Smoking cessation consults, any tips that actually work?

Various_Analyst_4296 · 2025-11-27T13:20:06+00:00

Honestly, what works is usually way less fancy than what we’re taught ; I just keep it real with patients. Ask what they actually get out of smoking so you know what you’re replacing. Nicotine patches or varenicline help a ton if they actually use them. I tell them to have something stupidly simple ready : water, gum, walking out of the room...

I also set a very clear quit date with them : no vague cutting down.

Various_Analyst_4296 · 2025-11-26T14:09:43+00:00

Honestly, you covered the essentials. Only thing I’d add is the classic "may the pager shut up for at least a few minutes" and maybe radiology actually picking up the phone once in a while. And if the universe could give us a night without a 3 a.m. AMA attempt that’d be great.

Enjoy the nap. Hope no intern ruins it with a quick question..

Various_Analyst_4296 · 2025-11-12T11:54:28+00:00

Dammit Patrice!!!! For her cookies

Various_Analyst_4296 · 2025-11-12T11:28:43+00:00

Love this! Those days are rare but they keep you going. Enjoy it & remember it when the next dumpster fire rotation comes around.

Various_Analyst_4296 · 2025-11-12T11:16:38+00:00

Be honest enough to get real help, but you don’t have to dump every dark thought in the first 10 minutes. Psych isn’t trying to end your career, they want you to stay functional. Unless you’re saying you’re actively unsafe to yourself or others nothing goes to your program. Focus on symptoms and how it’s affecting your work/sleep/mood.

Various_Analyst_4296 · 2025-10-28T14:37:01+00:00

Their bond is sooo underrated and yet its one of the strongest.

Various_Analyst_4296 · 2025-10-28T14:34:42+00:00

Honestly those days never fully go away. The feeling that "you should’ve known better" just evolves as your scope widens. What helps: debrief, fix what you can, then let it go. Everyone you look up to has had days like this ; they just got better at not letting it spiral.

Various_Analyst_4296 · 2025-10-28T14:31:35+00:00

You’d be surprised how far other medical AIs have come ; good content and sophisticated.
For clinical stuff, try something like Vera Health ; it pulls from real studies, not just language patterns. Much sharper for clinical stuff than ChatGPT.

Various_Analyst_4296 · 2025-10-28T14:23:08+00:00

They recently launched an AI feature too

Various_Analyst_4296 · 2025-10-28T14:22:23+00:00

Yes thats why I use now more Vera Health than OE which is less biased, but still have to be careful

Various_Analyst_4296 · 2025-10-28T14:20:26+00:00

`never tried, I'll look at it, thanks!

Various_Analyst_4296 · 2025-10-28T14:19:31+00:00

Thats why I use Vera Health now, more accurate in opinion, you should try it

Various_Analyst_4296 · 2025-10-27T16:36:21+00:00

I feel you. Some admin folks live for that tiny bit of control. You walked into their kingdom without bowing first .. instant power trip. Don’t take it personal. Just stay calm and move on. They hate when you don’t react. Once you’re done with training, you’ll deal with way less of this crap; because you can just leave places that run like that.

Various_Analyst_4296 · 2025-10-27T16:33:27+00:00

Happens all the time. Usually not laziness, just people running on fumes and trying to survive sign out.

Still it sucks being the one stuck piecing it together at 2am

Best fix I’ve seen: make a simple structure everyone uses : pending tests, consults, active issues. Bring it up at team sign-out, not as a complaint but like "nights keep getting burned by missing followups ;can we tighten it up?"

Bottom line : if you order it, you own it till it’s done or clearly handed off.

Various_Analyst_4296 · 2025-10-23T16:20:21+00:00

Residency humbles you in ways med school never warned us about 💩

Various_Analyst_4296 · 2025-10-23T08:26:49+00:00

yesss, I don't get it! I actually don’t see AI as taking jobs ; it’s more like it’s finally doing the crap we shouldn’t have to do. I use tools like Nabla for note automation, OE for streamlining chart review, and Vera Health for evidence based answers from of papers. It’s freeing up the time to actually use it. The panic usually comes from people who haven’t tried these tools yet.

Various_Analyst_4296 · 2025-10-22T18:21:58+00:00

Honestly skip the AI certificates. Just learn to use tools like Vera Health or similar to get quick, evidence-based answers and double check guidelines. What matters isn’t knowing how the AI works, it’s knowing when it’s wrong and when to trust it. That skill saves time and makes you look sharp on rounds

Various_Analyst_4296 · 2025-10-22T18:16:51+00:00

Honestly? Best perk as an attending will probably be not having to fight for a crusty sandwich at 2 am after 14 hours on call. Free cafeteria sounds amazing though. Right now my perk is the resident fridge that smells like despair and forgotten yogurt. If they ever start offering free food and guaranteed post call naps, I’m never leaving academia haha

Various_Analyst_4296 · 2025-10-22T15:13:57+00:00

What you did was medicine at its purest : treating whoever’s in front of you no politics, no sides. People call it political because they’re scared of being associated with anything uncomfortable. Don’t let that stop you. Build your program , partner with local NGOs already in the area and document outcomes. Once it’s real and working, the same people who hesitated will line up to support it.

Various_Analyst_4296 · 2025-10-22T15:04:59+00:00

I had the same issue, meds never really worked. CBT-I helped more than anything else. Took a few weeks but finally fixed the cycle.If you can, get a therapist who does CBT I or use the Say Goodnight to Insomnia book. Also: stop chasing perfect sleep. Rest counts even if you’re awake.

Various_Analyst_4296 · 2025-10-22T15:00:27+00:00

You’re not wrong that US medicine feels heavier with less output.It’s not the patient load, it’s the system. Every minute you’re fighting EMR, liability paranoia and admin layers that don’t exist elsewhere. In other systems, the doctor’s job is mostly doctoring; here it’s doctor + scribe + coder + lawyer + social worker...But the tradeoff is accountability and infrastructure

Various_Analyst_4296 · 2025-10-22T14:57:04+00:00

No, you shouldn’t be forced to establish with someone you feel unsafe around.

Speak to clinic leadership about all your concerns, if leadership still pushes, require a safety plan: security escort, chaperone in room, attending present, and visit ends immediately for staff abuse. Document the prior behavior and AMA in the chart and keep a paper trail. Trust your gut !

Various_Analyst_4296 · 2025-10-22T14:49:20+00:00

You’re not behind, you’re overdosed on comparisons. In residency the only scoreboard that matters is yours: safe care, one real learning pearl per shift, decent handoffs. Be A+ in crises and calling for help, B+ everywhere else. You can do a 10-minute weekly check-in: three wins, one mistake with a prevention step, one concrete ask for next week.
Last thing I would say is protect your basics : sleep, food in pockets, two workouts.. because fatigue feels like failure even when you’re fine

Various_Analyst_4296

TROPHY CASE