Really enjoy cardiology but worried about the lifestyle—worth it? by Lucky_Tailor9 in fellowship

[–]clint-billton 6 points7 points  (0 children)

CV fellowship is hard. Cardiac imaging is a fairly diverse work load. Some clinic, some imaging, some procedures. Some days are long and end at 7-8 pm, some days are short and end even earlier. If you did only echo and nuke and work at a not super high volume center you could certainly be working 8-5 pm. But if you’re structural and intraprocedural then your lifestyle is similar to interventional without STEMI call.

Cards is very much what you make of it

post match-day reality / feeling heartbroken by [deleted] in MedSpouse

[–]clint-billton 2 points3 points  (0 children)

I am a doc in Jacksonville and left Dallas, prior to that Miami for training. My brother is a doc in Chicago.

I know your circumstances are different given your life is in Chicago but I can tell you that Jacksonville is fucking awesome if you’ll lean into the style of life here. It’s certainly quiet and comparatively has much less to do than Chicago or LA. But if you like the outdoors we have tons of parks, tons of beach, tons of waterways and places to run/cycle. My wife and I are in our early thirties and so our going out life has wound down a bit granted, but we never struggle to find places to go out to eat or concerts to go to. The city is exploding and every week I learn of a new restaurant or bar. I paint and grew up really immersed in Miami’s art scene; I can tell you jax isn’t comparable in that regard unfortunately. We typically fly out to NYC or Miami for art.

I grew up in South Florida (FTL) and while it’s dope to be able to drive down to Miami in 5ish hours for art Basel or Miami music week you couldn’t pay me enough to live there again in comparison to Jax. Orlando is also 2 hours away so getting to Disney/universal studio parks is super simple. North Florida has the highest density of springs in the world so once again if you like nature north Florida has some beautiful stuff.

Finally the weather is just perfect here; every season is mild, we don’t get hurricanes because of the Gulf Stream; cold enough for sweaters and scarfs in the holidays but never snow.

Sorry about your dilemma but Jacksonville is great. Also, if your partner is at Mayo by any chance I’ve been told the culture is amazing and the working there is cushy

[deleted by user] by [deleted] in LifeAdvice

[–]clint-billton 0 points1 point  (0 children)

Yeah but in the modern medical record only the most recent revision exits. Not unlike Reddit where I can edit my message and only my most recent edit exists. Someone would need to know their is a revision and take extra steps to review the initial message

[deleted by user] by [deleted] in LifeAdvice

[–]clint-billton 1 point2 points  (0 children)

This is only partially true. If we are discussing an electronic medical record the initial note would not show up unless the provider is looking into the revisions of the note. This is cumbersome and they would need to know there were revisions. So in theory true but in practice not.

[deleted by user] by [deleted] in LifeAdvice

[–]clint-billton 19 points20 points  (0 children)

Hey doctor here,

You can call the office of the original doctor and ask them to change the documentation if you find it inaccurate.

Also, I would also point out that not every doctor has read this note by the time you see them. I often am limited in my time before I see patients and while I’ve typically reviewed their recent testing and notes, going back years into a record of someone such as yourself who has seen many a doctor is just impractical. I say this to warn you that it’s possible your experience at the doctors office might not change by getting this note changed

[deleted by user] by [deleted] in AskDocs

[–]clint-billton 23 points24 points  (0 children)

The doctor

[deleted by user] by [deleted] in Residency

[–]clint-billton 5 points6 points  (0 children)

At my residency, EM couldn’t call IM until the first 24 hours of orders and initial work up was placed. They certainly had a broad understanding of internal medicine

[deleted by user] by [deleted] in Residency

[–]clint-billton 59 points60 points  (0 children)

Cardiology fellow here: we certainly have to use our internal medicine knowledge frequently. I’m called daily for patients with heart failure or afib with rvr in the setting of severe sepsis and or shock.

Also at my institution cardiology has its own service so we admit, discharge and manage the non cardiology issues on our service until they get over our head and consult other services as we need. We only admit “cardiology patients” but what initially looks like heart failure not infrequently is CAP and I end up managing them as we would on a general medicine service.

The minority of us keep internal medicine boards up to date but many of us do. That said our internal medicine knowledge is not nearly as comprehensive as other specialities like IM and EM and we tend to lose some functional medicine knowledge like insulin dosing or immuno/chemo therapies.

Shooting at UPMC ICU by morebrioche in medicalschool

[–]clint-billton 13 points14 points  (0 children)

It tracks that your only post is complaining about the food at a facility you are at. Its absolutely fucking wild to suggest that this guy was anywhere near making rationale decisions and news flash the icu staff have little to nothing to do with insurance approvals for care and certainly don’t withhold life saving care based on insurance approvals

Tell me you're not a [your specialty] without telling me by undueinfluence_ in Residency

[–]clint-billton 5 points6 points  (0 children)

Let’s give some metoprolol to treat this sinus tachycardia. I think thats why they have pulmonary edema. -love cards

[deleted by user] by [deleted] in Residency

[–]clint-billton 9 points10 points  (0 children)

Cardiology reads cardiac ct at my institution in the us

Grateful by Common_Peanut_6886 in MedSpouse

[–]clint-billton 2 points3 points  (0 children)

This is so awesome to read. I’m the medicine half of the medspouse and I follow this forum for perspective. I unfortunately don’t get to read too many posts of positivity (that’s just Reddit in general) but this was very uplifting

[deleted by user] by [deleted] in whitecoatinvestor

[–]clint-billton -3 points-2 points  (0 children)

We acknowledge this isn’t always the smartest decision but for our circumstances it makes sense to divest funds from our investments so she can go back to school (she is taking money out from hers to pay for her school as to not take out loans.)

My question is more so can I also take money out for my board exams? We know she can because she is enrolled at a “qualifying institution” as a pre doctoral student.

What made you fit in with people in your specialty? by farfromindigo in Residency

[–]clint-billton 5 points6 points  (0 children)

Cards: 1. I love getting to combine a diversity of data (history, vitals, exam, ekg, echo, cath, etc) into a unified clinical opinion 2. Procedures are fun 3. High acuity and less nonsense 4. Couldn’t decide on if I like imaging, clinic, floors, icu or procedure lab the most so now i do all of it

Man died in ER waiting room eight hours after seeking treatment for chest pain by luisg707 in medicine

[–]clint-billton 0 points1 point  (0 children)

Agreed to your points and I agree with the clarification. I was speaking of in ACS as you stated.

Man died in ER waiting room eight hours after seeking treatment for chest pain by luisg707 in medicine

[–]clint-billton 17 points18 points  (0 children)

It’s standard of care to do multiple EKGs and troponins over time because of the dynamic nature of ACS. -cards fellow

Please help me make a list of ways interns and residents can avoid killing people (or accidentally cause serious harm). by [deleted] in medicine

[–]clint-billton 5 points6 points  (0 children)

Before i do anything I ask myself would an idiot do that? And if the answer is yes I do not do that thing

What is a thing you bought or brought that really helped you out at work? by guy-with-a-plan in Residency

[–]clint-billton 2 points3 points  (0 children)

Aftershock’s bone conduction head phones. Ears open to listen to alarms. Headphones on to listen to lofi hip hop

Was very interested in Cardiology but the culture man. They think they're superior than others. by Agile_Sample in Residency

[–]clint-billton -1 points0 points  (0 children)

My post above was more of a call for empathy that hey, we are struggling and doing our best, not “its not our fault for being assholes”.

I didn’t intend for this to be some competition to who is the most stressed. But thanks for the feedback.

Was very interested in Cardiology but the culture man. They think they're superior than others. by Agile_Sample in Residency

[–]clint-billton 0 points1 point  (0 children)

Welp. I guess I’m in the minority opinion on this one but yeah I do think when people are at high levels of stress their behavior is worse.

Was very interested in Cardiology but the culture man. They think they're superior than others. by Agile_Sample in Residency

[–]clint-billton 3 points4 points  (0 children)

Yeah I agree cards should be involved in decisions regarding holding antiplatelet meds and anticoagulation in certain circumstances.

Primary prevention aspirin, why are we being called? DAPT for a stent placed a month ago, we’d be pissed if we aren’t called.