Recent content by SXMMD

No I honestly don't think so. I think we are overstating the intensity of residency, ignoring rotations when one does have a more normal schedule, families/relationships don't just whither and die because mom is working (medicine or other industries). Child is 2, a relationship is already there...

Would echo what has been said above 1) if you are passionate about patient care/being a physician, the opportunity cost of doing residency significantly outweighs not doing residency. You may never get another chance to do this if you walk away now- not an absolute, but a very likely...

When they start to decompensate: continue to discuss treatment options and do what you can reasonably do. If they continue to decline CT or surgical care, have goals of care discussion. If they remain full code, they will continue to decline until they're admitted to the ICU and die. This is...

Why? I am also a hospitalist and I don't understand your rationale, please help me to understand. A) patient has an indication for admission B) the relevant services (ED, GS) have thoroughly discussed treatment options C) patient declines optimal recommendations but agrees with suboptimal...

Keep discussing with the patient until he agrees or deteriorates and becomes non decisional. If he becomes non decisional talk to family and get surgeon involved if they agree to further care. If not agreeable, do the goals of care talk and whether hospice or full code, patient dies. I hate...

As a hospitalist I would refuse this admission until the steps you outlined were completed before the patient reached me. 1) patient refused imaging, ED MD had thorough discussion regarding risks/benefits and suboptimal alternatives that may well result in death 2) surgeon consulted evaluated...

agree with others here- sounds like your concerns aren't about cardiology as much as self doubt and a tough environment. Training will give you confidence. Completion of training will get you out of that environment- it's temporary. If you like the work, stick with it. You can always do...

You can't rationalize people out of a position they didn't rationalize themselves into in the first place. Unfortunately the diagnosis is stupid- and stupid is terminal. Palliative care consulted, appreciate recs.

My mother sent me this article. I nearly had a GI bleed reading it at work. I sat my mother down and talked her through the case and why this guy isn't a clown 🤡 but the whole damn circus. My favorite is the line about his shock giving him dementia, CHF and ckd... He was taken for procedure...

People make bad choices under duress when there's no "safe" option all the time. It is what it is, I don't get mad if I can't break through to those people. Brother who misses dialysis on the regular so he can smoke and drink with the boys, get his emergency dialysis once in a while while...

As a hospitalist I lose way too many of these patients to delirium related complications. Falls, aspiration pneumonia (after being doped up with ungodly doses of Seroquel or zyprexa for agitation overnight), c diff (because of all these gomers have UTI based on a poorly collected UA at the NH...

Hey all, I'm working on transitioning back to primary care after 2-3 years of adult hospitalist work after residency. I'm a little out of touch with key things to look for (or avoid) in primary care jobs and was hoping to get some feedback; I'm seeking 4-4.5 day work week no ob +/- peds. I'm...

Unfortunately no one going to bat for us- it's a free for all. I'm not surprised it's happening elsewhere too Edit: see timpview opinion above. Burnout has us fighting each other.

Going through this with my employer currently, the writing is on the wall

They don't check cannon fodder for quality, just fyi