- Joined
- Feb 10, 2008
- Messages
- 12,689
- Reaction score
- 25,639
Sure, won't hurt.So simply email the board group to ask?
Sure, won't hurt.So simply email the board group to ask?
I'm so glad you reached out! It's refreshing to know that your goals aren't as farfetched or far off as they seem at firstUpdate: the ACVB got back to me saying it depends on the practice and how much exposure I would get to various specialty cases. I'm able to submit information about my hospital to see what sort of timeline I would have here. So waiting for them to let me know what sort of information they need and how to submit it!
Second update: meeting with a non-boarded behaviorist tomorrow to discuss career goals and how to reach them. So say I need 3 or 5 years at this practice, but she's willing to take me to her practice, then that may happen.
oh, and might I add that this was the first day where a DACVECC/ senior resident wasn't in the hospital with me that morning (DACVECC was sick). So I grabbed the overnight vet who was still there doing records and was like "yeah you're helping me with this one k thnx"I did a stat pericardiocentesis today! on a cat too!
My first pericardiocentesis!!! Did I feel like I was going to die? Yes. Did I? no!
You're so badass!!! Well done!oh, and might I add that this was the first day where a DACVECC/ senior resident wasn't in the hospital with me that morning (DACVECC was sick). So I grabbed the overnight vet who was still there doing records and was like "yeah you're helping me with this one k thnx"
a parasite rare enough that even the internist you called to ask questions has never heard of it...
It has been almost a year since my last spay and my first one recently is a c-section on a 10 year old lab mix. It was awful and immediately followed by a pyloric sand impaction.It was like a good 3-4 months of work before I got to do my first c-section.
And now in the last 3-4 months, I have done four of them.
Closing the big incision is annoying, but the rest of it is fun.
Also did my first foreign body and it went well. I feel like I've come a long way with my surgical skills which is awesome because I did not get as much experience as I wanted or planned during school.
Do you get any leeway with charges? We're allowed to waive our exam fee at our discretion because then we're waiving the charge fornour services. Or do you guys not get that sort of discretion due to intern status or hospital/doff corporate than me status?I felt guilty having to charge them $150 for an exam fee
100% would have gotten a waived fee so I didn't have to write a damn record. 😂Do you get any leeway with charges? We're allowed to waive our exam fee at our discretion because then we're waiving the charge fornour services. Or do you guys not get that sort of discretion due to intern status or hospital/doff corporate than me status?
I waive my ER fee for criticals that end up euthanized/coding, QOL discussions that don't take long, and situations like this. Some things I'll still write a brief record (criticals that code); but overall, most of those things get "Patient presented normal. Advised clients of puppy behavior and supplied Sophia yin website". Boom. Done100% would have gotten a waived fee so I didn't have to write a damn record. 😂
Correct we don’t get the discretion.Do you get any leeway with charges? We're allowed to waive our exam fee at our discretion because then we're waiving the charge fornour services. Or do you guys not get that sort of discretion due to intern status or hospital/doff corporate than me status?
I’ve done this with some simple things hahaha. Torn nail? Tech visit.100% would have gotten a waived fee so I didn't have to write a damn record. 😂
That’s where the technician comes into place. The owner asked the tech “could this be bloat?” and she said “I don’t know, I’m not a doctor”. So yes usually they do a good job with triaging them away, especially if they call. But if they show up it’s not the same.I’m almost positive our ER would’ve triaged them away before even making it to a doctor so there wouldn’t be a few or paperwork 😂
We have a “euthanasia consult and support” fee for things like that which… is the exact same cost. I don’t waive the ER fee for those who end up euthanized or coding. If it takes more than 5 minutes or 1 tech, they have to get charged the full amount. It’s not like I get paid the Dr fee, but it goes to help pay for the rest of the staffI waive my ER fee for criticals that end up euthanized/coding, QOL discussions that don't take long, and situations like this. Some things I'll still write a brief record (criticals that code); but overall, most of those things get "Patient presented normal. Advised clients of puppy behavior and supplied Sophia yin website". Boom. Done
And my techs definitely would have stopped this at the phone call lol
We have a euth only charge if they come in requesting euthanasia (though obviously doctor's discretion to actually perform), but if it's an exam and conversation with the owner they get charged the exam fee (+ a moderately lower "euth with exam/workup" fee). Doing CPR also definitely gets charged out, that's way too much adrenaline and staff time to not.We have a “euthanasia consult and support” fee for things like that which… is the exact same cost. I don’t waive the ER fee for those who end up euthanized or coding. If it takes more than 5 minutes or 1 tech, they have to get charged the full amount. It’s not like I get paid the Dr fee, but it goes to help pay for the rest of the staff
Correct we don’t get the discretion.
I’ve done this with some simple things hahaha. Torn nail? Tech visit.
That’s where the technician comes into place. The owner asked the tech “could this be bloat?” and she said “I don’t know, I’m not a doctor”. So yes usually they do a good job with triaging them away, especially if they call. But if they show up it’s not the same.
We have a “euthanasia consult and support” fee for things like that which… is the exact same cost. I don’t waive the ER fee for those who end up euthanized or coding. If it takes more than 5 minutes or 1 tech, they have to get charged the full amount. It’s not like I get paid the Dr fee, but it goes to help pay for the rest of the staff
For the criticals that run in actively dying and end up dead/euthanized, the only thing I don't charge is the exam fee. I still have to charge out CPR, emergency drugs, etc. because those are "products" per corporate, not a "service" I'm providing. They are then charged for the euthanasia drugs, cremation, etc. on top of the life saving measures. How that distinction works, im not really sure; I just go with it. My discretion of not charging the ER fee ($132 in my hospital) is the same thing; paying for appropriate stuff, but wanting to limit the financial hardship on top of the emotional suck. Since switching to 50/50 ER/GP, I've been hitting production and beyond. So I'm willing to take the hit on the $27 I would make off it and I'm more than pulling my weight financially from corporate's perspective. Granted, we'll see what happens when April/June comes around and they actually look at my numbers for contract negotiations 😅We have a euth only charge if they come in requesting euthanasia (though obviously doctor's discretion to actually perform), but if it's an exam and conversation with the owner they get charged the exam fee (+ a moderately lower "euth with exam/workup" fee). Doing CPR also definitely gets charged out, that's way too much adrenaline and staff time to not.
I think it's a nice happy medium to make sure the time and skills get reimbursed while not aggressively charging for sadness.
Oh we will straight up send them away from the vth. When the tech goes up to triage they will most definitely send **** away if it doesn’t need to be seen.That’s where the technician comes into place. The owner asked the tech “could this be bloat?” and she said “I don’t know, I’m not a doctor”. So yes usually they do a good job with triaging them away, especially if they call. But if they show up it’s not the same.
If anyone else (who I'm friends with on fb) wants invites let me know, I'll just invite you to the ones I have and you can pick which ones you like.
Sorry I’m late it’s been 370 daysI’ll bother you for those in 365 days
Pepper your angus, invites are coming your waySorry I’m late it’s been 370 days
dubz plz whyPepper your angus
Words of wisdom for new grads?We've been doctors for a year, guys!!! Any changes, any highlights/lowlights?
Close your mouth when expressing anal glands. Everything else will be fine as long as you remember that.Words of wisdom for new grads?
Just do your best.Words of wisdom for new grads?
Go watch the first season of Scrubs. It's one of the most accurate representations of the transition from baby doc to competent clinicians out there, imo. It covers the gamut.Words of wisdom for new grads?
Why have you not written a book or done a TED talk?!Go watch the first season of Scrubs. It's one of the most accurate representations of the transition from baby doc to competent clinicians out there, imo. It covers the gamut.
....oh, you want real suggestions that aren't a TV binge? Disjointed thoughts:
We have a really freaking cool career, but an intense one. Be better about your mental health than I was.
You're going to care more about some of your patients than their owners, and that's going to hurt. Accept it now and think about management strategies (that aren't booze).
Even if something is potentially fixable - in complicated cases there needs to be emotional, financial and time buy-in. If these aren't available, a kind euthanasia is rarely the wrong decision.
With that said, expect to end up with a new animal in the next year or two, probably without a leg or eye or something. Sometimes it's just too much, especially when you haven't 100% figured out your mental barriers and coping strategies.
Do no harm, BUT take no ****. Assume benign intent until people have proven otherwise, then act kindly but ruthlessly.
Feed your support staff regularly. Try to include a vegan/GF option, because most clinics have one or the other.
Realize clients who are dinguses to your support staff but are nice to you are dinguses.
Listen to your techs, especially experienced ones. My only patient I've had die in radiology a tech warned me about, and I ignored her. I was experienced enough to know better, and bawled with the owner.
With that said, techs are techs, and they don't hold the liability. Listen to them, but forge your path.
Learn from your mistakes. Even better, learn from other people's mistakes!
If your first clinic isn't a good fit, leave sooner rather than later. Nobody will hold it against you - sometimes it takes time to find the right place! And toxic situations make you a stressed, sad doctor, not a thriving one.
Don't feel broken if a clinic that works for someone else doesn't work for you. We're like plants. Some need different climates and watering.
Everyone has no idea what they're doing like, all the time. How often that "all the time" is does eventually go down, but as far as I can tell doesn't go away, haha.
Also there will ALWAYS be someone who could be a better doctor for that particular patient with that particular disease. Even if you're a specialist. Even if you have thirty years of experience. But you're the one in front of them right now so you're the best doctor RIGHT NOW, do your best.
Okay I gotta go into a shift now. Feel free to stay tuned for more Troutisms.
Psh, too many of both to even list.We've been doctors for a year, guys!!! Any changes, any highlights/lowlights?
Staying on top of your notes is underrated.Words of wisdom for new grads?
I didn't expect you to see itdubz plz why
I hate EST
I pulled a puppy out of a uterus today.
I'm sure in the not terribly distant future this will feel like a typical day to me, but today it's exciting.
What about your choice do you regret, out of curiosity? I’m sorry that your first month haiku is a sad one.A haiku detailing my first month of residency:
I regret my choice
And I am always tired
… It’s only the start
I just feel like an absolute idiot all the time. I’m constantly busy, never able to ever stop. Between working 70+ hours a week in the hospital and then doing readings, assignments, teaching, research, and being on call for my cases 24/7, I feel like I work from 6 am to easily 1 am every day.What about your choice do you regret, out of curiosity? I’m sorry that your first month haiku is a sad one.
I’m already 7 months behind in journal reading and I’m just… super excited about the prospect of doing this for 35 more monthsI just feel like an absolute idiot all the time. I’m constantly busy, never able to ever stop. Between working 70+ hours a week in the hospital and then doing readings, assignments, teaching, research, and being on call for my cases 24/7, I feel like I work from 6 am to easily 1 am every day.
I’m sure it’s just getting used to everything but it’s just been a hard adjustment
That sounds really difficult, from all angles. Big hug.I’m already 7 months behind in journal reading and I’m just… super excited about the prospect of doing this for 35 more months
Social worker is there to help clients navigate tough choices for their animal. It's an ER only hospital. Social worker is also there to help staff with resources on grief/burn out.@battie that sounds like an awesome opportunity. IDK your work environment but I think if you're honest about not being able to justify the commute especially with a new born it's totally reasonable. Just out of general curiosity what is the social worker's role envisioned to be? Like I can imagine how one could be integrated and it sounds fantastic especially with some clients...
Does your contract specify how much notice you have to give? If not, then a month is fine. They’ll be mad until they replace you, but sometimes you just have to take the opportunity that shows up.I've low key been considering a new hospital for quite a while. With the baby, I finally pulled the trigger to talk to new hospitals as I drive 30 miles one way four days a week during rush hour. It's just not going to work.
The hospital I talked to this morning is literally better in every way on paper. The hospital is currently being built and will be brand new. A personal plus to me is two dedicated lactation suites and a social worker for clients. It is 13 miles from my house with a 20 minute commute vs 30 miles and an hour commute.
The listing originally stated opening in spring 2023. That was perfect cause then I could give the new routine the good old college try and give reasonable notice. But talking them today, they said constriction and hiring is going well and they now estimate an opening of late October 😶 I'm totally down for that. My only concern is giving my current hospital a minimum a month's notice and not burning bridges. I'm sure it'll look obvious that I was looking before coming back from maternity leave. But this opportunity is one I don't think I can pass up.
Any general thoughts?