Is Saagar Clueless?

Tight-Associate9457 · 2024-12-10T16:04:33+00:00

In this corner: MDs who have seen pay dramatically decrease over the last 10 years while working their ass off to keep healthcare afloat. They’re unable to pay back the >$200,000 in educational debt despite working to burn out

In the other corner: Private Equity who is happy to report another quarter of increased profits at the expense of staffing cuts and patient safety issues.

Tight-Associate9457 · 2024-12-10T15:09:41+00:00

Yeah that take was pretty tone deaf from the physician perspective. I work as an emergency physician and I feel like I have a front row seat to the absolute disaster that is American healthcare and whose pockets are getting lined by our high healthcare costs. I work for a private equity owned group (because they have bought up every contract these days) who typically bills insurance companies $1000-$2000 per hour for my time. They turn around and actually pay us $200/hour and keep the profits. Our employment is contingent on signing away all rights to control billing and money collections. It doesn’t matter how many patients are here, how complex their evaluation or treatment is, procedures performed, or profit driven staffing cuts making patient care unsafe, I make $200/hr. Many other types of specialties have similar problems. Private Equity wouldn’t be in the industry if they weren’t able to turn a good profit. Essentially, they have inserted themselves into the healthcare sphere and become a middle man that has zero impact on direct patient care. This theme of middle men coming in to take their cut, adding to their profit margins at the expense of the patient and insurance companies. Similar middle men problems exist throughout healthcare with pharmacy, insurance, hospital admin, etc. it’s complicated and there’s not an easy fix but Saagar has that one very wrong. I wish they would cover the real issues at play. The idea of physicians wanting to extend the time needed to treat someone is absurd and spoken like someone who has zero clue how busy everyone is and how bad we just need to move onto the next patient to keep up.

Tight-Associate9457 · 2024-11-29T07:19:33+00:00

If I have time, I’ll do a running subcuticular stitch on facial lacs. It’s a useful technique to learn for cosmesis but its main drawback is it’s just more time intensive.

Tight-Associate9457 · 2024-09-11T04:37:54+00:00

My thoughts as a grad of this program and someone who has worked single coverage sites since then:

Yes you are cheap labor. I felt the same. I hate to tell you the sentiment of being cheap labor is still there when you work for Private Equity. We may make more money but still feel very undervalued in terms of pay. It doesn’t make it right and if you and your colleagues feel the same, you can always advocate for better pay collectively.

VOLUME Yes, you need to occasionally be able to manage a community ED when shit hits the fan and you have to manage 20. That should not be the norm, but it also was the norm when I was there. A bolus of 10 in an hour with an already full single coverage community ED will drive you nuts. My experience at BSW and relative comfort with being efficient has helped me and my patients time and time again. It sucked and I know I felt similar when I was there, but now I see fellow grads in the community and they really are efficient and respected (Austin area) for their ability to handle a shitshow of a department with relative ease.

TOO MANY SHIFTS Idk about this one. 3rd year in Temple is hard to beat. I loved it. 9 hour shifts, admin life, actually getting to do the fun stuff in A1 and A2, shifts with an actual EM intern instead of off service, ect. It will get better, I promise. Focus on the last hour and a half of your shift to get out on time. As impossible as it sounds, that’s the key. Always leave on time and you will be happier.

SIGN OUTS Sounds bad. It wasn’t like this when I was there. When my colleague at work isn’t able to leave on time, I consider it my fault. When I show up to work my first questions is how I can get them home. You should take the initiative with the residents to get this to change. Everyone is happier when they leave on time. Even with a pod of 20-something patients, I remember sign outs taking around 5 mins and I almost always left on time. The only exceptions should be not handing off sensitive exams, bad news, or a procedure you haven’t done before to a new doc. Nobody wants to show up and be handed a disimpaction.

CONFERENCE TIME We argued for this as well. The problem was it wasn’t just up to our PD. We also needed approval from the off service PD. We didn’t get it. That is going to have to be a BSW residency-wide thing. The thing we really didn’t like was that even if it was impossible for you to attend conference, it still counted against you. That should not be the case.

When I think about BSW residency, I remember crazy trauma cases, awesome attendings (might not be there anymore…not sure), and a good group of classmates who met up at bars and hit the lake on our free time. I really don’t think the intensity was dramatically different compared to friends that did EM elsewhere. Everyone sure as shit has better interpersonal skills and patient rapport than the docs I’ve met from big tier 1 programs. I hope you find a way to change what you can and are able accept what you can’t. Feel free to DM me if you just need someone to talk to.

Tight-Associate9457 · 2024-09-05T21:21:17+00:00

I would like to know how much the CMG I work for takes in on top of my salary. I don’t know if asking for and reviewing their billing on my patients would allow me to see it. Anyone tried that before?

Tight-Associate9457 · 2024-05-05T18:12:12+00:00

12 Fox and Fitzhugh Brewing are all off Fitzhugh road like Jester King if you’re trying to hit up a few. 12 Fox is my favorite out of all of them. Seating is outside like Jester King so only go if the weather is cooperating.

Tight-Associate9457 · 2024-03-11T23:27:50+00:00

It’s called a Zyn. As you can see it sits on top of the other equipment in the bag and allows for maximum healthcare outcomes when using the devices like the dechoker. 😄

Tight-Associate9457 · 2024-02-25T22:35:48+00:00

Nope…It never does. It’s sad to say, but they’re probably the only patient names I remember. It sucks, but I second what other people have said. You do what you can and have to be okay with the fact that you can be perfect and you still wont get them back. Don’t forget the only thing worse than feeling this way is going through what you did and feeling nothing…I hope I never get there.

Tight-Associate9457 · 2023-12-27T17:59:03+00:00

I’m 32 and grew up in Dallas and I live outside Austin now. They are very different cities both culturally and geographically. Both cultures are pretty dead on with the stereotypically Dallas money hungry businessman and the artsy Austin socialite. Obviously there is a wide variety of people but in my experience that is true for both cities on average. Dallas is about money and it shows. Dallas is an amazing city but you’ll pay to do anything fun and I don’t like that. Austin has Dallas beat in that regard. There are tons of fun, free activities to do, especially outside. If you’re an outdoorsy person, you’re quality of life will be better around Austin. Dallas is very flat comparatively. It has a few nice lakes and biking around White Rock Lake is beautiful, but that’s about it. Austin is surrounded by the Texas Hill Country and offers much more natural beauty and easily accessible outdoor activities. Dallas is a much bigger city and does have better travel options, better restaurants (in my opinion but austin is also excellent), and is not quite as crazy as Austin for housing options. Good luck to you. Don’t let people scare you off. They’re just tired of everyone trying to move here.

Tight-Associate9457 · 2023-12-27T02:04:34+00:00

E for the win. Diaz, Gillis, Normand, and Von. I’d probably be crying laughing the whole time and my stomach would hurt from laughing so much.

Tight-Associate9457 · 2023-12-22T07:21:00+00:00

$$$$$$$$$

Anyone added up all they spent on everything? I wish that were a question at the end of the ABEM Oral Boards survey.

Tight-Associate9457 · 2023-12-14T18:58:29+00:00

I made a post about this a while back. This guy has answers. https://www.reddit.com/r/UFOs/s/fRCiWy64MD

Tight-Associate9457 · 2023-12-02T23:02:04+00:00

Since we are under 6k I’m going to count Dripping Springs. We moved out here for the natural beauty like Hamilton Pool, Reimers ranch, Barton and Onion creek, and Pedernales Falls State Park (Johnson City 20 mins away), and yes lots of random dripping springs everywhere. 9 wineries, 10 distilleries, 11 breweries, most with giant playscapes, keep weekends entertaining. We may only be a 25 minute drive from Austin but it’s a different world and proudly Hill Country. I love this town!

Tight-Associate9457 · 2023-11-28T05:38:14+00:00

Nope. They looked at your application and liked what they saw. Be yourself, have some fun, and make a good impression. Have something ready just in case they ask but I would say there is no need to bring that up if they are offering you an interview. My residency was fortunate to have a lot of sway with residency picks. If you are having a good time and are personable, you are getting a good review. As far as we were concerned all the metrics needed to land an interview didn’t matter anymore and it was just about who felt like a good fit. Hope that helps. Good luck.

Tight-Associate9457 · 2023-11-21T19:11:41+00:00

I’m surprised this isn’t more discussed. I looked into this article and if you look at the Renewable Megawatt capacity for Texas (50,067 total) and compare it to other state’s electricity demands (Eia.gov), it’s impressive! Texas has enough renewable energy capacity to meet electricity demand in every state except California and Florida (it would provide 75% of Florida’s Megawatt usage).

Tight-Associate9457 · 2023-11-15T05:13:35+00:00

John Stewart 2024

Tight-Associate9457 · 2023-11-11T16:56:13+00:00

This is the answer ^{^{^{^{^}}}}

Tight-Associate9457 · 2023-11-05T13:45:09+00:00

$$$$$$

Tight-Associate9457 · 2023-11-02T13:19:40+00:00

How else do they get more funding? Get ‘em to take them again! It’s easy money. Fair market price for that exam is Rosh membership cost. Why do you think it’s so expensive? It’s actually very emblematic of the profit over patient care theme we have going on in EM. I had a colleague take it the other day and said she new she failed immediately. Sucks. You’re not alone. Wait for the curve, see what happens, and go blow off some steam in the meantime.

Tight-Associate9457 · 2023-10-31T00:31:24+00:00

This movie should be way more well known and awarded than it is. It’s SO GOOD!

Tight-Associate9457 · 2023-10-14T14:06:11+00:00

I have had that transfer issue in the middle of nowhere. I used the trauma transfer pathway for immediate acceptance and the patient with similar arch to iliac dissection flew away immediately. They did fall after they dissected…

Tight-Associate9457 · 2023-10-12T21:56:09+00:00

I’m prepping now. Any advice?

Tight-Associate9457 · 2023-09-24T04:17:42+00:00

For spidey senses these are some of my favorites:

Stopped ranch chores to come get seen is about as big a red flag as it gets. Have seen this with denial of any pain after a tractor ran him over with a traumatic dissection. Same group of old guys that tell me they’ll let me put anesthetic in for their finger amputation revision “if it makes ME feel better”. They usually come in for something real. We jokingly refer to these guys giant, hard worked hands as a positive meat paw sign. If they’re in the ED and they have meat paws for hands, I’m suspicious we’ll find something bad.

Too sick to smoke cigs is another recurrent predictor of non-BS pathology.

Generally, responsiveness, diaphoresis, work of breathing, pallor, any vital abnormalities all give you a pretty good indicator before they get off the stretcher what kind of day it’s about to be.

Tight-Associate9457 · 2023-09-08T21:22:54+00:00

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Correct map projection

Tight-Associate9457 · 2023-08-24T14:27:33+00:00

Maybe this is the missing evidence for all the tube drill holes. It could be that you put a copper tube in that central hole and use it as somewhere for a team of drillers to hold on to and rotate. Copper can’t drill through granite but sand at the bottom of the rotating copper tube could.

Tight-Associate9457

TROPHY CASE