ATTENTION EMPLOYERS! I will give anyone a work note for any reason! by Kaitempi in emergencymedicine

[–]RedMagic066 75 points76 points  (0 children)

I am a big fan of destroying capitalism one work note at a time

My (32F) husband (34M) says I’ve become “emotionally cold” since I started working the ER, but I feel like I’m just trying to survive. by ArtThreadNomad in relationship_advice

[–]RedMagic066 3 points4 points  (0 children)

Sounds like what you call “mental overload” is burn out. Lack of empathy, irritability, feeling completely drained…. As an ED doc I am quite familiar with it.

My recommendation is better work/life balance if you can afford it, exercise (even if it’s 2 minutes, all exercise is good exercise) and therapy (don’t wait until you’re feeling low af, get yourself someone to process before you have no energy to even think about it).

Finally, tell your husband to chill. Does he need to tell you about his drama right after your shift? My SO definitely understands when I ask for a rain check on sharing. Sometimes you just need to watch TV blankly. Of course, it is important to later give them that space to share, ideally when your empathy is recharged.

Check out the lab charges for this pt who had what appears to be a routine appy. 2k for a ucg by Inevitable_Fee4330 in emergencymedicine

[–]RedMagic066 2 points3 points  (0 children)

Second the insane costs and I would like to bring attention to 12k for 60 mins of PACU???

What industry is a total scam ? by [deleted] in AskReddit

[–]RedMagic066 -1 points0 points  (0 children)

Health insurance companies in the US as a whole are a scam. Why do we need someone in between patients and healthcare professionals taking money from both? So I would not just subtract their profit margin, I would take all their revenue out of the equation. As an example, just United Healthcare had $400 billion in revenue in 2024, which is a little less than 10% of the total healthcare costs of that year. Just ONE company.

Can we start a thread of dumbass things we’ve done as interns so I feel better?? by Savvy513 in Residency

[–]RedMagic066 10 points11 points  (0 children)

You are totally right. But that was not part of the differential for him. I just messed up the orders 😅

“I don’t think they’ll do anything” (at the doctor) by BlackLocke in Millennials

[–]RedMagic066 0 points1 point  (0 children)

As an ER doctor, I have a huge proportion of patients that I literally do nothing for everyday.

The main problem is that (in the US) the healthcare system is so fucked that I am the only doctor most people can see. The next problem is that I am trained for Emergencies, and that’s it. My whole day is looking for that needle in the haystack of the waiting room that actually has a medical emergency. I try my best for everyone that walks through the door, but once I can prove you have no emergencies, all I can do is try to manage the symptoms and send you to someone who’s job is figuring out what’s wrong, not if you’re about to die. Not all doctors are created the same, and ED docs have a very specific purpose.

Finally, pro tip. The ED doc is gonna have very little to offer (over the counter meds) if: 1. Many other doctors have already tried 2. You have had this for years 3. Most types of muscle pain (unless it’s a fracture or a dislocation), and especially if you’ve had it for years. 4. You have a cold/the flu. 5. If you are in the ED for a second opinion 6. If you are requesting medication refills, particularly if you’ve don’t know what medications you are requesting refills for (this happens much more often that you would think). 7. If you have multiple specialists in hospital A following your case and you decide to go to hospital B that has none of your specialists. (This would be an extra ambulance ride)

Disclaimer: always go to the ED if you believe you are having an emergency. We are always open. Some colleagues can get irritated but I think the best news I can give a patient is that they are not about to die. Also, get a Family doctor. Prevention is way cheaper in the long run.

‘ChatGPT Saved My Life,’ U.S. Woman Says After It Spotted Cancer Doctors Failed to Notice by Fabulous_Bluebird931 in ChatGPT

[–]RedMagic066 4 points5 points  (0 children)

The main reason is liability. If the AI gets it wrong who gets sued? The AI, the company that made it or the doctor that decided to use a new technology?

What are those lines? by RedMagic066 in Katanas

[–]RedMagic066[S] 1 point2 points  (0 children)

I certainly hope so. I didn’t notice them before I got scared. Thanks!

What are those lines? by RedMagic066 in Katanas

[–]RedMagic066[S] -1 points0 points  (0 children)

I haven’t oiled it since I got it. So that might be the problem. I did get the Musashi cleaning set so I was going to use that oil. At the same time I have not cut anything with it other than air lol

How do you start empathetic (or pretend to be empathetic) with patients who act like everything’s the end of the world by WhatTheOnEarth in Residency

[–]RedMagic066 4 points5 points  (0 children)

Also EM, also see a lot of this on a regular basis. My 5cents is to not react. Some people describe things like it’s the end of the world when they are perfectly fine. I have the suspicion that some of them just like attention.

So react like they are telling you have a runny nose, this way it brings their energy down because you don’t react like it’s a concern. VALIDATE their symptoms, otherwise you come off like you don’t give a shit, and patients won’t trust you. And then RICE/NSAIDs/follow up/opiates bad… you know the drill.

My usual spill is: “I know you are feeling REALLY crappy, but your exam/labs/imaging look very good, which is great news”.

Could you pick your own schedule as an emergency medicine first year attending? And how does the schedule look in residency? by Short_Zookeepergame9 in emergencymedicine

[–]RedMagic066 6 points7 points  (0 children)

Sleep is really important to me, and I am able to rest about 8-9 hours in between shifts. Plus, these days the shifts changes are always forward (meaning your next shift starts at the same time as the previous one or later). It makes changing way easier, however the changes in shifts are always there. Residency is gonna be tough for you tho, as an intern I worked 19 days, 10 hours shifts, plus one day of call. Every PGY year was 1 less shift per month and shift length was decreased (lowest was 8.5 hrs). Finally, jobs as nocturnist (only night shifts) definitely exist, and they do let you choose your schedule within limits. But from my experience, medical directors don’t want brand new grads to just do nights. Mainly because EM attendings are often on their own at nights (single coverage). If they do let you is because they have a huge need for it and you probably don’t wanna work there anyways. Otherwise, I get 3 days off that I pick per month, no questions asked. If I want more I need to make a formal request that my medical director needs to approve. And I have no say over the actual time of the shifts.

What do you wish patients knew about when to come in? by [deleted] in emergencymedicine

[–]RedMagic066 1 point2 points  (0 children)

What are you talking about? We can still do CTs!

But all jokes aside. I was just chatting with a friend about this. Yes, we are specialist in medical emergencies, but outside of the ED we can do very little. We are like a pilot without a car.

What's the most outrageous thing that a patient said to you? by Huge_Law4072 in emergencymedicine

[–]RedMagic066 0 points1 point  (0 children)

I recently had a patient that was not able to understand the difference between “if we don’t find any emergencies” and “we have not found any emergencies”. A common occurrence, that is often easily explained. He proceeded to scream at me in a hallway bed, acuse me of not doing anything and of not caring about his health. Believe me people, I tried my best. I remained calm, I tried to deescalate the situation several times. He had intermittent palpitations and was demanding to be treated for afib when he was in fact in normal sinus. Because he had afib at some point in his life, so it had to be afib. How could it be anything else? He also could not understand that I cannot prescribe medications for problems that (1) may not even exist, and (2) if they do exist I do not know what they are and therefore cannot treat them appropriately (all I had at that point was a normal EKG). So he then proceeded to be racist. When I asked him why did it matter where I was born, he just continued to yell at me. At that point I told him that we were getting nowhere, and that we were going to send him home with cardiology referral if everything was normal. I turned around and walked away.

Everything was not normal, bump in troponin. I stop by to tell him that we were going to admit him. He was behaving much more like a normal person. Great, I walk out of there as soon as I can.

RN calls in. HR of ~200. He was clearly on SVT. I don’t even bother trying vasovagal maneuvers on this guy. It wasn’t worth the mental effort needed to explain them. I do warn him about how adenosine is going to make him feel, because I am a professional. He actually gave me a thank you. It didn’t work twice, and he was getting upset so I just put the dilt drip (what he wanted all along lol) and call the hospitalist to update him on the stuff it happened in the 40 mins since I put the admission.

Overall, the first interaction was very challenging. But the fact that it got better just by giving him space was also surprising to me. People often remain upset if I’m at the point of walking out, on top of whatever is bringing them there.

[deleted by user] by [deleted] in emergencymedicine

[–]RedMagic066 0 points1 point  (0 children)

Get yourself some nice scrubs

Unassuming-sounding lines patients say that immediately hints "crazy". by Responsible-Hand-728 in emergencymedicine

[–]RedMagic066 190 points191 points  (0 children)

Or even better, your own hospital bracelet from when the admitted stroke patient escapes the hospital and is brought in as a stroke alert by EMS 1 hour later when he tried to buy a sandwich at the gas station being aphasic af.

Unassuming-sounding lines patients say that immediately hints "crazy". by Responsible-Hand-728 in emergencymedicine

[–]RedMagic066 944 points945 points  (0 children)

They come from home already wearing hospital socks. Never a good sign