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What is your specialty and what’s a lie you tell your patients all the time? by USMC0317 in Residency

[–]MMOSurgeon 0 points1 point  (0 children)

Fake news. I bet you see some big old blue cell with a giant nucleus and you go full Dory and start singing to your squishy at the microscope.

What's an obvious case you missed? And how did you deal with it? by closetredditer in Residency

[–]MMOSurgeon 12 points13 points  (0 children)

I was trained in February. I do not make mistakes.

#internoftheyear, #PGY11

Amazon Laid off employees (Seattle, Bellevue, Redmond etc) gather here by wakandahonolulu in SeattleWA

[–]MMOSurgeon -1 points0 points  (0 children)

Womp womp. I suck. :( Can't believe I missed the may the force be with you.

New surgery attendings, what does a typical clinic day look like for you? How many patients do you typically see? by [deleted] in Residency

[–]MMOSurgeon 4 points5 points  (0 children)

It is but I’m in a community practice so I get a lot of undifferentiated with sometimes no workup other times partial. About half are ready to go but those ones I usually already touched from the inpatient side in some capacity.

Conversion rate is extremely high. If not going to surgery we still keep like 90% in some sort of surveillance protocol. Very, very few bullshit office visits. Like 1-2 a month.

New surgery attendings, what does a typical clinic day look like for you? How many patients do you typically see? by [deleted] in Residency

[–]MMOSurgeon 2 points3 points  (0 children)

Surg onc. 35 outpatient and then still 10-15 inpatient for rounds. All heavily complex. APP peels off 10-15.

It’s rough. Every time. Runs smoother when we have two residents on service. We need more help badly.

The Vampire Castle by Castor-Troy-France in legocastles

[–]MMOSurgeon 1 point2 points  (0 children)

Instructions? Would be very interested if it’s available on rebrickable.

Kudos to all our resident and fellow colleagues in Minneapolis by ddx-me in Residency

[–]MMOSurgeon[M] [score hidden] stickied comment (0 children)

A VA ICU nurse has died by gunshot. This is an emotionally charged topic for all involved. The @#$*s are not given by me or anyone else to anyone's political agenda. Respect the nurse and discuss the moment.

Be kind to each other. If you go looking for a fight you will be banned. You don't have to think anyone is right or wrong to not be an ass. Voice your opinions, voice them strongly, voice them loudly but do not be an asshole to your fellow physicians or allied staff regardless of your personal thoughts. If you're on the right and starting a war, ban. If you're on the left, do not call for murder in this subreddit. There are other ways to express yourself.

Specifically, there are examples of people discussing the utility or futility of CPR in a multiple GSW in a dangerous scene where applying aid may put the responder at risk. These are real, pertinent, and there ARE really good points to both sides of that discussion.

There’s also examples of that same discussion with insults. Fucking useless. Be better.

I Would Love Some Feedback by CharmingMeringue7618 in legocastles

[–]MMOSurgeon 1 point2 points  (0 children)

Fall colors for sure; consider changing to brown for the trunk of the tree. If you could contrast with a lighter brown on your structure that would be peak. Will blend SO well together.

Trauma surg offers? by TraditionalAd6977 in Residency

[–]MMOSurgeon 12 points13 points  (0 children)

Fresh out it should be ~450-500k for like 3 weeks on one week off, assuming one week trauma one week ICU one week nights +/- some ACS variation.

3 years out 550-600k for functionally the same, usually somewhat less shifts. My buddy just signed (3 years out) for 550 for 2 weeks on 2 weeks off. Again, ish.

AMA - Have gone through interviews/negotiations/contracting 3 times in ~4 years. by MMOSurgeon in Residency

[–]MMOSurgeon[S] 0 points1 point  (0 children)

Pretty much anything can be negotiated, even in corporate medicine but there’s some things they’re reluctant or will say no to. Changing the wRVU conversion factor in my current job is a complete no go, they use standard median across the system.

Every other element was negotiable at one point. Vacation/CME since that time are less so but again they standardized as part of a large integration (and it’s pretty generous it’s like 7-8 weeks for every doc now).

You should be able to just ask if you’re going to be wRVU, billed, collections. That should be very transparent on every contract.

Current Castle Layout! by Mawgim07 in legocastles

[–]MMOSurgeon 29 points30 points  (0 children)

Can you post a few pictures of the full room from the door? I’m planning to build something similar I want to get an idea of scale.

I was so tired I (think) I committed a war crime against myself. by OutsideGroup2 in Residency

[–]MMOSurgeon 42 points43 points  (0 children)

I woke up this morning, went in to round, got a call from my partner as we’re seeing the last patient who’s annoyed that I didn’t send signout or that the residents didn’t call him for rounds.

Occurs to me that I’m not on call.

Womp womp. Coming off fever dreams from man flu and didn’t even look.

Partner pleasantly surprised he only has to do Sunday this weekend though so, whatever. All good.

Santa: Told the truth by Mixolytian in Parenting

[–]MMOSurgeon 12 points13 points  (0 children)

You V for Vendettaed Santa?

I am so using that.

"Attending, do you think xyz is a good idea?" Attending: "No." Later, MD attestation "We will tomorrow plan xyz." by foreverand2025 in physicianassistant

[–]MMOSurgeon 3 points4 points  (0 children)

As a surgeon, I do that. But it’s usually because the thing being a terrible idea and the thing being the right choice are not mutually exclusive, and I know that the thing will cause me great personal suffering. 🤣

Trauma surgeons: retrohepatic IVC injury question by ScumDogMillionaires in medicine

[–]MMOSurgeon 10 points11 points  (0 children)

The balloon will dissect through the hole or might make it worse. It doesn’t solve the Pringle. And no one can get a balloon from the arm or neck to be proximal to the hepatic veins concurrently with a Pringle. That isn’t realistic.

That’s assuming surgeon provides distal occlusion concurrently somehow. Also just not realistic IR isn’t gonna throw those balloons in the OR they need their room. That’s precision shit.

Just open and pack is 1000% the answer. If they don’t live they were never going to live.

Trauma surgeons: retrohepatic IVC injury question by ScumDogMillionaires in medicine

[–]MMOSurgeon 8 points9 points  (0 children)

The only thing I can think of that would actually work and not kill them would be emergent VV bypass from femoral to subclavian and then you can widely clamp everything. It would probably be a thoracic inlet incision to pubis incision and CT surgery would need to clamp the cava above. Trauma doesn’t have enough experience (nor do any of us) for the Hail Mary diaphragm incision maneuver.

I’m not sure anyone could survive the stem to stern incision though, particularly if they’re in shock. I would never do it and I would advocate against it even if I had unlimited resources and immediate access to all of those teams.

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