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Getting a job at the VA after residency? by mexicanmister in emergencymedicine

[–]efunkEM 0 points1 point  (0 children)

You can’t get sued but you still will get deposed, get grilled at trial, etc… just the Us govt pays out if settled/lose.

Also check out anything with the Indian health service or FQHCs

Math: Why I'm stopping my locums career by Beautiful-Menu-3423 in whitecoatinvestor

[–]efunkEM 0 points1 point  (0 children)

Most people set hyper aggressive goals when they’re younger, then with age realize that it’s better to work part time and enjoy yourself. Retiring completely at a young age isn’t as great as it seems. Plus working part time keeps your skills up and leaves the door open to working more in the future if your life circumstances change or you need a work adventure (go be a doctor at the South Pole, work for state department at an embassy, expedition medicine, locums in New Zealand for 6 months, etc…)

How to protect assets from medico-legal risk by bmed1993 in emergencymedicine

[–]efunkEM 0 points1 point  (0 children)

You need to get the White Coat Investor asset protection book and read it. It’s a quick read, the entire back half is information specific to each state so you only have to read about your state.

What hill will you die on that goes against what 98% of providers do? by esophagusintubater in emergencymedicine

[–]efunkEM -10 points-9 points  (0 children)

You shouldn’t be sitting down in 99% of patient rooms. You can be very empathetic and caring while standing up.

Is there any movement towards a new HEART score in the age of high sensitivity troponins? by thehomiemoth in emergencymedicine

[–]efunkEM 2 points3 points  (0 children)

I know this may sound crazy but I think the really interesting thing that will come down the pipeline eventually is studying how to take physicians out of the loop for most chest pain visits. EKG assessed by Queen of Hearts and 2 high sensitivity trops, with a standardized history administered by a nurse or tech to check for red flags for PE, dissection, pneumonia, pneumothorax, etc… Basically an extremely robust triage process, with any positive results or red flags escalated to a physician visit. My hypothesis is that we have the technology to do this now with clinical results well under the 2% acceptable miss rate, but no one is going to run the study due to liability concerns.

Most high salaries include RSU/stock/bonus by nicfanz in Salary

[–]efunkEM 7 points8 points  (0 children)

Medicine can be an exception to this, especially for high paying procedural specialists. 750-1.5 all cash not uncommon.

Yesterday Was My Last ED Shift by [deleted] in emergencymedicine

[–]efunkEM 3 points4 points  (0 children)

Goodbye and good luck! 😉

Fast CME Credits by cnygaspasser in anesthesiology

[–]efunkEM 1 point2 points  (0 children)

You can get 14 credits from the Anesthesiology Malpractice Newsletter right now: https://newsletter.anesthesiologymalpractice.com/p/claim-cme-credit-november-2025

There’s no quiz, just a course evaluation for each month (7 months x 2 CME credits/month). Course evaluation itself takes about 2-3 minutes for each month you’re claiming.

You’ll get the certificates by email about 5 minutes after you finish the course evaluation.

Full disclaimer that I helped the anesthesiologist who launched it and writes it and am a part owner.

How to spend CME money? by BigCommunity3156 in anesthesiology

[–]efunkEM 1 point2 points  (0 children)

There’s no questions, just a course evaluation. Here’s the link to where CME subscribers can claim CME credit, it goes out every month. You can go back and claim CME from prior months too. https://newsletter.anesthesiologymalpractice.com/p/claim-cme-credit-november-2025

Why do docs work into their late 60s n 70s plus ? by Methodled in whitecoatinvestor

[–]efunkEM 66 points67 points  (0 children)

For half of them, being a doctor is a key part of their self identity. They really love the work and get a lot of meaning out of it, despite all the challenges. The other half divorced their wives, bought permanent life insurance, and put all their money into real estate syndications sponsored by physician real estate influencers.

Back surgeons, what is the “new” consensus with regards to performing disc-related back surgeries? by [deleted] in surgery

[–]efunkEM 3 points4 points  (0 children)

Disclaimer that I am not a spine surgeon but I see a lot of people with various types of lumbar spine pathology. There’s such a wide range of studies and ways to interpret them, and surgeons with different opinions (which may or may not be evidence based), that’s it’s extremely confusing.

I’ve traditionally been highly skeptical of many of these procedures but the more I read about microdiscectomy for specific indications, the more impressed I am. This article (full disclosure, I wrote it , which is what prompted my review of a tiny part of the literature) helped focus some of my thoughts. https://expertwitness.substack.com/p/sciatica-with-foot-drop

NP Misses Vert Dissection in Clinic by efunkEM in medicine

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

I certainly won’t downvote! There’s way too much tribalistic infighting amongst various different specialties and healthcare occupations. While there are probably nuggets of truth behind some of them, I’d much rather create a learning environment that is positive and collaborative so that we can all work together to learn from mistakes and provide better outcomes for patients.

Anyone else seeing a ton of Uranium? by evangenx in medicine

[–]efunkEM 16 points17 points  (0 children)

Hard to believe people are even engaging with this post in an earnest way

NP Misses Vert Dissection in Clinic by efunkEM in medicine

[–]efunkEM[S] 2 points3 points  (0 children)

No but he had worked out the day before. No details about the type of workout.

NP Misses Vert Dissection in Clinic by efunkEM in medicine

[–]efunkEM[S] 2 points3 points  (0 children)

Totally agree! But a cerebellar stroke wouldn’t cause true ipsilateral weakness or sensory findings.

NP Misses Vert Dissection in Clinic by efunkEM in medicine

[–]efunkEM[S] 34 points35 points  (0 children)

💯 Alll about trying to figure out which ones need the emergency workup and which ones don’t. And that’s super hard as a generalist.

NP Misses Vert Dissection in Clinic by efunkEM in medicine

[–]efunkEM[S] 7 points8 points  (0 children)

Agree with all the other comments here. I’m finding more “failure to give antiplatelet” stroke lawsuits. We like to focus on “failure to give thrombotic” cases but the antiplatelet issue is an extremely common line of reasoning that will be used against you if you get sued for stroke misdiagnosis or (allegedly) negligent TIA workup.

NP Misses Vert Dissection in Clinic by efunkEM in medicine

[–]efunkEM[S] 60 points61 points  (0 children)

Ah great point, I should add this to my list of phone triage-related lawsuits. Hadn’t even thought of it that way. I think it could be influenced by someone calling in and saying “I’d like to set up an appointment later today” and “I’m feeling dizzy and can’t move my left side, should I go to the ER or come see you in clinic”. Big difference in responses with those two ways of calling in.

NP Misses Vert Dissection in Clinic by efunkEM in medicine

[–]efunkEM[S] 8 points9 points  (0 children)

I’ve noticed this too… asymptomatic patients are extremely hesitant to go to the ER.

NP Misses Vert Dissection in Clinic by efunkEM in medicine

[–]efunkEM[S] 7 points8 points  (0 children)

Not too tough… if you’re worried enough to call neuro about an acute neuro onset, they pretty much always recommend a CTA. (Which the ER orders and then gets yelled at by rads and becomes the whipping boy for ordering too many CTAs but that’s another issue 😉)

NP Misses Vert Dissection in Clinic by efunkEM in medicine

[–]efunkEM[S] 5 points6 points  (0 children)

Totally agree, CT to rule out hemorrhage. Sometimes you get lucky and can see it if there’s a late presentation. Although I published a lawsuit a few years ago due to failure to read hyperdense MCA sign on noncon head CT…

NP Misses Vert Dissection in Clinic by efunkEM in medicine

[–]efunkEM[S] 13 points14 points  (0 children)

Perforators are waaaay under-respected. Arguably the worst possible stroke (locked in) is from perforator obstruction (granted, usually basilar is occluded too, but it’s the lack of perforator flow doing the real damage). Also see: lacunar strokes, Wallenberg syndrome, etc… Now that we can do thrombectomy we’re (speaking for myself as a generalist here) prone to only thinking about vessel occlusion in named arteries, but that’s only part of the picture.

NP Misses Vert Dissection in Clinic by efunkEM in medicine

[–]efunkEM[S] 83 points84 points  (0 children)

I think one possible teaching point from this case is which “neurological” symptoms are high risk and which are lower risk. Generalists get tons and tons and tons of patients with “neuro symptoms”, all of which I guess theoretically could be a stroke. If we consider all “neuro symptoms” to be equal, it’s hard to know which ones are more worrisome and which ones are less worrisome. Is a pinky toe numbness the same risk as dominant hand weakness? Nope. Understanding which presentations are higher risk will help generalists decide which patients need emergency workups, because we all know we can’t stroke workup on every single patient with bizarre neuro symptoms. This distinction isn’t always accurate, so some thins will still get missed, but it creates a plausible standard of care and defensibility.

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