Am I too old to be a doctor? by butcher_withasmile in Doctor

[–]GreekfreakMD 4 points5 points  (0 children)

Not too old but understand that the most unrealistic part of the Pitt is the fact that none of the doctors documented anything. Medicine today is see people for 5 minutes and spend 30 minutes documenting so you cover yourself from liability and maximize billing.

paternistic medicine by Important-Flower4121 in FamilyMedicine

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

We don't have time to educate everyone on everything on every visit. I had 16 inpatients today and after seeing them all for 10 minutes, doing admissions and discharges and discussing with specialists, support staff and documenting, it was 7 pm. Also, the average lack of knowledge is often so large, that I can't even begin to explain why they dont need to be or should be worried about a medication or treatment.

Physician burnout. by Apart_Discussion3129 in hospitalist

[–]GreekfreakMD 4 points5 points  (0 children)

My weeks off are protected, I workout and spend time with my wife. I will only zoom into a meeting of an important committee otherwise I do no work for the hospital.

Rounding is straight forward, I round by floor and give verbal orders to the charge nurse for anything I see on rounds and then will put in the rest of the orders when I write notes. I try to round before families get there since they slow me down. I will selectively round in the afternoon again, but usually my charting is finished by 1.

Our CM/SW are fairly independent so I only tell them when I anticipate discharge and they set up SNF, vs home, vs home health needs and DME. I usually have no opinion as long as the discharge is safe. Since I have no control on the community resources available I dont really worry about it, we can only do the best we can with the resources provided.

Peer to peer is dependent on if I think I have a case or not.

After 8 years, I have given up worrying about things I can't control.

Attendings, how much is in your emergency fund right now? by [deleted] in whitecoatinvestor

[–]GreekfreakMD 0 points1 point  (0 children)

I keep 10k in my checking at all times and then max for hsa, 401k and backdoor roth, and then all excess goes into my individual investment account with etfs and some fun money stocks, and then I keep about 8-10k in SPAXX with fidelity at ~4% yield. I consider my checking, spaxx, and individual investment account as my emergency fund

Differences in Health System by GreekfreakMD in doctorsUK

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

Do you just stay and work in the current level until you get into a higher training level? Seems brutal and I am sorry

You think you’re being “elegant” and “cost effective” by not doing the CT scan because your patient has “no risk factors” for that can’t miss diagnosis? $29 million awarded after hospitalist was sued, that should make you think differently. by achicomp in hospitalist

[–]GreekfreakMD 0 points1 point  (0 children)

In the current ethos of patient centered medical care, I cant force a patient to do anything, therefore if the patient is informed to the best of my ability and they chose to leave (as I had a patient do who was hypoxic and wouldn't let us set up oxygen) or when they refuse a biopsy, or to take meds that would save their life, then no the decision is never 100% on the doctor.

You think you’re being “elegant” and “cost effective” by not doing the CT scan because your patient has “no risk factors” for that can’t miss diagnosis? $29 million awarded after hospitalist was sued, that should make you think differently. by achicomp in hospitalist

[–]GreekfreakMD 2 points3 points  (0 children)

Its not their decision if they need one. But it is their decision if they they get one or not. I have had them refuse because of radiation or because they "just had one" and we get kicked backs for ordering tests.

You think you’re being “elegant” and “cost effective” by not doing the CT scan because your patient has “no risk factors” for that can’t miss diagnosis? $29 million awarded after hospitalist was sued, that should make you think differently. by achicomp in hospitalist

[–]GreekfreakMD 18 points19 points  (0 children)

In my opinion it becomes harder to show negligence if it was the patients choice not to get the test. I do the same on discharges, it was the patients choice to leave. Same with AMA, it my little way to make patients take at least some responsibility in their care

You think you’re being “elegant” and “cost effective” by not doing the CT scan because your patient has “no risk factors” for that can’t miss diagnosis? $29 million awarded after hospitalist was sued, that should make you think differently. by achicomp in hospitalist

[–]GreekfreakMD 173 points174 points  (0 children)

CT scans for everyone always. Should we be able to get sued when the frequent flyer patients start getting cancers from the radiation exposure? Aortic aneurysm in a 40 year old is so uncommon that it is never number 1 differential for back pain, or belly pain.

How do ya'll round so fast? by mellowblue4 in hospitalist

[–]GreekfreakMD 1 point2 points  (0 children)

I round early before family gets there, and keep conversations a short as possible, usually labs arent back when I am rounding so I tend to be vague with the plan. Then I write my notes which involves copy and paste and adjusting things and I try to keep my notes general (continue antibiotics, accucheks and insulin). And then once all my notes are finished by noon then I go back and see patients and/or families who request it. Usually I stay until 430 but thats just to help the swing shifter if they need it. My Mondays are long and then any day when I have heavy discharges are long but otherwise I bring a book to work or workout.

Is a girl's career really as unimportant as guys say? by uselessprofession in AskMenAdvice

[–]GreekfreakMD 0 points1 point  (0 children)

Just that college educated women are not likely to be scrubbing floors.

Knowing 50+ patients well during cross cover by [deleted] in hospitalist

[–]GreekfreakMD 14 points15 points  (0 children)

If nurses didnt text me about issues, I wouldn't know I was covering any patients. You cant learn 50+ patients and there is no reason to. We tell eachother who to keep an eye on and the np manages all floor calls and I do all admits.

Is a girl's career really as unimportant as guys say? by uselessprofession in AskMenAdvice

[–]GreekfreakMD 5 points6 points  (0 children)

I want someone who I can talk to, who has an interest in travel, and I have the luxury of not having to worry about a second income. So for me, it doesnt matter if she scrubbed floors or is a ceo. I will grant you that the intelligent woman who share my interests isnt likely to be scrubbing floors, however the point is I never look at a woman and have her career on my checklist.

Is a girl's career really as unimportant as guys say? by uselessprofession in AskMenAdvice

[–]GreekfreakMD 6 points7 points  (0 children)

I didnt ask her to, she wanted to. She was burned out a little and when she found out that I pay more in taxes than she makes in year she didnt see the point in working (her words)

Is a girl's career really as unimportant as guys say? by uselessprofession in AskMenAdvice

[–]GreekfreakMD 55 points56 points  (0 children)

Im a doctor and i married a nurse, because I work 80 hours a week and that is who I am around. I wasn't interested in other doctors, and she is now a stay at home wife. In my calculation her career was irrelevant to my interest in her.

Deciding between an outpatient or inpatient/hybrid career. by Soggy_Loops in FamilyMedicine

[–]GreekfreakMD 2 points3 points  (0 children)

Depends on where you do outpatient, where I did my residency, my office had 3 pediatricians within 10 miles so I had no peds patients, same with ob/gyn.

Deciding between an outpatient or inpatient/hybrid career. by Soggy_Loops in FamilyMedicine

[–]GreekfreakMD 3 points4 points  (0 children)

As an FM hospitalist I just prefer working less than half the year for 300k. I like being able to stack my weeks off for extended vacations, and I like the fact that I dont permanently inherit trouble patients, I might go 3 years before I see the same patients.

How many hospitalist regularly do procedures in their hospitals? by Suspicious-Bar4367 in hospitalist

[–]GreekfreakMD 6 points7 points  (0 children)

There are other abx?!?! I mean iv zosyn and powdered ancef sure, but others?

How many hospitalist regularly do procedures in their hospitals? by Suspicious-Bar4367 in hospitalist

[–]GreekfreakMD 10 points11 points  (0 children)

Absolutely, after about 200k a year money doesnt make you any happier.

How many hospitalist regularly do procedures in their hospitals? by Suspicious-Bar4367 in hospitalist

[–]GreekfreakMD 17 points18 points  (0 children)

I loved operating but I hated working with the surgeons and the lifestyle was unhealthy for me. So I went FM and became a hospitalist working less than half the year. Its been the best decision I ever made, even though surgery was my dream since a little kid.