the face of overwhelming odds.21https://www.blogger.com/profile/09560786230715552515noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-78762758196402381702010-05-18T19:37:15.530-05:002010-05-18T19:37:15.530-05:00Panda
Have you considered joining an Urgent Care ...Panda<br /><br />Have you considered joining an Urgent Care Center? It's heresy I know. But as a soon to be 3rd year medical student very interested in Emergency Medicine, I consider it my retirement plan. It's great to have one of my favorite authors back.Shahnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-41657448290782724272010-05-18T19:36:43.323-05:002010-05-18T19:36:43.323-05:00Panda you are wrong, MOST of them don't get it...Panda you are wrong, MOST of them don't get it!!<br /><br />I am very old and have seen a lot. But what is happening now is past sad.<br /><br />PB says "how do I get out?" Don't the rest of you get it? The question should be, WHY IS HE ASKING THE QUESTION??<br /><br />Don't y'all get it??<br /><br />Medicine has become so unpalatable that we will NOT ALLOW our children to apply to medical school, much less go to medical school. What don't YOU understand? We didn't go in to medicine to make a million bucks a year. We did not go in to medicine to fight with insurance companies to pay us for services rendered either..And that is where we find ourselves now. <br /><br />Hey guess what? If you take your car to the mechanic and he fixes it when do expect to take your car home? Before you pay the dude? Really?<br /><br />Hey, here's a quick test. Why don't you pricks go find an American born, studied in a US medical school, and trained in a US residency doctor to take yourself to or your kids?(Heaven forbid try to find a male!) If you can do that, you better latch on to that person now and do not let go. In 10 years they will will not exist..And if you think there is NO DIFFERENCE then you deserve what you get..<br /><br />I'm tired, I'm old, and I am OLDFART!!!!Oldfarthttps://www.blogger.com/profile/14333534023484494721noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-46728980169154179862010-05-18T19:18:50.483-05:002010-05-18T19:18:50.483-05:00PB, strong and excellent post. I would much rathe...PB, strong and excellent post. I would much rather Panda Bear take care of me or my family member in the ER (remarkably we somehow manage to not use the ER like a vending machine) than the narcissistic Anon commenter whose ego was so beautifully documented in his own above commentary. Although I do think he has excellent advice. Yes, PB, get out of the ER. And I would encourage ALL ER DOCS TO GET OUT OF THE ER. Let's see how long JCAHO, HIPPA, and EMTALA will last if there are no longer any providers who will put up with pain scales. Take a page out of Atlas Shrugged and go on strike. It is inappropriate for patients to threaten ER staff and get away with it b/c the administration is afraid that the thug might give us (cringe!) a bad "customer" satisfaction score! And God forbid I don't give John Smith his oxycontin Rx for his ankle sprain! When did we become a nation of such wimps? God truly help us.QuiXXotehttps://www.blogger.com/profile/10948058137479355538noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-62267854028503715282010-05-18T19:08:02.094-05:002010-05-18T19:08:02.094-05:00RadGirl, have I told you lately how much I luv U? ...RadGirl, have I told you lately how much I luv U? And I need some more cookies!!OFOldfarthttps://www.blogger.com/profile/14333534023484494721noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-741367746987291372010-05-18T18:12:53.066-05:002010-05-18T18:12:53.066-05:00To put things in perspective, I got a patient comp...To put things in perspective, I got a patient complaint because I didn't order any lab work on a well-looking patient with the sniffles. The response from my administration? Maybe I should just order lab tests (and presumably imaging) just to keep the customers happy.Panda Bearhttps://www.blogger.com/profile/17063321291844482367noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-42748302989415322562010-05-18T18:07:22.100-05:002010-05-18T18:07:22.100-05:00This is my third career, by the way. I am also a ...This is my third career, by the way. I am also a structural engineer.Panda Bearhttps://www.blogger.com/profile/17063321291844482367noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-27311730670803941832010-05-18T18:05:38.895-05:002010-05-18T18:05:38.895-05:00Many of you don't get it. There is no "...Many of you don't get it. There is no "getting out." What am I going to do? Go back to engineering for a sixth of what I'm making now? Likewise, saying that somehow I should have known how ridiculous medicine has become is idiotic. You don't really learn this until it's too late. My problem is that I am s rational, intelligent, hard-working guy in a system whose rules are created and mutated by bureaucrats and lawyers who have a vested interest in keeping things the way they are.<br /><br />Suggestions to improve things? Meaningful legal reform and an end to the welfare state.<br /><br />I ain't holding my breath.Panda Bearhttps://www.blogger.com/profile/17063321291844482367noreply@blogger.com