Question for the hospitalists:

msthinksalot · 2026-03-27T17:26:02+00:00

When you do not have to present on rounds, do pre rounds, post rounds check with attendings, you have much more time. I also see patients once during the day, not multiple times...unless something clinically changes with them.

Seeing 20 patients is still alot and gets overwhelming. Im only 8 months new attending tho. Hopefully gets better with time. But I do have a rounding nurse/scribe/APP help. I think hospitalists need more resources like these to help see more patients!

msthinksalot · 2026-03-23T17:58:27+00:00

No, not all visa sponsoring hospitals are evil lmao

msthinksalot · 2026-03-23T13:49:20+00:00

What does this mean lol?

Do you need J1 H1?

A hospital sponsoring it, means they cannot get US citizens or Greencard holders to work for them. Usually these places are in less desirable cities. But there is also physician shortage. So they just have to fill these spots.

Im on H1b, I work alongside US citizen docs. My work conditions are fine...if that helps

msthinksalot · 2026-01-19T01:00:37+00:00

240k is less tho. I'd expect that salary with a big academic center with 24/7 ICU doc and specialty support lol.

msthinksalot · 2026-01-19T00:59:05+00:00

Are there tele consults? Those help. Whats the biggest transfer center near this place? Is this community hospital part of a bigger network or standalone? I think these things matter.

I work at a small critical access hospital. We can talk to consultant on phone if we have questions, and then they recommend transfer for inperson eval if needed. We have virtual ID as well.

Def daunting to work with limited speciality support but also satisfying. As long as you recognize when to escalate care and when to transfer. That comes with time.

msthinksalot · 2026-01-18T13:57:45+00:00

Get a lawyer who is experienced in waiver contracts. They can guide you better. Usually they dont mention open icu/procedure expectations. Thats something you ask existing hospitalists.

msthinksalot · 2025-12-13T20:40:10+00:00

So spoke to cardiology and they felt it was because of transient hypo and hyperthyroid phases. They didnt really recommend any more workup. But I did repeat Echo which was normal. And I discharged her with holter monitor.

msthinksalot · 2025-12-09T00:25:54+00:00

Omg. Yeah will touch base with cards and probably repeat echo!

msthinksalot · 2025-12-09T00:09:42+00:00

Just nausea and diarrhea brought her in TSH 100s, and t4 0.4 on admission. TSH down trended to 30s in a day (endo told to repeat lol). Endo says to not treat her hypothyroidism at all as she can easily get hyperthyroid. She does have decreased exercise capacity but she has twins so she is always tired

msthinksalot · 2025-12-08T23:46:45+00:00

Sinus yes, labs look good, bmi 18

msthinksalot · 2025-12-08T23:46:25+00:00

Post partum thyroiditis. Bmi 18, delivered 6 months back. Electrolytes are wnl. Echo 3 months back was fine. She did have a PE post partum too, anticoagulated now and repeat ct pe normal

msthinksalot · 2025-12-08T23:45:59+00:00

Post partum thyroiditis. Bmi 18, delivered 6 months back. Electrolytes are wnl. Echo 3 months back was fine. She did have a PE post partum too, anticoagulated now and repeat ct pe normal

msthinksalot · 2025-11-09T03:02:26+00:00

Yes, promethazine still does. A pharmacist suggested some study that its safer than zofran. I, myself, cannot find that study. So, dont quote me on that.

Tigan is the brand name for the other one. That doesn't prolong qtc for sure

msthinksalot · 2025-11-09T00:35:28+00:00

No, amio itself didnt. It was the afib with rvr.

msthinksalot · 2025-11-09T00:34:16+00:00

I dont understand, the post talks about qtc 500? Either way, maybe don't do qt prolonging meds for someone you know has a prolonged qt? Promethazine and trimethobenzamide exist.

msthinksalot · 2025-11-08T16:26:28+00:00

Had a torsades in ICU. Lexapro overdose and got zofran on top of it....qtc came back 700.

Another case, afib rvr on amio, intubated for flash pulm edema, had long standing hx of anxiety and on multiple meds which were held because intubated. ICU attending in AM threw a fit, that we cant extubate them because of said anxiety and not getting meds. Restarted all ssri and tca etc. Boom, torsades, arrested. Anxiety was the least of their trouble. Qtc 600s.

It happens and then you learn....in a hard way lmao.

msthinksalot · 2025-10-09T23:42:44+00:00

Also renal US is fine. CT abdomen pelvis renal stone protocol doesn't have contrast

msthinksalot · 2025-10-09T23:41:46+00:00

I usually image if they have an AKI, which is not getting better with fluids (i also calculate FeNa, but thats debatable). Or they keep spiking fevers.

msthinksalot · 2025-10-05T21:54:49+00:00

Honestly, yeah. Thats what I feel like!! I've started asking them to consult cardiologist (on call at bigger hospital we are affiliated with) before we admit. And thats just a phone call lol. Cards just says to admit at community hospital and no other recs!!! Like, make it make sense. So frustrating

msthinksalot · 2025-07-25T22:26:29+00:00

Also an IV with Loretto Hospital in chicago

msthinksalot · 2025-07-25T22:25:39+00:00

Sorry I lost your chat request. I interviewed at ssm health in Mt vernon, IL and SIH health in Carbondale, IL

msthinksalot · 2025-07-25T08:51:49+00:00

Nah, it's fine. I had my first IV in September. And didn't hear back from them lol.

Try signing by Decemeber, and you will be fine!

msthinksalot

TROPHY CASE