re: The ER is such a joke

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You didn’t really elaborate on the reason she wants to leave. First hand input is appreciated.

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Hospital Administrators are increasingly empowered to force nonsensical care constructs on employed physicians, directing them to do as they are told, or else. Those constructs are inevitably driven by EOY Administrator bonus pay. The ability to control, coerce, or manipulate employed MDs has led to hospitals increasingly excluding independent practitioners in favor of employees. For a number of reasons, ER MD's are at that spearpoint, and COVID handling/reporting further skewed the paradigm.

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excluding independent practitioners in favor of employees. For a number of reasons, ER MD's are at that spearpoint, and COVID handling/reporting further skewed the paradigm.

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Never understood what the financial incentive was for a doctor to take call. What are they paid by the hospital? ER and Anesthesia have always been sub contractors through my career. Seeing the shift to an employee model. But it will take another generation of docs being fed to the machine before they will accept working FOR a hospital.

So many changes are coming. My head hurts thinking of all the tangents.

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suspect there are fewer private ER staffing scenarios out there than you realize. Hospitals are heavily incentivized to control that portal.

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Not yet in Houston.

I believe it is coming. Memorial Hermann has a group. Methodist has one. HCA I believe has one. With HCA that’s a huge move hiring enough Docs systemwide to staff each ER. HCA still has a lot of baggage to overcome. Can’t imagine seeking them out as an ER doc. Saint Luke’s since CHI took over? No idea. Texas Children’s? No idea.

The push is coming. What you have always had were the same doctors just jumping ship to each company that took over the contract for coverage of facilities they were familiar with. Older the doc the less apt to move.

My ER nursing career is 90% exclusively in Houston though.

"If the United States had universal healthcare like the rest of the civilized world, then illegals and others wouldn't clog up the emergency rooms."

Wrong....It is abused because of the ER Act that was set forth many years ago that says you cannot restrict care based on the ability to pay. They can do this at the clinics and in the private walk-in doc-in-a-boxes. The ones who abuse the system know exactly what they are doing. I had a lady come in one night at 230 am with three kids in tow, on a school night. Said that one of the kids had been coughing for four days and she needed a script for cough syrup. When asked why she did not just pick up a bottle at the pharmacy, she responded with "if she had a perscription she could get it for free". Then went on to explain that despite the other two kids being "fine" she wanted a prescription for them as well. When queried as to why she had waited until 2 in the morning to come in, she gave some excuse about being busy, yet she showed "unemployed" on the entrance paperwork. My limited days in the ER were filled with daily episodes of this. Most of the illegals now are told exactly how to manipulate the system for their benefit. They know they will not get turned away. People, both domestic and here illegally, use the ER like it is their own private family doctor. It bogs down the system and accounts for a huge amount of the cost in overhead to a hospital.
Government healthcare will not fix that. Giving people a freebie does nothing when there is no accountability. if they think they can get it for free, they want everything coming to them plus more. Try explaining to a 30 year old that repeated CT scans for your vague problems does you absolutely no good, and the long term effects could be worse.

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If the United States had universal healthcare like the rest of the civilized world, then illegals and others wouldn't clog up the emergency rooms.

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I live in a country that has universal healthcare. I don't think there exists an emergency room in the country that isn't clogged up. And we don't have anywhere near as bad a problem as the U.S. has with illegal aliens. If we did, we would go from constantly clogged up, to overrun. Universal healthcare isn't the solution to the problem of overwhelmed health care systems.

Just tell them you have chest pains and you’ll skip the line everytime.

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Got it. Sick people who are poor should die in the street. Thank you for pointing out the error of my ways.

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Nope, they should receive care and the bill should be sent to you.

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My wife (no pics) is an ER doc and she has debated leaving the medical field entirely bc of the current system

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Have her get a couple partners and open and Emergency Hospital. We have one here and it seems to do well.

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I went to was full of illegals with colds

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How did you know they were illegals?

if you think the ER is bad try working as a paramedic in a large metro area. When I graduated from paramedic school in 1989, our physician/instructor stated "If you got to a large metro area and 911 only your career expectations are 8 years or less" I survived 7 years. The call you see were ridiculous, babies with diaper rash, toothaches, "my cat is sick" cells (Vaginal area issues).