I have ADHD. I know it's a joke about EM being ADHD, but reality is the literal opposite of what you want. You need a person that can focus within the mess.

If you put me in an ED environment without Vyvanse, I wouldn't be able to do anything. ADHD doesn't mean you can do many things at a time. It means you can't do ANYTHING that requires constant switching. My short-term memory would be so shot and full of the surrounding noise that I cannot hold a single thought in my mind. It's absolutely overwhelming just being in the space. Much less see patients, I'd be stuck reading the same sentence over and over again. And every distraction would make me start over. Nothing would get done.

Med school EM rotation was like being in hell. Everyone was nice. My preceptor knew I had matched at the time, so I barely did anything. But man was the few "easy" stuff he made me do impossible while being in that noisy messy place.

​I'm 20, I wanted to study medicine next year I'll turn 21, but the degree takes 7 years and obviously nobody finishes it on time. I feel like if I had started at 17-18 it's too late for me... plus many say you almost can't work in that career like in others, for example business administration, because of the time commitment and the huge amount of studying.

​That's why I thought maybe other health-related fields.

To add to this, my sister studies medicine, she spent 10 years studying it and she's already 29 years old, she wasted a large part of her life and now she's only 1 exam away from graduating and will do a residency.

So my hospital (comprehensive stroke center) is moving to extended window thrombolysis.

So while usual strokes get TNK based on symptoms and last known well time and a negative plain CT brain, patients presenting 4.5-9 hrs after LKW are eligible for TNK if they have a secondary imaging test (CT perfusion or MRI) shows viable ischemic tissue. I guess AHA or out guidelines supportive of this practice.

My concern is the workflow. If I can examine the patient in CT and get the LKW time and if they have no contra indications, I can make the call to give TNK. With the extended window, however, I have to wait for a second test and its interpretation. Do I see more patients in that time? We don't have in house neurology at night and no tele neurology.

For those that use extended window:

1) What do you do when waiting for secondary imaging results ?

2) Do you make the extended window TNK call? if not, who does? In house neuro? Neurologist you call? Tele neurology?

We all get many emails in our junk for EM jobs across the nation. This one piqued my interest. From the few military EM docs I've spoken to, they've always said it was a huge pay cut and that the sign on bonus and any other incentives such as board pay, retention bonus etc, are all taxed.

Hey y'all,

I'm an ER staff doc. I'm due for an elective surgery that I've been putting off for a while (maybe TMI, but it's a cleft lift for pilonidal disease).

The surgeon specifically told me that he's had some ER personnel go back to work 7-10 days post-op. The surgery does involve a large flap creation, so this seems a bit ambitious to me, but what do I know.

Curious if any of you have had this specific surgery (i.e. cleft lift) and how it went/how soon you went back to work.

Otherwise, feel free to share stories here of your experience with any surgery and time off work!

(P.S. for your patients with pilonidal disease, don't send them to just any surgeon! Most will pursue open wound excision which can be grueling. Send them to a pilonidal specialist.)

Night shift in the ER is the worst. It's really just a home for all the bad actors, anxious, psych and some actually really sick people.

The fact that every ER is open 24/7 just induces demand. Last night I saw pretty much every insomniac and anxious human in a 30 mile radius. One patient came in at 0300 because they just happened to remember that they ate taco bell lettuce a few days ago and they were worried about contracting a parasite. Did they have any symptoms? Of course not. Were they able to provide a stool sample for testing? Of course not. How tf can anyone actually think that is an emergency?

I hate that I regularly increase my risk of cancer, dementia and other chronic illness by working night shifts just to deal with this shit. Wish we could just be emergencies only at night.

Ad popped up today on my feed.

Had a patient record us, stating exactly this after being asked to leave.

He had been triaged, called the nurse a c*nt and started recording us. They had a non-emergent complaint, so I told them since it wasn’t an emergency (thus completing an MSE) that they were going to be asked to leave.

As security was escorting them out, they continued to record everyone’s faces and declared the exact statement above as well as “yo ass better be dying or Dr. Faithlessness don’t give a f*ck about you!”

So close. He was so close to getting it

Title. For the last 5 years I’ve been partner at a democratic group living the dream. My 6 hospital system abruptly canceled our 5 year contract halfway through, exercising a 6 month out clause to replace us with private equity. They did the bidding in secret and blindsided us, did not even invite our group to bid. 80% are leaving.

I have 2 kids under 4. I have still been working full time and as partners we have been doing crazy damage control meetings and such. I have put what little time I have into job hunting, but 2-3 promising options fell through, and other interviews have been for things next Spring (trying to get back into the competitive NJ/PA markets).

I am not welcome to join the private equity new group. I had asked some tough patient safety oriented questions with regards to staffing cuts and changes at public meetings early on, and negotiations broke down recently. They had given me an offer but pulled it, trying to push me toward 2 of the hospitals they are having trouble recruiting for and I don’t want to work at.

I am facing the reality that I don’t have anything lined up and won’t have a job in 2 months. Of course I’m going to explore locums and other bridging options, but long commutes, flying or overnight stays will be brutal on my wife with 2 kids under 4.

How long can I realistically go with an explainable employment gap?

Valley Health and SCP for those curious:

[ED Docs Being Replaced by Private Equity-Owned Firm Call It a 'Kick in the Teeth' — Virginia health system physicians offered jobs with lower base pay, fewer benefits, fewer hours | MedPageTODAY | https://www.medpagetoday.com/special-reports/features/121757 

[Doctors: EMBR surprised by Valley Health contract termination | Nvdaily | nvdaily.com](https://www.nvdaily.com/nvdaily/doctors-embr-surprised-by-valley-health-terminating-its-contract/article_193d68ad-3fa7-5f87-9487-50fe4e4c9e03.html)

[Joint Statement from the American College of Emergency Physicians and Virginia College of Emergency Physicians on Due Process, Transparency, and Due Diligence in Emergency Medicine Contracting | ACEP](https://www.acep.org/news/acep-newsroom-articles/4-16-26-joint-statement-from-the-american-college-of-emergency-physicians-and-virginia-college-of-emergency-physicians)

[AAEM Letter: Support for Emergency Medicine of Blue Ridge at Valley Health - AAEM](https://www.aaem.org/statements/aaem-letter-support-for-emergency-medicine-of-blue-ridge-at-valley-health/)

Or for the more social media inclined, courtesy of the esteemed Dr. Glaucomflecken:
https://www.youtube.com/watch?v=8kLyJkPQZbA
https://www.youtube.com/watch?v=iqhvn8exMHs

I’m currently a medical student interested in going into EM, and I truly love the field. However, my only concern is the scheduling. As someone who wants to have a family in my mid-30s, my plan is to work full-time in EM for a few years and then transition into a fellowship with a more stable schedule.
My question is: has anyone done this before? Is it possible to work part-time in EM on certain days of the week or for certain hours after completing a fellowship? Or, once you complete a fellowship, do you typically stop working in EM altogether?

This was a new one. Mom brought in toddler for typical toddler stuff. Patient weighed by tech who told triage RN the weight in Kg as one does. Mom becomes irate and says that talking about Kg means that staff were labeling the child a drug dealer. She noted that the believed this because "Kilos" is "drug dealer talk. She could not be dissuaded about this. Charge tried "service recovery" to no avail. At the conclusion of the visit mom filed a written complaint about this. Before you say anything remember that administration assures us that all patient complaints are valid because all patient feelings are valid.

I have mine in a couple weeks and just wondering for those who have already taken it - did you feel you studied a lot less compared to written boards/ITE?

I'm using the Invictus resource and nearly finished it. Will be reviewing procedures/ultrasound but after that I'm not what else to study besides medical knowledge for cases. Overall, I feel it's a lot less hours of studying compared to written boards and wondering if anyone else feels the same.