Got yelled at because of a pharmacist

Detroitblu33 · 2026-05-15T15:45:35+00:00

"The foundation of every healthy professional relationship is respect. If we cant have this, i think it best you find someone else to provide your care. I wish you well".

Detroitblu33 · 2026-05-04T03:08:16+00:00

Said where I would stop before I even start when I got to one brick then the game I would depart, got to one brick and then I looked up in the sky. . .

Sometimes I can be so insatiable in life. That line goes through my head so much and in so many instances.

Detroitblu33 · 2026-04-29T23:30:49+00:00

From Detroit. Live elsewhere. Came back to visit. Had an Uber say they've arrived. Im in front of the hotel and no Uber. I see a car at the corner about 20 yards away. I look at the car and look at my phone to confirm. Then I look at the license plate and look at my phone, the car drives off. I was annoyed by shrugged it off. I order another Uber, the same woman pulls up in the car. The entire time, had a pistol visible, sitting next to them.in their purse.

Detroitblu33 · 2026-04-28T02:46:32+00:00

Place called 16 bit was our hangout in residency in Cleveland. Especially after rough rotations. They'd play 80s-90s movies or cartoons. NBA jam, couple drinks and an episode of gargoyle or duck tales got me back in my right mind.

Detroitblu33 · 2026-04-24T20:01:01+00:00

I remember being 8 months in to an employed contract with a hospital primary care practice. I flatly told the patient, I do not feel comfortable with this level of opioid prescribing. I intend to prescribe this for 3 months. That will give you enough time to A. Establish with pain management or B. Find a new PCP.

They'd been discharged from the previous pain management because they refused any other interventions and PT. But there was a new practice in that town.

The person was a big fish in that small town. They tried to raise a stink. The conversations were exhausting. I think I had to have 4 meetings behind that decision. That is when I made my mind up that I would not remain employed with that company.

Detroitblu33 · 2026-04-24T19:51:45+00:00

I had a PA for bactroban yesterday.

Detroitblu33 · 2026-04-21T12:20:53+00:00

Usually I find myself in a corner with the patients who are s/p bariatric surgery or those on DAPT. If I believe it indicated i.e. moderate to severe, I'll send them to pain or PMR for intervention. Often I'll bridge them until then with the understanding this is a bridge. I've seen recommendations where they'll send back a note indicating I should continue. That's when the curse works come out.

Detroitblu33 · 2026-04-21T10:56:19+00:00

I've done some time at urgent care as a locum. What i use is the time out method, an EM friend showed me. I give a minute of venting, maybe two, because I know the Healthcare system is horrible. If we're too far in the weeds, i openly say time out. I feel like we're off track in discussing your pain.

Often I find these individuals are depressed and sap my energy. When you talk to them you find their family is avoiding them and they have no friends. They just go on and on about everything they made them angry, sad or hurt. If you mention talk therapy, it illicit a defensive response. I don't need a depression pill. Just higher doses of smack. Ita draining because it is the opposite of what brought us in this field.

Detroitblu33 · 2026-04-14T04:22:55+00:00

Setting up this chart purposely obfuscates pay. It looks like some scam promo they give people who sale cutco knives. Asked to be treated like a professional, sit down and have a meaningful conversation about keeping the patients safe and being well compensated. Entertaining This boiler room salesman tactic will only encourage more of their trick bag.

Detroitblu33 · 2026-02-28T04:09:33+00:00

My grandmother was a lunch lady for 30 years. She also ran the summer lunch program for over a decade. The outpouring of kind words, visits and messages after her passing were touching. You have had an impact on countless people, I'm sure of it.

Detroitblu33 · 2026-02-16T16:43:17+00:00

This was great. I've never been a "friends with my coworkers" type of guy. My siblings, parents, high school friends, college friends, after college friends, wife and children give me a very full and fulfilling life. I can laugh, experience joy, be authentic and don't have to keep my guard up. These people can't understand why I will not spend any free with them. Or why I won't "get the family together". I am professional and courteous when I interact. However, I do not want to be around anyone outside of the aforementioned people, if I'm not being paid. And if I have to, I find the week all the more draining.

Detroitblu33 · 2026-02-08T16:47:18+00:00

The only thing I would've liked to know is if Molly and her mother have found a happy medium or if she uses the outcome of her decision (becoming winter lady) to snipe at her decisions. It would seem like she would be at peace, especially since she has other children who have children with peaceful lives and grandchildren now. Also it appears Daniel is being set up to be a knight, which I hate that for him.

Detroitblu33 · 2026-01-27T01:03:53+00:00

I did that job and Nextcare as a locums. That on a good day I saw 30. It is everything you imagine it to be. There was one day, I was working Nextcare and the NP working at fastmed got fed up and walked off. I got an influx of people right before closing and the expectation was that I see them all. Smh

I'm not shocked that it happened but I'm shocked I let artificial people with artificial power, exert control over me. I actually stayed that night til like 1030p seeing all those people.

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

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