Hospitalist

So glad I'm in anesthesia and not end up in internal medicine. ::happy sigh::

The biggest issues I had was that I felt like a social worker/case manager instead of physician. For every patient, it was dealing with where would they go, how would they get meds, insurance issues, who would take care of them and follow up after discharge. There are little medicine involved. Only complicated patients would I feel like that I'm actually practicing medicine.

Other than that, it has been a fairly good month. Reminding me of some basic medicine since I haven't really seen medicine since Jan of my 4th year. It's a good practice and learning to prep for my Step 3.

The funny thing is that there's a fellow for hospitalist. Why would anyone want do 1 yr fellowship in hospitalist medicine? Shouldn't anyone who had finish IM residency should be able to practice hospitalist medicine? Bizzare.

One thing that really irked me was that a patient was transferred from cardiac ICU after MI was ruled out. When I saw the patient, she was breathing really fast and in pain. There was a CT report of pancreatitis vs cholecystitis. Of course, no abx was started, totally unconcerned that it could turn into necrotizing pancreatitis. When I got patient, decided to watch carefully for the night with low threshold to go to MICU. Of course the next AM, disaster struck. Septic picture, change in mental status, respiratory distress. MICU she went. I followed with what happened. She coded and suffered anoxic brain injury. CT read 75% necrotizing pancreatitis. Passed few days later when family withdraw care. Sad. what a disaster from too focused specialties and units/floors.