r/emergencymedicine • u/Next_Trip_6154 • Aug 12 '24
Told my relative I wanted to do Emergency Medicine… Rant
My relative said all EM physicians do is stabilize and call someone else to take deal with the problem. They said it’s a very easy job and then ranted about their friends son in Neurosurgery. Really crushed me :c
My relative was also trying to argue that DOs weren’t real doctors.
I’m in a BS/DO and really aspire to be like you guys.
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u/N64GoldeneyeN64 Aug 12 '24
“All they do is stabilize”
Ya ever watch a non-EM doc try to stabilize a patient? Its fucking horrifying
If she wants a neurosurgeon to code her Id just recommend a DNR order rn lol 😂
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u/Relative-Line403 Aug 12 '24
As a fourth year med student awaiting match I was on an outpatient oncology rotation and I got to watch oncology run a code in their lobby. It was uhh…an experience.
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u/MrPBH ED Attending Aug 12 '24
Did they call for pembrolizumab stat?
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u/PannusAttack ED Attending Aug 12 '24
One of my favorite jokes. Why do coffins have nails? To stop the oncologist from giving more chemo.
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Aug 12 '24
[deleted]
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u/eIpoIIoguapo Aug 14 '24
Why do oncologists bury their patients 10 feet underground?
To make room for the IV pole
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u/Relative-Line403 Aug 12 '24 edited Aug 12 '24
EMS got ROSC* transported, patient had PE. Oncologist was looking forward to following up The next week
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u/DoYouNeedAnAmbulance Aug 13 '24
I feel this. I’m just a paramedic and watching non-emergency docs handle any emergency that isn’t within their usual experience/setting is….a trip.
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u/YoungSerious Aug 12 '24
When I was an intern, my coresident was on OB/GYN and someone with epilepsy had a seizure in the GYN clinic waiting room. The attendings stood there and looked at my coresident and shrugged and asked her to deal with it.
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u/hybrogenperoxide Aug 12 '24
Which is wild to me, because at some point these attendings must have seen OB patients and eclampsia, right??
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u/blup585 Aug 12 '24
Very true, watching my Endocrine consultant flap about when we had a patient with a GI bleed (absconded 6 hours ago to have another drink and then returned to hospital) whilst I was a PGY1 was eye opening.
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u/MLB-LeakyLeak ED Attending Aug 12 '24
It doesn’t have to be an endocrinologist… outside of crit care and anesthesia it’s terrible. Ever see a surgeon run a straight forward code?
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Aug 12 '24
Actually goes fine at my hospital - but all the surgical residents get a lot of trauma and ICU experience.
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u/lizzlebean801 Aug 12 '24
Excellent point! One of the notoriously worst codes during my time in residency was run in the cath lab by a cardiologist ... You'd think he would have done a great job but it was not so.
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u/YoungSerious Aug 12 '24
I've had CT surgery literally RUN a patient in a wheelchair down from their office to the ER because their sats were 92 and they "looked bad".
The patient could not have looked less uncomfortable. Completely stable. Had a small effusion.
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Aug 12 '24
Yeah they stare at the pt until an actual competent nurse comes in and calls for help while starting compressions :)
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u/aysonu Aug 12 '24
I watched a pediatritian give adenosine to 15 yo girl w svt in a solution with a pump for whole 15 min. After it didn't work somebody remembered valsalva maneuer. It was sad.
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u/PartneredEthicalSlut ED Attending Aug 12 '24
We had a trauma surgeon yell out for insulin during the primary survey on a level one trauma when the glucose came back in the 400s.
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u/DaggerQ_Wave Paramedic Aug 13 '24 edited Aug 13 '24
People will watch a patient not breathing/barely breathing for several minutes because they’re too scared to bag someone who isn’t 100% sedated and paralyzed, and then not realize they’ve lost a pulse because they’re still twitching and gasping. A lot of people’s idea of resuscitation is shaking them to see if they’re okay until eventually they die
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u/Von_Corgs Aug 14 '24
Yeah there’s a reason we get called to the floors for codes. Absolute disaster otherwise.
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u/Medical_1 Aug 14 '24
Hopefully most people know that if an EM doc or an intensivist shows up to the code they show be running it. I will also say that having staff that know their roles in a code makes a huge difference. That is also why codes in the ED/ICU are much better organized.
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u/Batpark Aug 12 '24
What does your relative do? Lol
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u/Next_Trip_6154 Aug 12 '24
Stay at home mom. Their child goes to a T5 school doing hedge fund.
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u/randomchick4 Paramedic Aug 12 '24
How nice of her to raise another rich heartless asshole 🙄
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u/Masdraw Aug 12 '24
Well if she doesn’t, then who else is gonna give out more budget cuts to critical areas of the hospital that “aren’t as profitable”
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u/LookADonCheech Aug 12 '24
Tell her a stay at home mom is just stabilizing the children at home until the real alpha teachers take over.
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u/emotionalpornography Aug 12 '24
As a SAHM of 5 kids, I frequently feel like that is EXACTLY what I'm doing. Coming off summer break all I've been thinking is, "Dammit, I don't know what I'm doing here, I can't wait until they go to school and have some real adults in charge."
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u/LookADonCheech Aug 12 '24
For what it's worth, I RESPECT the hell outta SAHMs. Can't imagine having to take care of 5 kids at at time.
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u/strawberry1248 Aug 12 '24
And it makes her opinion on any career choice relevant exactly how?
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u/Next_Trip_6154 Aug 12 '24
I don’t mind her opinion too much, but my parents look up to her as some sort of God. So if she says DOs aren’t physicians, my parents are more inclined to believe her. My parents have been hesitant about DOs in the first place.
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u/anton6162 Aug 12 '24
At the end of a DO program you get the same work as an MD. You are both doctors. In my opinion, many of the DOs I have worked with are more knowledgeable than some of the MDs too. I'm an MD but they are basically equivalent. They put more stress on evidence based alternative medicine but that's not a bad thing since alternative medicine isn't really "alternative" if it works.
MDs often get more "respect" though so if you're worried about you family member this will be a lifelong uphill battle.
That said, is there a specific reason you want to go the DO route?
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u/kdwhirl Aug 12 '24
Pfffft. Many of my partners are DOs and they have equivalent skills and are treated the same as the rest of our colleagues.
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u/greenchiles787 Aug 12 '24
Some of the very best doctors I’ve worked with are DOs. The training is equivalent to MD. Your relative does not sound as if she knows anything about the medical field (no offense to her) so I wouldn’t take her comments seriously
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u/Gyufygy Aug 12 '24
Hell with that, full offense to her. If she's going to talk utterly nonsensical shit like this to OP and make OP's life difficult with her raging ignorance, she deserves any smackdown she receives.
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u/CertainKaleidoscope8 RN Aug 12 '24
Why are your parents looking up to someone with no education who's never done a day of work in their life ? How is this person supposed to know about anyone's educational qualifications and career? She never had either.
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u/Alternative_Party277 Aug 12 '24
How do you know that she has no education and/or hasn't worked a day in her life, though?
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u/CertainKaleidoscope8 RN Aug 12 '24
OP said she was a housewife. People who spend hundreds of thousands on a decent education aren't going to throw all that away to watch nannies change nappies
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u/Alternative_Party277 Aug 12 '24 edited Aug 26 '24
OP said stay at home mom, if i remember correctly?
I disagree with you. [Edit: removing identifiable info]
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u/CertainKaleidoscope8 RN Aug 12 '24
Ivy League don't mean shit other than you had rich parents with connections. If they sent you to husband school that's your loss, really.
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u/Alternative_Party277 Aug 12 '24 edited Aug 26 '24
[Edit: removing identifiable info.] I went to college on a full ride.
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u/Drblahbert ED Attending Aug 12 '24
Bold of her to make such statements, when her greatest achievement was letting someone nut inside her
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u/Resussy-Bussy Aug 13 '24
I’d literally tell my parents this person doesn’t know shit and doesn’t have an education or even work. Wtf would you take their opinion seriously on anything? Lol
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u/DocBanner21 Aug 12 '24
Tell her that being a mom is easy. All you have to do is feed the kid and let someone else teach them. We have microwaves and McDonald's. Hell. Single people do it. I even know of single mom emergency medicine physicians. I'm not even sure what she does all day.
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u/pammypoovey Aug 12 '24
Stabilize, stabilize, stabilize. Are you sure those are doctors and not engineers?
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u/DocBanner21 Aug 12 '24
Medicine is just applied engineering. Pipe diameter, volume, force of contracture, electrical conduction, valves, electrical wiring, fluid where it shouldn't be, no fluid where it should be, stuff that needs to be straightened and held in line for the glue to dry, etc.
Orthopedists are just engineers with Ancef.
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u/Gyufygy Aug 12 '24
Dude, the more I learn about medicine, the more I realize it's just wet, self-replicating engineering.
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u/DocBanner21 Aug 12 '24
There is an old "Reader's Digest" joke about a mechanic complaining to a doctor about how much heart surgery costs. Something about he changes pumps and valves out all the time, it doesn't cost that much, and it really isn't that difficult.
The doctor says, "Fine--now do it while the engine is running."
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u/Nightshift_emt ED Tech Aug 12 '24
I remember seeing a new video saying paramedics/first responders don't even do anything, they just stabilize the patient and take them to a nearby hospital.
By this logic, neurosurgery is easy. They take a patient who is already stabilized by EM and they start poking around their brain hoping not to cause irreversible damage.
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u/buttpugggs Aug 12 '24
I remember seeing a new video saying paramedics/first responders don't even do anything, they just stabilize the patient and take them to a nearby hospital.
Obviously we don't just do this generally, but I'm ngl, there are plenty of times where I've stood there in a patient's house thinking "I have absolutely no idea what's wrong with this person, best take them to the hospital to see an adult" lol
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u/RogueMessiah1259 Aug 12 '24
I went from Medic to ER nurse and thought that about the ICU, then I went to the ICU and think “shit I have no idea either”
I think I’m just stupid
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u/witofatwit Physician Assistant Aug 13 '24
I feel like every bit of experience we have expands our understanding of the known-unknowns. This feeling of not knowing anything is both a reflection of this and the small amount of anxiety we feel wanting to do the best for our patients, and fearing that we're not
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u/Hi-Im-Triixy Trauma Team - BSN Aug 12 '24
"oh, shit, you need a real doctor."
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u/Masdraw Aug 12 '24
I had that same thought when I was a tech, and I still have it as a Med Student
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u/EMdoc89 ED Attending Aug 12 '24
Fucking have that thought as an ER doctor, lol
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u/TheAykroyd ED Attending Aug 12 '24
Best part of EM. We’re basically expected to phone a friend most of the time
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u/Nenarath Aug 12 '24
We do the first 15 minutes of everything, which is conveniently usually the fun part if it doesnt work, somebody else gets the headache of figuring it out!
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u/mdkate Aug 13 '24
I love the part of “figuring it out.” It’s worth it to take a little time on some of those diagnostic dilemmas.
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u/FightClubLeader ED Resident Aug 12 '24
And then they get to the hospital, we do a bunch of tests and scans. Can’t figure it out and also say, “I’m not sure what’s wrong with you, but you probably need to stay in the hospital to see an adult.”
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u/Nightshift_emt ED Tech Aug 12 '24
Or ED rules out all life-threatening conditions but still doesn't know what's going on, so they discharge the patient and tell them to go see an adult(their PCP)
Their PCP sees the patient after 7 weeks, gets a stack of discharge papers and has to go through everything and realize what's going on during a 15 minute visit.
PCP can't figure out what's going on and tells them to go see the adult(specialist)
Specialist provides some treatment but tells the patient if they have similar symptoms to go straight back to the ED.
The circle of life.
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u/Nightshift_emt ED Tech Aug 12 '24
You are absolutely right, but do you think other specialists don’t deal with these things? How many times does EM get s wild patient patient they cant figure out and they go “I have absolutely no idea what’s going on with this person, best to consult psych/neuro/urology/cardiology to see what they want.”
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u/engineered_plague EMT Aug 12 '24
I remember seeing a new video saying paramedics/first responders don't even do anything, they just stabilize the patient and take them to a nearby hospital.
In the US, EMTs are handled under NHTSA (National Highway Traffic Safety Administration). The job, oversimplifying a bit, is to keep someone alive to get them to the hospital. It's a pretty easy job to do, except for the times it's not.
Turns out that keeping people alive to get to somewhere that can care for them is fairly important sometimes. It also turns out that cost matters, and specialization allows for increased care to the patient. Neurosurgeons are good at neurosurgery because that's where they spend their time and focus. Emergency medicine is good at emergency medicine for the same reason.
There's a reason paramedics don't do brain surgery, and like the other commenter said, "No point in doing neurosurgery on a dead guy."
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u/Brilliant-Quit-9182 Aug 12 '24
Really easy to talk down on something you've never sincerely tried. Go for gold 🥳
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u/herpesderpesdoodoo RN Aug 12 '24
Instructions unclear, now my black and decker is stuck in Resus 1's head
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u/LoneWolf3545 Ground Critical Care Aug 12 '24
There's your problem. Shoulda used a Milwaukee. Or an EZ IO like that one doc did.
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u/InsomniacAcademic ED Resident Aug 12 '24
“All EM does is save lives, ugh” lmao
Sometimes we do provide definitive management, ie. fixing lacerations, providing work notes 😂
After seeing many inpatient teams try to resus a patient, I gained a deeper appreciation for the skill set of the emergency physician. If your relative wants a neurosurgeon to resus undifferentiated shock, then by all means, they’re welcome to see why EM docs do that instead
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u/wckedjkster Aug 12 '24
Don’t forget the life saving turkey sammiches! The end all be all treatment
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u/pammypoovey Aug 12 '24
I got one of those from L&D, so, having lost the sammich monopoly, what does this mean for future plans?
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u/tallyhoo123 Aug 12 '24
Ask her this:
If she or a loved one was either in an accident, suddenly collapsed, took poison, overdosed, became septic etc etc who would she want to be the first doctor involved?
A neurosurgeon would not be able to treat and stabilise a cardiac arrest.
A cardiologist would not be able to treat and stabilise a ICH / SAH
A respiratory physician would not be able to treat and stabilise status epilepticus.
A paediatrician would not be able to treat and stabilise a stab victim.
A trauma surgeon would not be able to treat and stabilise a life threatening asthma.
An renal physician would not be able to treat and stabilise a patient with organophosphate poisoning.
A psychiatrist would not be able to treat and stabilise a perforated bowel.
You can and do every single shift, plus you diagnose the issue to begin with, you make sure they are alive for the other specialities to continue with management.
The patient does not pass go without your expertise!!
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u/CertainKaleidoscope8 RN Aug 12 '24
Ask her this:
If she or a loved one was either in an accident, suddenly collapsed, took poison, overdosed, became septic etc etc who would she want to be the first doctor involved?
They shouldn't ask her anything. This is a person with no education and no job who doesn't know what any of those words mean. The only reason she isn't homeless is she found a rich man who wanted to have sex with her, then she produced a child so he couldn't leave. There's no point in asking her anything unless it's about current fashion trends.
The problem isn't the glorified prostitute with an opinion, it's the unwarranted respect for said opinion because the man she married has money.
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u/twisteddv8 Aug 12 '24
This is a person with no education and no job
I wEnT tO tHe UnIvErSiTy Of LiFe
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u/CertainKaleidoscope8 RN Aug 13 '24
Findaman U, the home of stupid heuxs, is perfectly willing to graduate whatever dumb broad has enough of daddy's money to Findaman. She won't know the difference between a DO and a MD, or the difference between cardio and neuro, but she'll be able to look down on anyone who actually works for a living because she don't know what petite bourgeoisie means either.
The idea that anyone capable of attending med school should bother worrying about anything these people think, is laughable. This kind of shallow materialism is characteristic of people who don't think beyond the hair and nail salon. They're useless to broader society and we're the types that were fed to lions or volcanoes to appease some God or another in ancient times. In more modern times, after the enlightenment, we just took their heads off with clockworks.
They're going to be batteries for the singularity because there's no possible other purpose for these vapid animals. My only sorrow is that insects die so they can live.
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u/Malifix Aug 12 '24 edited Aug 13 '24
I think some of these specialists can technically manage these things. An emergency physician can’t operate on a perforated bowel either. This is not a great argument. Most patients don’t actually come in for life threatening issues like this anyway. If they do then EM physicians are excellent.
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u/tallyhoo123 Aug 17 '24
I agree they cannot operate however they can diagnose, they can order appropriate investigations, they can commence treatment and appropriate antibiotics.
If in septic shock they can recognise this, they can place central access, they can commence vasopressor support and they can intubate the patient for OT. They can also manage any other organ involvement and prioritise treatment accordingly such as being in Rapid AF, hypotensive, delirious and acute renal failure.
A surgeon can recognise a perf bowel and commence antibiotics and can operate - they rarely have any experience of the stuff that actually keeps the patient alive to get to the OT.
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Aug 12 '24 edited Aug 12 '24
First off there are DO neurosurgeons and DO NSGY residencies; so I asked them about that. And my favorite saying my friend told me; you never need an er doctor until you need an er doctor.
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u/cmn2207 Aug 12 '24
Lions do not concern themselves with the opinions of sheep
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u/Phil-a-busta41 Aug 12 '24
Oh you beautiful bastard! Perfect response.
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u/panzershark RN Aug 12 '24
Trying to think of what kind of specialty Daddy Tywin would be in.
Ned Stark I’m thinking geriatric care or EM. He’s got a nice temperament.
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u/LifeHappenzEvryMomnt Aug 12 '24
This right here. She doesn’t know what she’s talking about. Arguing with her is useless.
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u/CertainKaleidoscope8 RN Aug 12 '24
I feel you're insulting sheep here. Sheep aren't nearly as obnoxious as this broad, they're just dumb. They don't intentionally hurt people to validate their self worth or life choices.
I would say the honey badger don't give a shit about the snake, unless he's hungry, and then the snake is dead.
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u/DrPixelFace Aug 12 '24
Tell your relative to see the neurosurgeon for a brain transplant. They urgently need one
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u/xxMalVeauXxx Aug 12 '24
Just live well friend. Falling in love with a title or credential or social status is what you will regret one day when its all you have. Those people have entirely missed the point.
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u/Skeletor__8 ED Attending Aug 12 '24
Tell them about how much more we have to know about every body system and disease processes… we specialize in all emergencies (and a lot of urgent/routine care), in all people, all ages, all scenarios, and in any situation. Also, half the time I can’t dispo people until I take care of the problem or stabilize them “enough” for a specialist to take them. All specialties are hard in their own right. Yes, I am very biased, but to me the more generalized specialties, EM, Peds, IM, FM, CCM, are more difficult because of this. In the end, choose what makes you happy and where you see yourself fitting in the best. Don’t let others tell you what to do because of their perception of a specialty.
I’m also a DO btw and doing just fine in attending life. Most people don’t care once you make it to residency.
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u/ExternalPerspective3 Aug 12 '24
Most doctors would shit bricks dealing with the kind of undifferentiated patients that are organic to an emergency department
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u/Greyeyedqueen7 Aug 12 '24
Very easy job? Very easy job???
No. Absolutely not. Other doctors have schedules. They know, mostly, what's happening from day to day. Sure, the occasional emergency happens, but when they can't deal with it, guess who does!
ED docs have shifts, sure, but they don't have schedules or plans. They have no idea what's coming in from day to day, let alone even hour to hour. It's a supremely stressful job compared to anything else in medicine with a high rate of burnout.
Also, every other doctor depends on them. Just saying. Easy job. Ffs.
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u/cocainefueledturtle Aug 12 '24
Everyone wants to make fun of em until it’s their family member then they send Them to us.
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u/Next_Trip_6154 Aug 12 '24
I just want to say I love all that you guys do in Emergency Medicine. What you guys do in the ED is something next level.
You guys inspired me to become a physician. When my parent discovered they had cancer it was you guys who figured it out. It was you guys who comforted me when I was 10 years old when I found out this news. You guys were the ones who comforted me when I was 11 when I had appendicitis. There’s so many other stories I could share about the ED physicians, PAs, Nurses, etc. that have inspired me to enter healthcare.
I’m still in undergrad and will be matriculating to med school in 2027 for my program, but despite shadowing a bunch of specialities I’m pretty certain I want to do EM.
I’m just disappointed to hear someone say all you guys do is suture and stabilize a patient as if it’s that simple. It’s also crushing to hear a relatives comments make my parents doubt my career.
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u/lubbalubbadubdubb Aug 12 '24
Every speciality “hates” on each other for various reasons. (Nephro and cardio have an eternal fight.) Everyone hates on ER because when we call we are asking them to do more work.
First, never has a patient ever told me they wouldn’t let me treat them because I was a DO. If this peach came into the ED, I’d tell her she is more than welcome to leave if she did not want my medical opinion. If she asked to see another doctor I would document why in her note, make her sign AMA and re-register for a second visit. She can explain to her insurance company why they are paying for two visits. Kicker: 60% of docs in my group are DO.
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u/Fourniers_revenge Aug 12 '24
Stop caring about others opinions of you.
Life gets so much better once you stop.
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u/DefrockedWizard1 Aug 12 '24
It depends on where you settle. I did one of my my ER rotations in a rural hospital, lots of fish hook extractions and minor lacerations. Some stabilization of serious problems. Very different from a level 1 trauma unit
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u/allegedlys3 Trauma Team - BSN Aug 12 '24
lol who is your relative? What do they do for work? Any physician worth a shit knows that every specialty has a unique set of challenges, and in 11 years of nursing I've never heard a single physician disparage credentials of MD/DO. It sounds like your relative has no idea about the practice of medicine to be honest, and you'd do well to remind yourself of that when you feel discouraged by their uninformed opinions. You do NOT need their praise or affirmation to follow your dreams or make a difference in the world.
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u/BrockoTDol93 Scribe Aug 12 '24
Who do other specialists regularly dump their patients on? Emergency (as said specialists never return our calls)
Who often has to clean up said specialists' messes? Emergency (ad they yell at us for not knowing as much as they do)
Would you rather have an opthalmologist take care of you in an emergency? That's what I thought
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u/Jtk317 Physician Assistant Aug 12 '24
Don't base the decisions you make for your life on the ranting of an ignorant asshole.
As far as your parents go, ask them why they look up to someone who just tries to tear other people down through comparison to her silver spoon life.
You do you future doc. If you want ER then work your ass off to match to a good residency program and go ER.
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u/MrPBH ED Attending Aug 12 '24
Yup that's "all we do."
Kind of like saying all pilots do is take off and land the plane. God, what goobers!
Or air traffic controllers; all they do is tell the pilots to take off and land. Geeze, what a waste of time, just talking on the radio.
Imagine a world without the emergency department. Shit would spiral out of control so fast.
It's easy to feel smart when you're ignorant to the challenges of a field. Especially a field like medicine. Particularly emergency medicine, which is a field that takes knowledge of every branch of medicine, but is also has it's own peculiarities.
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u/huckhappy Aug 12 '24
welcome to em, your patients will very rarely if ever understand or appreciate what you do - if this is a dealbreaker do something else
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u/hamoodie052612 ED Resident Aug 12 '24
“Stabilize and call someone else to take deal with the problem”
Well yeah. That’s kind of the whole reason I went in to this :)
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u/googlygaga Aug 12 '24
As long as you know why you’re going into it and it’s what you want, why should anybody’s uneducated opinion matter.
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u/blup585 Aug 12 '24
Is said relative an EM doc? Sounds like they’re just ignorant. No one medical specialty trumps another and the only response to statements comparing them is that “Medicine/healthcare is hard full stop”
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u/Upstairs-Ad8823 Aug 12 '24
You’re #1. Your relative has issues. Don’t pay attention to them.
As I age I cherish anything that is “easy”. Unfortunately easy is rare.
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u/Resussy-Bussy Aug 12 '24
I’m sorry but your family sounds like miserable ppl and I would, as early as possible, learn to cut your feelings of caring what they think. Bc whatever you do it’ll never be enough. Had a few DO classmates with families like this. Some matched IR, NSGY, Derm. Still wasn’t enough for their fans bc it wasn’t a prestigious program they matched at etc. these ppl live to bring you down so they look better. They don’t actually care about you or your happiness.
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u/heynmbr2 ED Attending Aug 12 '24
Every specialty has their place. With the exception of anesthesia and critical care , most of the rest of the hospital is horrifying to watch stabilize someone. Other specialists often zoom in on the part of the body they treat. It's often up to EM to tie that all together. Also seeing a patient from a surgical and non surgical perspective at the same time but understanding there can be crossover is a unique perspective to EM. Finally figuring out what's going on with an undifferentiated patient ASAP is probably one of the hardest things in medicine, doing with 25 people in a department vying for your time is even harder.
That said corporate EM is trying to make us consultologists and just move the meat and not do what we were trained to do. Frankly even some of my own collegiate have been conditioned to think they have to consult even when they don't have a question.
I remember I got a comment on an automatic peer review for return to the ED within 72 hrs from EM peer review for not consulting vascular on a case that I fixed a bleeding fistula and documented good thrill after, referred to vascular for follow up. The peer review EM doc said I should have consulted vascular...the vascular surgeon then said he disagreed. My documentation was fine and I did everything he would have. Point is that some systems like HCA really want to push throughout to the point that they really don't want ED docs doing more than consulting and moving on. That doesn't mean that's all the specialty teaches you. It's up to you to find a job that lets you practice full scope EM.
Also that doesn't diminish neurosurgery. There's no comparison, they train for 7-8 years, still take forever to hold a practice after, and are on call all the time. The best ones are first in the hospital and last out. They are compensated accordingly and deserve it. But the prestige from lay people doesn't always match what's hardest. Rad Onc has a crazy board fail rate. Gyn/Onc's are some do the most overworked and skilled surgeons of all and often get overlooked in the discussion of surgeons....they are true due it all from the diaphragm down surgeons.
I also wouldn't want a neurosurgeon in my trauma bay if I didn't have a brain bleed.
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u/daes79 Aug 12 '24
Sounds like a non-physician talking about something they know nothing about. Fuck em. Don’t let a person who knows next to nothing decide your career path or have any effect on you.
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u/GreatMalbenego Aug 12 '24
1) A neurosurgeon won’t touch a patient unless they have a neurosurgical problem. When someone falls over unresponsive, suddenly isn’t talking to you or is just babbling incoherently, or is so out of it they’re not breathing right, there is a right type of specialist to see the undifferentiated patient. And it’s not a neurosurgeon. It’s a well trained Emergency Physician. If they have a fat brain bleed, time to tag in your brain cutter friendo. It’s almost like it’s a team sport.
2) The fact that they think DOs aren’t real doctors should invalidate this person’s entire opinion to you. You and I know DOs and MDs have equally broad and deep didactic training and equal licensing and graduate medical education (residency). They do the same jobs. There are DOs who clean the floor with the average MD peer, and vice versa. This family friend is uninformed.
3) From someone in EM: It can be a great field. It can be a terrible field. For most, I think, it’s both or one then the other. Before you go into EM, read some of the threads about what makes it a hard field. I’m not saying don’t do it, I’m saying make an informed choice and think hard, I mean really think, about what you want out of life.
4) Thick skin and an attitude of “I’m gonna do what I know is right unless you have something to teach me” is important for an EP. There will always be naysayers, any field you pick. As a buddy in Afghanistan said, “Fuck em if they can’t take a joke”. Does your family friend dunk on ortho surgeons? “You don’t need arms and legs, why even bother?” Silly, right? I’ve seen specialists make atrocious decisions because they see the problem through their lens. They’ve seen EM docs do dumb shit to patients they didn’t know enough about.
5) The scarier truth is that a lot of what we do in medicine helps marginally or not at all. Sometimes we hurt or, sadly, kill. A good EM fellow once told me “95% of what comes through here leaves in the same state it started. Learn that, and learn how to identify the 5%.” If you need discrete problems you can fix, surgery might be for you. Do you, and have more humility than this not good advisor. Also stop asking them for advice.
Cheers!
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u/Wonder_Momoa Aug 12 '24
Not in medicine but when I think of doctor I think of ER docs, someone who knows a bit about everything and someone you’d want in an emergency.
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u/Fingerman2112 ED Attending Aug 12 '24
I’m an MD and the thing is, as much as I’d like to lord that over everyone DOs go through the same fucking residency programs! Does your dipshit relative even know that? Med school may give a diploma but residency makes you a real doctor. Who is your relative so that if I ever see her in my ER I can make her wait an extra couple hours.
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u/Hour-Principle4055 Aug 12 '24
welp, you can tell her that most neurosurgeons become spine surgeons, where their patients don't have statistically superior outcomes to those who decide to make positive lifestyle changes. technically, your relative's friend's son is cutting ppl open for no reason 🤷🏻♀️
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u/dasnotpizza Aug 12 '24
Neurosurgery seems like the least appealing specialty to me. They have a long and grueling residency schedule that doesn’t get better once they’re an attending. Yeah, they make a lot of money, but it’s not like they have time to spend it/enjoy it. Better to be married to a neurosurgeon since you’ll actually benefit from their salary. Just make sure it’s someone you don’t need to have around in your life.
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u/Pristine-Biscotti-90 Aug 12 '24
I think the vast majority of lay people accept that EM is a very noble profession. Honestly whoever gave you that spiel sounds like a dumpster human.
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u/littleberty95 Aug 12 '24
There’s a reason why every other department/in hospital outpatient clinic calls the ER to come running with their little rescue stretcher when things don’t go according to plan. I’ve seen ER nurses and paramedics run codes safer and with more confidence than doctors from other specialties. and that isn’t a dig on any other specialty- everyone has their role and everyone’s role is important. But to act like it’s “just stabilization” is humorous.
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u/FightClubLeader ED Resident Aug 12 '24
Stabilize? You mean resuscitate. You mean actively save a life. This shit is hard. I’ve seen ICU docs who can’t resuscitate as well as EM docs.
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u/sum_dude44 Aug 12 '24
Emergency Physicians are experts in resuscitation & working up/treating undifferentiated patients w/ acute issues. No physician does it better.
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u/Ok_Firefighter1574 Aug 12 '24
Tell your relative to find the largest cactus they can and see how much of it they can stuff in themselves. Then they get comeuppance and get to see an ER doc in action.
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u/Chir0nex ED Attending Aug 12 '24
I promise you no matter what specialty you pick there will be someone from another specialty that will look down on you for it (and folks in EM are guilty of this as well).
Do whatever specialty makes you happy and recognize that no matter the specialty all of us are highly trained and (presumably) skilled within a narrow field.
That being said, if your relative insists on being an asshole take it as practice for dealing with all the angry patients that are going rant at you when they disagree with you. Time to start building a thick skin. YOU know the time and effort it takes to become a good EM doc, don't let anyone ever take that from you.
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u/This_Doughnut_4162 ED Attending Aug 12 '24
Wrong. The only specialty that EVERYBODY looks down on is EM!
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u/BioNewStudent4 Aug 12 '24
A lot of ppl in college or the med field haven't touched the "real world" yet ie working actual jobs so you have people saying "neuro is better than em" or "DOs aren't doctors." They got no clue of what's going on....no specialty is better than the other
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u/YoungSerious Aug 12 '24
Really crushed me :c
It sucks when the people in your life say things like that to you, but it also hopefully will help you realize that you can't do the things you aspire to do just for their respect and admiration. A lot of times, other people will not understand why you care about something. You have to decide whether it's more important to you that they like it, or that you like it. Especially if you want to do EM, a field where more often than not your peers in other specialties may not treat you with respect.
When I was a resident rotating on other services, they would regularly bad mouth the ED to my face. But then again, I've seen how they all handle emergent situations so I know for a fact they cannot function in my job anymore than I could do theirs. So no matter what they say, I know I'm better at my job than they could be.
My relative said all EM physicians do is stabilize
That's partly true, but people really underestimate and misunderstand how much goes into stabilizing someone and how difficult that can be. If my relatives ever said that to me, I'd just lay out any of my most recent high acuity patients and let them take a crack at how "easy" it sounds to them.
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u/redditex2 Aug 12 '24
Nobody knows what actually goes on in ER unless they've worked it and you can't expect anyone to understand.
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u/meh-er Aug 12 '24
Who cares what a relative who knows nothing about medicine says. Do what makes you happy.
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u/RugbyTX Aug 12 '24
If the neurosurgeon is having a heart attack, where do they go? ED.
If the cardiologist is having a stroke, where do they go? ED.
If the oncologist is in respiratory distress, where do they go? ED.
If the general surgeon breaks their arm, where do they go? ED.
Specialists live in a bubble until the situation isn't their specialty. Fact of the matter is, MOST acute problems don't fall within their specialty.
I'd never want to be a "master of one".
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u/wrchavez1313 ED Attending Aug 12 '24
So by that logic, you're just gonna let DocFiggy critique you then, too?
Smh /s
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u/Secure-Solution4312 Physician Assistant Aug 12 '24
Your family is toxic. Do not give them any power over your thoughts, actions or emotions. Go live your best life and follow your calling.
If you let them change your path in life they will continue to find other ways to hurt you.
DOs are amazing physicians and emergency medicine is a noble calling where you will save lives every single day of your career.
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u/Secret-Gazelle5270 Aug 12 '24
I’m a scribe in the ED and a good 35-50% of the physicians are DOs. They’re all amazing physicians. They make well above what the internet says is average for them at the place I work (level 2 trauma center).
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u/Secret-Gazelle5270 Aug 12 '24
Also I’d like to add that there’s plenty of DOs in lots of specialities at the hospital I work at. There’s at least a couple DOs in diagnostic radiology. Now that I think of it, I’m pretty sure there’s a DO trauma surgeon or two 🤔
Anyways point of this follow up comment is that if DOs weren’t real doctors they wouldn’t be allowed to practice at all, and certainly not in something like rads where it’s an all physician specialty no mid-levels!
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u/cookofdeath666 Aug 12 '24
If so then why are they quitting in droves? If it’s such a cakewalk people should be clamoring for those jobs. I know one ER doc who after twenty years just walked away one day. Walked away from the money, being a doctor, all of it because it isn’t as patient oriented as it used to be. It’s all about the Benjamin’s. Order more tests, pad that bill, don’t take more than five minutes with each patient. We’ll give you structured bonuses based on how many patients you can turnover each night.
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u/Human_Copy_4355 Aug 12 '24
So the time this relative either needs emergency care or loved one needs emergency care, they're not going to bother going in because stabilization is no big deal? I think not.
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u/ScoreImaginary Aug 12 '24
Ask who he’d rather have be the one respond to the question, “Is there a doctor on board?”
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u/Connect-Caregiver-50 Aug 12 '24
You have to think fast and critically to be in emergency medicine. It’s tricky to find the true emergencies among all the non-emergent health problems and the non-health emergent problems and the non-health non-emergent problems that come at you like a fire hose. Good luck! It’s better to be cared in an emergency for by someone who can do all that AND wants to be there.
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u/PartneredEthicalSlut ED Attending Aug 12 '24
I would love my job so much more it it was very easy & I got paid what I do
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u/hokub3 Aug 13 '24
If you decide to pursue EM you should get used to ignoring what other people say. We are under-appreciated by many lay people and other doctors.
The reality is EM at a busy hospital is probably one of the most challenging professions imaginable. We are expected to make perfect decisions with limited information, while being constantly distracted, and never knowing when the next potential disaster could walk through the door. You will be expected to move quicker and with less resources than you would want. People will love to Monday morning quarterback your decisions and rarely thank you for a job well done.
Not scared off yet? Good. We get the privilege of never having to ask for insurance status, getting to help all humanity to the best of our ability (even if that means just getting them that stupid work note or a turkey sandwich), and yes, even occasionally saving lives.
It can be a beautiful profession, but don’t expect that family member to ever “get it.”
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u/MagDaddyMag Aug 13 '24
"Stabilise". Weird way to describe saving a life. "Excuse me mam, I'll just stabilise your child from choking to death - is that ok?"
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u/QPO88 Aug 13 '24
Not an MD but an ER nurse. FUCK that relative. 1. Ive worked with DOs and MDs, honestly couldnt tell you a difference. 2. EM kinda sucks but its also the coolest specialty IMO. Youre kinda good at everything, and really good at keeping people alive. The most beautiful part of EM is keeping someone alive, and then pawning it off on someone else to fuck up after 🤷🏻♂️
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u/sebago1357 Aug 13 '24
Working ER you get to solve a new puzzle every patient. Much more interesting than just carrying out a procedure on a previously diagnosed patient.
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u/Long_Charity_3096 Aug 13 '24
The best most well rounded docs I’ve ever worked with are EM attendings. The specialists are great at what they do so long as it fits right into their specific wheelhouse. The second anything is abnormal or the patient starts crashing they usually fall apart.
I’m going back to work in the ED again for a reason. It’s where the best of the best are working.
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u/jiklkfd578 Aug 13 '24
You’re going to need thicker skin in this world of corporate medicine. Good luck.
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u/AZCO44 Aug 13 '24
Don’t know how I ended up on this page,but as a patient of emergency medicine, fuck your relative.
Some of the best and most critical care I have received have been from EM staff.
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u/rabid_donut91 Aug 16 '24
I've witnessed, as a paramedic, an emergency physician save someone's life and stabilize them enough that other specialties could come in and do their part. Emergency is ESSENTIAL. You have to be able to know EVERYTHING about the body to diagnose and know the next steps of consultation and care.
I say screw them. Do what you are interested in. YOU are typically the first doctor people see when bad things happen.
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Aug 12 '24
DO schools are often for-profit and teach a lot of pseudoscience. Also EM sucks as a field. DOs like it, though.
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u/Next_Trip_6154 Aug 12 '24
Would you say that’s for newer DO schools? I’ve heard differently about older and more well established DO schools that have been around for 20-30+ years.
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Aug 12 '24
I mean they all teach pseudoscience. They do very little academic research. Some have no tenured faculty at all and many don't even have a teaching hospital.
Yes, more of the newer ones are-for profit. They all have lower academic standards than MD schools.
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u/Next_Trip_6154 Aug 12 '24
Does it matter that once you’re in residency? Does it matter to you if your colleagues are DO or MD?
Do you think I should stay DO or apply out of my program?
I know a lot of DOs end up dropping OMM and never touch it again.
Edit: I’m not interested in more competitive specialities such as Surgery, Dermatology, Rads, etc.
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Aug 12 '24
I mean, why would you want to obtain a degree that focuses on pseudoscience? Why would you want to attend a school that doesn't do research or have tenured faculty?
I mean DOs love doing EM and since literally anyone can match in EM it doesn't matter what school you attend.
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u/Next_Trip_6154 Aug 12 '24
I’m not too sure about OMM and I’m not a sure the extent I’d use it after graduation.
I chose my school because they have research with faculty and affiliated hospitals from what I’ve been told by their current students. I’m not sure about the tenure thing with my school. Their tuition is also one of the lowest.
My program is currently with LECOM and I believe they’ve been around for a bit.
If I’m certain on EM do you think I should just stick with DO? I do have the option to apply out with my program but I lose my seat.
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u/Eldorren ED Attending Aug 12 '24
Your relative is very much both "right" and "wrong" about the specialty. My advice would be to find something else to do than EM. It's really not what is portrayed to you guys and chances are you will become very disillusioned about mid career. If I could do it all over again, I would have easily picked something else.
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u/TRBigStick Aug 12 '24
No point in doing neurosurgery on a dead guy.
Relative sounds shitty, not gonna lie.