It's been a busy month. For the first couple of weeks, my "cold" continued to get worse - to the point that I think I had walking pneumonia. My preceptor (Dr. Wiss) wrote me a prescription for a Z-pack and in 24 hours I was feeling 100% better. I'm sure my immune system was weakened by the stress and exhaustion. The ironic thing is that I had two of my easiest rotations yet over January.
The first two weeks of the New Year were supposed to be Neuro. However, my preceptor, Dr. Winograd, took vacation over the first week so it ended up as a one week rotation. I saw a lot during that week though and gained a new appreciation for neurology. It was actually quite fun, but would be too narrow to interest me from a career standpoint.
Becky's relatives then arrived for an extended stay. Her mom and significant other (S.O.) started working on a long list of home projects that we needed done to get the house ready to sell. it was a great help since I was worthless between being sick, traveling, new rotations and playing with the kids. In fact, I've been a terrible host.
The second half of January was a rotation in gastrointestinal medicine. However, the preceptor, Dr. Wiss, didn't make me go to the hospital for colonoscopies and procedures. Normally I would have loved to get in some procedures. But in this case I could rest and try to recover. The second week I missed most of my clinic time with my last two interviews, to St. Vincent's and Case/Metrohealth/Cleveland Clinic. In the end I worked one full day and three half days!
The interviews went great. I really enjoyed seeing many of the residents I got to know at St. Vincent's and they made it clear they would love to have me. The only reason I'm not ranking the program high is that Toledo is in a depression, like Detroit and most of Michigan, so Becky would have a difficult time getting a job. In fact, the program is very similar to UConn: friendly, great training, good facilities, good patient volume and some good attendings.
Case Western was new to me and I ended liking it more than I expected. The program seemed very good with great didactics and friendly residents, attendings and staff. It felt like this familiar attitude is a Midwest culture thing. And for a county program (Metrohealth) it is pretty cushy and well supported. Moreover, you spend 1/3 of your time at Cleveland Clinic (they pay 1/3 of your salary) and, while not as glitzy as I imagined, the place is pretty impressive. Finally, while Cleveland certainly offers more job opportunities for Becky than Toledo, the city sure showed signs of economic hardship. At this point, I will probably rank it fourth or fifth.
I enjoyed a rare couple weeks of being a slacker by sleeping more, riding our new mountain bikes on family trips to local mountain trails and playing some World of Warcraft with the boys. They are now at the age that they enjoy social games, whether playing with me or friends from school. And while WOW isn't that impressive from a graphics or class/race aspect, it plays on even my dinky three-year-old ultralight notebook.
This week I started Trauma Surgery at Maricopa county. It's kind of like a long second look at the EM residency program and a warm-up for residency. However, I'm feeling like a glutton for punishment when senioritis is starting to take over. We start at five or six am everyday and end at five or six pm. Then it's at least a 40-minute commute into downtown. Worse, with PAs, PA students, interns, residents and fellows on the service with me it's very slow. I've had one patient each day this week and got to do a couple procedures for the first time today: a foley and a bronchial lavage of blood from an motorcyclist vs. semi victim (without helmet of course).
Maricopa isn't looking too impressive at this point. I like the residents, but the volume is slow, the facility adequate at best and, worst of all, the hospital is on probation with JHACO. When residents joke about the place closing down, you really have to consider the implications.
I'm just getting up to speed now and tomorrow, on day five, we have three new residents replacing the experienced ones that were doing most of the work this week. Tomorrow I will one of the "experienced" people on the service! I'm just thankful that I will miss most of nest week while I travel to Christiana and Johns Hopkins for second looks. I may ask for Monday off even though I don't fly until Tuesday just so I have a day to rest up.
I got a 92% on my neuro test, so now it's time to start studying for Critical Care test. That is once I get used to my new schedule. I'm exhausted because I can't fall asleep until 11 or 12 and then get up at 4 or 5. And I still need to find a way to fit workouts in during the week. I finally stopped by an LA Fitness to swim after work today only to find the pool was an unattended facility off by itself with a bunch of ducks swimming laps! Obviously that wasn't going to do, so I'm still looking for something outside of our weekend mountain bike rides to keep healthy.
Thursday, January 31, 2008
Tuesday, January 01, 2008
New Year's Eve - it's 2008!
I had many possible choices for my New Year's resolution, including getting into shape, graduating from medical school, getting one of my top residency selections and staying healthy (this cold is still holding me back). I'm going attempt all of them for an ambitious 2008.
Tucker and his family came over for the evening. The kids get along great and seemed to have a great comparing Rock Band for the Xbox and Guitar Hero III for the Wii. The former has drums and a microphone, but the latter has much better songs.
It was a pretty laid-back evening with some wine, a baked potato bar and a lot of socializing. Tucker and I agreed that our motivation for medical school is pretty low right now. Fourth year you just want to get your residency slot, not get as many patients as possible on rotation or work your tail off to impress attendings. Makes me wonder what I was thinking when I scheduled three tough rotations for end of fourth year: Trauma Surgery; Internal Medicine Sub-I; and Critical Care. At least I have May off for our long-awaited family vacation.
We celebrated New Year's on New York time so Tucker and his family could get home at a reasonable to avoid the drunks and have the kids in bed before midnight. The boys and I stayed up until New Year's local time and watched the apple, but it was kinda anti-climatic.
Here we are on January 1st, 2008 and we're just lounging around. Becky went for a run, I'm filling up Kleenex boxes with used tissue and the boys are playing Xbox.
My most important goal for today is get my Thank You cards out for the New England interviews I had two weeks ago. The holidays, being sick and the PE exam slowed me down, but the cards are my desk and the task has been in the back of my mind for days and days. Time to stop procrastinating. I finally got caught up on this blog, so that's a good start.
Tucker and his family came over for the evening. The kids get along great and seemed to have a great comparing Rock Band for the Xbox and Guitar Hero III for the Wii. The former has drums and a microphone, but the latter has much better songs.
It was a pretty laid-back evening with some wine, a baked potato bar and a lot of socializing. Tucker and I agreed that our motivation for medical school is pretty low right now. Fourth year you just want to get your residency slot, not get as many patients as possible on rotation or work your tail off to impress attendings. Makes me wonder what I was thinking when I scheduled three tough rotations for end of fourth year: Trauma Surgery; Internal Medicine Sub-I; and Critical Care. At least I have May off for our long-awaited family vacation.
We celebrated New Year's on New York time so Tucker and his family could get home at a reasonable to avoid the drunks and have the kids in bed before midnight. The boys and I stayed up until New Year's local time and watched the apple, but it was kinda anti-climatic.
Here we are on January 1st, 2008 and we're just lounging around. Becky went for a run, I'm filling up Kleenex boxes with used tissue and the boys are playing Xbox.
My most important goal for today is get my Thank You cards out for the New England interviews I had two weeks ago. The holidays, being sick and the PE exam slowed me down, but the cards are my desk and the task has been in the back of my mind for days and days. Time to stop procrastinating. I finally got caught up on this blog, so that's a good start.
Playing with Santa's gifts
The weekend before New Year's was spent riding our new bikes, fixing their flat tires and playing Rock Band. The boys are also playing their new single player games as well, but Rock Band is the most popular, especially with their friends.
I did get some news. My Neuro rotation won't start until January 7th because my preceptor is taking the week off. So my rotation is basically going to be one week. If I can get motivated, that should give me plenty of time to read my Neuro book in preparation for the post-rotation exam.
I'm writing this from my notebook as we manged to confirm that the desktop PC is dead. The kids and I would love a new mid-level gaming PC, but it's going to have to wait after an expensive Christmas. I might have to forego the iPod Touch again and get a new PC for mine and Connor's Birthday presents.
I did get some news. My Neuro rotation won't start until January 7th because my preceptor is taking the week off. So my rotation is basically going to be one week. If I can get motivated, that should give me plenty of time to read my Neuro book in preparation for the post-rotation exam.
I'm writing this from my notebook as we manged to confirm that the desktop PC is dead. The kids and I would love a new mid-level gaming PC, but it's going to have to wait after an expensive Christmas. I might have to forego the iPod Touch again and get a new PC for mine and Connor's Birthday presents.
Level 2 PE in Philadelphia
I left on Thursday the 27th for Philadelphia and finished reading the FirstAid book's mini-cases on the plane. However, I had acquired a nasty virus that was wearing me down. By the time I go the hotel I was exhausted and hadn't started to practice writing out the full cases.
After a long nap I managed to write out 4-5 cases and review another 10 or so. I didn't feel well prepared but knew that passing is all I need and sleep was probably more important. Luckily the cold and nap didn't keep me from getting a decent night's sleep.
The proctors running the exam were nice enough and really explained everything in detail. None of us examinees were nervous when it was time to start. After the first four cases we had lunch. Then four more cases before a short 15-minute break. After the last four cases, I left as quickly as possible to catch my flight back to Phoenix.
The PE exam seemed like most things in the osteopathic world - a joke designed to pad AOA egos and save face for them in front of AMA MDs. I am pretty disgusted that I had to spend over $1500 and two days for a brain-dead test with actors worse than the ones we had for on-campus standardized cases. I found the cases in the FirstAid book on the USMLE Step 2 CS much tougher and more realistic.
If the AOA and osteopathic community were really interested in improving patient care and physician education they would have tried something new instead of just copying the allopathic tests for millionth time.
My irritation with the NBOME and AOA was almost enough to make me forget how irritated I was with their preferred hotel, Marriott, for nickle and diming me bill to the point of being a rip off.
The flight home was fine and allowed me a chance to read up on my forthcoming Neurology rotation. But to top the trip off, I arrived home to find out that our four year old desktop PC had died.
After a long nap I managed to write out 4-5 cases and review another 10 or so. I didn't feel well prepared but knew that passing is all I need and sleep was probably more important. Luckily the cold and nap didn't keep me from getting a decent night's sleep.
The proctors running the exam were nice enough and really explained everything in detail. None of us examinees were nervous when it was time to start. After the first four cases we had lunch. Then four more cases before a short 15-minute break. After the last four cases, I left as quickly as possible to catch my flight back to Phoenix.
The PE exam seemed like most things in the osteopathic world - a joke designed to pad AOA egos and save face for them in front of AMA MDs. I am pretty disgusted that I had to spend over $1500 and two days for a brain-dead test with actors worse than the ones we had for on-campus standardized cases. I found the cases in the FirstAid book on the USMLE Step 2 CS much tougher and more realistic.
If the AOA and osteopathic community were really interested in improving patient care and physician education they would have tried something new instead of just copying the allopathic tests for millionth time.
My irritation with the NBOME and AOA was almost enough to make me forget how irritated I was with their preferred hotel, Marriott, for nickle and diming me bill to the point of being a rip off.
The flight home was fine and allowed me a chance to read up on my forthcoming Neurology rotation. But to top the trip off, I arrived home to find out that our four year old desktop PC had died.
Christmas 2007
My dad and stepmother came into town from California and stayed for a few days. It's always fun to have company for the big holidays and this was no exception. For Christmas Eve we started a new tradition of having salmon and then had a more standard honey-baked ham on Christmas Day.
Christmas Eve we let the boys open their presents from relatives and us. They knew the bikes were the big ticket item, but we pleased to get two of their most desited Xbox 360 games and a few appropriate books. I gave Grandpa a hilarious book from the Onion called Our Dumb World that the adults laughing to tears while the boys tried out their new games.
Christmas morning we had our traditional one present from Santa and several "love presents" in their stockings. The one present was the hard-to-get present for 2007 that we managed to snag from at a local vendor. Rock Band doesn't have as many good songs as we expected or would like, but the kids love using the guitar, drums and microphone to score points (get fans). In the sleep-overs they have had with friends since Christmas, they played for hours screeching out REM, the Clash and the Who. It is quite funny to watch and hear.
I started playing an online game on the PC afterwards as a way to procrastinate from studying for my PE exam on Friday the 28th. That and buying replacement tubes for bikes.
Christmas Eve we let the boys open their presents from relatives and us. They knew the bikes were the big ticket item, but we pleased to get two of their most desited Xbox 360 games and a few appropriate books. I gave Grandpa a hilarious book from the Onion called Our Dumb World that the adults laughing to tears while the boys tried out their new games.
Christmas morning we had our traditional one present from Santa and several "love presents" in their stockings. The one present was the hard-to-get present for 2007 that we managed to snag from at a local vendor. Rock Band doesn't have as many good songs as we expected or would like, but the kids love using the guitar, drums and microphone to score points (get fans). In the sleep-overs they have had with friends since Christmas, they played for hours screeching out REM, the Clash and the Who. It is quite funny to watch and hear.
I started playing an online game on the PC afterwards as a way to procrastinate from studying for my PE exam on Friday the 28th. That and buying replacement tubes for bikes.
Getting ready for Christmas and Level 2 PE
I spent the vast majority of my time preparing for Christmas, not the PE exam. I inconsistently read the FirstAid book for allopathic version of the test, USMLE Step 2 CS. But didn't get very far. Instead, Becky and I laid out the plans for Christmas and I got to shopping.
The big item this year ended up being mountain bikes. We are all having a rough time getting back into shape and definitely ate too much crap (me while traveling the last fours months). I haven't gone swimming or biking more than a couple times each even though Becky now has a road bike and the kids are old enough to leave them home alone for an hour or so. Moreover, the kids had gotten a little tired of swimming, and we of forcing them to go to practice.
So I decided that mountain biking would be something we could all do as a family on weekends an the boys could even do after school in the local "wash". That's a Phoenix term for overgrown drainage ditches. They are the size of a river to handle floods, but are dry 99% of the time, so coyotes, rabbits and human use them most of the year.
This was an expensive decision for us at this point, but Becky and I committed that we'd get our tushes out of the house on weekends and spent some quality with our kids. The boys and I visited the top local store, Swiss American Cycling, and the immediately fell in love with the idea of mountain biking. Probably more accurately, with the idea of getting new bikes. Colton had always had hand-me downs from his brother, so he was ecstatic about gettin a cool new bike.
We picked them up on Saturday before Christmas so the boys would have something to do other than start their two week break glued to the TV. We managed to get the bikes home and surprise them, only after realizing that we'd be getting a new bike carrier. After very minimal set-up the boys and I went out for a quick ride.
They were tentative, Colton less so, but really enjoyed it. On Sunday Connor had a head-over-handlebars crash in the street and hurt his wrist, so Colton and I went exploring. The following day all four of us went for an easy ride. I still felt the boys were excited, just not as passionate about it as I would have liked. That changed after Christmas went to some BMX trails by AZCOM with lots of obstacles, jumps and gullies. Now they boys are huge fans and can't wait to go riding every day. It's starting to feel like money well spent.
Our biggest hassle has been popped tire tubes. I'm putting on Slimes now, but we had 1-2 punctures per ride for the first week! That gets old fast.
The big item this year ended up being mountain bikes. We are all having a rough time getting back into shape and definitely ate too much crap (me while traveling the last fours months). I haven't gone swimming or biking more than a couple times each even though Becky now has a road bike and the kids are old enough to leave them home alone for an hour or so. Moreover, the kids had gotten a little tired of swimming, and we of forcing them to go to practice.
So I decided that mountain biking would be something we could all do as a family on weekends an the boys could even do after school in the local "wash". That's a Phoenix term for overgrown drainage ditches. They are the size of a river to handle floods, but are dry 99% of the time, so coyotes, rabbits and human use them most of the year.
This was an expensive decision for us at this point, but Becky and I committed that we'd get our tushes out of the house on weekends and spent some quality with our kids. The boys and I visited the top local store, Swiss American Cycling, and the immediately fell in love with the idea of mountain biking. Probably more accurately, with the idea of getting new bikes. Colton had always had hand-me downs from his brother, so he was ecstatic about gettin a cool new bike.
We picked them up on Saturday before Christmas so the boys would have something to do other than start their two week break glued to the TV. We managed to get the bikes home and surprise them, only after realizing that we'd be getting a new bike carrier. After very minimal set-up the boys and I went out for a quick ride.
They were tentative, Colton less so, but really enjoyed it. On Sunday Connor had a head-over-handlebars crash in the street and hurt his wrist, so Colton and I went exploring. The following day all four of us went for an easy ride. I still felt the boys were excited, just not as passionate about it as I would have liked. That changed after Christmas went to some BMX trails by AZCOM with lots of obstacles, jumps and gullies. Now they boys are huge fans and can't wait to go riding every day. It's starting to feel like money well spent.
Our biggest hassle has been popped tire tubes. I'm putting on Slimes now, but we had 1-2 punctures per ride for the first week! That gets old fast.
Sunday, December 23, 2007
New England Interviews
I had a direct flight that got me into Hartford, CT around 11pm on Sunday, December 17th. Luckily, I missed several days of snow from a major storm. Getting my rental car and driving to the hotel went smoothly. But I heard lots of stories of people stuck in traffic for hours after 13 inches fell in eight hours during the workday.
It was a little crazy getting the 2-3miles to UConn Monday morning due to the snow and icy conditions, plus I missed a turn-off. It was a little stressful but I made it to the interview exactly on time.
I started out not being too impressed with the UConn program for the initial didactic lecture we sat through the PD's program overview. But during the interviews and lunch the warm fuzzy feeling about the people returned. By the end of the day, they were right back at the top tier of my ROL and I was looking forward to driving Tuesday for dinner with some of the residents.
I spent the night in Springfield near the Baystate EM offices. The Baystate/Tufts also gave me the warm fuzzies about the people, but I just wasn't as impressed with the actual program. I was actually irritated that they made applicants get on the hotel shuttle at 7am and sit around the ED offices for an hour and a half while the PD drove in. The cooridinator, a nice lady, did the program no favors by mentioning how the facility was falling apart and one resident almost got by falling ceiling debri while snoozing in the oncall room. As I remembered from my previous visit, the place is packed and very efficient in an old school way. They put more patients through fewer beds than any other program I know of. By the end of the day, after mentally bouncing them up and down my ROL, they returned to the same I had them before starting the trip.
I headed back down to Hartford for the UConn resident dinner and had a chance to ask lots of questions that came up during the interview. I had a really good time and enjoyed the people and atmosphere a lot.
Then I drove an hour or so to Worcester, MA. It sure looked familiar having finished my month there only 6-7 weeks ago. I arrived on time for my UMass interview of the trip and immediately got the "wow" impression I had had from reading about the program and my initial visit. The offices, ED and hospital are all brand new and gorgeous. The new sim lab being built in the new building across the street will likely be just as impressive. Like the other applicants, I was on their leash through the PD's introduction and the resident slideshow. On paper, the place has everything going for it including a month in HI for a PGY-III hyperbaric elective. I even enjoyed the interviews. However some of the problems quickly came to the forefront. The Attendings don't do much teaching and you don't see them at conferences. Jeremy, whom I had rotated with, and I compared notes afterwards and came to the same conclusion. There is great training, but it isn't a warm place and do get very busy moving meat in the ED.
So the I started to question the value of the whole trip since all three programs ended exactly where they had started in my ROL. Of course I had to make the interviews in order to rank the programs, and I will rank all three. It just seemed like a lot of time and energy for not a lot of new information or gut feelings.
My drive back to Hartford, night at the hotel and flight back was uneventful. I shouldn't have scheduled a 5:30am flight because I had to get up at 2:30am East Coast time. But I managed to sleep a bit on the plane and start studying for my upcoming COMLEX Level 2 PE exam the following week.
It was a little crazy getting the 2-3miles to UConn Monday morning due to the snow and icy conditions, plus I missed a turn-off. It was a little stressful but I made it to the interview exactly on time.
I started out not being too impressed with the UConn program for the initial didactic lecture we sat through the PD's program overview. But during the interviews and lunch the warm fuzzy feeling about the people returned. By the end of the day, they were right back at the top tier of my ROL and I was looking forward to driving Tuesday for dinner with some of the residents.
I spent the night in Springfield near the Baystate EM offices. The Baystate/Tufts also gave me the warm fuzzies about the people, but I just wasn't as impressed with the actual program. I was actually irritated that they made applicants get on the hotel shuttle at 7am and sit around the ED offices for an hour and a half while the PD drove in. The cooridinator, a nice lady, did the program no favors by mentioning how the facility was falling apart and one resident almost got by falling ceiling debri while snoozing in the oncall room. As I remembered from my previous visit, the place is packed and very efficient in an old school way. They put more patients through fewer beds than any other program I know of. By the end of the day, after mentally bouncing them up and down my ROL, they returned to the same I had them before starting the trip.
I headed back down to Hartford for the UConn resident dinner and had a chance to ask lots of questions that came up during the interview. I had a really good time and enjoyed the people and atmosphere a lot.
Then I drove an hour or so to Worcester, MA. It sure looked familiar having finished my month there only 6-7 weeks ago. I arrived on time for my UMass interview of the trip and immediately got the "wow" impression I had had from reading about the program and my initial visit. The offices, ED and hospital are all brand new and gorgeous. The new sim lab being built in the new building across the street will likely be just as impressive. Like the other applicants, I was on their leash through the PD's introduction and the resident slideshow. On paper, the place has everything going for it including a month in HI for a PGY-III hyperbaric elective. I even enjoyed the interviews. However some of the problems quickly came to the forefront. The Attendings don't do much teaching and you don't see them at conferences. Jeremy, whom I had rotated with, and I compared notes afterwards and came to the same conclusion. There is great training, but it isn't a warm place and do get very busy moving meat in the ED.
So the I started to question the value of the whole trip since all three programs ended exactly where they had started in my ROL. Of course I had to make the interviews in order to rank the programs, and I will rank all three. It just seemed like a lot of time and energy for not a lot of new information or gut feelings.
My drive back to Hartford, night at the hotel and flight back was uneventful. I shouldn't have scheduled a 5:30am flight because I had to get up at 2:30am East Coast time. But I managed to sleep a bit on the plane and start studying for my upcoming COMLEX Level 2 PE exam the following week.
Finished plastics
Get getting around to this rotation summary a week and a half late. My Emergency Medicine post-rotation exam and several interviews side-lined me for awhile. I passed the exam and will blog about the interviews next.
Well I am very impressed with Dr. Kotoske's practice. It's almost unique in medicine today to have a sole practice with its own operating room and over twenty employees (6-8 at any given time). But cosmetic surgery, as cash pay service, is one of the last truly lucrative fields in medicine.
More importantly, Dr. Kotoske has a great reputation for his Quicklift procedure, breast augmentation and tummy tucks. I also saw him do one nose job (rhinoplasty) on a gorgeous young lady that had had a life-long complex about a slight asymmetry. But who has a naturally symmetrical nose anyway?
Breast jobs are just fun. You take young, generally already attractive females and give them these large, shapely breasts that are incredibly attractive. But the best part is seeing their new self-confidence and huge smiles (many times with smiling significant others present as well) at the post-op visits a couple of days after surgery. I guess if I was a breast guy I would find the artistry more appealing. I'm just not a perfectionist like Dr. Kotoske when it comes to breasts.
The Quicklifts are a great invention. They are the perfect surgical treatment for the majority of women over 50 that want to look 10 years younger. I might be interested in one myself someday, except that I'd need something for my forehead wrinkles. I don't see myself doing botox anytime soon.
The tummy tucks were the most physically demanding procedures and the most "barbaric" on the patient. Lots of flank and abdomen liposuction followed by blunt dissection of the abdominal tissue from belly button to ribs. Then two big, generally several pound, flaps of flesh get removed. Finally, there's a multi-layer closure with multiple deep sutures and staples on the skin.
All the patients looked great at the post-op visits, were thrilled with the results and couldn't stop thanking Dr. K. for his work. Not a bad gig!
If it wasn't so competitive and cut throat to get into with a masochistic residency I would be tempted. However, Emergency Medicine is definitely a better fit for me and for the family. It was an easy rotation that convinced me cosmetic surgery isn't too vain and Dr. K. is one of the surgeons I would consider using for myself someday.
Well I am very impressed with Dr. Kotoske's practice. It's almost unique in medicine today to have a sole practice with its own operating room and over twenty employees (6-8 at any given time). But cosmetic surgery, as cash pay service, is one of the last truly lucrative fields in medicine.
More importantly, Dr. Kotoske has a great reputation for his Quicklift procedure, breast augmentation and tummy tucks. I also saw him do one nose job (rhinoplasty) on a gorgeous young lady that had had a life-long complex about a slight asymmetry. But who has a naturally symmetrical nose anyway?
Breast jobs are just fun. You take young, generally already attractive females and give them these large, shapely breasts that are incredibly attractive. But the best part is seeing their new self-confidence and huge smiles (many times with smiling significant others present as well) at the post-op visits a couple of days after surgery. I guess if I was a breast guy I would find the artistry more appealing. I'm just not a perfectionist like Dr. Kotoske when it comes to breasts.
The Quicklifts are a great invention. They are the perfect surgical treatment for the majority of women over 50 that want to look 10 years younger. I might be interested in one myself someday, except that I'd need something for my forehead wrinkles. I don't see myself doing botox anytime soon.
The tummy tucks were the most physically demanding procedures and the most "barbaric" on the patient. Lots of flank and abdomen liposuction followed by blunt dissection of the abdominal tissue from belly button to ribs. Then two big, generally several pound, flaps of flesh get removed. Finally, there's a multi-layer closure with multiple deep sutures and staples on the skin.
All the patients looked great at the post-op visits, were thrilled with the results and couldn't stop thanking Dr. K. for his work. Not a bad gig!
If it wasn't so competitive and cut throat to get into with a masochistic residency I would be tempted. However, Emergency Medicine is definitely a better fit for me and for the family. It was an easy rotation that convinced me cosmetic surgery isn't too vain and Dr. K. is one of the surgeons I would consider using for myself someday.
Thursday, November 29, 2007
Maricopa
I'm starting feel like life is getting back to normal. However, I still have mail and magazines stacked around the house. And my diet and exercise routine aren't up to snuff. After all, it's not like things are "back to normal".
I started a new job on Monday. My plastic surgery rotation is going to be interesting, but I don't get to do anything since these are patients paying cash for a celebrity plastic surgeon to work on them. And there isn't a whole lot of wound care going on, it's all cosmetic procedures.
I've seen four "Quicklift" facelifts over two days. Very interesting procedures and a very lucrative business model. Dr. K. has patented the procedure with a partner, so they get royalties from othe surgeons around the country and can exclude the run-of-the-mill surgeons from messing up the procedure's reputation. A local news host had the procedure done and was back on TV in two days. Can't get better marketing than that! Anyway, I have enjoyed talking with Dr. K., his surg tech, the anesthetists and the circulating nurses, all of whom have been great. And the results are fantastic. Heck, I might have to get one of these in 10 or 15 years!
If plastics wasn't so darn competitive I would probably put up with the long, difficult residency/fellowship and go for it. I can see myself doing these procedures easily. The cosmetic operations make the mint and the reconstructive stuff makes you feel good (or at least removes the guilt). Plus you're working with a great patients (healthy, cash pay and frequently already very attractive), being creative and owning your own business. Dr. K. advertises the "eyes of an artist" while employing 21 people (most part-time) and operating his own private, JHACO approved, surgical suite. No surprise here I'm sure, but he drives a nice Porsche as well. Not bad!
Becky and I went to Maricopa's pre-interview dinner on Monday night with a big group of current residents and fellow applicants. Dave Levin from my class was there as well. He's been rotating there for two months, so I was the one asking all the questions. Becky was a bit bored, but we had an ok time. The dinner was just mediocre.
The interview on Tuesday went well. I really like the Program Director, whom I met in Seattle at the ACEP Residency Fair. The tour went fine. It's a county ED, but not a bad as I feared. They will be building a new one well after I'm done with Residency, but the current one, curtains and all, will suffice. I was pleasantly surprised by how well the department is funded and how strong the leadership throughout the county system. I feel confident I could get a great education there. The regional (southwest USA) burn center is a unique factor I like. They teach EM residents how to do fasciotomies and skin grafts! Finally, we would save a ton of time and expense because we could stay in our current home. The commute is much more doable than I thought and many residents live further away than we do now.
Maricopa will definately be in my top five, likely in my top three. The big decision comes down to whether we want to put Hopkins #1. Becky and I have been talking a lot about that lately.
Today I mostly relaxed. I could have gone in for office visits of patients following up on surgeries. But understandably Dr. K. doesn't want a student in the room when he's having potential patients baring their souls and skin as he makes his pitch. So I stayed home and finalized travel plans for the COMLEX PE test at the end of the month and my five remaining interviews, three in New England and two in Ohio. I still need to cancel MCG. But right now I'm torn between finishig Wired magazine or playing an Xbox 360 game...
I started a new job on Monday. My plastic surgery rotation is going to be interesting, but I don't get to do anything since these are patients paying cash for a celebrity plastic surgeon to work on them. And there isn't a whole lot of wound care going on, it's all cosmetic procedures.
I've seen four "Quicklift" facelifts over two days. Very interesting procedures and a very lucrative business model. Dr. K. has patented the procedure with a partner, so they get royalties from othe surgeons around the country and can exclude the run-of-the-mill surgeons from messing up the procedure's reputation. A local news host had the procedure done and was back on TV in two days. Can't get better marketing than that! Anyway, I have enjoyed talking with Dr. K., his surg tech, the anesthetists and the circulating nurses, all of whom have been great. And the results are fantastic. Heck, I might have to get one of these in 10 or 15 years!
If plastics wasn't so darn competitive I would probably put up with the long, difficult residency/fellowship and go for it. I can see myself doing these procedures easily. The cosmetic operations make the mint and the reconstructive stuff makes you feel good (or at least removes the guilt). Plus you're working with a great patients (healthy, cash pay and frequently already very attractive), being creative and owning your own business. Dr. K. advertises the "eyes of an artist" while employing 21 people (most part-time) and operating his own private, JHACO approved, surgical suite. No surprise here I'm sure, but he drives a nice Porsche as well. Not bad!
Becky and I went to Maricopa's pre-interview dinner on Monday night with a big group of current residents and fellow applicants. Dave Levin from my class was there as well. He's been rotating there for two months, so I was the one asking all the questions. Becky was a bit bored, but we had an ok time. The dinner was just mediocre.
The interview on Tuesday went well. I really like the Program Director, whom I met in Seattle at the ACEP Residency Fair. The tour went fine. It's a county ED, but not a bad as I feared. They will be building a new one well after I'm done with Residency, but the current one, curtains and all, will suffice. I was pleasantly surprised by how well the department is funded and how strong the leadership throughout the county system. I feel confident I could get a great education there. The regional (southwest USA) burn center is a unique factor I like. They teach EM residents how to do fasciotomies and skin grafts! Finally, we would save a ton of time and expense because we could stay in our current home. The commute is much more doable than I thought and many residents live further away than we do now.
Maricopa will definately be in my top five, likely in my top three. The big decision comes down to whether we want to put Hopkins #1. Becky and I have been talking a lot about that lately.
Today I mostly relaxed. I could have gone in for office visits of patients following up on surgeries. But understandably Dr. K. doesn't want a student in the room when he's having potential patients baring their souls and skin as he makes his pitch. So I stayed home and finalized travel plans for the COMLEX PE test at the end of the month and my five remaining interviews, three in New England and two in Ohio. I still need to cancel MCG. But right now I'm torn between finishig Wired magazine or playing an Xbox 360 game...
Friday, November 23, 2007
Finished Christiana and the audition rotations
Today was my last shift at Christiana. It was a little short since I took off at 1pm to get errands done before I fly out tomorrow. One memorable case was a guy with a "surgical belly" from, we believe, his second bowel perforation. He had the first repaired last month, but it didn't have nearly as much free air, free fecal matter or perotinitis. These are happening because mets from his stage IV lung cancer are eating holes through his intestines. And he's a young guy.
Over the last week I've had several good cases at Christiana. Good traumas, some acute injuries and some interesting work-ups. Yesterday in Wilmington we had a homeless lady with Pyoderma Gangrenosum. She was a sad case that used alcohol and crack to self medicate on the street. The bandages we took off were at least two weeks old. They were black and the smell of rotting flesh lingered around the ED for hours after she was admitted. The ulcers were easily the worst I've ever seen. Her breasts, back and left hip were craters. If she would try to take care of herself and stay on her medications it wouldn't have gotten nearly this bad.
On Tuesday I had my Christiana interview. It went better than I expected. I really liked the answers to my questions. There's some great new changes like a $5M sim lab and one-on-one teaching rounds. And the EM department is very strong with the hospital organization. I really enjoyed meeting the Assistant Program Director as well. Right now, it feels like it will come down to whether we want a 4-year program with fellowship (i.e. Hopkins) or 3-year program that really takes care of its residents (i.e. Christiana).
Hopefully Becky and I can come back in January for a second look at the programs and areas (homes, schools, job opps for her).
Now though I have to pack. I'm getting up at 2:30am to turn in my rental and catch a shuttle to the Baltimore airport. My flight leaves at 7am and gets me into Phoenix around 2pm. Then we have a late Thanksgiving meal with Tucker and his family at our house. It's going to be a long, tiring day tomorrow.
Luckily I've managed to get 8-9 hours of sleep the last couple of nights. I'm starting to feel like myself again. If I had to use one word to describe the week it would be exhaustion. The lack of days off, numerous interviews, stress of setting up interviews and getting rejections all caught up to me. I've also done a terrible job of keeping shape.
I'm going to have to spend some serious hours in the pool and on the bike to shed a few pounds and get back into shape upon returning to Phoenix. But on the plus side, I'm halfway through my interviews!
Time to pack and try to get a little sleep.
Over the last week I've had several good cases at Christiana. Good traumas, some acute injuries and some interesting work-ups. Yesterday in Wilmington we had a homeless lady with Pyoderma Gangrenosum. She was a sad case that used alcohol and crack to self medicate on the street. The bandages we took off were at least two weeks old. They were black and the smell of rotting flesh lingered around the ED for hours after she was admitted. The ulcers were easily the worst I've ever seen. Her breasts, back and left hip were craters. If she would try to take care of herself and stay on her medications it wouldn't have gotten nearly this bad.
On Tuesday I had my Christiana interview. It went better than I expected. I really liked the answers to my questions. There's some great new changes like a $5M sim lab and one-on-one teaching rounds. And the EM department is very strong with the hospital organization. I really enjoyed meeting the Assistant Program Director as well. Right now, it feels like it will come down to whether we want a 4-year program with fellowship (i.e. Hopkins) or 3-year program that really takes care of its residents (i.e. Christiana).
Hopefully Becky and I can come back in January for a second look at the programs and areas (homes, schools, job opps for her).
Now though I have to pack. I'm getting up at 2:30am to turn in my rental and catch a shuttle to the Baltimore airport. My flight leaves at 7am and gets me into Phoenix around 2pm. Then we have a late Thanksgiving meal with Tucker and his family at our house. It's going to be a long, tiring day tomorrow.
Luckily I've managed to get 8-9 hours of sleep the last couple of nights. I'm starting to feel like myself again. If I had to use one word to describe the week it would be exhaustion. The lack of days off, numerous interviews, stress of setting up interviews and getting rejections all caught up to me. I've also done a terrible job of keeping shape.
I'm going to have to spend some serious hours in the pool and on the bike to shed a few pounds and get back into shape upon returning to Phoenix. But on the plus side, I'm halfway through my interviews!
Time to pack and try to get a little sleep.
Friday, November 16, 2007
Tough week with four interviews!
The Drexel interview went well last week. I'm still trying to schedule a second look at their CCU where they complete about seven months of training. It's a solid program with good people in downtown Philadelphia.
Over the weekend I had a couple really good shifts at Christiana. I finally got to see some of the trauma and procedures that I knew could be found here. I saw two motor vehicle deaths and was allowed to listen to one of the Attendings talk with the family. It was a good learning opportunity and I am glad I sat through it. Tough to explain to the adult children how family members died unexpectedly, but it's something that Emergency Physicians have to be able to do.
Then I had most of the week off to complete three interviews. I only worked on Thursday at the secondary hospital in Wilmington. It's a more urban location and patient population. I had a good time there as well. I also got a chance to talk ask one of the residents a lot of questions about Christiana. I'm looking forward to my interview on Tuesday so I can ask the leadership some questions.
Monday I drove to upstate New Jersey and had dinner with the Morristown residents. They were incredibly nice. During the interview, I got the feeling that it's a small residency with very nice people that has a family feel. You get lots of face time with Attendings. The residents and attendings are very close. Morristown is also a nice area for families. For trauma you go to Newark, NJ to see penetrating trauma.
Wednesday I interviewed at Cooper in lower New Jersey. It also impressed me more than I expected but for different reasons. The Program Director is very impressive and I like their unique track system where you use your RRC required scholarly project to concentrate on an area of interest that you can list on your CV. The trauma and pathology is more acute for the patient volume than most places. Camden, NJ is a very poor area with lots violent crime. It would also give us the option of living near Philadelphia so Becky's job opportunities would be great.
Friday, today, was the most surprising of all. But first, I had to get to Baltimore. I got off work in Wilmington at 4pm last night. The resident dinner was at 6:30pm. I thought that would be plenty of time to drive down about 65 miles with a quick stop at my hotel room to change out of scrubs and grab a bite to eat. Well, the Wilmington traffic was horrible. It took me over an hour to get 7 miles from the hospital to my hotel room! So I spent an hour chilling out and hoping rush hour traffic would die down a bit. After all, I was going into Baltimore so it should be against traffic. However, construction on the main freeway, I-95, turned a 57-mile drive into a three and half hour parking lot. I kept thinking it would speed up once we passed some fatality accident. But they just kept reducing lanes after miles and miles of more stop than go traffic. Six lanes reduced to one for no apparent reason! They didn't seem to be doing any work on the road at all!
I arrived at the hotel, Mt. Washington Conference Center, at 10pm. The bar where I was supposed to meet the residents was the closest place to get food so I walked thinking I was going to foot the bill for a very late dinner. After inquiring though, four residents were still there. All the other applicants had already headed home. We talked for two hours over a couple glasses of Guiness, which greatly helped me recover from the drive down. The appetizers filled me up at well. I got six and a half hours of good sleep.
Hopkins itself is incredible. Their are three cranes there right now building the largest hospital expansion in history. A two billion(!) dollar expansion including a new ED. However, it won't be ready until early 2011 according to the latest estimates. I really liked the residents, including the three D.O.'s there now. No overblown egos, just lots of nice friendly people, many of whom are world renowned for writing our textbooks are publishing prominent studies. The Mt. Washington offices are opulent and were effective at demonstrating how well funded the Emergency Department is. Friday is conference day at Hopkins, and the training seemed very good. Then we took a tour of the city even though most of the applicants knew the city as well as our guides. It's a nice place of about 650,000 that would offer a reasonable cost of living with lots of opportunities for Becky. The Hopkins ED was fairly plain, but seemed more than adequate for a place to get good training. And finally the interviews were, like everywhere else, low key and a friendly Q & A session with equal time for both parties to ask questions.
I left really impressed. They are now a four year program, so the decision really comes down to whether that fourth year will pay for itself either financially or in new opportunities. I think it would, especially with the Hopkins name backing it up. And they have 12 tracks to choose from, which I don't think could be offered at any other institution. Education, administration and ultrasound are the most interesting to me right now. In the end, I would put Hopkins at the top of my list of places I've interviewed so far. My top four will probably end up being UConn, UMass, Christiana and Hopkins but I have no idea what order they will ranked. Cooper and Maricopa may also make it in there.
Lots to think about. It's been a very stressful week nailing down four of the five interviews while I'm here in the MidAtlantic region. Plus I nailed down St. Vincent's and Case Western/Cleveland Clinic in January and Maricopa in two weeks back in Phoenix. I also got a number of rejections. The only one that is really disappointing is OHSU. MUSC was equally surprising, but not nearly as disappointing. Financially my current schedule will be much more doable with only two more trips. The amazing thing is that the numbers are working exactly like I was shooting for. Five interviews while I'm here at Christiana and ten total. I actually have eleven if I don't cancel MCG, plus I'm still on the waiting list at three programs and there's five or six I haven't heard from yet. But I'm pretty satisfied.
My Tuesday interview is just me for three half hour sessions with the Christiana leadership. I'm a little nervous about that one since it will be just me with no warm and fuzzy introduction to the program over lunch. At least I have one of my two days off this month the day before it. What a month!!
Over the weekend I had a couple really good shifts at Christiana. I finally got to see some of the trauma and procedures that I knew could be found here. I saw two motor vehicle deaths and was allowed to listen to one of the Attendings talk with the family. It was a good learning opportunity and I am glad I sat through it. Tough to explain to the adult children how family members died unexpectedly, but it's something that Emergency Physicians have to be able to do.
Then I had most of the week off to complete three interviews. I only worked on Thursday at the secondary hospital in Wilmington. It's a more urban location and patient population. I had a good time there as well. I also got a chance to talk ask one of the residents a lot of questions about Christiana. I'm looking forward to my interview on Tuesday so I can ask the leadership some questions.
Monday I drove to upstate New Jersey and had dinner with the Morristown residents. They were incredibly nice. During the interview, I got the feeling that it's a small residency with very nice people that has a family feel. You get lots of face time with Attendings. The residents and attendings are very close. Morristown is also a nice area for families. For trauma you go to Newark, NJ to see penetrating trauma.
Wednesday I interviewed at Cooper in lower New Jersey. It also impressed me more than I expected but for different reasons. The Program Director is very impressive and I like their unique track system where you use your RRC required scholarly project to concentrate on an area of interest that you can list on your CV. The trauma and pathology is more acute for the patient volume than most places. Camden, NJ is a very poor area with lots violent crime. It would also give us the option of living near Philadelphia so Becky's job opportunities would be great.
Friday, today, was the most surprising of all. But first, I had to get to Baltimore. I got off work in Wilmington at 4pm last night. The resident dinner was at 6:30pm. I thought that would be plenty of time to drive down about 65 miles with a quick stop at my hotel room to change out of scrubs and grab a bite to eat. Well, the Wilmington traffic was horrible. It took me over an hour to get 7 miles from the hospital to my hotel room! So I spent an hour chilling out and hoping rush hour traffic would die down a bit. After all, I was going into Baltimore so it should be against traffic. However, construction on the main freeway, I-95, turned a 57-mile drive into a three and half hour parking lot. I kept thinking it would speed up once we passed some fatality accident. But they just kept reducing lanes after miles and miles of more stop than go traffic. Six lanes reduced to one for no apparent reason! They didn't seem to be doing any work on the road at all!
I arrived at the hotel, Mt. Washington Conference Center, at 10pm. The bar where I was supposed to meet the residents was the closest place to get food so I walked thinking I was going to foot the bill for a very late dinner. After inquiring though, four residents were still there. All the other applicants had already headed home. We talked for two hours over a couple glasses of Guiness, which greatly helped me recover from the drive down. The appetizers filled me up at well. I got six and a half hours of good sleep.
Hopkins itself is incredible. Their are three cranes there right now building the largest hospital expansion in history. A two billion(!) dollar expansion including a new ED. However, it won't be ready until early 2011 according to the latest estimates. I really liked the residents, including the three D.O.'s there now. No overblown egos, just lots of nice friendly people, many of whom are world renowned for writing our textbooks are publishing prominent studies. The Mt. Washington offices are opulent and were effective at demonstrating how well funded the Emergency Department is. Friday is conference day at Hopkins, and the training seemed very good. Then we took a tour of the city even though most of the applicants knew the city as well as our guides. It's a nice place of about 650,000 that would offer a reasonable cost of living with lots of opportunities for Becky. The Hopkins ED was fairly plain, but seemed more than adequate for a place to get good training. And finally the interviews were, like everywhere else, low key and a friendly Q & A session with equal time for both parties to ask questions.
I left really impressed. They are now a four year program, so the decision really comes down to whether that fourth year will pay for itself either financially or in new opportunities. I think it would, especially with the Hopkins name backing it up. And they have 12 tracks to choose from, which I don't think could be offered at any other institution. Education, administration and ultrasound are the most interesting to me right now. In the end, I would put Hopkins at the top of my list of places I've interviewed so far. My top four will probably end up being UConn, UMass, Christiana and Hopkins but I have no idea what order they will ranked. Cooper and Maricopa may also make it in there.
Lots to think about. It's been a very stressful week nailing down four of the five interviews while I'm here in the MidAtlantic region. Plus I nailed down St. Vincent's and Case Western/Cleveland Clinic in January and Maricopa in two weeks back in Phoenix. I also got a number of rejections. The only one that is really disappointing is OHSU. MUSC was equally surprising, but not nearly as disappointing. Financially my current schedule will be much more doable with only two more trips. The amazing thing is that the numbers are working exactly like I was shooting for. Five interviews while I'm here at Christiana and ten total. I actually have eleven if I don't cancel MCG, plus I'm still on the waiting list at three programs and there's five or six I haven't heard from yet. But I'm pretty satisfied.
My Tuesday interview is just me for three half hour sessions with the Christiana leadership. I'm a little nervous about that one since it will be just me with no warm and fuzzy introduction to the program over lunch. At least I have one of my two days off this month the day before it. What a month!!
Monday, November 05, 2007
First Interview: tomorrow at Drexel
The first week at Christiana was good. Nothing about the program swept me off my feet, but everything has this unspoken confidence of doing things right. A resident would get a good education here, but the program has also shown me that I could get a good education at many programs. The only question mark in my mind is how they handle their volume with only two trauma bays. Their older design reminds me of UConn except I think UConn had four with two pairs back-to-back.
The attendings and residents have all been good to work with. I think I have been doing a good job based on the limited feedback offered thus far. I need to remember to ask for feedback directly at the end of each shift. Yesterday I had a chance to work with the Program Director. Since I had never met him I didn't even know who he was until a resident pointed him out. That was annoying. But it went well otherwise. His parting comments included mentioning that 80% of their interview invitations go out today. So I've pretty anxious all day.
I finally just started phoning up programs to ask what the status of my residency interview applications was. The only one I got through to anyone was Christiana. The Program Director wants to get some feedback from my attendings and residents before deciding whether to give me an interview. Not what I had hoped, but if I continue doing a good job I believe I'll get an interview while I'm here.
Dean's Letters went out on November 1st, last Thursday. I expected a rush of interview invitations and even rejections by now. But nothing until an hour or so ago when I received an invitation from Cooper in New Jersey. That's number seven. They are an inner city program across the river from Philadelphia, where I'd most likely live. Not a ton of volume, but lots of trauma and serious illness. I'm trying to get that scheduled while I'm here as well. However, the ones I really want to fit in, UMaryland and Hopkins, haven't responded yet :(.
Tonight I'm driving to Philadelphia for an informal social with Drexel residents. The interview is tomorrow at 11am. I'm trying to prepare my questions, review the program information online, etc. but it's been difficult with the anxiety of waiting to hear from all the other programs I applied to. Well, time to stop procrastinating with this blog and go back through all my first year research. I'm certain to get asked questions on it.
The attendings and residents have all been good to work with. I think I have been doing a good job based on the limited feedback offered thus far. I need to remember to ask for feedback directly at the end of each shift. Yesterday I had a chance to work with the Program Director. Since I had never met him I didn't even know who he was until a resident pointed him out. That was annoying. But it went well otherwise. His parting comments included mentioning that 80% of their interview invitations go out today. So I've pretty anxious all day.
I finally just started phoning up programs to ask what the status of my residency interview applications was. The only one I got through to anyone was Christiana. The Program Director wants to get some feedback from my attendings and residents before deciding whether to give me an interview. Not what I had hoped, but if I continue doing a good job I believe I'll get an interview while I'm here.
Dean's Letters went out on November 1st, last Thursday. I expected a rush of interview invitations and even rejections by now. But nothing until an hour or so ago when I received an invitation from Cooper in New Jersey. That's number seven. They are an inner city program across the river from Philadelphia, where I'd most likely live. Not a ton of volume, but lots of trauma and serious illness. I'm trying to get that scheduled while I'm here as well. However, the ones I really want to fit in, UMaryland and Hopkins, haven't responded yet :(.
Tonight I'm driving to Philadelphia for an informal social with Drexel residents. The interview is tomorrow at 11am. I'm trying to prepare my questions, review the program information online, etc. but it's been difficult with the anxiety of waiting to hear from all the other programs I applied to. Well, time to stop procrastinating with this blog and go back through all my first year research. I'm certain to get asked questions on it.
Thursday, October 25, 2007
A little dreaming
Over the week of vacation, I've made a point to do very little medically related. I need to get mentally recharged for a month audition intermixed with a month and half of interviews.
To keep motivated I love National Geographic's Adventure Travel magazine as well as Wired magazine. Travel and gadgets keep me going. But here's a couple YouTube videos that are also motivational:
There's more great ones for giggles and spectacles at http://www.flixxy.com/.
To keep motivated I love National Geographic's Adventure Travel magazine as well as Wired magazine. Travel and gadgets keep me going. But here's a couple YouTube videos that are also motivational:
There's more great ones for giggles and spectacles at http://www.flixxy.com/.
Week of vacation
It's almost time to head to Delaware for my Christiana rotation. And while I'm getting excited to see the program, I'm going to miss playing with the family. I've spent a lot of time with the boys playing catch; mostly baseball and football. I feel a little guilty not having done a good job teaching the fundamentals of throwing a ball or catching a ball until now, but life has been crazy and soccer and swimming were all I could manage.
They are a little more confident with friends and in gym class now. Moreover, I'm still the cool dad :-).
All four of us swam together at the Arrowhead pool. The boys on their team and Becky and I on the Masters team. The coach had us doing hypoxia drills. Wow, I thought I was in decent shape, but 2000 yards of it wiped me out. The competitiveness of swimming with the other guys really pushed me.
I've also had a chance to work on a bunch of paperwork and small To Dos. I reviewed my Dean's Letter as recommended by the four EM PDs in Seattle a couple weeks ago. And I organized my four (so far) interviews. I scheduled my Morristown, NJ interview as early in the Christiana rotation as possible. It will be my work-up. Then I hope to take four or five more days off to interview at Christiana, UMaryland, Hopkins, Drexel, Georgetown and/or Cooper. It would save a ton of time and money.
I'm also enjoying hanging out, drinking wine with Becky and her sister in the evenings and playing a bit on the Xbox 360. Time to start printing all my logistical paperwork for the next month. And a couple more errands to try to squeeze in. Then it's off to Delaware.
They are a little more confident with friends and in gym class now. Moreover, I'm still the cool dad :-).
All four of us swam together at the Arrowhead pool. The boys on their team and Becky and I on the Masters team. The coach had us doing hypoxia drills. Wow, I thought I was in decent shape, but 2000 yards of it wiped me out. The competitiveness of swimming with the other guys really pushed me.
I've also had a chance to work on a bunch of paperwork and small To Dos. I reviewed my Dean's Letter as recommended by the four EM PDs in Seattle a couple weeks ago. And I organized my four (so far) interviews. I scheduled my Morristown, NJ interview as early in the Christiana rotation as possible. It will be my work-up. Then I hope to take four or five more days off to interview at Christiana, UMaryland, Hopkins, Drexel, Georgetown and/or Cooper. It would save a ton of time and money.
I'm also enjoying hanging out, drinking wine with Becky and her sister in the evenings and playing a bit on the Xbox 360. Time to start printing all my logistical paperwork for the next month. And a couple more errands to try to squeeze in. Then it's off to Delaware.
Baystate and saying goodbye to UMass
The day after visiting UConn I went to Baystate not really knowing what to expect. I reviewed the web site for the residency program but it didn't really give me a good idea of what to expect.
First, the hospital is very suburban. No high rise parking lots here. And it's a mix of stages built over probably fifty years. The existing ED is an older section and not expected to be upgraded for a few more years. The didactics were held in the newer wing and fine. Nothing spectacular, but nothing to fault either. Residents and students all got along, seemed to be having a good time and were learning a lot.
The ED itself is cramped! They take care of more patients per year (~120k) in a smaller space than I ever seen. It's very efficient but also a little chaotic. The main physician/nursing area is small enough that everyone can see the gigantic whiteboard used to track patients. Every square inch of hallway space is used with carts, beds and even recliners for the asthma patients. I am sure I would get a good education there, but I didn't get the warm fuzzies that I did at UConn.
The last two days of shifts were pretty easy. Busy as usual, but I was able to get in some suturing and run a few patients on my own. Nothing too crazy. The night before I left the owner of the house I stayed at mentioned a bunch of great restaurants nearby. Unfortunately the other roomie and I chose one with poor service and mediocre service. Then we topped it off with a funny but amateur comedy show. I packed and got a few hours sleep before starting the day of travel.
The trip back was long, a full day, but got me into Phoenix around 3pm due to the time zone changes. Becky picked me up and then we headed home to see the kids. I'm really glad I took the two days to see UConn and Baystate. While UMass has everything going for it on paper including high patient volume, a new ED, airflight service and a Hawaii elective, I felt more at home at UConn. I think that was recognized by UConn as well. They already sent me an invitation for an interview!
First, the hospital is very suburban. No high rise parking lots here. And it's a mix of stages built over probably fifty years. The existing ED is an older section and not expected to be upgraded for a few more years. The didactics were held in the newer wing and fine. Nothing spectacular, but nothing to fault either. Residents and students all got along, seemed to be having a good time and were learning a lot.
The ED itself is cramped! They take care of more patients per year (~120k) in a smaller space than I ever seen. It's very efficient but also a little chaotic. The main physician/nursing area is small enough that everyone can see the gigantic whiteboard used to track patients. Every square inch of hallway space is used with carts, beds and even recliners for the asthma patients. I am sure I would get a good education there, but I didn't get the warm fuzzies that I did at UConn.
The last two days of shifts were pretty easy. Busy as usual, but I was able to get in some suturing and run a few patients on my own. Nothing too crazy. The night before I left the owner of the house I stayed at mentioned a bunch of great restaurants nearby. Unfortunately the other roomie and I chose one with poor service and mediocre service. Then we topped it off with a funny but amateur comedy show. I packed and got a few hours sleep before starting the day of travel.
The trip back was long, a full day, but got me into Phoenix around 3pm due to the time zone changes. Becky picked me up and then we headed home to see the kids. I'm really glad I took the two days to see UConn and Baystate. While UMass has everything going for it on paper including high patient volume, a new ED, airflight service and a Hawaii elective, I felt more at home at UConn. I think that was recognized by UConn as well. They already sent me an invitation for an interview!
Tuesday, October 16, 2007
UConn visit
The drive to University of Connecticut was beautiful. The trees are all changing to Fall colors and there were numerous ponds and creeks along the way with forests of Fall trees lining the banks. Plus it was a sunny brisk day.
I found the parking lot and department offices in plenty of time to get lunch and be assured that my business casual (Prna pants, Quicksilver button down and Keen loafers) attire was fine. The two hours of lecture from noon until two PM was fun. The material was fine, but I really appreciated the camaraderie the residents displayed. Their was joking and teasing and plenty of talk about after work get togethers. They had DO residents and one older than me!
We then proceeded to their very cool sim lab with dummies and set-ups for ICU, Trauma and more. We donned hazardous environment suits and entered two sim labs for training in running codes for patients with highly contagious or poisonous exposures. It was challenging and a blast. I actually felt part of the team and was able to contribute a bit. The PGY-2 residents certainly knew more than me, but I never felt patronized or looked down upon.
Finally I headed to the Emergency Department to work with one of the PGY-3 residents for a few hours. We had a trauma and several really sick patients. But I was able to get feel for the ED and ask a bunch of questions. Even though they have paper charts (with efficient electronic ordering software) and the ED is a bit dark, I liked the place and the people I met.
I certainly hope I get an interview at UConn.
I found the parking lot and department offices in plenty of time to get lunch and be assured that my business casual (Prna pants, Quicksilver button down and Keen loafers) attire was fine. The two hours of lecture from noon until two PM was fun. The material was fine, but I really appreciated the camaraderie the residents displayed. Their was joking and teasing and plenty of talk about after work get togethers. They had DO residents and one older than me!
We then proceeded to their very cool sim lab with dummies and set-ups for ICU, Trauma and more. We donned hazardous environment suits and entered two sim labs for training in running codes for patients with highly contagious or poisonous exposures. It was challenging and a blast. I actually felt part of the team and was able to contribute a bit. The PGY-2 residents certainly knew more than me, but I never felt patronized or looked down upon.
Finally I headed to the Emergency Department to work with one of the PGY-3 residents for a few hours. We had a trauma and several really sick patients. But I was able to get feel for the ED and ask a bunch of questions. Even though they have paper charts (with efficient electronic ordering software) and the ED is a bit dark, I liked the place and the people I met.
I certainly hope I get an interview at UConn.
Monday, October 15, 2007
What's so great about New England?
Today I really had to question what's is so great about New England. It's overpriced, overtaxed, overly Liberal and filled with gruff, even mean, people. Ok, I was a bit unlucky today, but maybe it's another sign.
I was running late to my 11am shift because I slept in late. Had to catch up on sleep after a very busy week of shifts that never stayed at the same times (morning, afternoon, overnight, afternoon and then morning again). I also had a down comforter so I was comfy warm for the first time.
As I walked out to the car at 10:40a, here's what I saw:
Granted, it wasn't the sweetest ride to begin with, but WTF!?! How did my car get singled out when there were tons of other cars on the curb? How come I didn't hear anything (my window was only 20 feet away)?
Today just got worse and worse. After taking the pictures and talking to the police, I limp to the hospital. Luckily it was very close since the steering had play now measuring in feet! The mangled front hubcap was rubbing into the tire and brakes.
So I arrive late and can't find parking anywhere. I finally park in the spot the furthest away from the stairs thinking it's a safe spot. Par for the course, I found a parking ticket on my windshield when I returned later that night. However, on my way into Fast Track, 20 minutes late for my shift, VISA tells me that the car isn't covered by my credit card because the rental is over 15 days!!! Since I rented for one continuous month, they probably won't cover it. (I haven't decided whether to cancel it or just change next month's rental into two consecutive 14 day rentals.)
Becky talked to Geico and they inform us that they'll cover it after the $500 deductible. So I file the third stinking claim for the morning and proceed to work a slow, uninteresting shift. At the Attending was cool. He was a hospitalist moonlighting in the ER. Nice guy that was fun to talk to considering that he owns multiples of just about every toy I've ever dreamed of owning. Plus he travels at least once a month. Helps that his wife is a physician as well and they have no kids. I wouldn't trade the kids for anything, but puts it all in perspective.
Enterprise was across the street from the hospital so I headed over there. They upgraded my vehicle and were very nice about taking my credit card for $500. I can't complain about their service at all.
I can only hope that my trip to UConn in Hartford tomorrow is better. It's a bigger, nicer car (if you can call a Chevy Cobalt nicer). I'll get out of the big city. Maybe the sour taste for all of New England will melt away with the drive through the forests of fall trees.
I was running late to my 11am shift because I slept in late. Had to catch up on sleep after a very busy week of shifts that never stayed at the same times (morning, afternoon, overnight, afternoon and then morning again). I also had a down comforter so I was comfy warm for the first time.
As I walked out to the car at 10:40a, here's what I saw:
Granted, it wasn't the sweetest ride to begin with, but WTF!?! How did my car get singled out when there were tons of other cars on the curb? How come I didn't hear anything (my window was only 20 feet away)?Today just got worse and worse. After taking the pictures and talking to the police, I limp to the hospital. Luckily it was very close since the steering had play now measuring in feet! The mangled front hubcap was rubbing into the tire and brakes.
So I arrive late and can't find parking anywhere. I finally park in the spot the furthest away from the stairs thinking it's a safe spot. Par for the course, I found a parking ticket on my windshield when I returned later that night. However, on my way into Fast Track, 20 minutes late for my shift, VISA tells me that the car isn't covered by my credit card because the rental is over 15 days!!! Since I rented for one continuous month, they probably won't cover it. (I haven't decided whether to cancel it or just change next month's rental into two consecutive 14 day rentals.)
Becky talked to Geico and they inform us that they'll cover it after the $500 deductible. So I file the third stinking claim for the morning and proceed to work a slow, uninteresting shift. At the Attending was cool. He was a hospitalist moonlighting in the ER. Nice guy that was fun to talk to considering that he owns multiples of just about every toy I've ever dreamed of owning. Plus he travels at least once a month. Helps that his wife is a physician as well and they have no kids. I wouldn't trade the kids for anything, but puts it all in perspective.
Enterprise was across the street from the hospital so I headed over there. They upgraded my vehicle and were very nice about taking my credit card for $500. I can't complain about their service at all.
I can only hope that my trip to UConn in Hartford tomorrow is better. It's a bigger, nicer car (if you can call a Chevy Cobalt nicer). I'll get out of the big city. Maybe the sour taste for all of New England will melt away with the drive through the forests of fall trees.
Thursday, October 11, 2007
Getting Comfortable At UMass
Only nine days and seven shifts left at UMass. The two days off I'm going to drive out to the UConn and the Baystate/Tufts EM programs in Hartford, CT and Springfield, MA, respectively. I'll get to meet some residents at their didactic conferences, then spend a couple hours in the ER shadowing a senior resident.
I am definitely getting more comfortable here. The residents have all been pretty cool. And the Attendings have been very good as well. The "systems" side of things (EMR, charting, admitting, protocols) still have kinks to work out. They may be long-term issues, but I get the feeling these issues have gotten more obvious since the new ED opened a year ago.
No super exciting cases. I've sutured lots of lacerations, seen a few traumas and learned how to treat many kinds of patients. The didactics continue to be one of this programs strong points. And the morning shifts we usually get a good 30 minute lecture in the ED from an Attending. The volume is high, and while there's not too much penetrating trauma, there's a ton of acute cases that need monitoring, airways and eventually ICU beds.
I spent the weekend in Seattle with the family which was terrific. Friday I arrived early and spent most of the day playing with the boys. You could just tell they needed some daddy time. Even at 9 and 11, they enjoyed the tickling, wrestling, hugs, etc. Becky did too; wink, wink. Saturday we met Becky's brother Paul and his family. It was a cold, gray Seattle day but the enjoyed playing at my old stomping ground, Greenlake. We even had some Spud's Fish & Chips for old time sakes.
Saturday night we went Becky's older brother's, Dave's, house. It was a huge family gathering mostly to send Paul and his family off to Zurich for the Microsoft job he just accepted there. The food was good. Everyone seemed to be doing well. And the kids (lots of cousins and second cousins) played great together. Only once or twice was there a scream followed by everyone looking at me "Dr. Grady" for some reaction. My mother seems to be well too, and I enjoyed driving her Prius around.
Sunday Becky drove me into Seattle for the American College of Emergency Physicians (ACEP) Scientific Assembly's Residency Fair (whew!). I spent in obvious reasons and made it to the 10am meeting. We had several good lectures until about 2pm on improving residency applications, being a good resident and interview tips. The rest of the afternoon was the "fair" part of the program where 100 EM residency programs hosted tables in a ballroom.
I was able to see most of the programs I've applied to and got a lot of positive feedback. Sure they hadn't seen my application, and they were selling there programs, but my confidence in getting more interviews was definitely increased. In case I didn't already mention it, St. Vincent's in Toledo, OH where I rotated at last year for Peds and Surgery has already invited me for an interview. Anyway, I met a lot of program directors and current residents while getting excited about seeing many of these programs I only know from a web site.
The day was worthwhile and I was happy to have attended, but I don't think it would be worth going if you don't family nearby or some other reason to make the trip. Becky, the kids and I had a nice dinner together and then I changed out of my suit and played a little flashlight tag with the boys. All too soon, Becky was back in the car driving me to the airport for my red eye flight back to Boston.
After the trip home, I'm ready for this rotation be over. However, there's still more to learn and more to prove. I don't know if I'll get a LOR from this rotation simply because I haven't gotten to know any one Attending very well. And I'm still trying to decide whether or not to ask the PD, Dr. Cukor, for an interview while I'm here.
Well one more rotation after this, Christiana in Delaware. The residents at the ACEP meeting were very nice. I'm excited about that program as well as several of the one's nearby; UMaryland, Hopkins, Georgetown and one in Phili I can't remember right now.
Off to an evenign shift now, then my only overnighter tomorrow. 237 days left in the short coat.
I am definitely getting more comfortable here. The residents have all been pretty cool. And the Attendings have been very good as well. The "systems" side of things (EMR, charting, admitting, protocols) still have kinks to work out. They may be long-term issues, but I get the feeling these issues have gotten more obvious since the new ED opened a year ago.
No super exciting cases. I've sutured lots of lacerations, seen a few traumas and learned how to treat many kinds of patients. The didactics continue to be one of this programs strong points. And the morning shifts we usually get a good 30 minute lecture in the ED from an Attending. The volume is high, and while there's not too much penetrating trauma, there's a ton of acute cases that need monitoring, airways and eventually ICU beds.
I spent the weekend in Seattle with the family which was terrific. Friday I arrived early and spent most of the day playing with the boys. You could just tell they needed some daddy time. Even at 9 and 11, they enjoyed the tickling, wrestling, hugs, etc. Becky did too; wink, wink. Saturday we met Becky's brother Paul and his family. It was a cold, gray Seattle day but the enjoyed playing at my old stomping ground, Greenlake. We even had some Spud's Fish & Chips for old time sakes.
Saturday night we went Becky's older brother's, Dave's, house. It was a huge family gathering mostly to send Paul and his family off to Zurich for the Microsoft job he just accepted there. The food was good. Everyone seemed to be doing well. And the kids (lots of cousins and second cousins) played great together. Only once or twice was there a scream followed by everyone looking at me "Dr. Grady" for some reaction. My mother seems to be well too, and I enjoyed driving her Prius around.
Sunday Becky drove me into Seattle for the American College of Emergency Physicians (ACEP) Scientific Assembly's Residency Fair (whew!). I spent in obvious reasons and made it to the 10am meeting. We had several good lectures until about 2pm on improving residency applications, being a good resident and interview tips. The rest of the afternoon was the "fair" part of the program where 100 EM residency programs hosted tables in a ballroom.
I was able to see most of the programs I've applied to and got a lot of positive feedback. Sure they hadn't seen my application, and they were selling there programs, but my confidence in getting more interviews was definitely increased. In case I didn't already mention it, St. Vincent's in Toledo, OH where I rotated at last year for Peds and Surgery has already invited me for an interview. Anyway, I met a lot of program directors and current residents while getting excited about seeing many of these programs I only know from a web site.
The day was worthwhile and I was happy to have attended, but I don't think it would be worth going if you don't family nearby or some other reason to make the trip. Becky, the kids and I had a nice dinner together and then I changed out of my suit and played a little flashlight tag with the boys. All too soon, Becky was back in the car driving me to the airport for my red eye flight back to Boston.
After the trip home, I'm ready for this rotation be over. However, there's still more to learn and more to prove. I don't know if I'll get a LOR from this rotation simply because I haven't gotten to know any one Attending very well. And I'm still trying to decide whether or not to ask the PD, Dr. Cukor, for an interview while I'm here.
Well one more rotation after this, Christiana in Delaware. The residents at the ACEP meeting were very nice. I'm excited about that program as well as several of the one's nearby; UMaryland, Hopkins, Georgetown and one in Phili I can't remember right now.
Off to an evenign shift now, then my only overnighter tomorrow. 237 days left in the short coat.
Friday, September 28, 2007
First week at UMass
Monday was an ok day. We had an excellent orientation of the ED software programs and the facility itself. However, I was the only student in scrubs. It made the program feel stuffy, especially when one of the Attendings pointed out that ties highly encouraged by the program's directors. First, who where's a tie in the ED!?! Kinda hard to jump in on a trauma in a friggin' suit! Second, I only brought my interview suit with two shirts!
After the students made our schedule for the first week, I decided to wear my new suit slacks and dress shirts only when I working with one of the PDs. I ended up getting the more conservative PD's only two shifts of the month, Monday and Friday. So I headed home after orientation and changed into my $1000 suit slacks vowing to send UMass a bill if I got blood and guts on them.
The facility is less than a year old. The $120M hospital included a new $50M ED and new offices for the ED department, some of which don't even have furniture yet. They did a nice job with the design. It's attractive and functional. The only problem I've seen so far is that the hospital beds are so full, the ED is becoming an Observation Unit.
The software is a little nicer than MUSC's, but has plenty of usability issues and glitches in its second version. Bottom line, they are still using paper charts for the foreseeable future. Unlike, MUSC however, the paper chart system is horrendous. It's a pain to find charts and make sure orders or being seen and acted on.
The residents are very nice. I've only met a handful of the 36, but they are helpful both on the job and in answering questions about UMass and EM. They seem very happy with the program. And they never wear ties in the ED! In fact, most of the attendings wear traditional "in the trenches" scrubs and casual clothes. I guess it's just the PDs and attendings involved in running the program that are stuffy.
Didactics have been pretty good. Wednesday conference involved five hours of lectures, case studies (M&M lectures), going over EM Board prep questions and small group break-outs sessions to work through case management together. Journal club Thursday night was well attended by residents and attendings, included dinner and had some great content on Pediatric Lumbar Puncture procedures. Today was my first morning shift, so I got to experience teaching rounds by one of the PDs on overdoses and found it very good.
The shifts have been very tiring. This is a very busy ED and I rarely get a chance to eat and take bathroom breaks. So far it's been a little too busy for optimal learning. The cool cases get snatched up and I never have time to peak in on them or procedures. My patients are either run-of-the-mill or very complicated. The former mean I don't get much attending attention and therefore don't learn much. The latter mean I have the patients all day and do a lot of babysitting between specialty consults and extensive tests. I'm hoping that as I take more morning and overnight shifts things will settle down a bit. I also think the 8 hour shifts make things more chaotic with a lot more turnovers and long stay after shifts to finish discharges. I usually stay 30-60 minutes after my shift tidying up paperwork.
Hopefully, when we finalize the schedule for the rest of the month on Tuesday, I can get some easier shifts.
As for cases, my luck seems to be hanging with me. I was able to help out on a paraplegic guy, probably homeless, who had his foot mangled by his girlfriend's chihuahua. They are both in wheelchairs, and probably sleeping on the street by their smell. He states that while sleeping their new puppy had a free meal of his left fore foot! The big toe was gone as was most of the next one and the flesh where bunions occur. I didn't stick around to see who won the debate about whether the patient should be admitted to Ortho or Plastics.
The other cases have been pretty standard. And while I'm out of practice working on adults, it coming back pretty quickly. Exhausted as I am, I'm enjoying the job which is very comforting this close to the Match.
Probably the highlight of the week had nothing to do with UMass. I received both my SLORs in the mail from the PDs at Arrowhead and MUSC. That was a relief. I immediately updated my ERAS applications to include them. A close second was winning an auction on Ebay for a new Phone/PDA since mine broke. Hate spending the money, but at least it's an upgraded model and I can have access to all my medical programs while on shifts.
Finally, the house I'm staying at is a nice old Victorian three story being remodeled by another 6th year student (MD, PhD). He and his wife, along with the two other renters are nice. It's a comfortable place with lots of room to study, store food, etc. My favorite thing is having a big room with a desk and wireless Internet access.
One week until I fly to Seattle to see the family and attend the ACEP Scientific Assembly Residency Fair!
After the students made our schedule for the first week, I decided to wear my new suit slacks and dress shirts only when I working with one of the PDs. I ended up getting the more conservative PD's only two shifts of the month, Monday and Friday. So I headed home after orientation and changed into my $1000 suit slacks vowing to send UMass a bill if I got blood and guts on them.
The facility is less than a year old. The $120M hospital included a new $50M ED and new offices for the ED department, some of which don't even have furniture yet. They did a nice job with the design. It's attractive and functional. The only problem I've seen so far is that the hospital beds are so full, the ED is becoming an Observation Unit.
The software is a little nicer than MUSC's, but has plenty of usability issues and glitches in its second version. Bottom line, they are still using paper charts for the foreseeable future. Unlike, MUSC however, the paper chart system is horrendous. It's a pain to find charts and make sure orders or being seen and acted on.
The residents are very nice. I've only met a handful of the 36, but they are helpful both on the job and in answering questions about UMass and EM. They seem very happy with the program. And they never wear ties in the ED! In fact, most of the attendings wear traditional "in the trenches" scrubs and casual clothes. I guess it's just the PDs and attendings involved in running the program that are stuffy.
Didactics have been pretty good. Wednesday conference involved five hours of lectures, case studies (M&M lectures), going over EM Board prep questions and small group break-outs sessions to work through case management together. Journal club Thursday night was well attended by residents and attendings, included dinner and had some great content on Pediatric Lumbar Puncture procedures. Today was my first morning shift, so I got to experience teaching rounds by one of the PDs on overdoses and found it very good.
The shifts have been very tiring. This is a very busy ED and I rarely get a chance to eat and take bathroom breaks. So far it's been a little too busy for optimal learning. The cool cases get snatched up and I never have time to peak in on them or procedures. My patients are either run-of-the-mill or very complicated. The former mean I don't get much attending attention and therefore don't learn much. The latter mean I have the patients all day and do a lot of babysitting between specialty consults and extensive tests. I'm hoping that as I take more morning and overnight shifts things will settle down a bit. I also think the 8 hour shifts make things more chaotic with a lot more turnovers and long stay after shifts to finish discharges. I usually stay 30-60 minutes after my shift tidying up paperwork.
Hopefully, when we finalize the schedule for the rest of the month on Tuesday, I can get some easier shifts.
As for cases, my luck seems to be hanging with me. I was able to help out on a paraplegic guy, probably homeless, who had his foot mangled by his girlfriend's chihuahua. They are both in wheelchairs, and probably sleeping on the street by their smell. He states that while sleeping their new puppy had a free meal of his left fore foot! The big toe was gone as was most of the next one and the flesh where bunions occur. I didn't stick around to see who won the debate about whether the patient should be admitted to Ortho or Plastics.
The other cases have been pretty standard. And while I'm out of practice working on adults, it coming back pretty quickly. Exhausted as I am, I'm enjoying the job which is very comforting this close to the Match.
Probably the highlight of the week had nothing to do with UMass. I received both my SLORs in the mail from the PDs at Arrowhead and MUSC. That was a relief. I immediately updated my ERAS applications to include them. A close second was winning an auction on Ebay for a new Phone/PDA since mine broke. Hate spending the money, but at least it's an upgraded model and I can have access to all my medical programs while on shifts.
Finally, the house I'm staying at is a nice old Victorian three story being remodeled by another 6th year student (MD, PhD). He and his wife, along with the two other renters are nice. It's a comfortable place with lots of room to study, store food, etc. My favorite thing is having a big room with a desk and wireless Internet access.
One week until I fly to Seattle to see the family and attend the ACEP Scientific Assembly Residency Fair!
Sunday, September 23, 2007
Election Year Politics
Everyone talks about how healthcare reform is the issue in the upcoming Presidential election. However, the candidates and, especially, the media treat it like a distraction. A good editorial from the NYT today reminded me of where we're at in this mess.
While the Democrats are least talking about the issue, they seem to be taking the easy road as much as the Republicans. No on either side mentions how generate competition between insurance companies, pharmaceutical companies (or at access their offshore pricing) and other Biotech companies. Equally detrimental to the country is that neither side mentions how we are going to cover health costs as a nation so that our biggest employers and exporters aren't burdened with costs that hurt their competitiveness internationally.
Recent articles and TV reports portrayed CEOs of multi-nationals as very interested in reform foremost because of the competitiveness issue internationally, but also because the liability of retirees is hurting stock prices and company values.
So why aren't there more substantial discussion going on? Are we Americans so naive that we can't face the truth - any solution with hit all of us in the pocketbook? Are we going to wait until this is a crisis and the babyboomers bankrupt the country between Social Security and Medicare?
It's very frustrating that elections now seem to direct their campaigns (and their terms in office in large part) towards the lowest common denominator of society: the uneducated or uninformed, those who vote on one emotional issue (gun rights, abortion, etc.) and the those naively think they can escape any pain or consequence of costly decisions.
How long can a Democracy last catering to clicks and Junior High mentalities?
The Battle Over Health Care
While the Democrats are least talking about the issue, they seem to be taking the easy road as much as the Republicans. No on either side mentions how generate competition between insurance companies, pharmaceutical companies (or at access their offshore pricing) and other Biotech companies. Equally detrimental to the country is that neither side mentions how we are going to cover health costs as a nation so that our biggest employers and exporters aren't burdened with costs that hurt their competitiveness internationally.
Recent articles and TV reports portrayed CEOs of multi-nationals as very interested in reform foremost because of the competitiveness issue internationally, but also because the liability of retirees is hurting stock prices and company values.
So why aren't there more substantial discussion going on? Are we Americans so naive that we can't face the truth - any solution with hit all of us in the pocketbook? Are we going to wait until this is a crisis and the babyboomers bankrupt the country between Social Security and Medicare?
It's very frustrating that elections now seem to direct their campaigns (and their terms in office in large part) towards the lowest common denominator of society: the uneducated or uninformed, those who vote on one emotional issue (gun rights, abortion, etc.) and the those naively think they can escape any pain or consequence of costly decisions.
How long can a Democracy last catering to clicks and Junior High mentalities?
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