If I Were Your Attending

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  • Everybody will leave work no later than 5pm. Working late sucks.
  • Keggers will be held every Friday night after work, attendance is optional.
  • Rounds start at 11 am, and then end at noon. Lunch is important, and fuck getting up early.
  • Gym Time: I like my residents and medical students to be in shape, but I really don’t give two shits if you’re fat and dumpy. 9-11am is the designated gym time, but you can do it whenever it’s most convenient for you. As long as you get your work done, work out whenever. If you hate working out, do what you want to do instead.
  • Once your work is done, it’s time to go home. Don’t ask for permission, just leave.
  • Business attire in the hospital is stupid. Wear scrubs on my service if you like. If you want to pimp your nicest suit, I don’t give a fuck.
  • Saturday and Sunday are off limits for the hospital, I hire hospitalists to take care of that kind of shit. If you want to work on Saturday and Sunday, go for it.
  • Residents and students will spend at least 20% of their working time working on personal projects. Entrepreneurism is encouraged.
  • Residents and students will be expected to take at least one nap per day. I don’t care when you take it.
  • World of Warcraft and XBOX games (including, but not limited to, Call of Duty 4) will be played on a daily basis. If you’re not into this sort of thing, go do whatever it is that you like.
  • Anyone that is determined by me, to be a “gunner”, has to complete the following for time: [Run 1 mile, 100 pull-ups, 200 sit-ups, 300 squats, Run 1 mile], all while wearing a 25 pound weight vest. Any time greater than 35 minutes earns the “gunner” a week of doing nothing but scut work, digital rectal exams and manual disimpactions.

Let’s have some fun!

How Did You Stay Sane During Training?

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I didn’t, actually. I just worked all the time. I gained 25 pounds, and developed varicose veins and plantar faciitis so painful, I took analgesics constantly. My blood pressure went up, and despite my best efforts, I could not eat healthy as a resident. I developed prediabetes, and basically ignored my physical needs altogether. It is a show of weakness to express the need for the requirement of basic human needs as a surgical resident. Going to the bathroom was a big deal, actually. My only saving grace was the fact that I was only in my mid/late 20s, and my body tolerated the abuse…abuse that would be difficult (perhaps impossible) to physically recover from for someone a bit older.

I had no hobbies, nor could I engage in any meaningful discussion with other people (outside of medicine), since I had no time to engage in the world activities and issues. I became very one dimensional, and my entire identity became “me, the surgeon.”

Living the dream.

I Roll Late Nights

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It’s been awhile since I’ve posted, and I’ve been getting emails asking if I’m still around. I’m here, but I’ve really taken a hiatus from the whole medical school thing recently. Now that I’ve been out of the game for awhile, it’s getting tougher and tougher to post shit about medical school.

I’ve recently taken on a new client in a revenue-sharing agreement, and I’ve been working hard at that. I’m currently reading a book on personal finance that kicks all kinds of ass, and should be required reading if you’re of high-school age or above. I think I’ll write more about that book in near future, but right now I’m kicking back and pulling in the $$$ doing what I love.

I’m not disappearing forever, but I’ll definitely be posting less in the future. Just giving you guys a heads up, but I love what I do and when I’m doing it, it’s like a vacation.

Updates soon (hopefully).

Hoover

Welcome To Hell

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Ahh, July 1st.

It came around so fast, just a mere two months of sleeping in and traveling since you walked across that stage with your medical degree in hand. Today’s a new day. Today begins the ritualistic flogging of new interns across the nation.

Waking up at 7am used to seem early, but now it will be considered late.  Weekends will now simply be another work day of another work week. Pimping will take on a whole other meaning now that you have to grin and bear it. Personalities that you thought never existed will be encountered every minute of your existence. While once sacred in your mind, medicine will — at some point — be something that you hate, even for a brief moment.

With the sound of a beeping pager going off somewhere in the background, we welcome you to Hell.

We’re glad you’re here.

Doctors Vent Their Discontent

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A recent story in the New York Times talks about some of the reasons physicians are frustrated with medical practice today. I’ve outlined some of the more concerning reasons below. Please, for your own well-being, consider these before you dig yourself too deep into the medical school hole.

1. Loss of Autonomy
“I’d write a prescription,” he told me,” and then insurance companies would put restrictions on almost every medication. I’d get a call: ‘Drug not covered. Write a different prescription or get preauthorization.’ If I ordered an M.R.I., I’d have to explain to a clerk why I wanted to do the test. I felt handcuffed. It was a big, big headache.”

2. Payment Denials
“Thirty percent of my hospital admissions are being denied. There’s a 45-day limit on the appeal. You don’t bill in time, you lose everything.”

3. “Informed” Patients
“Stories of patients armed with medical knowledge gleaned from the Internet demanding antibiotics for viral illnesses or M.R.I. scans for routine symptoms are rife in doctors’ lounges.”

4. Malpractice
“Malpractice worries also remain at the forefront of many physicians’ minds, compounded by increasing liability premiums that have forced many into early retirement.”

5. Decreased Realized Income
“Doctors are working harder and faster to maintain income, even as staff salaries and costs of living continue to increase. Some have resorted to selling herbs and vitamins retail out of their offices to make up for decreasing revenue. Others are limiting their practices just to patients who can pay out of pocket.”

6. Declining Reimbursements
“A 10.6 percent cut in Medicare payments to physicians is scheduled to take effect on July 1. Further cuts are planned in coming years. Many doctors have told lawmakers that if the cuts go through, they will stop seeing Medicare patients. But reimbursement cuts are only a small part of doctors’ woes today.”

7. Naive Pre-Meds
“I was naïve, Saeed Siddiqui said. When I was a resident I thought it was enough to take good care of patients. But the real world is totally different.”

The practice of medicine has made its way over the hill. Don’t say I didn’t warn ya.

All quotes taken from the original article.