Comments on: You Can Tie, You Can Lose, But You Can Never Win

By: Birdstrike

Birdstrike — Sat, 07 Jul 2012 04:57:34 +0000

I’ll keep this in mind. Thank you.

By: Birdstrike

Birdstrike — Sat, 07 Jul 2012 04:55:25 +0000

Thanks, I’m glad you identified with it. My point was to present what is essentially a moral and ethical argument against this practice as it is currently applied that goes far beyond simple whining and complaining, that if people get behind it, could empower those affected, specifically EM doctors, hospitalists, and patients. The focus should be on moral and ethical fairness for those who are subjects of the surveys, and what is best for patients. We cannot lose sight of these things for the sake of profits alone.

By: Birdstrike

Birdstrike — Sat, 07 Jul 2012 00:12:32 +0000

You’re right. Hospitalist deal with the other side of the identical coin and work very much “in the trenches” like EM physicians.

I’m curious as to what parts you “had to read out loud?”

By: Birdstrike

Birdstrike — Fri, 06 Jul 2012 02:23:07 +0000

I like your take on this. Unfortunately, I think you are right, that no one will really listen until the doomsday scenario you describe. I’m working on something right now, which will explain more where I think this is going, and how we can best empower ourselves. It’s good to here someone’s view of things from the other side of the world, literally.

By: D

Thu, 05 Jul 2012 09:59:46 +0000

And although you guys dont realize it cause you take care of people at the worst moment of their lives or people living the effects of poverty

You have more public support than any other physician group hands down

Not a police department in the country that would break up a sit down strike of ED physicians and I think certain labor agreements can allow for nurses not interfering by somehow using them to pick up the clog you want to leave

This article is great and I think Im still doing the EM match next year, but nothing else is going to fix these issues except straight up action as much as you can without anyone dying. All the billing and RVUs can be paid back in full if it was pulled off right

Jon q public who already feels like shit reading his newspaper in his underwater mortgage is not going to feel any better reading of stories that if he should get in a car accident his life may be compromised from inhumane work conditions from a toothache or hangnail

Its media and lobbying working against physicians every step of the way with this obamacares attempt to enslave healthcare workers

Its just going to follow this downward trajectory, they are playing dirty and like I said 2.5 trillion a year in the biggest profit margin business in this country and the last thing they can strip from people to piss away on wall street

Not enough people will see this article and it wont effect them as strongly as it does people in healthcare.

I see a labor lawyer as the best investment to your careers

Even the largest group should see how this will play out and that theyll be down as well soon enough

By: D

Thu, 05 Jul 2012 09:25:31 +0000

Any possibility of a good old union?

Working in groups you guys are just underbidding each other and further undermining yourselves

Australia which has a union culture, the EM docs have better pay,, lifestyle, and dignity

The whole bill is nonsense, 2.5 billion annual health expenditures, 6% is physicians, 31% administrative cost,
Not sure rest but: 6% other workers maybe, then what 30% corporate profits minimum Id say

Just do a sit in strike and take care of emergent cases and FT screen. Let everything else pile up and you can get any lost wages back when you negotiate from a place of strength

By: Dillon

Dillon — Sun, 01 Jul 2012 07:18:46 +0000

This is one of the greatest things I have ever seen written about the current state of Emergency Medicine, Sad but true.
Luckily, I work in a place where we don’t do satisfaction surveys. We don’t call toothaches back to check on them, and you know what? The job is still plenty hard enough!

By: Amy

Amy — Fri, 29 Jun 2012 00:20:31 +0000

Hospitalists feel much the same way as you do. I had to stop several times while reading this post and read parts out loud to any doctor within earshot.

The patients are essentially asked if the doctor “always” did everything perfectly – the vagueness of the question should automatically invalidate the response. Not to harsh on surgeons – (but I’m an internist, it’s second nature) but if the orthopod rushes in and is abrupt and doesn’t take time to hold grandma’s hand and walk the family through the whole hospital stay then the patient won’t say the doctor ALWAYS explained everything and treated them with respect. When the hospitalist may well have spent a great deal of time doing just that – making sure all the home meds are correct, arranging rehab, taking care of the fall at 3am, controlling pain meds, actually addressing code status…etc. The sat scores are not parceled out in a way to delineate any of that data.

We are told we suck. Maybe we do…but this data sure as hell isn’t a valid way to show that.

By: Lisa K.

Lisa K. — Mon, 25 Jun 2012 20:10:19 +0000

In your honor, when my husband unfortunately ended up in the Emergency Department twice recently I made a point of filling out the Press Ganey surveys and giving everyone the highest scores.

By: Nurse K

Nurse K — Mon, 25 Jun 2012 19:16:05 +0000

Nursing fun: Our ER (ED if you’re Whitecoat) is seeing approximately 30-50% more than we are budgeted for each shift. Yesterday alone, we saw the # of patients budgeted for in the entire day just during the evening shift. The least amount of patients that we’ve been seeing lately is the amount we’re budgeted (ie. staffed) for.

We are expected to, and I kid you not, spend time calling all of our discharged patients to check on them, see how they’re doing after discharge and see if they have any questions and encourage them to fill out their survey when it arrives. This involves pulling up and reviewing everyone’s chart, making a call, getting no answer, and moving on to the next one. It doesn’t matter if you’re an elderly fall patient discharged home with home care or an 18-year-old who wanted a pregnancy test…you have to call them.

So we’re 15 deep in the lobby and 10 deep in the back and we’re calling toothaches and chronic abdominal pains.

So, the last time I got all my scheduled breaks was like last job, but I’m expected to do mandatory education, online renewal of my ACLS/BLS while on my shift, call a bunch of toothache patients who list the grocery store as their home address, and then see a couple more patients than is safe to take care of. But, please, “Look for a survey in the mail in the next month and please take the time to let us know how we did.”

Only good thing about the surveys is that if the numbers start creeping down and the volumes start creeping up, SOMETIMES (although rarely) this can be used as muscle to get more staff.