Pic of the Year!
CRNA SMILING WHILE PATIENT CIRCLES THE TOILET
I nominate Coastie, from the SDN forums, a Pulitzer Prize for this find! The CRNA smiling without a care in the world while the patient’s blood pressure reads 76/35 is ……well……uh…..(can anyone think of a word that encompasses the thoughts of shocking, hilarious, outrageous and disbelief all rolled in one?!)
If Air Travel Worked Like Health Care
IF AIR TRAVEL WORKED LIKE HEALTH CARE
there would be 757’s falling out of the sky like dead flies (assuming they even made it off the ground). The crushing bureaucratic BS that medicine has morphed into this nation is enough to make oneself buy a one way ticket to the insane asylum. If you took all the paperwork that I wrote during my internship alone, I am sure it would easily top the 560,000 words in Leo Tolstoy’s War and Peace. Makes going to work everyday just that much more pleasurable.
ER Resident Posts Cadaver on Facebook
and is now in SERIOUS hot water (now being investigated by state health dept and her ER residency at Stony Brook University Hospital on Long Island where she is a PGY2 is now on the line). The above photo which was taken by this resident of a fellow medical student (who could also find himself on the chopping block …Thanks for the tag!) is apparently now going viral and can easily be found online with a simple google search. Now whenever this particular resident googles her name, hundreds of hits involving this incident will pop up for posterity! You know future employers are going to love that! I wouldn’t be surprised if this story winds up on the front page of yahoo real soon. To those on the outside of medicine, this pic of a medical student giving two thumbs up in the presence of a cadaver could be erroneously seen as being as sensational as those involving the prison wardens of Abu Ghraib.
You can read more of the lurid details here
Looks like one of her facebook “frenemies” turned her in. Reminds me of the story I posted sometime back about the chief surgical resident in Arizona who got expelled from residency after taking a pic of his patient’s hot rod penis on his phone cam and was allegedly snitched out by one of the OR nurses (according to a source). In the cut throat world of medicine this does not surprise me in the least.
Why is photography even permitted in the gross anatomy lab in the first place with cadavers all over the place??? This is 2010 and we now live in the digital age. I’m sorry but this resident is so screwed. She would have been better off having a secret sex tape leaked involving her than this. Don’t laugh. I am sure if given the choice she would agree with me and you would too!
MD Underground
Thanks to www.jdunderground.com and the suggestion of others in the medical community, I have been inspired to start the medical version- www.qfora.com/mdunderground/ . Since medicine is going to hell in a handbasket, I strongly feel we need a forum of our own. The starting of this forum is even more imperative since SDN (Student Doctor Network) has been undergoing a recent Chinese crackdown where more vocal members have been threatened and outright banned for speaking the truth on the harsh realities of pursuing a career in medicine. Numerous threads have also been moved, locked, and outright shut down. I welcome you to the break away republic of mdunderground where the truth shall finally prevail over censorship. Please please please contribute to ensure it’s success so we can get it off the ground! Registering takes two seconds and you can be posting right away.
Thoughts on Sicko
Thanks to www.tiphero.com, I learned of a website where you can watch some of your favorite documentaries for free at freedocumentaries.org. Much to my pleasant surprise, Michael Moore’s Sicko was one of the featured films on the front page. Being that I never got the chance to watch Sicko and had a dreary Sunday afternoon to kill some time, I thought this was the perfect opportunity to view this film. Let’s just say that all my feelings of angst regarding our broken healthcare system have been reaffirmed.
The gripping stories of typical Americans are real and their wrenching testimonies can not be discounted. Juxtaposing our system to those of Canada, the UK, France, and gasp …Cuba, only accentuates the needless absurdity that ours has become. Only in America would a for profit model like this be ever be introduced in the first place. The HMO’s are no different from the big banks in this country who have bought out Congress to further their own domination. They are an unnecessary parasite who have siphoned off billions of healthcare dollars that should’ve gone to the sick. Think of the number of cancer treatments, organ transplants, or preventive healthcare checkups that could be payed for by just one HMO CEO’s salary? Before this whole health reform got underway, I could’ve told you that not in a million years would we have one govt run system. Seriously, what would happen to the HMO’s? Did we honestly think that they would just disappear overnight without a fight? Instead, they are fighting tooth over nail to rid the govt option which is on it’s death bed right now.
There are many doctors who despise Obama’s quest to reform healthcare. They feel that their salaries will plunge only further. Medicare and medicaid is run by government and their reimbursements are ABYSMAL. I fully understand this opposition. Some also don’t trust our government since they have a history of bungling everything up. One only need to be reminded of the Katrina disaster to see this. So what is the solution??? Since American medicine has turned into one really bad game of Jenga, I believe that the whole system needs to be bulldozed and restarted from the ground up. Medical school tuitions need to be reset to zero and those with current student loan balances should have them forgiven. HMO’s would be rid off the face of the earth for eternity. Salaries should be set at a level appropriate and commensurate for the level of training required to become a doctor (meaning NO medicare pittance rates). Tort reform would be mandated. 99 year olds would be allowed to die with dignity instead of languishing in ICU’s at 10K a day because daughter Sally demands it. Taxes would obviously have to be raised (sorry millionaires, but you will just have to cut back a mansion or two so your fellow human beings can access the healthcare system) but this would benefit the country many times over. Unfortunately, ”healthcare reform” has turned into a ridiculous folly and is only spiraling further out of control into an ever worsening bureaucratic mess.
There is no excuse for the wealthiest country on the planet to not be able to provide healthcare to it’s own citizens. I am embarassed as an American and a physician to live in a country where greed trumps generosity like this. There is a heated debate whether having access to healthcare is a basic human right. I don’t get this. It is simply the RIGHT thing as a society to do.
Defining Success
“What’s money? A man is a success if he gets up and goes to bed and does everything he wants to in between” -Bob Dylan
How do you measure success? By the amount of money in your bank account? the town you live in? the type of car you drive? the schools you attended? the places you’ve been? the title of your job? I would say no unequivocally to all of the above. Here’s a story of one person that I crossed paths with in my life that illustrates why.
Dr. Slaughter was a highly “successful” orthopedic surgeon on staff. He would crank through patients in the OR as if it was some Michigan automotive factory back in it’s heydey. Time was money and money consumed his life more than he could ever bargain for. He thought very highly of himself for training at one of the premier surgery residency programs in the country (which he “name dropped” whenever the opportunity would (forcibly) arise) and made it well known that he lived in a million dollar house in a gated community. He also had two children and was already on trophy wife number two.
However, Dr. Slaughter was a miserable pathetic man. He would yell at the nurses, curse out his residents, belittle the medical students, and always be complaining to the administration about something. He was an absolute nightmare to work with on so many levels. He was also having an affair with one of the scrub nurses which was widely known. His wife would call him on his cell phone and the conversations were always heated. His one son was in and out of drug rehab while the other was reportedly doing very well in prep school but their relationship was distant and strained.
I just wanted to take a moment and personally thank Dr. Slaughter. If you ever happen to come across this post, thank you for being such an asshole and showing me everything NOT to do in my life. Thank you for proving that money truly does not bring happiness and success. Thank you for making me better realize that the quest for money and success can rob you blind of your soul and divert your attention from what REALLY matters in this world. Thank you Dr. Slaughter for giving my life more meaning.
I will end with the following poem by Edwin Arlington Robinson that I read in the eighth grade. Though I would not classify Dr. Slaughter as “a gentleman from sole to crown”, I still think it is most befitting on how success can only be measured from within.
Richard Cory
Whenever Richard Cory went down town,
We people on the pavement looked at him:
He was a gentleman from sole to crown,
Clean-favoured and imperially slim.
And he was always quietly arrayed,
And he was always human when he talked;
But still he fluttered pulses when he said,
“Good Morning!” and he glittered when he walked.
And he was rich, yes, richer than a king,
And admirably schooled in every grace:
In fine — we thought that he was everything
To make us wish that we were in his place.
So on we worked and waited for the light,
And went without the meat and cursed the bread,
And Richard Cory, one calm summer night,
Went home and put a bullet in his head.
-Edwin Arlington Robinson
The Joys of Working in a Pain Clinic
Pain Medicine Anyone?
Medicinesux, of all the specialties in medicine which one do you dislike the most? PAIN MEDICINE – Hands down by a mile…..actually, make that a lightyear! Could you even imagine medicinesux in the above scenario??? I would’ve spontaneously combusted before she rattled off her third allergy. (video made by youtuber “crickethk”)
Noctors aka “Nurse doctors”
Did you know that there are currently 101 doctorate of nursing programs in the United States accepting patients???? ONE HUNDRED AND ONE! This is nearly as many as the number of allopathic medical schools in the entire United States. Here is the official list according to the American Association of Colleges of Nursing. There is no escaping NP’s. They have even managed to make headway as far up and away as the Yukon!
Yes, you too can enter the Texas Woman’s University (just make sure you were able to crack a whopping 960 on the GRE to qualify) and a mere 46 credits later (don’t worry you will never have to take more than 9 credits a semester) and you too can call yourself DOCTOR. If you fear that 46 credits maybe too much of an academic burden, then you can always apply to the Frontier School of Midwifery and Family Nursing as they only require 33 credits to achieve the doctorate! Or maybe you hate having to sit in class. Well thanks to the the University of Cincinnati you can do your entire doctorate online (plus no GRE needed)! I had to pull out my old med school transcript to calm myself down since I knew working my butt off for a doctorate certainly required more than the above. Guess what? I can safely say that I did not lose my mind- just shy of 160 credits it was.
Oh and it gets better. There are another ONE HUNDRED additional noctor programs in the planning stages. So if you had concerns that your credentials were not competitive enough, you could always wait a couple years since there will be nearly double the spots.
Between greater govt control of healthcare in this country and the explosion of allied professionals, primary care salaries are not going up anytime in the foreseeable future while inflation and compensations in other occupations will only increase. This is chimpanzee economics. To add insult to injury, while your recently graduated med student is working like a racehorse in residency barely able to pay the minimum (assuming he is not in deferment or forebearance) on his quarter of a million dollar student loan balance, your noctor zipped through a one week residency (at the end of the first paragraph in this article) and is humming away making just shy of your future attending salary with a fraction of the loans. Actually, while you were sitting in lecture all day racking up those loans, your future NP was busy at work full time bringing in a nice salary. I will leave it to one recent NP grad’s remarks about her noctor program over on allnurses.com, “University of Cincinnati (UC) is 100% on-line, it allows me to continue to work!” Someone tell me how it is even possible to learn all there is to know in medicine entirely online and while holding a job? Please tell me I am dying to know, as are your future patients whom many of you will be independently treating.
PEDIATRICS- The Most Underpaid Specialty
It is no secret that pediatrics is the most underpaid of all medical specialties. It just goes to show you how much our country really values it’s youngest and most vulnerable citizens. Exactly how bad has it gotten? Check out and see for yourself on this forum where DC housewives congregate and discuss the matter.
“I left private practice as an internist because the money was awful and the hours were even worse. I made $110K and worked my butt off; on top of that I have to pay down $150K in student loan debt.
My friends are leaving practice in droves — esp. OB’s because of increasing malpractice premiums.”
“I always assumed that my sister in law who has a nice practice in Baltimore was doing well. Then I found out that she made 89k last year. That is after all the late nights and weekends, her pager is always going off.”
“I worked for an insurance company in claims, and at times (sadly) we laughed at the small checks we would send the docs.” |
“I am a pediatrician. Full-time docs starting out make $90,000. I’m part-time, so I actually make proportionately less.”
“If you thought I had it made…I really HAD IT!!”
“I do not have any desire to go to the hospital anymore. It cost more to pay the malpractice insurance than what you collect for your services in the hospital”
“The problem is that you are on a treadmill to keep up with expenses in the face of lower insurance reimbursements — so the way to make up for it is to see more and more patients.”
“There’s no prestige left in it, and the salary is not that great. Last year, had I worked full-time, I would have made 1/10 what my non-physician husband made (who spent 9 fewer years in formal education than I did). And I’m a surgeon.”
“I doubt it will be too long before I stop going back to work.”
“My husband is a dean at one of the medical schools in town and while I don’t have an exact figure, I know that a daily concern of his is just how much debt his medical students are graduating with these days. Almost universally 100K+ and often $250K+.”
MD Living in Poverty
I have received several inquiries on a recent posting where I mentioned that I live under the poverty line. According to the 2009 poverty guidelines, for a single person in my state one needs to make under $10,830 to qualify. I am here to tell you that I do indeed live in “poverty” as my annual expenses throughout my working career since graduating from medical school have been under this amount. How is this possible and even if true, how could I allow myself to suffer like this?
I do concede that living so frugally is not for everyone. For starters, it is very anti-American to not spend spend spend. I will be perfectly honest with you when I say what you read on this blog you will rarely see elsewhere. Why is that? Well I am not getting paid to sell you something that you really don’t need! When you live in a capitalist consumer throw away society where advertisers are working hard to part you from your hard earned dollars, it can be hard to say NO. Wherever we look, we are being constantly bombarded with images of how we should be living the “American dream”. It is as if the media and society are programming us on HOW we should live. Everything from the kind of car we drive down to the brand of underwear that gets to caress our ass has now become some sort of status symbol. Are we that unhappy or insecure that we need to buy “stuff” to fill an empty void? Rather than looking at others for approval through the silly tokens of importance that we buy or the degrees after our name, we should instead realize that it is by being a good person at heart that inevitably leads to contentment and fulfillment. So part of the reason why I live this way is out of protest. The protest of turning into a person I do not want to become. I do not need “things” to validate myself to others. I will leave that to my actions, contributions, and the way I treat others. If you are throwing scalpels across the OR or belittling med students on rounds, I guess buying a lot of stuff is the only way you get to make yourself feel important.
Everyone has their threshold for what they can tolerate. As I’ve mentioned in the above posting, a major impetus for living below my means is to achieve financial independence. The cornerstone of my plan to get out of a highly toxic career is to break my golden handcuffs (aka student loans). If one is able to live below their means, one is able to live the life they always wanted. Think about that for a second. Ironically, it is almost tantamount to asking yourself if you won the lottery, what would you do for the rest of your life? It is incredibly liberating to know that you can spend your time doing whatever it is you wish if you are able to live in this manner. And this is the reason why I am happy as a clam living in poverty. I do not see it as suffering at all. Every dollar that I am able to save is one minute less that I have to suffer in the hospital. If this isn’t motivation than I don’t know what is. I know that one day soon I can walk away from medicine forever and pursue an alternative career that I will greatly enjoy. As if this wasn’t enough of a reason, by continuing to live under my means (spending less than what I make), over the course of time I will SAVE more money than I could ever imagine simply by refraining from buying into the American lifestyle trap. One day I hope to find myself in a position to upgrade my lifestyle (if I so wish) while many of my fellow Americans will drown further into debt.
So how do I exactly live under the poverty level? I will keep this brief as I don’t think the numbers are as important as the reasons which I discussed above. If you take the $10,830 annual amount and divide it up over 12 months, you are left with approximately $900. Here is the rough breakdown of my monthly outflow as a resident:
RENT: $550 -for an old small, but perfectly adequate, studio (found off craigslist) in a good part of the city 3 blocks from the hospital. Needless to say this is not NYC or LA but still a major culturally vibrant city in the top 20 in terms of population. Housing is the number one expense in anyone’s budget and this is the one place where anybody can save the most. If you are willing to live small in the right location, you can save big. Europeans already do this, I don’t know why we can’t???
TRANSPORTATION: $5 -I purposefully chose my apt near the hospital so I didn’t have to get a car and pay $9400 a year which is what the average American pays a year to own a car. No monthly car payment, no car insurance, no gas, no paying for a monthly parking spot. Everything I needed was within walking distance of my apt since it was literally in the middle of everything. I could always drop a dollar here and there to take a bus if I needed to hoof over to the opposite side of the city. I never took taxis. Taxis are for lazy people or those who don’t know how to use public transportation.
FOOD: $150- spent roughly 35 dollars a week at the local major chain grocery store. Whatever is on sale is what I eat that week. Online coupons help somewhat. I also got about 50 bucks a month to eat on call which also helped. I eat healthy and didn’t starve. Would eat out maybe once a month, and usually for lunch. Prefer cooking myself.
UTILITIES: $35- water and cable were free in my studio. Since my place was small, my electric bill was only 15 bucks on average. In summer, I would open the windows and turn on the fan- I only turned on the window AC unit if it went over 90 degrees and only for like 15 minutes since again my apt was small (notice a trend here). Another 20 bucks for gas to cook.
CELL PHONE: $42 with employee discount. My contract is now up and considering going pay as you go to save here.
INTERNET: $30 This is the one NEED in my life. I can’t live without it.
GRAND TOTAL:$812 which is well under 900 dollars as you can see. This left me with an extra 90 dollars a month that I could use as I pleased for MISC EXPENSES. I would usually bank this into my “vacation fund” so I could put as many miles as I possibly could between me and my residency program during my four weeks of allotted vacation time. Here’s an actual pic from a recent domestic excursion to illustrate this point ==>
[Yes, I felt more relaxed being a mere earshot from communist Cuba than remaining within a thousand miles from the hospital]
Interest earned off my savings helped supplement this expense but I am quite the budget traveler as you could probably guess. Per year, I averaged one international trip, one domestic trip, and two visits home which was about 200 miles away. I love to travel and this is where I will be spending more and more money in the future as my debts begin to quickly erode away.
On one last note- someone suggested that I must moonlight in order to be able to do this. Absolutely not! No amount of money was enough to entice me back into the hospital after already being there 60-70 hrs a week. My coresidents who lived in their 1500 a month one bedroom apts and had expensive car leases had to. I felt sorry for them while I ate bons bons in my pajamas watching a free movie on hulu.com. Only if they knew about this blog.
VISITORS TO MEDICINESUX
