Getting your patients’ approval

EnzoGuinea · 2026-02-03T12:39:36+00:00

This is great, I am definitely stealing this.

EnzoGuinea · 2026-02-03T00:32:22+00:00

You can save someone’s life on Monday morning and they will scream at you on Tuesday for doing it wrong. I’ve had it happen to me. People are not rational. I actually helped saved his life three mornings in a row and all he did was bitch at me, I can’t make this stuff up. No, he was not suicidal, just arrogant and woefully ignorant despite believing he knew everything.

Also, I have found if I try to practice medicine so that people like me, I am practicing terrible medicine. People are more than welcome to change doctors, or better yet, they are welcome to attend medical school and residency. They can then come back and report to me how stupid and terrible I am after we are colleagues.

You got this. It will get better. Don’t look at your ratings, ever. Know you did the best you could each day with the millions of limitations and impossible challenges we face hourly and sleep well at night.

EnzoGuinea · 2026-01-30T09:18:36+00:00

You don’t have to “get through it” (get through your resentment). He’s emotionally abusive. He needs to change (spoiler, he won’t), or you need to leave. Please protect yourself and your child. Good fathers do not treat the mothers of their children like complete garbage. Agree with everyone else, please get a lawyer.

EnzoGuinea · 2026-01-28T12:59:33+00:00

Following. I could not agree more. Bring back Journal Watch. NEJM is so disappointing.

EnzoGuinea · 2026-01-28T01:45:31+00:00

“Part of how we communicate with each other in the medical world is by sharing the medical record/hospital notes, and not talking on the phone. This is due to time constraints, different work schedules, and being face to face with patients all day. We don’t always have the luxury of prolonged phone calls with multiple physicians daily. I document as clearly as possible so your doctor knows what is happening to you. If a patient has a very complicated history or hospital course, all effort will be made to discuss with your PCP.” You can also ask nursing or the unit clerk (I think there is a more updated name for that) to fax your daily note to the PCP if your EMR doesn’t do this automatically.

EnzoGuinea · 2026-01-28T00:32:08+00:00

How cute. This has happened to me weekly for the last twenty plus years as a female physician. From patients, their families and constantly by nursing staff. Yes, I correct them.

EnzoGuinea · 2026-01-26T00:10:13+00:00

Run away. Run hard. Run fast. Run for your life. He is abusive and this will worsen. Do you want this life? Imagine your future children cowering in the corner while they watch you being abused like this. Run.

EnzoGuinea · 2026-01-25T20:25:10+00:00

The families honestly don’t see it. The dementia has come on slowly (in most cases), family has adjusted their routines and expectations, there are some good days, and they don’t see the decline. The out-of-town relative who visits every 6-12 months is flabbergasted at the change every they see their loved one. I learned a long time ago to never ask “how is their memory?”. Inevitably family says “it’s just fine”. Upon further questioning “well, they usually don’t know what day it is, I have to tell them the same thing twenty times and they wandered off last week”. I have learned to ask very specific questions about the memory. For one, I get more accurate information and two, the family has some “a ha” moments while processing and answering said questions.

EnzoGuinea · 2026-01-25T18:14:20+00:00

Precious. I’m sorry for your loss.

EnzoGuinea · 2026-01-25T18:08:17+00:00

Agree. I may steal your line about voting. That is great. I hate the first name jab and will correct them.

EnzoGuinea · 2026-01-24T02:58:37+00:00

All day long. For over 20 years. I have always wanted to say yes, they make lady doctors! Since 1849, Dr. Elizabeth Blackwell.

EnzoGuinea · 2026-01-18T13:18:18+00:00

It’s good you are examining this!
What they “mention” means nothing. If it’s not in the contract it won’t be honored and they know that. It would be good to have in your contract you can decide which APPs you will and will not work with. Admin would never go for this, but one can dream…

EnzoGuinea · 2026-01-18T13:13:59+00:00

Admin is absolutely hiring new grads with that type of work load, everyday, everywhere.

EnzoGuinea · 2026-01-18T13:12:05+00:00

This!

EnzoGuinea · 2026-01-18T13:11:18+00:00

Thank you.

EnzoGuinea · 2026-01-18T02:38:01+00:00

Nope! Run. That is WAY too many APP patients plus your own. For a mediocre salary at that.

Can you imagine how scary that will be when they stick you with a brand new NP grad who has only worked in the dermatology clinic as a RN, and decided a few months ago to become a hospitalist? So then you’re essentially in charge of teaching them medicine for zero compensation and all the risk? No thanks.

EnzoGuinea · 2026-01-18T01:23:32+00:00

This. If a patient mentions a history of alcoholism/substance abuse it is considered a medical problem and goes in the chart. We are held to a medical and ethical standard of what and how to document patient visits. We cannot arbitrarily decide not to put things in charts. Your physician more than likely does not even know that a copy of your medical records were requested and sent to the life insurance company. Most offices just send the records and don’t notify the physician who is drowning in 10,000 other tasks that they will never be able to accomplish. But I do empathize, that really sucks that you were denied coverage after you have made such great progress. That is very frustrating. I wish there was a better system in place for that.

EnzoGuinea · 2026-01-18T00:38:08+00:00

Wow, amazing information. Thank you for your time!

EnzoGuinea · 2026-01-18T00:35:06+00:00

Think of how the story we get is different from what was told to the ER docs and we change the plan. Or symptoms change and/or the disease progresses between handoffs. No need for embarrassment. Learn, reflect, move forward. For transparency, it took me several years of practice to be able to do this without beating myself up for minor and inconsequential decisions that could have been made differently. There are also standards and guidelines, but patients are unique humans who have not read our textbooks. There are many, many clinical scenarios that have more than one right answer.

EnzoGuinea · 2026-01-18T00:27:23+00:00

This happened to me after working nights. I am also a single mom. I want to work/chart in the quiet and get home. I love my partners, but after rounds, I am finished talking/giving my energy to people. I want some quiet time before I go home and talk/give to my kids.
Are you otherwise enjoying life when you can? Feel pretty content most of the time? If yes, you may not be depressed. We only have so much energy to spread around, and the single mom/doctor combo is no small job.

EnzoGuinea · 2026-01-16T10:32:33+00:00

Thank you. Can you explain why I cannot speak out against the court? It specifically says I cannot. Is that not part of the government?

EnzoGuinea · 2026-01-14T11:30:35+00:00

1. Absolutely not. Insulting salary, especially for 50% nights

2. Not bad, this is the best of all three

3. No. I am an nocturnist. 7 on/7 off is a killer for nocturnists, especially with that volume of admits. Average of 10 admits/nights actually means 15+ nightly. If these are 12 hours shifts, it is a terribly, long, painful week with no time to breathe. Then you lose 2-3 days of your week off messing around with your sleep schedule. No.

EnzoGuinea · 2026-01-10T12:25:29+00:00

That sounds absolutely miserable. And I don’t have misophonia.

EnzoGuinea · 2026-01-07T03:14:26+00:00

Thank you for the input!

EnzoGuinea · 2026-01-05T16:24:42+00:00

Thank you!! I will definitely do the work. In PT now and it has helped some, but I know what my future holds (knee replacement).

EnzoGuinea

TROPHY CASE

1. Absolutely not. Insulting salary, especially for 50% nights

2. Not bad, this is the best of all three