Perhaps I'm not meant to work in the ER?

[Anonymous]

Anonymous wrote:OP, I get it. I'm debating primary care vs ER. I have the same questions/concerns as you.

Neither. Do ICU. At least patients are consistently legitimately ill.

[Anonymous]

Anonymous wrote:OP, I get it. I'm debating primary care vs ER. I have the same questions/concerns as you.

[Anonymous]

I get it OP. Some people are wired to handle crisis and emergencies well, others aren’t. If you’re someone who’s talented in crises, then you SHOULD be in a place where those skills get used. I wouldn’t want to see my GP if I were in crisis, and it’s a skills mismatch for you to be in a ER that’s more of a clinic than an emergency room.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Op here.

Chest pain that turns out to be anxiety is something I'm happy to see someone for. I prefer when people come to the er to rule out stemi, cva or appy. It's fine if you think you are having an emergency and it turns out that you aren't. I'm thrilled when my possible cvs patient is actually a migraine and they don't need to go through all the hospitalization that a cva would require. I can bring in neuro to follow up with them and get them feeling better. Same with people who are anxious, I can get them the appropriate help to deal with the condition.

What I'm not okay with is when people come in requesting a check up at 1 am. Or the people who have been referred out to a specialist but keep coming to the er expecting something more than comfort measures.

Doesn't your ER have a triage and say no to those wanting a check up? Ours has an triage and you see a nurse who does the basics, including medicating kids with high fevers (she got medicine in my kid gratefully that he refused from us even when we tried to force it).

Be grateful you've never had a bad migrane or any of the conditions you treat. I have them daily and most have no clue the pain involved. I gave up going to doctors as most like PP have said give you the blow off and act like you are faking.

Op here. It's not the people in pain who are the issue and I'd never assume someone is faking or make them feel badly about a true concern. you on the other hand do make assumptions because I do in fact know what migraine and other intense pain feels like. Usually when I rule out a stroke or other fatal conditions in a patient presenting with a bad headache, I start to look to the possibility of migraines and then I treat them accordingly and they are usually discharged with reference to a neurologist. We have a lady who comes in frequently for gyn issues and I have no problem treating her because she has pain and other symptoms. I'm not saying her symptoms aren't valid. When you come in and ask for a flu shot is when I get annoyed.

[Anonymous]

I think you need a different ER. I'm with my father right now at GWU ER in a bay with two other patients. Between the three there are chest pains, possible blood clot, and possible intestinal obstruction.

[Anonymous]

Anonymous wrote:Why would anyone go to the ER for 'sniffles' or 'general medical exams'? My urgent care copay is like $30. What idiots.

Come to Virginia and your question will be answered

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Op here.

Chest pain that turns out to be anxiety is something I'm happy to see someone for. I prefer when people come to the er to rule out stemi, cva or appy. It's fine if you think you are having an emergency and it turns out that you aren't. I'm thrilled when my possible cvs patient is actually a migraine and they don't need to go through all the hospitalization that a cva would require. I can bring in neuro to follow up with them and get them feeling better. Same with people who are anxious, I can get them the appropriate help to deal with the condition.

What I'm not okay with is when people come in requesting a check up at 1 am. Or the people who have been referred out to a specialist but keep coming to the er expecting something more than comfort measures.

Doesn't your ER have a triage and say no to those wanting a check up? Ours has an triage and you see a nurse who does the basics, including medicating kids with high fevers (she got medicine in my kid gratefully that he refused from us even when we tried to force it).

Be grateful you've never had a bad migrane or any of the conditions you treat. I have them daily and most have no clue the pain involved. I gave up going to doctors as most like PP have said give you the blow off and act like you are faking.

Op here. It's not the people in pain who are the issue and I'd never assume someone is faking or make them feel badly about a true concern. you on the other hand do make assumptions because I do in fact know what migraine and other intense pain feels like. Usually when I rule out a stroke or other fatal conditions in a patient presenting with a bad headache, I start to look to the possibility of migraines and then I treat them accordingly and they are usually discharged with reference to a neurologist. We have a lady who comes in frequently for gyn issues and I have no problem treating her because she has pain and other symptoms. I'm not saying her symptoms aren't valid. When you come in and ask for a flu shot is when I get annoyed.

That is the responsibility of the ER triage, not the person. They are probably doing it as insurance covers it. Your triage staff should give them a list of local clinics for things like a flu shot vs. accepting them as a patient. Our ER would not accept you for that stuff in less it was something that you went to your doctor and got a blow off. I had that happen once and knew I had an issue so I walked over to the ER and they were great and said it happened all the time that the regular docs blow off so patients will go to the ER. That is an administrative issue.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Why would anyone go to the ER for 'sniffles' or 'general medical exams'? My urgent care copay is like $30. What idiots.

Come to Virginia and your question will be answered

I have gone concerned about an infection or something worse as I knew that the doctor assigned to me would blow me off and the ER staff would at least look at me and order testing. But, our ER is free. Urgent care would be hundred's of dollars. But, no big deal. Our primary care docs change every few months so every so often I get a good one, get all my appointments caught up (and then they leave or get transferred).

[Anonymous]

OP, what I think would be difficult about working in the ER would be the amount of self-harm you would see. It's one thing to treat people who are victims or are sick. It's another to see people who are there as a result of drug overdoses, or even shootings in which their own idiocy played a role.

[Anonymous]

OP, visit the Student Doctor forums, specifically the one about Emergency Medicine.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I went to the ER during a thyroid storm last year. My husband worked in the ER decades ago.

I'm SO glad your days are filled with non-life-threatening issues.

What does this have to do with anything? You utilized an ER for an emergency condition. This post was not aimed at you.

Do I really have to spell it out to you?

If an ER doc wishes for more emergencies, that means he or she wishes for more suffering people in mortal danger. Having been in that uncomfortable predicament, I don't wish that on anyone. My husband, having been on the medical side, has never once uttered such a wish as OP's. And he got all the druggies as well.

I was trying not to express how disgraceful it is for a doctor to say the ER is boring, but hey, you asked for it.

Omg that must have taken some serious mental gymnastics to conclude that OP wishes for more suffering people in mortal danger.

That's not what she's saying at all.

There will ALWAYS be people suffering and in danger. Always. OP just prefers to help those people rather than the ER people that come in to have their athletes foot looked at (happened to me in the ER many moons ago when I was with ORAL SURGERY - I was like dude - not my department).

OP I totally get it. You want to see the big cases. That's probably why you chose emergency medicine. Can you move to an inner city hospital? Something in Baltimore? Probably more of what you're looking for there.

Don't listen to all these other people telling you to leave medicine. Please don't. It's probably just time for a change.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why would anyone go to the ER for 'sniffles' or 'general medical exams'? My urgent care copay is like $30. What idiots.

ER is free for us. If something happens, it is the fast track to a specialist appointment. You can get a specialist appointment within days vs. weeks with a regular doctor appointment.

PP here: hmm, interesting. Sounds like an issue more with insurance then.

Yea that's what OP mentioned that in the first post....

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why would anyone go to the ER for 'sniffles' or 'general medical exams'? My urgent care copay is like $30. What idiots.

ER is free for us. If something happens, it is the fast track to a specialist appointment. You can get a specialist appointment within days vs. weeks with a regular doctor appointment.

PP here: hmm, interesting. Sounds like an issue more with insurance then.

Very much. I'd rather go to an urgent care but I sent my husband once to one on their list and we got a huge bill and they wouldn't cover it. We did everything we were supposed to and called in. So, easier to go to the ER, which is closer anyway. Our ER is great. They try to get the sick folks in/out and have special kids rooms. They encourage you to come back if you are unsure of something and know its hard to get regular doctor's appointments or the regular docs give you the blow off.

You do know that someone ends up paying for you to enjoy this ease. Figure out how to use your insurance...

[Anonymous]

Anonymous wrote:

Anonymous wrote:Why would anyone go to the ER for 'sniffles' or 'general medical exams'? My urgent care copay is like $30. What idiots.

Because they don't have the same generous insurance plan as you? You might be the idiot, or at least, the person without empathy.

If they pay for non emergencies in the ER, they have MORE generous insurance...

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why would anyone go to the ER for 'sniffles' or 'general medical exams'? My urgent care copay is like $30. What idiots.

ER is free for us. If something happens, it is the fast track to a specialist appointment. You can get a specialist appointment within days vs. weeks with a regular doctor appointment.

PP here: hmm, interesting. Sounds like an issue more with insurance then.

Very much. I'd rather go to an urgent care but I sent my husband once to one on their list and we got a huge bill and they wouldn't cover it. We did everything we were supposed to and called in. So, easier to go to the ER, which is closer anyway. Our ER is great. They try to get the sick folks in/out and have special kids rooms. They encourage you to come back if you are unsure of something and know its hard to get regular doctor's appointments or the regular docs give you the blow off.

You do know that someone ends up paying for you to enjoy this ease. Figure out how to use your insurance...

I have and sadly it can take months to get appointments and they don't tell you when your doc leaves so you can try for weeks to realize they are gone. I have tried to get into primary care for a few weeks and can only get an urgent appointment when it isn't urgent.