NLengr Posted April 7, 2013 Report Share Posted April 7, 2013 I wish some of them did carry pagers. Maybe it would help their judgement when it was appropriate to call a consulting service. It's amazing how quickly they forget what it means to be on call. Some outwardly state that they enjoy abusing residents that are in-house call. Rant over. S. When I was an R1 I was once told by an ER doc to flat out lie to a consulting service so they would see the patient. He actually said "just lie to them". Needless to say I don't trust him as far as I can throw him when he calls me now. I double check everything he tells me. Besides that our ER guys seem pretty good lately. I'm home call and they tend to try and hold things in the ER till 6:30 am and then ask us to see them in the morning. They sometimes call for phone advice in the middle of the night but generally will try to handle things themselves overnight unless they are really worried about a patient (probably OR, septic etc.). Link to comment Share on other sites More sharing options...
shaka84 Posted April 7, 2013 Report Share Posted April 7, 2013 There are 4-5 guys at my centre who are just terrible. They don't work up the patients appropriately, call you about outpatient follow up at all hours of the night and have the attitude that the consulting services are at their beck and call. When I was an R1 one of them stated that he had to "keep his consultants in line." A few of them drop the term peritonitis to ensure that the patient gets seen ASAP. When you get there the blood work is still pending or not ordered. Imaging had not even been considered but the patient has even told they need an operation. Inappropriate and unprofessional. S. Link to comment Share on other sites More sharing options...
aaronjw Posted April 7, 2013 Report Share Posted April 7, 2013 There are 4-5 guys at my centre who are just terrible. They don't work up the patients appropriately, call you about outpatient follow up at all hours of the night and have the attitude that the consulting services are at their beck and call. When I was an R1 one of them stated that he had to "keep his consultants in line." A few of them drop the term peritonitis to ensure that the patient gets seen ASAP. When you get there the blood work is still pending or not ordered. Imaging had not even been considered but the patient has even told they need an operation. Inappropriate and unprofessional. S. Isn't there any recourse for such deliberate dereliction of duty and conduct? Link to comment Share on other sites More sharing options...
shaka84 Posted April 7, 2013 Report Share Posted April 7, 2013 Every service in the hospital knows these guys. They get spoken to by staff from time to time and things get a little better for awhile but they fall back to their old tactics. They truly believe that their job is simply to determine what service should see the patient and of course bill the system. Sadly, the remainder of the emerg docs say there is little they can do. It is amazing how only 4-5 bad ones can make such a big impact even in a large city. S. Link to comment Share on other sites More sharing options...
rmorelan Posted April 7, 2013 Report Share Posted April 7, 2013 When I was an R1 I was once told by an ER doc to flat out lie to a consulting service so they would see the patient. He actually said "just lie to them". Needless to say I don't trust him as far as I can throw him when he calls me now. I double check everything he tells me. That is exactly how to shoot yourself in the foot in medicine. All you have is your integrity and your skills. Link to comment Share on other sites More sharing options...
Satsuma Posted April 8, 2013 Report Share Posted April 8, 2013 Every service in the hospital knows these guys. They get spoken to by staff from time to time and things get a little better for awhile but they fall back to their old tactics. They truly believe that their job is simply to determine what service should see the patient and of course bill the system. Sadly, the remainder of the emerg docs say there is little they can do. It is amazing how only 4-5 bad ones can make such a big impact even in a large city. S. Sadly this is true in any profession and any specialty. There are good apples and bad ones. You may get some crappy consults from some emerg docs. But there are bad consultants too. The ones who hang up on you for no good reason. The ones who refuse to come see a patient you are worried about. The ones who just don't answer their pages. The ones who order a bunch of tests on their patients, and then when they are abnormal dump them on the ER to get things sorted out when they could have just managed it themselves. Hopefully, as we have all experienced both ends of this in our training, we will strive to be better physicians and work in a collegial manner, taking the patient's best interests to heart. Link to comment Share on other sites More sharing options...
ploughboy Posted April 11, 2013 Report Share Posted April 11, 2013 Every service in the hospital knows these guys...They truly believe that their job is simply to determine what service should see the patient and of course bill the system. Sadly, the remainder of the emerg docs say there is little they can do. It is amazing how only 4-5 bad ones can make such a big impact even in a large city. S. So sorry you've had to deal with that. That type of emerg doc embarrasses us, too... Link to comment Share on other sites More sharing options...
ploughboy Posted April 11, 2013 Report Share Posted April 11, 2013 I bet these docs feel as if their practice autonomy has been snatched from them. It won't matter what they do, someone will berate them for it. The consultant will berate them for managing the patient; the nurses will berate them for ordering too many investigations; the administration will berate them because their "wait times" are too long, or their patient satisfaction scores are low. When everything one does is met not with praise, or even acceptance, but with scorn, one tries to do as little of anything as possible and just get by. Disagree with some of your other statements, but I think the "wait times" one rings true. When "dispo" is valued over patient care then things start to fall apart. That's how people with new radiographic diagnoses of lung cancer wind up referred to cardiology ("but he's having chest pain and was seen in your clinic last week...") Link to comment Share on other sites More sharing options...
holiday1001 Posted April 11, 2013 Report Share Posted April 11, 2013 http://www.cma.ca/multimedia/CMA/Content_Images/Inside_cma/Membership/profiles/Emergency_en.pdf that number 238764$ is exactly the same as the average for FM making over 60k in the family med pdf... coincidence? i think not Link to comment Share on other sites More sharing options...
Dany Posted January 13, 2014 Report Share Posted January 13, 2014 In this document from BCMA - Section of EM (dated 2010) https://www.bcma.org/files/Emergency_Medicine.pdf on page 4: BC ERPs make 283k per FTE, making it 168-211$/h Manitoba 232$/h Ontario 248-255$/h Alberta 311$/h But these numbers are only cited as "confirmed by xxx physicians" instead of "official" statistics. Plus, as the whole purpose of this document made by BC ERPs is to whine about low pays, their biased position might have artificially skewed higher the number elsewhere Link to comment Share on other sites More sharing options...
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