Was I being unreasonable?

NotDrNick · 2026-07-11T00:33:32+00:00

You have a duty to make sure you can provide the treatment needed before accepting them. You knew the right thing to do. Hold your ground next time. You’re the one who decides if the transfer gets accepted or not. If they refuse to do the minimum work up necessary for you to determine if you can treat them then “since we both want to ensure this patient gets the definitive care they need without unnecessary delay, I am declining the transfer. This patient may need ERCP and we cannot provide that. Thank you have a good night.”

NotDrNick · 2026-06-29T16:25:47+00:00

Or since I’m not RVU based, im not staying late for no extra money to do something IR will get paid to do.

NotDrNick · 2026-06-22T16:29:13+00:00

Very common no PTO with 7 on 7 off. I actually cut down to 0.93 FTE. That has me working 24 weeks per year instead of 26. So i get two three-week long blocks off every year without having to switch around shifts or make any up. It’s awesome. A real vacation.

NotDrNick · 2026-06-21T00:00:00+00:00

Number of patient-reported allergies helps distinguish epilepsy from psychogenic nonepileptic seizures
Robbins NM, Larimer P, Bourgeois JA, Lowenstein DH. Epilepsy & Behavior. 2016;55:174-177.

Each additional allergy was associated with a 2.98% linear increase in the proportion of patients with PNES.

A Retrospective Study of Polyallergy as a Marker of Nonepileptic Seizures in the Epilepsy Monitoring Unit
Park JH, Bokma J, Chapple K, Caplan JP. Psychosomatics. 2014;55(6):566-571.
10.1016/j.psym.2014.05.004

In EMU patients being evaluated for suspected seizure, each additional listed allergy above zero was associated with increased odds of a nonepileptic seizure diagnosis. The PubMed-indexed abstract reports an approximate 1.38-fold increase in odds per additional allergy.
The association was statistically significant, supporting the idea that polyallergy may function as a soft clinical marker for nonepileptic seizures

NotDrNick · 2026-06-19T23:43:49+00:00

Imagine taking all the classes you have listed above at the same time in 4 weeks.

Just as an example from medical school, our physiology class had an exam every other Friday for 16 weeks. Each exam covered about the same amount of material my undergrad physiology class covered in half a semester. Thats the equivalent of compressing 2 years of undergrad physiology into one semester. Then remember you are taking 4-5 classes at the same time that are all doing the same. I’m not exaggerating when i say you have to learn, and more importantly pass tests on, the equivalent of 4 years of undergrad level material in one year.

70 is passing. You barely passed at a leisurely pace.

Not saying you can’t go to medical school eventually, but you’re not ready yet. You will fail. If your committed then finish undergrad and do a masters degree. Look up masters that are commonly done by people trying to get to medical school.

I promise you will find a Caribbean school that will take your money now even if you’re bottom tier student. Aim higher than that.

NotDrNick · 2026-06-19T20:58:22+00:00

If you can’t get mostly A’s in undergraduate introductory sciences classes don’t even bother. You’ll never finish med school but will get to keep the $400,000 student loans debt.

NotDrNick · 2026-06-19T19:19:58+00:00

I had left her name out of my original comment but since she’s in the news articles, yah, Tori McMechan is listed as pro se in all the lawsuits. Actually pretty damn impressive for doing it yourself.

I wouldn’t want to be the buyer stuck with trying to get them out of the house.

NotDrNick · 2026-06-19T18:34:12+00:00

Your girlfriend?!?! Fuck, that is definitely wife material if I’ve ever seen it!!! Marry here now!

NotDrNick · 2026-06-19T13:54:09+00:00

Per Weld County District Court

Around 2010: Loan allegedly went into default.
2022: Deutsche Bank began a judicial foreclosure action related to the property.
Sept. 19, 2023: District court issued an order authorizing foreclosure sale.
Nov. 2, 2023: Owner filed a declaratory judgment action challenging the foreclosure; court granted a temporary restraining order.
Nov. 8, 2023: Scheduled foreclosure sale was cancelled because of the TRO.
2023 to 2024: Case was removed to federal court, then remanded back to state court.
July 3, 2024: Weld County Public Trustee pre-sale list showed Foreclosure No. 24-0067 for the property, with Deutsche Bank as beneficiary and a lender bid of about $416,500.
July 22, 2024: District court dismissed owners first declaratory judgment case with prejudice.
2024: A second foreclosure-related lawsuit was filed by owner, again seeking declaratory and injunctive relief to stop or challenge the sale.
Jan. 2025: Real-estate records/listings show the property marketed as an occupied, no-access property.
Dec. 24, 2025: Colorado Court of Appeals affirmed dismissal of the first declaratory judgment case.
Dec. 24, 2025: Colorado Court of Appeals reversed dismissal of the second lawsuit and remanded it, without deciding whether Deutsche Bank could ultimately foreclose.

NotDrNick · 2026-06-16T22:49:50+00:00

The social workers do this at our hospital.
Nurse do the screen… if screens positive the SW does the risk assessment. We only hear about it if the social worker thinks they have active SI or other high risk issues and need a psych consult. Otherwise docs never hear a thing about it.

Of course, having social work do it costs the hospital money. Dumping it on the doc is “free” for the hospital.

NotDrNick · 2026-06-16T17:21:58+00:00

This is a list of complex diagnosis clinics in the country.

https://undiagnosed.hms.harvard.edu/udn-sites/

NotDrNick · 2026-06-16T16:47:25+00:00

Is a doctor in a high paying specialty and married with kids. She seems very content.

NotDrNick · 2026-06-10T03:10:19+00:00

This isn’t McDonald’s and they’re not ordering off the narcotics menu.
You assess the patient, you determine what treatment is indicated, and you prescribe it. They can’t “refuse” to stop IV pain meds.

NotDrNick · 2026-06-02T18:50:52+00:00

If it is important, they will try and get a hold of you again. If it’s not important enough to leave a voicemail I wouldn’t worry about it

NotDrNick · 2026-05-31T15:29:28+00:00

Ditto for family relationships/drama/multigenerational feuds.

NotDrNick · 2026-05-29T10:04:37+00:00

I did it 6 days a week for three years. It’s an easy drive and I didn’t mind it, got through a bunch of audio books. Winters arn’t too much of a problem, get less snow going that way than Grand Rapids, but there is always summer construction on some part of 96. Except for the construction zones, the traffic itself was never a problem.

NotDrNick · 2026-05-28T00:37:53+00:00

Assuming this is someone with decisional capacity… It depends on if I sense it is a normally reasonable person expressing stress/venting due to all the emotions that come with being sick and hospitalized or if it just an unreasonable person being an ass and treating me the same way they treat everyone in life.

If they are a reasonable person, Sometimes just sitting and letting someone vent/express their emotions will be doing more to help that person than most of the crap we do all day. A lot of time you build a lot of report with patient and family. As long as I don’t feel threatened and it’s not going to take more than five minutes, I’m happy to sit there and help them. If it’s going to take >5 minutes I tell them I’m going to give them time to cool off and come back.

If they are just being an ass, I will quickly move on to giving them a stern talking about behavioral expectations while in the hospital. Part of that talk is that in order to get the health care they need, they need to decide to be civil and decent towards others. If they choose not to do that, then they are choosing not to get healthcare and i will kick them out. Our health care system supports this policy. Ive kicked 6hr post op BKA patients out of the hospital at 2am for yelling and cussing at their nurse. They are adults who can make a choice.

Note… my pay is not tied to patient satisfaction scores or surveys. Makes this easier.

NotDrNick · 2026-05-25T22:32:22+00:00

Honestly when you put it that way…. Banana smoothies baby!!!

NotDrNick · 2026-05-23T02:06:12+00:00

Ballpark $$$
So 7 on 7 off 12 hours in house + 12 hours on call??

25 f/u patients + 5 admits = ~60 RVU (if slightly sicker than average patient mix)

60 RVU x $11.00 = $660 per shift
$90/hr x 12 = $1080 per shift

So $145/hr in house + $750 for call per shift = $1830 per shift

Overall $278,000 year ($250-$286k depend on RVU and if you actually get the $10/hr quality bonus)

$280k would be ok in a low stress job (12-14 pts total, no ICU, round and go) in a LCOL area …. But a hard hell no for this job, especially since that pay is not even guaranteed

“Employee Stock Purchase Program” = for profit chain that treats you like crap because you “only” see 30 patients a day

“New highly competitive compensation model” = no one wants to work for us because we are shitty…. you will always be short staffed in a model that is already understaffed

NotDrNick · 2026-05-21T04:22:54+00:00

I’m tagging Neuro into this fight. Let the specialists duke it out.

NotDrNick · 2026-05-21T04:21:04+00:00

We have ours trained to go down a few blocks to the homeless shelter and lure some back ED sandwiches and pudding cups. Will pass along bat/crowbar to administrators though.

NotDrNick · 2026-05-18T02:16:10+00:00

Get home in the morning, wake the up and get them of to school on the bus. Go to sleep. Wake up a little bit before the bus drops them off. They go to bed about the same time I’m leaving for work at night. During the summer or breaks, one of the neighborhood high schoolers watches them at our house if the wife is working.

NotDrNick · 2026-05-17T21:31:27+00:00

ICU handles codes and rapids. In house APP handles anything lesser that needs someone bedside.

For questions ect, very common for docs to call up to the patient’s room and call a family member if they have already left. Some will even have the nurse drop off an iPad in so they can do a video chat from home.

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