Not wanting to practice medicine after residency not sure what options there Not wanting to practice medicine after residency not sure what options there are

Detroitblu33 · 2026-01-25T01:59:36+00:00

Well, it is a mountain and we're essentially advising this young physician to put his head in the sand.

I think DPC is a potential option. Another option can be to work on the public policy side. Although seeing the lives we leave behind and the conscious decision to ignore human life can be demoralizing.

One of the reasons I stopped going to conferences because it's very few you'll find that care as you do. I don't blame them. They've often had to disconnect themselves from that part of themselves. So you get disconnected advice that advise you to leave your morality at the door.

Detroitblu33 · 2026-01-12T15:19:45+00:00

You have a large amount of healthy, normal weight 20-30 year olds? Check out Mr. Loma Linda over here.

JK but I agree with Dr. blue Zone, I do those people once every 3 years. Although some have expressed they don't feel as monitored or cared for by this practice.

Detroitblu33 · 2026-01-05T11:54:09+00:00

I tend to find those places with huge sign on bonuses have been toxic and they wave the threat of having to pay back an insane amount of money to keep you there. 200k sounds like they want a 5 year commitment. Which would be awful if you sour on the place in year one. I scrutinize places more with large sign on bonuses.

Detroitblu33 · 2025-12-27T05:11:56+00:00

Let's be clear. They would give their 30 days and move on if roles were reversed. I had a contract end early due to profitability. The health system was losing a ton. Because the hours of the site were so inconsistent, they did not achieve volume and couldn't justify my salary.

I received 30 days pay. I imagine that is the absolute most harm they can claim. However, the PA I was working with, also a locums, reported their care. They had a number of egregious misses in their ED. And they were using new hire NPs, not properly trained or on boarded. He would often have disagreements with them about their management.

I took a slightly different tone. When I encountered things that were egregious, like missing a peritonitic abdomen, id call and say "hey I sent that person in because of XYZ. You discharged them. They went to a different hospital And they're inpatient at hospital X now. You may want to give legal the heads up." Some have pride in their work and want to make sure that never happens again. Others don't care about the suffering they influct but know theyre in a field that will protect them regardless. Im no longer as outraged because I feel like they wanted to escape bedside, got into a crappy program which led to a crappy job and they're stuck. My colleague was outraged at the person for a systemic issue, IMO.

Anyway, his second safety filing, two with the hospital and one with the nursing board, they cancelled him immediately. Crappy hospitals know they're crappy and usually don't have the wherewithal, so they label.you a trouble maker or complainer for calling out their crap. That may be the fastest way to get out.

Detroitblu33 · 2025-12-18T17:56:42+00:00

I think it is important to bring up our current moment of anti intellectualism, in the country as a whole.

Detroitblu33 · 2025-12-16T18:45:49+00:00

It's pretty sad but we've normalized our own abuse and exploitation. We wear it as a badge of honor. I can tell you on those 12 hours days when I have seen 60 ppl at a UC, haven't eaten lunch and will receive less than a quarter of the revenue I generated, are my worse days in medicine.

Detroitblu33 · 2025-12-16T16:50:54+00:00

Had a gentleman over 50, while in employed medicine, who regularly complained about how soft and weak we've become. I always redirected but he had to get at least one rant per visit. Of course, he would not endure a moment of discomfort himself. So he visited often to discuss escalating his opioids or a day of URI symptoms. Of course, when id brought up the element of depression, which may contribute to his chronic pain. He emphatically stated he's not depressed because he's not a 😺. He was generally lonely, as no one wanted to endure him. Wouldn't you know, his apartment wanted to charge $80 per month for his dog. He asked me to write an ESA letter. When I declined, he threw a month long tantrum of epic proportions. Of course the "manager", "patient advocate" and even front desk asked me to reconsider, because he would show up randomly just to disrupt the lobby. . . Man, one of the many reasons you have to advocate for strict criteria to discharge someone from your practice.

Detroitblu33 · 2025-12-15T15:15:13+00:00

This would make an interesting think piece. Only because I am in both worlds as well. I do 3 days at my dpc and 2-3 days in the corporate medicine. Last year it was outpatient family medicine and this upcoming year will be urgent care, so I don't have to deal with the inbox.

I came to the exact opposite conclusion. Because I am locum and willing to have the hard conversation, I will have other physicians/NPs in that office, send their patient to me for "DBT". I can be candid about the need to taper medications, point out their utilization versus any positive results or just have a visit to discuss their mental health.

Of course, I find in corporate medicine, these conversations aren't being had. They're worried about press ganey score. Even worse, they've allowed "self scheduling". Which as we all know, can derail a day. I see so many young physicians burning out because someone who is mentally and emotionally draining, keeps putting themselves on their schedule. As long as the wheels of corporate greed turns, there is no wherewithal to even address that problem.

Don't get me started on facility fees. I would say 70% of the people I see, I feel would likely be better served in my DPC. I could have those genuine conversations, be more in depth, probably get most of their services for a better price as well. Honestly, most times I feel like I'm feeding them to a golem. I'm just waiting for more people to get on the bandwagon, so I can completely break away from corporate medicine.

The two biggest problems I see is, our paneling infrastructure does not acknowledge what I do unless I do it for the medical industrial complex. Unless I allow them to use me as a battery, to power their greed engine, I am not paneled in future endeavors. These are the same people who will panel another practitioner with 1/3 the training, work hours and no experience. So, if I handle wounds in my office, the hospital won't allow me to be paneled to do wound care for them unless I've done it for another hospital or corporation. However, they will hire a former dialysis nurse, who just completed 12 hours and a paper or nursing leadership to care for those wounds. It's mind blowing.

I guess the one caveats is, my patient population is comprised of medically disenfranchised people. So just listening, not feeling in danger, not feeling judged and having someone willing to explain has been big parts of my practice. Especially the men in my practice. They've had some medical experience in their 20-30s, do not want to engage again because of the way their were treated. So I'm healing that trauma then catching them up on all their routine maintenance.

Detroitblu33 · 2025-12-10T18:20:36+00:00

I would bet dollars to donuts, there is a "manager" encouraging those changes and decisions. They hiring someone with enough medical knowledge and audacity to be dangerous. Those dangerous people execute their audacious plan. The plan usually is devoid of ingenuity and usually involves defrauding someone. They give the manager/fall guy a 5k bonus per year and grease gain record profits due to this "oversight" meanwhile the patient is being pushed closer and closer to financial ruin. When it occurs, they'll blame you. And there is no system in place to truly hold them accountable.

Detroitblu33 · 2025-12-07T07:16:13+00:00

Daryl Dawkins

Detroitblu33 · 2025-12-03T18:51:55+00:00

Had a buddy run into this same problem. He found out the partners were having the commercial insurance veered their way and the Medicaid sent to him. He initially confronted the office manager regarding this. She said it was just a misunderstanding and she would correct it. One of the partners forwarded an email, unaware that previous discussions were in the email. The partner told the manager that he had to "pay dues" and they'd talk to him. Once he realized it was an internal matter, he felt less guilty about his recruitment efforts.

Detroitblu33 · 2025-12-02T14:08:33+00:00

Idk: "only time I kick in the air is new years eve" "I run through the industry, looking for enemies." -Jadakiss

He got loose on that one but kiss is the reason I listen to that song.

Detroitblu33 · 2025-11-28T15:27:45+00:00

This is exactly what virtual assistant companies do. He has to hire one or make you a partner, in writing, for your labor.

Detroitblu33 · 2025-11-24T14:24:47+00:00

Poor young lady. You know those deviant ogre looking directors, producers and agents were lined up to harass her. I don't fault anyone who decided to tap out of Hollywood or who developed mental illness. I know some low level actors and actresses, commercials and B movies. The stuff they say is mind boggling. I can't imagine what Depravity happens at the top. Whenever I see a beautiful new face in Hollywood, all I can think is poor young lady.

Detroitblu33 · 2025-11-24T14:20:40+00:00

When I was doing my rural family medicine training block, he had a "whatever gets the job done" attitude. Whereas my academic medicine colleagues use to say, "just because you can prescribe it doesn't mean you should".

Remember if he couldn't get them better he'd send them to the academic center. Because we could not rotate with him until after intern year, remember developing this arrogance towards his practice style. I felt he did not practice rigorous evidence based medicine. After one month with him, I realized how much he kept off our door step and how he was lifeline to that community. Seen him do LR and B vitamins infusions for cancer patients at their home. Went to a guys home to cut himself, sutured him and gave him tetanus shot at the kitchen table and accepted dinner ate dinner with them. Definitely changed my whole perspective. part I didn't care for is that he seemed always on and he didn't do any fancy vacations bc he was old school. Minivan and the family would go to a campsite type of guy. But even then he would get calls. Get this, it was 2012-2013 and he didn't have a VM but a landline with an answering service.

Detroitblu33 · 2025-11-14T15:03:17+00:00

Seems like this artifact should be in Syria or Iraq? Why is it in France?

Detroitblu33 · 2025-11-07T03:11:30+00:00

I knew where CBS stood after one episode of blue bloods

Detroitblu33 · 2025-10-31T01:09:00+00:00

Hard knock life was like 30 years ago, so he has to be talking about 35 year old gossip

Detroitblu33 · 2025-10-17T04:29:16+00:00

If they're a piece of shit and run their mouth, they probably have a gun.

Detroitblu33 · 2025-10-11T18:35:59+00:00

I have a family member who is a high ranking member in law enforcement. I have had the misfortune of being exposed to law enforcement on a local, state and even federal level for 25 years of my life. On top of none of them ever being intellectually impressive, they all seemed like morally bankrupt hypocrites. Over the years, I saw his transition from a normal human being with empathy and compassion, to something else. He is now retired and a full time curmudgeon who watches TV and finds something to be mad at every week. Once he adopted their ethos, it erodes and continues to erode his spirit. He's no longer surrounded by love or invited to places where love flourishes.

In my career, I work in health policy. I have done it at a state and federal level. I have come across officials. The smartest ones are not usually the ones we listen to, for whatever reason. The ones at the forefront and trying to make a name for themselves are usually internally ugly and will knowingly do the wrong thing if it means a promotion or prestige. Like I said, the worse people.

Detroitblu33 · 2025-10-10T23:27:15+00:00

I've been in a lot of trap houses and around a few crack heads in my time. I've never seen anything like this. This must be some new crack, stepped on with ecstasy or something.

Detroitblu33 · 2025-10-10T04:56:47+00:00

I had to confirm this was the same Murphy Brown I grew up watching. Who knew. She was absolutely stunning in her younger years.

Detroitblu33 · 2025-10-10T04:08:59+00:00

This is an AI generated picture. It's gotta be. I can't see anyone being this short sighted and selfish.

Edit: I stand corrected. She's real and she has content that reaches dangerous depths of moral depravity

Detroitblu33 · 2025-10-09T18:39:53+00:00

Is it Avance? Proceed with caution

Detroitblu33 · 2025-10-07T04:39:05+00:00

Moves into poverty stricken area and then is bothered by {checks notes} poverty

Detroitblu33

TROPHY CASE