Doc Lightning
Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA
Member Since: 28th May 2001
Total posts: 13920
Posted:So I am 28 days away from the end of my residency. Residency has been hellish. I've been overworked. I have had my personal life and time treated as a rare privilege, rather than a right. I've had precisely one month in the last three years where I didn't have to work nights and weekends (the month I spent in Spain). I've been treated as an indentured servant "all for my education."

My last month of residency is in the Pediatric Intensive Care Unit (PICU). However, our hospital is now having some serious issues. We have no more paper. We failed to pay our paper bill. The hospital license has expired and so now all prescriptions must be written on the personal prescriptions of those who have New York License numbers.

And now, to justify the very existence of the PICU (because we haven't been having many critical patients), we have been admitting patients who don't need intensive care. Last night we admitted a child with no medical issues at all, but with psych issues. He needs help, but an ICU is not going to help him.

And so basically, I'm being kicked back to my first year where I was responsible for doing the daily scut work for non-critical patients. Except now I'm a senior resident and this sort of work is, frankly, beneath me. And by definition. An intern should be doing it so that s/he can learn to be a senior resident. But because I don't have enough sick patients to take care of, they're sending me patients who aren't sick to the detriment of the patients just to justify the existence of this ICU.

And I'm exhausted. I'm burnt-out. I'm frustrated. And now I have to work 80-hour weeks doing nothing of any educational value. I feel like I've been asked to violate the Hippocratic Oath at least three times just this week. I feel like I'm being asked to abuse the medical system by keeping kids in expensive ICU beds when they could very well be in much less expensive general ward beds.

28 days left and I'm ready to turn in my resignation. I'm not sure how I'm going to make it.


-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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BansheeCat
veteran
Location: lost
Member Since: 29th Jul 2005
Total posts: 1247
Posted:It terrifies me that we call this abuse our medical care system...

Hang in there Mike, and then get somewhere better fast.!!!

I hope at some point they dont overwork you so much, so you can have a little energy left to go to battle and force people to examine these problems and be a part of making positive change.

I dont understand why if there are not enough truly sick people, they can not just let you get some sleep , time off,and allow you suffiecient time to take care of your own health and sanity?

Good luck with it all!


"God *was* my co-pilot, but then we crashed, and I had to eat him..."

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Pele
Pele

the henna lady
Location: WNY, USA
Member Since: 15th Dec 2000
Total posts: 6193
Posted:Keep thinking of all the good you'll be doing elsewhere, when you leave there.

Even patience who are "beneath" your talents still need your expertise. You are still helping them.

You are being asked to abuse the system by keeping them in ICU and the subsequent fight with insurance agencies should be interesting for the poor families, and for other hospital staff.
And seriously, they let their license run out? OMG!

hug

Just take it minute by minute, think of those you *are* helping or can help and focus on your future when you get overwhelmed...cause it's nice and bright.

ubblove


Pele
Higher, higher burning fire...making music like a choir
"Oooh look! A pub!" -exclaimed after recovering from a stupid fall
"And for the decadence of art, nothing beats a roaring fire." -TMK

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Doc Lightning
Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA
Member Since: 28th May 2001
Total posts: 13920
Posted: Written by :BansheeCat


I dont understand why if there are not enough truly sick people, they can not just let you get some sleep , time off,and allow you suffiecient time to take care of your own health and sanity?




Because then I wouldn't get enough "education."

I don't think the corrupt NYS Medicaid system is amenable to my intervention.


-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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Pele
Pele

the henna lady
Location: WNY, USA
Member Since: 15th Dec 2000
Total posts: 6193
Posted: Written by :Doc Lightning


I don't think the corrupt NYS Medicaid system is amenable to my intervention.



Not even if you threatened to use permanent catheters, perform un-necessary procedures of great pain and length on them and well...treat them as they treat their "clients", or some combination thereof all on television for everyone to behold.

It's a sad, sad thing.
Disgraceful and hurtful beaurocratic bs.

Soon you will not have to look back, which is good for you but sad for the system who could use someone strong fighting it.


Pele
Higher, higher burning fire...making music like a choir
"Oooh look! A pub!" -exclaimed after recovering from a stupid fall
"And for the decadence of art, nothing beats a roaring fire." -TMK

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Doc Lightning
Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA
Member Since: 28th May 2001
Total posts: 13920
Posted:Well part of the problem with the medicaid system is that it is designed to be abused.

As an employed physician, if I call 911 and have EMS take my kid to the ER because he has a fever and I don't have ibuprofen at home, my insurance will not pay for EMS transport or the ER, stating that any "reasonable person" would know that a nose cold is not an indication for emergency medical care.

But medicaid patients do this all the time with impunity. They call EMS to use as a sort of medical taxi service. And then we give them free ibuprofen/Tylenol to go home. We even had a mother call EMS because the school told her that her daughter had head lice and needed to be seen. So $600 for EMS transport, $375 minimum for the ED, and now you have a $1,000 bottle of ibuprofen. And there is no repercussion for such an abuse of the system.


-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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Mr Majestik
Mr Majestik

coming to a country near you
Location: home of the tiney toothy bear
Member Since: 9th Mar 2004
Total posts: 4693
Posted:whats EMS and medicaid?

stupid private health insurance that is over used to the detrement of public health patients?

i just finished a three week placement in my states largest hospital on a specialty ward, the only one of its kind in the state. and? there was consistant pressure from all over the state to take more patients dispite the fact that there werent enough beds and other hospitals would refuse to take patients from our ward even though the patients came from their area and weren't in need of specialty care on a surgical ward any more. the politics and bureaucratisation of the healthcare systems is rediculous the world over.


"but have you considered there is more to life than your eyelids?"

jointly owned by Fire_Spinning_Angel and Blu_Valley

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Doc Lightning
Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA
Member Since: 28th May 2001
Total posts: 13920
Posted: Written by :Mr Majestik


whats EMS and medicaid?

stupid private health insurance that is over used to the detrement of public health patients?



EMS=Emergency Medical System=Ambulance

Medicaid is the public health system. I have private health insurance and they would never pay for EMS transport for head lice. Medicaid pays because they're afraid that if they don't someone won't call the EMS and will die. This is in spite of the fact that multiple studies have shown that not to be the case.


-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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Pele
Pele

the henna lady
Location: WNY, USA
Member Since: 15th Dec 2000
Total posts: 6193
Posted:Hell Mike, we *have* private health insurance and we *need* to be dieing before they'll pay out for an ambulance.

Though I do know that medicaid-medicare is treated differently down there than it is up here. But then NYC is treated very differently than the rest of the state, but then *everything* is.


Pele
Higher, higher burning fire...making music like a choir
"Oooh look! A pub!" -exclaimed after recovering from a stupid fall
"And for the decadence of art, nothing beats a roaring fire." -TMK

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Doc Lightning
Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA
Member Since: 28th May 2001
Total posts: 13920
Posted: Written by :Pele


Hell Mike, we *have* private health insurance and we *need* to be dieing before they'll pay out for an ambulance.



I went to the ER for a peritonsillar abscess, which is the sort of condition where you can lose your airway real fast. The insurance company didn't want to pay for the ER visit. I had to have a lawyer write a nasty letter. Thank god I have lawyer friends.


-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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Pele
Pele

the henna lady
Location: WNY, USA
Member Since: 15th Dec 2000
Total posts: 6193
Posted:Abscessed tonsils, yes? I had that many years ago and was told to drive myself. I didn't know any better so I did. I don't remember the drive, just being admitted.

I think that's a big problem with alot of it, people don't know their rights, or wrongs.
You have an upper hand in that.


Pele
Higher, higher burning fire...making music like a choir
"Oooh look! A pub!" -exclaimed after recovering from a stupid fall
"And for the decadence of art, nothing beats a roaring fire." -TMK

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Lurch
Lurch

old hand
Location: Oregon
Member Since: 1st Nov 2003
Total posts: 929
Posted:Now I understand your frustration with work, and the politics behind it and everything. But a doctor complaining that there aren't enough extremely sick people? Isn't that a bit like a cop complaining about a lack of crime? wink

#homeofpoi -- irc.newnet.net Come talk to us we're bored frown

Warning: Please Do Not Jump On The Seals

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Doc Lightning
Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA
Member Since: 28th May 2001
Total posts: 13920
Posted: Written by :Lurch


Now I understand your frustration with work, and the politics behind it and everything. But a doctor complaining that there aren't enough extremely sick people? Isn't that a bit like a cop complaining about a lack of crime? wink



No, I'm complaining that I'm supposed to be taking care of extremely sick kids and all I'm getting are kids who aren't that sick.

I'd rather sit around and do nothing than take care of a really sick kid. But in an ICU I'd rather take care of a sick kid than take care of a kid who's OK.


-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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Mynci
Mynci

Macaque of all trades
Location: wombling free...
Member Since: 27th Apr 2005
Total posts: 8737
Posted:You poor sod mike hug sounds a nightmare.

I can honestly say I am very grateful for our national health service here, I had to have an ambulance sent to me today due to an asthma attack at 0800 hours this morning (Rush hour traffic)
They sent a mobile car with nebuliser which was at my door within 1 minute of me puting the phone down (4 minutes total from time I picked phone up) and another full ambulance with crew ready to transport me if required was at my door 13 minutes from calling (9 minutes after car). the initial car was sent in case ambulance could not get through traffic quick enough because I had restriced airways. the crew were great I was initially treated in my bedroom and moved to ambulance for further treatment and checks. They even told me better to call ambulance than get a cab because I could be dead by the time the cab arrived.
I'd hate to have to stress that insurance wouldn't pay out for emergency transport OR that I couldn't afford private care because I have a pre-existing life threatening condition. Our system my not be perfect but I have great respect for medical practitiners biggrin
Hope it goes well doc, don't quit the beauracracy sucks but your purpose is a great one grouphug


A couple of balls short of a full cascade... or maybe a few cards short of a deck... we'll see how this all fans out.

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Mr Majestik
Mr Majestik

coming to a country near you
Location: home of the tiney toothy bear
Member Since: 9th Mar 2004
Total posts: 4693
Posted:our state government is currently considering making ambulances user pays because its cheaper to run it like that than fund it from taxes and their piggybank.

whee the politics of health.

anyone seen sicko by michael moore? there was a british gent who sounded much more interesting than anything in the movie.


"but have you considered there is more to life than your eyelids?"

jointly owned by Fire_Spinning_Angel and Blu_Valley

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Brenn
Brenn

Will carpal your tunnel in a minute.
Location: Melbourne, Australia
Member Since: 28th Jun 2004
Total posts: 3286
Posted: Written by :Doc Lightning


I'd rather sit around and do nothing than take care of a really sick kid. But in an ICU I'd rather take care of a sick kid than take care of a kid who's OK.



Totally with you on that one. If you're meant to be in a place or position to do an intended job, you will feel frustrated if you aren't doing what you are meant to BUT know there is a great deal more you can.

hug


ॐ

Owner of burningoftheclavey smile
Owned by Lost83spy

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