coastalhiker










An update on Alex Albon

Shows the Silver Award... and that's it.

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  1. $250-350/hr for locums. Never looked out West, but they seem to have lower rates

  2. Could they not design a tire (or use the extremes) to be put on a safety car, F2, or old F1 car to run before the race and during red flags to help clear the water and keep a dryer race line?

  3. Spent a few days in the hospital. Might need shoulder surgery and dealing with a serious concussion. All the minor bruises and cuts are healing up well. Wife was the passenger and she got out of it pretty easy minus the seat belt bruises. So I consider it about as good as can be.

  4. As a doc, make sure you get a neurology eval in a few weeks for a repeat concussion/head injury eval. Lots of people don’t realize how bad it is in the first month and just let symptoms drag on.

  5. As an RN, genuine question: if findings are present on the follow up neruo eval, what can be done? I suppose it depends on the severity… but let’s say something like poor recall?

  6. Neurocognitive rehab with physical therapy can help a lot with recovery. But, the eval is essential from a insurance coverage/disability settlement. Once it’s settled, if they have residual issues, may not be able to get more money later.

  7. Man, I saw a Chevy pickup truck in the front of a dealership the other day for $90k! It looked nice, but damn.. a pickup truck?!

  8. Yeah, lots of “rich” people here in the southeast drive Escalades around here. Dropped my kid off at school in the Model Y and all the other kids were asking how much the tesla cost. I said less than half of the Escalade in front of us.

  9. Because the physician is the leader of the healthcare team…

  10. Yep, reading a P&L statement isn’t hard. Most of the MBA stuff is super easy to learn. You can audit essentially the entirety of an MBA for free online if you want to hear the crap they speak about.

  11. I used to call every employer that required a work note for my patients and tell them that we do not provide them and they should stop asking for them for short term illnesses. There is no crystal ball for when a patient can return to work and they should trust their employees. Work notes are one of the most frustrating aspects of being a doc. If you can’t trust your employee to take off when they are sick, then just fire them and move on.

  12. Finally an EM response. I'm an MS1 trying to get a straight reply on what my salary will realistically look like in 7 years.

  13. For another EM comparison. US SE. 10 years out. Large EM group, W2. Base 325k/yr + $30k in bonus (ave get ~50%). Hours = 130/mo. Extra shifts paid ~$220/hr.

  14. Yes, they pay whatever copay their insurance charges. Places I have worked before bill ~$600 for an MSE. One of the other places I worked, if we sent you to urgent care after MSE, they would waive the upfront fee for Urgent Care.

  15. Anesthesiologist here. My guess would be that at the end of surgery, he was extubated (breathing tube was removed), and then there was some reason that he had to be reintubated.

  16. Agree with the above. That’s how I read it too as a doc. I would be very surprised if he makes it back for Singapore. I’ve had patients run marathon/races a week after appendectomy, but nothing that you would experience the amount of g-force that Albon will need to. I imagine he sits this week out and is back for the next race.

  17. It feels like being an asshole that is trying to collect insurance money, except you aren’t choosing to do it.

  18. I’ve done them in various ED settings (community, academic, etc). Serratus blocks are very quick to perform and minimal set up required.

  19. Non-sterile gloves in a vacuum but as always in this job gotta read the room - sometimes gotta do it up for optics as another commenter said

  20. Just curious, what optics? In my 10 years of practice, I’ve never had someone ask about the gloves I used while I sutured their lac.

  21. Every ED I have ever worked in, I certainly had both the ability to both consult in-house and/or refer as an outpatient.

  22. As a doctor, you just learn to go with less and feel like an inhuman pile of garbage. Averaged 4-5 hours per night for 5 years in training. Now life is better, but I’m sure it shortened my life span.

  23. Lots of issues contribute to this with blame on both sides:

  24. Agree with these points. The optics are also much different from a small community hospital and academic center. Working at the academic center, I’ll admit to 8 different teams in a shift, so each time, they have no idea how busy I am at all as it will be the only time I see them all shift. Whereas in the community hospital, 90% of admits went to a single team. So, if I’m calling them over and over, they know how busy the ED is in general.

  25. Must be RVU based. No where do they pay flat for that

  26. Base pay is $220-230/hr. We have a small incentive based bonus yearly that boosts it up.

  27. I have yet to get it. I work in healthcare. Worked on the covid unit for almost 30 days straight and didn't catch it. We tested frequently. I think there are people that have some genetic immunity or something. I work with a couple people who have never got it. They worked with me thru our outbreak- this was before vaccinations were available. At one point we had 30 covid patients I know I was exposed multiple times. Everyone in my immediate family had it except my daughter and myself. That being said I still wear my mask when I go out and avoid crowds.

  28. Work in the Emergency Dept, daily high risk exposures since onset of the pandemic, when masking wasn’t a thing and we ran out of all PPE. Still haven’t had it. About 10% of our department hasn’t gotten it. Most have had it more than once though.

  29. In my hospital, the hospitalist cannot decline admission over the phone. The ED attending is the one who evaluated the patient and determined they need admission. They cannot be overruled by a doctor who hasn't even laid eyes on the patient.

  30. The same reason they send in asymptomatic hypertension

  31. AAEM represents what I want for our specialty far more than ACEP. I’ll give them my money instead.

  32. Same here. Switched from ACEP membership to AAEM several years ago and haven’t looked back.

  33. Physicians will now go to the scene of a medical emergency and assist paramedics and other first responders in severe 911 calls or mass casualties.

  34. Pitt has been doing this for 20+ years. Works in higher density areas, like europe. Rural US, it doesn’t make any sense.

  35. “This patient doesn’t meet inpatient criteria for hypertensive urgency because there aren’t two recorded BPs greater than 180/110 after BP meds”

  36. So, do you have to do this for specialty consults as well?

  37. I was at a large, well-regarded program for residency with multiple sites. One of our main practice sites used this exact process (I actually wonder if OP is a resident at my program). It is so, so soul-sucking.

  38. I’m so sorry you and other people have to deal with this process. None of what you describe is really beneficial to the patient and I would say, detrimental. Also, the fact that the leadership didn’t know about it is depressing. I’m in a leadership role and if my residents knew more about this process, I’d be upset.

  39. Is there data that np’s actually send more time with each patient?

  40. From my experience, it’s because they lack the education and appropriate number of patient encounters to identify what is wrong quickly. As such, they take more time, order more tests. Patients see this as more caring, but it is just waste and more costly to the patient. I see it all the time.

  41. The answer I would have given to the spouse is one of 3 possibilities depending on my workflow and time. 1) Tell her the admitting team will call the surgeon and it is not time sensitive, so I will not be speaking to the surgeon as I don’t need their input in the next 60 min, 2) Tell her that if she has the number, she can call and talk to the surgeon and have the surgeon to call me directly if they have anything to add, or 3) Have the unit secretary page the surgeon. I would only have the unit secretary page if between 6a and 10p.

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