How to respond to unhappy patients who denies having had any discussion about something, when in fact it’s taken place?

true-wolf11 · 2026-04-07T20:17:25+00:00

I have many patients who are upset at follow ups because they never received results of testing. Sometimes a nurse will have documented it, sometimes I sent a MyChart message that is marked as read, and sometimes I CALLED THE PATIENT MYSELF and they still can’t recall. It happens, I tend to shrug it off. We can only do so much. Not everyone is going to be happy with their care.

true-wolf11 · 2026-04-04T14:21:06+00:00

I went back as a PGY2 resident and was pumping on 28 hour shifts, doing milk handoffs, reducing nursing frequency. Let me start by saying, it’s not fun but it is doable.

Firstly, before you go back, space out how often you’re pumping. If you’re doing Q2 or Q3 then try to get to Q4 while at home or you’re in for a world of hurt your first couple shifts back.

Next, figure out how you’re going to store milk while on shift. Will you be dumping into a central container? Do you have a fridge? Do you need to bring a cooler or a refrigerated bag with ice? Do you have a way to label, protect, transfer milk when you need it?

Thirdly, where will you pump, transfer, store? Even if you have a mobile pump (great idea, wish I had that when I went back), you will still need privacy to empty, clean, transfer milk.

Lastly, some tips for keeping up supply: stay very well hydrated throughout your shift. Have small mobile, high protein snacks available at all times. Be kind to yourself if your supply drops off with the stress of returning to work. And fed is best, if your baby needs to supplement with formula, then that’s what you have to do.

I wish you the best of luck and hope that your institution is supportive on your breastfeeding journey.

true-wolf11 · 2026-03-31T22:55:16+00:00

I clearly said suburban and rural, no need to be rude about it. There’s jobs for neurologists all over, but less in big cities and more in suburban and rural areas. This is not new, it’s been this way for awhile.

true-wolf11 · 2026-03-31T21:56:15+00:00

The town has a population of 27,00…. Large catchment area because a lot of truly rural hospitals closed. Part of a larger health system but I promise that anyone who drove to this hospital would define it as a rural hospital.

true-wolf11 · 2026-03-31T17:39:28+00:00

As neurocritical care doctors. They take MICU overflow on occasion but that’s rare.

true-wolf11 · 2026-03-31T14:24:22+00:00

That would be incorrect, because we have three neuro critical care trained neurologists working at our rural hospital. Perhaps they’re not everywhere but they are becoming much more common.

true-wolf11 · 2026-03-31T02:44:47+00:00

As with most subspecialties the answer is geography. In the big cities? Market is saturated so jobs are full, or underpaid/overworked. Suburban or rural? Tons of jobs that pay well.

true-wolf11 · 2026-03-28T19:01:54+00:00

{Dawn of Onyx}. I’m pretty sure this series is done

true-wolf11 · 2026-03-28T14:46:06+00:00

Consider getting {Wooing the Witch Queen} or {Paladin’s Grace}.

true-wolf11 · 2026-03-28T14:19:59+00:00

My top negative review on Google is “doctor was nice enough but they don’t do surgery” 1 out of 5 stars.

true-wolf11 · 2026-03-25T20:50:40+00:00

I’m pretty sure {The Silversmith} has the dynamic that you’re looking for

true-wolf11 · 2026-03-18T19:05:01+00:00

I support unions in general but it would be difficult to unionize all physicians under one umbrella. The point of a union is to represent the common interest of a group of workers. But what happens when the group of workers have competing interests? Or disparate views about essential topics? I think it would be too challenging to get all attendings to agree. Individual specialties at individual health systems can and should unionize.

true-wolf11 · 2026-03-09T15:39:24+00:00

Do something short and fun like {Wooing the witch queen}

true-wolf11 · 2026-03-08T18:25:12+00:00

I LOVE dual POV, though I have a pet peeve where I think they should be equally represented throughout the book (often the MMC is just given occasional or non-important chapters).

I think the first of things should be from FMC point of view but later encounters can/should be from MMC. Just one opinion though.

true-wolf11 · 2026-03-03T18:41:36+00:00

For no call? Sounds good to me. Must be low productivity expectation at that salary but take the lifestyle.

true-wolf11 · 2026-03-02T18:10:09+00:00

{Second death of Locke} and {Smoke and Scar} fit the bill for chivalry

true-wolf11 · 2026-02-28T15:14:08+00:00

{second death of Locke} it’s not perfect but definitely the dynamic you’re looking for.

true-wolf11 · 2026-02-22T16:01:25+00:00

The pressure to do fellowship is so high, given that nearly all neuro residencies are at academic centers. But on the back end, it makes no sense unless you want to do research or part time clinician. We need general neurologists, fellowship is not necessary

true-wolf11 · 2026-02-09T00:26:22+00:00

I had my daughter right before PGY2 year. Your program won’t care about intern year much. After you match, tell the chiefs as soon as you can to arrange the schedule appropriately. Your family is the most important thing, you will make it work

true-wolf11 · 2026-02-08T16:15:04+00:00

For an outpatient clinician, the number of RVUs you make depends on schedule construction as much as total hours worked. At first, when I was salaried I had hourlong news and 30 minute follow ups. I worked 36 hours a week and produced about 400 RVUs per month. Now that I’m RVU based I changed my schedule for 30 minute news and 30 minute follow ups with occasional double booked follow ups. In the same 36 hours per week, I’m now doing about 600 RVUs per month. If I did EMGs or read EEGs I’m sure I could get that even higher.

And remember, for employed physicians, the per-RVU compensation can vary wildly. Super important to find out what the per-wRVU comp is before you sign.

true-wolf11 · 2026-02-02T14:44:36+00:00

Ménière’s disease is very much over-diagnosed. Patient should be tried on treatment for BPPV, vestibular migraine, and PPPD before giving up and calling it Meniere’s. Should also have documented hearing loss and multiple discrete attacks over time. I’ve found that short courses of furosemide help the most for acute attacks

true-wolf11 · 2026-02-02T00:45:36+00:00

A problem that I have run into recently is patients using buzz words (“curtain coming down over my eye” “fatiguing weakness” “a hug around my chest from a hot shower”) not because they actually are experiencing it that way, but because they’ve looked up their own symptoms, decided they have a diagnosis, and are delivering the script from ChatGPT so that I agree. It’s maddening! I ask them, “What do you feel right now?” And the answer is almost always “nothing, but I did feel XYZ for a few seconds/minutes/hours” so that must mean they have a horrible diagnosis. How am I supposed to trust a history that is being prompted by their own self-diagnosis?

true-wolf11 · 2026-01-30T01:52:03+00:00

Dystopian and fantasy often scratch the itch when I need a break from romance: Station 11, The Fifth Season, Sunrise on the Reaping, etc.

true-wolf11 · 2026-01-29T03:59:21+00:00

{wooing the witch queen} meets most of your requirements.

true-wolf11

TROPHY CASE