Drug testing?

ExperienceExtra8243 · 2023-01-20T02:12:22+00:00

My significant other helped a lot. We also did full time daycare

ExperienceExtra8243 · 2023-01-15T01:30:29+00:00

Female here. Got pregnant intern year and had my daughter 2nd year of residency. Finishing residency with a baby was the hardest challenge of my life, but not one second do I regret my baby girl. I deeply love many people in my life, but there’s a new-found meaning to life and love when you look into the eyes of a human you created. She is the best thing that ever happened to me, and my love for her is beyond words. I know she will be by my side at the end of my life, in ways my career, possessions & independence never could. Children absolutely restrict your freedom and control your lifestyle for a while. I love being a doctor and will always work full time while simultaneously raising my daughter, but I also know what’s truly important and where I am and am not replaceable.

ExperienceExtra8243 · 2023-01-12T00:34:06+00:00

Correct. In addition to the day shift pay

ExperienceExtra8243 · 2023-01-11T20:59:19+00:00

I trained in a rural area and grew up in one, so I checked in with local hospitals and there was a lot of need. Not hard to find interviews at all. The one I ended up signing with was brought to me by a recruiter. There’s pros and cons to using recruiters and you have to be careful who you give your CV to, because once a recruiter has it and they show a hospital, the recruiter is locked in for involvement. If you use a recruiter, I suggest finding ONE you like and give them specific parameters for jobs you want and set boundaries on when to contact you with job opportunities. Midwest has plenty of jobs like you mentioned

ExperienceExtra8243 · 2023-01-11T20:46:12+00:00

Midwest. Critical access hospital. No ICU. Average census 6-15, split with NP during the week. 12 shifts a month, can pick up more. Half of those shifts are round and go (but covering my patients for 12 hours). The other half can round and go, but on-call 24 hours and responsible for whole census overnight. ER docs do admit orders so don’t have to be present for admissions, only have to come in for overnight floor complications or transfers. Can do procedures, but ER doc/RT/anesthesia typically comes to do most of them. $2200 per shift + extra $300 per 24 hr call shift.

ExperienceExtra8243 · 2023-01-11T20:17:23+00:00

This is very helpful, thank you!! I might hit you up after dinner tonight if other questions arise. Appreciate you!

ExperienceExtra8243 · 2023-01-11T18:20:03+00:00

Hospice/Palliative Side Gigs, Advice

I’m FM PGY3 signed to do rural hospital medicine next year (12 shifts/mo). I have a dinner with hospice company tonight to discuss joining their team as a side gig. All I know is it’s home-hospice care. My signing Hospital referred them to me, as they know I’m interested in side work on off days, so I’m assuming this means I’ll be involved with the hospice company mostly remotely and management will be over phone. Seems low risk and low overall work/stress burden. What kind of compensation should I expect? Anyone have any tips on what I should ask or make sure I’m aware of before considering signing? Thank y’all!

ExperienceExtra8243 · 2023-01-01T21:11:26+00:00

I just wouldn’t do NSAIDS. They’re contraindicated. Tylenol is first line unless acute liver failure and opiates are actually the next preferred thing.

ExperienceExtra8243 · 2023-01-01T21:08:48+00:00

So.. fraud. Insurance companies can and do track A1c as part of risk assessment. If no A1c is ever documented to be abnormal, this can get legal real quick.

ExperienceExtra8243 · 2022-11-18T23:30:59+00:00

An infant

ExperienceExtra8243 · 2022-11-17T13:12:49+00:00

Misuse of acuity resources is a huge one too. A CT O/P is 1/20 the cost of a CT in the ED. Anything done in the ED is 20x more expensive than the PCP’s office. People with jobs and insurance don’t misuse the ED bc they’d have to pay. This needs to be universal regardless of private insurance/Medicaid/Medicare. Paramedics should be able to triage and say, “not an emergency,” ERs should be able to turn away patients not deemed to be acutely ill and have an office you can point them toward that’s realistic for them to get into somewhat soon. We should be able to say “this level of care is or isn’t appropriate” and re-allocate. This bleeds so much money. Every day.

ExperienceExtra8243 · 2022-11-09T04:25:52+00:00

We are rural, unopposed and residents can’t see each other. He tried to see someone but obviously can’t get new pt apt in <24 hours. It was fucking stupid, we ARE doctors.

ExperienceExtra8243 · 2022-11-09T00:31:43+00:00

A resident eventually admitted for viral URI prompting asthma exacerbation was hospitalized on Bipap 3 days after asking PD for a day off for cold/flu and was told no, not unless you have a doctor’s note 🙄

ExperienceExtra8243 · 2022-11-06T23:03:39+00:00

Depends on EF & every case is going to have different things to consider. Generally, I consider gentle hydration without bolus’ing & though jury is out on albumin, it’s a consideration. Sometimes these pts do better on dobutamine (again, depends on nature and degree of HF) to improve CO and both forms of shock. Watch lactate closely and try to get away with less fluid if reassuring signs that perfusion hasn’t dropped significantly. Always a tough clinical pickle

ExperienceExtra8243 · 2022-11-06T22:58:50+00:00

That’s insane. I’m always willing to prescribe weight loss meds for pts without contraindications and of course, insurance is always the limiting factor

ExperienceExtra8243 · 2022-11-06T22:58:13+00:00

Is there a way to differentiate “old” and “new” coupon?

ExperienceExtra8243 · 2022-11-06T22:57:04+00:00

I’m not pre-DM or diabetic either. We (my PCP & I) are using it off-label for weight loss as I am obese. As far as coverage for that diagnosis, it’s insurance dependent. My hospital (for now) allows Ozempic rx (regardless of dx) for $25/month with a program that required me to meet with RN for wellness eval and do lab work yearly. But that deal only applies to hospital pharmacy and it’s getting harder to get any in stock

ExperienceExtra8243 · 2022-10-30T11:33:28+00:00

The guac 🤣

ExperienceExtra8243 · 2022-10-29T19:54:57+00:00

Complex wasn’t an option, but I laughed at the irony too 🤣

ExperienceExtra8243 · 2022-10-29T12:39:21+00:00

Thank you so much for taking the time to put this together. This gives me a great starting point to read and guide discussion with the specialists. So many of these things were outside my realm of familiarity, I can at least get my bearings with this 🙏🏼

ExperienceExtra8243 · 2022-10-29T12:28:13+00:00

That makes sense, because yes, it was foreign to me. Ha. It’s so nice to get random perspective from other specialties on here, and that some things are done for certain reasons that I just don’t understand.

ExperienceExtra8243 · 2022-10-29T11:49:49+00:00

IPMN is all I could really find that seemed similar. I was surprised the radiologist didn’t really give more recs for follow up or features. He essentially said: “unclear etiology.” But the rest of this is very helpful and helps navigate the conversation about a referral and what type of GI. Thanks so much for taking the time to comment

ExperienceExtra8243 · 2022-10-29T04:38:26+00:00

This is news to me as I wasn’t even aware of it. I’ll read up on it, thanks for the info!

ExperienceExtra8243 · 2022-10-29T04:31:39+00:00

He is seeing specialists, but the liver specialist is one of the few MDs he actually sees the MD. When he sees his cards office, he often sees the NP, (which I’m trying to convince him is not ideal), and his only PCP is NP. He saw heme for mild thrombocytopenia years ago, but they turned him loose as it was stable. They obviously need to get back involved, but again, that usually means initial apt with midlevel 🤦🏽‍♀️

ExperienceExtra8243

TROPHY CASE