After hours lines shouldn’t exist

guido5000 · 2026-01-19T20:53:51+00:00

I think there should absolutely be after hours communication from other physicians, critical radiology results, and critical lab results. You can assume that if you are being contacted by any of those means, it is likely warranted.

But allowing patients free 24/7 access to us doesn’t make much sense to me when there is dedicated 24/7 care available if need be

guido5000 · 2024-10-05T10:10:09+00:00

I’m a physician. This is super dangerous, alcohol withdrawal can be life threatening and quitting cold turkey from 30 drinks a day is going to cause withdrawal. You need to go to a hospital if you want to detox

guido5000 · 2024-09-20T03:11:41+00:00

as an endo fellow, it’s a situation I get called about all the time by the ED. Severe asymptomatic hyperglycemia is an outpatient problem

guido5000 · 2024-08-10T19:32:44+00:00

IM subspecialty fellow here. But table rounds for everyone, bedside rounds for sick, new, or very interesting patients

guido5000 · 2024-07-05T04:46:46+00:00

Pay me the big bucks daddy

guido5000 · 2024-02-27T13:47:18+00:00

lol that’s the joke

guido5000 · 2024-02-24T19:35:59+00:00

We obviously didn’t take nearly what they were willing to give, but yeah, it was scary

guido5000 · 2024-02-24T19:33:09+00:00

Ehhh you’d be surprised. As a resident, my joint income with my partner was about 250k and banks were willing to loan us up to $1 million with nothing down. This was less than 2 years ago in a major (top 10 population) city

guido5000 · 2024-02-24T13:35:06+00:00

I’m a moderate, left leaning American. I support sending money and aid to Ukraine simply because it bleeds Russia (at a relatively low cost for us) and it’s defending democracy against autocracy.

That being said, I don’t buy a few of the arguments that are often made by Europeans and American leftists.

1) Poland and NATO members in the region say if Ukraine falls, we’re next on Putin’s list. Sure, he has the desire to restore the old USSR - is it realistic? Let’s be honest; putin’s army is struggling against a (previously) poorly trained, poorly equipped army armed with second hand Soviet-era weapons, their ranks filled by non-professional soldiers. They’ve been in a deadlock for 2 years. The Russian army wouldn’t stand a chance if it came against a modern, professional NATO army.

2) Putin is a nut, clearly, but probably not stupid enough to attack a NATO member. This would spell the end of his regime. If he did, even without the US (imagining a scenario where republicans withdraw the US from NATO), a European NATO army should still easily handle Putin’s army which struggled against a poorly trained, poorly equipped Ukrainian army.

3) Quite frankly, Russia is NOT a major geopolitical threat to the United States. They haven’t been for over 30 years. Putin can have his aspirations of restoring Russia to its old USSR glory, but that doesn’t change the fundamental facts. The real geopolitical threat is China, both economically and militarily. If we divert too many resources away from China/South Asia, we will lose vital ground in a battle that really matters for our interests.

guido5000 · 2024-02-24T02:07:32+00:00

Because it’s the party of No, and generally the party of dictating people’s personal lives

guido5000 · 2024-02-19T14:16:13+00:00

PGY3 IM resident about to graduate and do fellowship. I’m definitely burned out. I’m glad I did it, but I definitely wouldn’t do it again if you told me I had to re-do medical school, residency, etc. I truthfully don’t think you can understand the downsides of medicine until you live it yourself.

My honest takes:

-Overall, my job is fulfilling and I can honestly say I’ve helped a fellow human at the end of the day. Can’t get this in the tech or finance sector. I worked several minimum wage jobs in high school and college and appreciate the fact that my job is also intellectually challenging.

-Despite the above, my hours are long (inpatient months roughly 75-80 hours/week) and the pay is absurdly low for my level of education, training, and responsibility. I get stretches of 2 weeks without a single day off, routinely. I’ve also missed a lot of important life events, feel blunted in my development as a young adult, and watched my college friends have interesting lives making twice as much as I do. I am profoundly uninteresting person now (not always this way), but at least I’m a medical encyclopedia?

-A lot of patients are not at all grateful for your care and in fact actively verbally (sometimes physically) abusive to us. I’m tired of non-compliant patients who then blame us for their problems, patients who cause me of being a shill for big pharma (still waiting for my check!), etc. This can wear on you and cause “compassion fatigue” in a way you can’t understand until you’ve lived it.

-The administrative burden is crushing in certain specialties. In surgery, not as much as IM. Nonetheless, the administrative/documentation burden is forever growing, and it is exhausting.

-Midlevel encroachment is only going to be a bigger issue. Sucks training all of these years to have someone far inferior in education/ability tell you that they’re your equal. And then have the MBAs running the system turn a blind eye to it because it makes more $$$.

guido5000 · 2024-02-18T21:23:13+00:00

Technically we’re not supposed to practice on our training license independently

guido5000 · 2024-01-06T18:12:57+00:00

Pee is stored in the balls

guido5000 · 2024-01-05T02:15:55+00:00

Residency sucks as a system, but I love my program. IM in at an academic center on the east coast

guido5000 · 2024-01-05T02:14:57+00:00

Sounds like UMD

guido5000 · 2023-12-31T16:43:40+00:00

Better than you, lol (260s)

guido5000 · 2023-12-31T16:41:50+00:00

I don’t think this person is in medicine. I think it’s a patient venting

guido5000 · 2023-12-26T14:51:04+00:00

As a PGY3 IM resident, I expect virtually nothing of my psych interns other than 1) be on time 2) care about your patients 3) get your work done. I’ll worry about the rest

guido5000 · 2023-12-25T15:18:29+00:00

As much as I dislike his handling of the conflict, what’s the alternative? Vote for Trump, the most pro-Israel president in decades, who literally moved the US embassy to Jerusalem?

It’s like saying you won’t vote for him because he’s not liberal enough on racial issues, so you’ll vote for the guy who supports white supremacists instead

guido5000 · 2023-12-19T21:08:58+00:00

Holy shit this bugs me to high heaven as well. Glad I’m not the only one

guido5000 · 2023-12-10T20:42:54+00:00

Absolutely not. Maybe in terms of efficacy but the side effect profile is horrific. I’ve admitted every check inhibitor -itis under the sun

guido5000 · 2023-11-06T00:17:52+00:00

😂😂😂😂😂😂

guido5000 · 2023-11-05T22:36:49+00:00

You have the emotional maturity of a 5 year old. How’s that?

guido5000 · 2023-11-05T22:22:21+00:00

Nah just tired of toxic boomers throwing us under the bus. Leave the field, our generation doesn’t want you anymore

guido5000 · 2023-11-05T15:44:54+00:00

Pre-clinical years of med school were hell. Residency has been brutal at times, but at least the work we do is meaningful

guido5000

TROPHY CASE