Liability is driving out board-certified ER docs, allowing internal medicine physicians to benefit:

Ironically, he credits the state’s years of high malpractice insurance premiums and fears of litigation with driving out the competition: board-certified emergency medicine physicians who, although they may live in Pennsylvania, commute across the river to work in New Jersey.

“As an ER doctor, I can make more money than I can as a hospitalist, more money than I can in primary care,” said Dr. Randall, who prefers to work part-time hours so he can spend more time with his two young daughters. “It enables me to work only 26 to 30 hours a week, making more money than I did at my last [primary care] job . . . where I was working 70 to 80 hours a week.”

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  • Anonymous

    And the Sodomites benefit too! Non-Emergency Residency Trained emergency physicians = less competence = more misses = more money for the starving sodomite!

  • Anonymous

    There’s no way that the Internist in the article will miss anything if he practices emergency medicine the way you do. Just order all the blood tests, CT scan everybody, refer to specialists, admit most of them. Anon 4:41 you might want to read the book I wrote just for you,”Emergency Medicine for Dummies”.

  • Anonymous

    Why Internists don’t get Board certified in EM, from the Board’s Website:
    “The American Board of Medical Specialties (ABMS) has approved ABEM as a primary board and Emergency Medicine as the 23rd recognized specialty. It is by definition not Internal Medicine, Pediatrics, Family Practice, etc., but a unique specialty in medicine. To argue that residency training in another specialty is equivalent to Emergency Medicine residency training demeans and undermines the process of Emergency Medicine training and the entire concept of specialty training in medicine.”

  • Anonymous

    IM would probably do a similar job to EM in a city setting where there are a multitude of consultants and resdients to call on; you just turf away. I think the liability is too high in ER therefore I would rather continue primary care and make less money…not much liability in writing z-paks and referring to specialists and the er…

  • Anonymous

    OK, That does it. I don’t know which of you guys is depressign me more. I’m getting out of medicine.

  • Anonymous

    why get out of medicine? Just keep ordering defensive testing and referrals, you’ll make decent money and be able to take care of yourself and your families…you just have to learn how to do it and you’ve taken the first step by reading this blog. The only doctors who successfully get sued are the doctors taht don’t perform tests, or refer the patients. That’s the key. Just do that and you’ll be fine…when you see a patient, think about how they could possibly sue you, then you’ll know what tests and referrals to order. As for these patients that act like animals…they are getting what they dserve, to be treated like animals…

  • Anonymous

    “IM would probably do a similar job to EM in a city setting where there are a multitude of consultants and resdients to call on”

    Have fun removing an airway foreign body from a 2 year old at 3 am with your IM training, or intubating a 400 pounder, or putting in a chest tube….you think the specialists are just sitting around the ER in these City Hospitals, awaiting your consult?

  • Anonymous

    anon 6:17. actually if you want to be a good Dr. you should never read this blog again. This guy is so full of anger that it is scary.

  • Anonymous

    Which of the many anonymouses are you referring to? There’s alot of anger on this site.

  • Anonymous

    The guy who was comparing im to er said they could do a “similar” job, not the same job; you’re right, IM training is not the same as er training and a primary care can’t put in a chest tube, etc. But then again, I have seen a whole lot of older er docs that couldn’t do those things either…what do they do when they run into a problem? I would say a young IM doc is equal to an old ER doc…

  • Anonymous

    Most used word on Kevin, M.D. weblog = sodomite

  • Moof

    I find it very difficult to take any anonymous commentor seriously.

    That’s some conviction you have – why should anyone bother reading what you write if you don’t even the nuts to put a simple “internet-identity” or “anony-blog” address behind it?

    I think that the vilest comments come from one or two individuals who have some rather interesting problems …

  • Samson Isberg

    Isn’t sodomite short for a person who is being found guilty of crimen bestialitatis?
    I think that our angry, but anonymous colleague is using the term broadly to cover both lawyers, patients who sue, “expert” witnesses who perjure themselves for a fistful of dollars, juries that reacts to emotions and not facts, judges that have lost control of the court and journalists that’ll do anything for a headline.

    Much the way that Rastafarians are using the word “Babylon” to cover anything that’s not purely Rasta, or some other fringe groups talk about “the Man” referring to all things official…

    I personally thinks the word “sodomite” is excellent, as I immideately understand what he is meaning by it, and it gives his postings an emotional value that a more laborous description of his target opponents would lack.

    Perhaps my opinion is flavored by my being a full day in court two days ago – every time I looked at the plaintiff’s attorney I thought of the word “sodomite” with all its implications…helped me through the experience…

    Besides, it makes it easy to identify his post among the other Anonymouses.

    Humbly,

  • Anonymous

    I “created” the word “sodomite” for this blog. To me it identifies plaintiff’s attorney’s, who personally, have had the same affect on my career as an ER Doc as a sodmite would have on his victim. It identifies the frustration, or feeling I have, that for every patient I see, there is a loaded gun, levered at my head, waiting to go off. When Peter ROsen, the author of the 3 volume “Textbook of Emergency Medicine” has been sued frivolously 5 times, I know my turn is coming up. I use this term for those who call themselves “lawyers”, I have nothing against the patients who sue, they are being victimized as much by the greedy sodomites as they are by the bad outcomes they have had.

  • Anonymous

    Doesn’t Samson Isberg live in Norway?

    Why do you anonymice continue in a profession where you are deathly afraid of everyone you meet? What a horrible way to go through life.

  • NoAcuteDistress

    Yes I rather like the term “Sodomite” too. Who knows? Maybe it will catch on- that is, until it runs into the wall of political correctness when we’ll see a group of gay personal injury lawyers shed crocodile tears about being “disrespected.”

  • Anonymous

    That word is found in The King James Bible:
    “1 Kings 14:24 And there were also sodomites in the land: and they did according to all the abominations of the nations which the Lord cast out before the children of Israel.”
    I don’t mind anybody using that word here as long as there is substance in what one is saying.
    I just don’t want to waste my time
    reading the same thought or ideas over and over.
    Or we can be like President George Bush(Greece, N.Y., May 24, 2005)who said:”See, in my line of work you got to keep repeating things over and over and over again for the truth to sink in, to kind of catapult the propaganda.”
    As Mark Twain said:” Let us be thankful for the fools. But for them the rest of us could not succeed.”
    -amd

  • Anonymous

    I so look forward to universal health care. When physicians realize they are nothing more than more govt. employees, perhaps they will finally be tolerable.

  • Anonymous

    Anon 12:37
    Look at the long lines at the VA Hospital and the Indian Health Clinics. I enjoyed working at those places when I was an Intern and a resident. We could sit down and relax all day just like the bureaucrats at nearby city hall. I can’t wait for universal health care. And they won’t be able to fire me just like that. Ask a VA hospital federal employee.

  • Anonymous

    I so look forward to universal healthcare, when I finally can see patients 9 to 5 ( with an actual 1/2 hour for lunch!),not give patients the meds that they want because the government won’t let me, limit the visits of patients with pain in the ass families, not be responsible that the STAT chest CT I ordered cant be done for 2 months, and when patients like Anon 12:37 finally realize that the system they so desired is a bust and they’re stuck with it. Besides, with Medicare and Medicaid, we’re already half govt employees. You think docs are going to be more tolerable under universal healthcare? Yeah, maybe we will because responsibility for getting you what you need won’t be ours anymore, but yours.

  • Anonymous

    I’m with you guys. Wait times? We patients already wait.

    Plus, since you’ll all be on salary, and not a very big one at that, there won’t be the rush or the unwarranted arrogance.

    How could that system be any more of a bust than the current one you keep whining about?

    We all win!

  • Anirban

    Then who is going to be a physician any way . The optimum performance a person can show in any job is where there is no undue stress. A slave can only dispense Slave medicine for other slaves.It doesn’t empower the patient any way. if the society moves in that direction so let it be. Finally we hope to learn the lessons in a hard way and start from the scratch. Society needs more physicians not less. Let’s not bite the hand which cares for us ,especialy if the dentures are borrowed from a lawyer.

    IMHO

  • Anonymous

    “We patients already wait.”

    Not for urgent studies you don’t – under universal healthcare, you will.

    “How could that system be any more of a bust than the current one you keep whining about?”

    See above. And when the govt won’t give you the meds you need because they won’t pay for it, when you have to wait for your medical equipment authorization, and when your cancer surgery can’t be done for 2 months – I hope you’ll be happy then. You win? I doubt it.

    “there won’t be the rush or the unwarranted arrogance”

    Thats because you’ll be waiting weeks to be seen for your sore throat, because then we’ll have 2 hour lunch breaks and only see patients five or six hours a day. No rush then – no arrogance either, since slave physician employees of the govt really wont give a damn what happens to you.

  • NoAcuteDistress

    Anirban “Let’s not bite the hand which cares for us ,especialy if the dentures are borrowed from a lawyer.” Excellent!

    I vote for Universal Legal Coverage! (Well, that is I’ll vote for it before I vote against it.) I wonder how lawyers would be if they took a flat fee per TYPE of case, not worked on commission. And if they worked with “Global Periods.” No charges for calls, FAX’s, copying, or paper clips. It’ll never happen.

  • Anonymous

    I can’t wait for universal health care so I can blog all day and get paid for it.

  • Anonymous

    I don’t know what universal health care system you guys are dreaming about. I worked in Montreal, and I don’t think I ever got a chance for lunch in 3 years.

  • Anonymous

    I’m thinking of one where I am nothing more than a government employee as Anon1237 mentioned. And I can be like Michael Brown.
    “And Brownie, you’re doing a heck of a job.” Yes, similar to that job.

  • Anonymous

    anon 2:45, You already do!

  • Anonymous

    “Then who is going to be a physician any way .”

    The same suckers who post here now and bitch incessantly about how bad it is.

  • Anonymous

    who’s the sucker, someone who makes > $100,000 a year and gets “respect” from society, or a loser sitting at home with a banged up knee farting around his computer all day…

  • Anonymous

    “who’s the sucker, someone who makes > $100,000 a year and gets “respect” from society, or a loser sitting at home with a banged up knee farting around his computer all day…”

    You just described CJD/Matt, and he’s not a sucker, he’s a sodomite!

  • Anirban

    NoAcuteDistress : 2:25 PM

    Thanks you liked the quote but it was not original. The biting part is from a prominent website advocating legal reform, the borrowing part was however my idea. Can I post this on lawyerstink? What do you think?

    Anonymous: 6:40 PM

    “”Then who is going to be a physician any way.”
    The same suckers who post here now and bitch incessantly about how bad it is.”

    What made you think it’s so great anyway.

  • Anonymous

    “You just described CJD/Matt, and he’s not a sucker, he’s a sodomite!”

    It burns you up that I make more money than you, doesn’t it? You’re stuck on the night shift and only in it for the money and I’m still happier.

    How sad for you.

    CJD

  • Anonymous

    No CJD I am in it to help people not screw them like you.