alanakinrich.medsky.social
“Some entitled little shit ER doc” 👩🏻⚕️, queer 🏳️🌈, home cook 🍳, sometimes dancer 🩰, cat person 🐱, lover of swishy skirts and warm sweaters 👗. My opinions are not my employer's. she/her
1,437 posts
5,247 followers
614 following
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Right?? It’s such a good scene
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Oh, same. And then it takes that crazy left turn, and then suddenly you’re on surface streets, and oh my god why am I still going 60 mph?
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My dating history from ages 15-23 was entirely bassists and guitarists. Still find them hot.
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Man, I lived there 2008-2011 and i definitely remember that before picture
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Yep! Although in my defense, I didn’t start watching severance until a couple of months ago.
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Champak’s straps are reconfigurable into ear loops! So smart. Also adjustable lengths.
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We still have waits, although it depends on the night. Last night wasn’t too bad. Sometimes when you come in at 11 pm people have been waiting for over five hours, and then you’re lucky if you clear the waiting room by 7 am. Mostly only happens if people get sick of waiting, give up, and go home.
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Nope! Very few places are these days, although I’ve never worked somewhere rural. I see about two patients per hour overnight.
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I did a lot of of my biology major upper courses on biodiversity and ecosystems, including classes that had labs like “go plant native plants in the local park.“ Super fun.
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Okay yeah that’s really silly.
Maybe FM is more of a west coast thing?
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Oh yeah! If your heart is doing this weird thing that they’ve never been able to catch on an EKG or a Holter monitor, and you can get to the ED while your heart is still doing the weird thing, we really appreciate that piece of information.
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I do! I love my family medicine doctor. She does my wellness, preventative care, Pap smears, and sick visits. She chooses not to do obstetrics, so I also have an obgyn. Assuming I have an uncomplicated birth/neonate, she’ll be my kid’s doctor too.
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This is one of my favorite poems of all time.
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A total, total shit show.
Not wanting to blame—I really just feel bad that I can’t offer the thing they’re looking for, and I don’t want people to feel like we’ve wasted their time and energy.
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Ooof, I’m sorry, that sounds awful.
Although I can imagine some situations in which that might come in handy. I’m sure they don’t outweigh the downsides though.
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It’s a conversation, but usually includes: Some people find that using marijuana paradoxically causes more nausea and vomiting. This is called cannabis hyperemesis syndrome. Unfortunately the only true diagnostic test is to stop using completely for several months and see if your symptoms resolve.
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Hot tip: if it’s feasible for you, get to the emergency room around 4 AM. That’s the lowest time for triage volume, usually the night docs have cleared out most of the people, and if you’re not seen on their shift it’s only ~3 hours until more morning docs arrive.
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Absolutely. And I recognize that some people are there because they feel like they are at their last resort. It’s sad and frustrating all around, because I can’t offer the answers they’re looking for.
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You’re right. And yet I’m shocked at how often this still happens.
Usually, I can get an established patient a phone call with some outpatient doctor in the next few days, and an office visit with their own PCP within 2-3 weeks. It’s one of my favorite things about this system.
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I think many of these named disorders have become catch-alls. That doesn’t mean they’re not real, but rather the diagnostic criteria are imprecise and some of it is trial-and-error. I think that’s why they cluster in groups. I’m glad that there are physicians/centers working on figuring them out!
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Same. Mostly it helps. Sometimes it feels like I’m running up against “so you refuse to do anything for me??” even after I’ve explained everything that has been done, and recommended next steps. It’s a hard spot for everyone.
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My mom’s PCP is in his 80s. I think she’s been going to him for over 30 years. He’s a dear man, but it’s time to switch. And all-encompassing docs like him don’t exist any more.
I feel like picking a medical/hospital system is almost more important that picking a particular PCP at this point.
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So true. And I’m not trying to demonize primary care doctors at all. What you guys do is incredible. I’m honestly in awe.
But I understand why some people end up in the ER for this, and I wish more people could understand why we are not the best next step on their medical journey.
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I work in an HMO system where there’s relatively good access to primary care, and it is relatively easy to change your primary care doctor. It honestly helps me practice better emergency medicine, because I know that they are (usually) practicing good outpatient medicine.
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My first answer is keep going to in-person PCP appointments. Be organized, bring a list of symptoms, layout everything as clearly as possible. If you think you’ve exhausted what that doctor can or will do for you, then you have to get a new one. And you’re right, it sucks, and can take a long time.
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I’m sorry. I have a lot of sympathy. I believe you. But what I can offer is basic labs, some imaging, and admission or not. Sometimes an outpatient referral. Usually you have to go back to primary care. The system sucks, and it’s particularly bad for things like POTS/mast cell/long COVID.
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This is incredible
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This is also my favorite for out-of hospital use. Ive even worn it for a 90 minute ballet class!
In the hospital, I’m a 3M Aura girlie
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Sometimes I opt for dark teal! Wild, I know.
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I have a strong and consistent use of the color teal in all its forms. Further example, my feet at present:
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Unfortunately not if you’re pregnant…
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Definitely not ideal!
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That would be a great question for my ID colleagues
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Yeah I wear an N95 for any possible infectious symptoms as per the triage note. But sometimes I’m wearing a droplet mask for “I fell and broke my hip” and then the nurse tells me they’re febrile…
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My obgyn told me not to see patients with a fever and a rash… this does not seem like a viable solution.
I am glad I live in a relatively well-vaccinated area and I work in a community hospital that’s unlikely to have recently-returning international travelers.