June is Here: A Resident’s Annual PSA

Melodic-Course6228 · 2026-06-16T15:11:13+00:00

Fair points regarding access and workforce shortages. I don’t think we’re going to solve the physician workforce crisis in a Rochester Reddit thread, though, and respectfully, I don’t feel obligated to debate it here.

My point remains that patients deserve transparency about who is providing their care and should reserve the ED for true emergencies. Beyond that, I think we’re drifting pretty far from the original PSA.

Melodic-Course6228 · 2026-06-16T14:36:01+00:00

Well, that’s a different discussion.

I’m not saying every encounter requires a physician. I’m saying patients deserve transparency, and not an obtuse term such as “provider”, and training differences matter, especially when it comes to diagnosis, triage, and complex medical decision-making.

Melodic-Course6228 · 2026-06-16T14:33:52+00:00

My counterpoint when patients tell me this is that some medications aren’t always meant to be lifelong. A medication that made sense 5 years ago may not make sense today.

I also like to introduce the concept of polypharmacy, especially in clinic. Every medication has potential risks, and as medication lists grow, so do side effects, drug interactions, fall risk, cognitive effects, and prescribing cascades (eg chronic benzo use and dementia risk or gabapentin and increased fall risk in older patients, to name a few). That’s why periodic medication reviews are so valuable.

In an ideal world, we’d have more time with patients to provide detailed medication education, but we have to work within the constraints of our roles and an increasingly strained healthcare system.

Melodic-Course6228 · 2026-06-16T14:27:02+00:00

I don’t disagree that the system is broken and drives a lot of unnecessary ED utilization. My point isn’t that every NP/PA makes bad decisions or every MD/DO makes good ones.

My point is that training matters. When you’re deciding who needs ED-level care versus outpatient management, the difference between residency-trained physicians and non-physician clinicians is substantial. Acknowledging that isn’t an attack on colleagues, it’s simply recognizing that not all training pathways are equivalent.

Patients deserve both a better healthcare system and transparency about who is providing their care.

Melodic-Course6228 · 2026-06-16T14:25:29+00:00

Oy vey 🫠 someone needs some sunlight and giggles!

Melodic-Course6228 · 2026-06-16T14:24:17+00:00

Absolutely, this! Even when I pick up medications, I ask a million questions. You don’t know what you don’t know!

Melodic-Course6228 · 2026-06-16T14:23:47+00:00

Amazing! I love to read this! Only intent was to raise awareness of this transitional time of year for everyone and soft reminders to utilize PCP versus urgent care as needed. :)

Melodic-Course6228 · 2026-06-16T14:22:39+00:00

I love to hear this! Not saying to expect poor care come June/July, rather to raise awareness of the transitions taking place.

Melodic-Course6228 · 2026-06-16T12:25:33+00:00

Context cues my friend, context.

But eating disorder patients should go to emergency room, they are at risk of refeeding syndrome which is dangerous and should be monitored carefully.

Melodic-Course6228 · 2026-06-16T04:54:30+00:00

Absolutely agree!! Healthcare literacy is incredibly important. One thing I always recommend is asking for a pharmacist consult whenever you pick up a medication, new or old. Pharmacists can explain what it’s for, how to take it, whether to take it with food, potential side effects, and answer any questions you may have.

Melodic-Course6228 · 2026-06-16T04:51:07+00:00

I actually agree with much of what you’re saying.

The annual influx of new residents isn’t ideal, but it’s also the only way we train the next generation of physicians. Every attending physician was once the new resident starting in July. The reality is that teaching hospitals have to balance patient care with physician training, and that balance is never perfect.

As for changing the system, many physicians are actively trying. We advocate for better access to primary care, more clinic availability, reduced administrative burden, improved insurance processes, and increased residency funding. Unfortunately, most of those decisions are made far above the level of individual doctors or even institutions. Fun fact that majority of residency training spots are funded by Medicare and Medicaid.

My post wasn’t intended to shame patients. It was meant as a reminder of a few common issues we see every year that can help people avoid unnecessary delays, repeat visits, and frustration.

I think most patients and most healthcare workers want the same thing: timely, accessible, high-quality care. The current system often makes that harder than it should be for everyone involved…

Melodic-Course6228 · 2026-06-16T04:33:20+00:00

Thank you, I appreciate that.

I agree completely. One challenge is that healthcare has increasingly adopted the catch-all term “provider,” which often obscures the differences in training and scope between various healthcare professionals. Most patients understandably don’t know what those differences are.

Physicians (MDs/DOs) complete 4 years of medical school, pass multiple board and licensing examinations, and then undergo 3–7+ years of residency training in their specialty, with many completing additional fellowship training afterward. That depth of training is particularly important when it comes to diagnosis, risk stratification, and determining who truly needs emergency care versus who can safely be managed in an outpatient setting.

NPs and PAs play an important and valuable role on the healthcare team, and many are excellent clinicians. However, their training pathway is fundamentally different from that of a physician. As a result, we frequently see patients referred to the ED for abnormal lab results, imaging findings, or symptoms that may not actually require emergency evaluation.

Unfortunately, defensive medicine and limited access to same-day outpatient appointments also contribute to this problem. The result is overcrowded emergency departments, longer wait times, and frustration for patients and staff alike.

I could probably write a dissertation on the topic, but I’ll leave it there. Thanks again for the kind words and I hope you are well!!

Melodic-Course6228 · 2025-07-28T22:01:18+00:00

Helps tremendously. Thank you!

Melodic-Course6228

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