@yasmine2224 so that the talking half of one phone goes to the listening half of the other, otherwise they couldnt hear each other- he has Ortho-bro talking to someone in the other department, and both are on the landline phones. Not sure why he didnt just transfer the call (probably bc that wouldnt have been as funny :p)
@@meiliodinson Everyone's a doctor these days, it seems. Drs, Drs, everywhere, and not an MD to be found. Heck, the MDs are so demoralized and downtrodden that they they don't even tell people that they're doctors. But PhDs love telling people that they're doctors. That's how you know the difference between a doctor and a doctor. One (the MDs) will not call themselves a doctor, the other (PhDs) will happily call themselves a doctor. I say this as an MD, who interacts with many PhDs, many of whom are college administrators, and demand the title Dr.... Ignorance must be bliss.
Was working in ICU & had to call surgeon at 3am when there was a change in pt status. He yelled at me “what do you want me to do!?!” I said “pretend you’re a doctor and do what one of them would do.” And hung up on him. He called back and apologized before. Taking care of business.
@@GiraffeFeatures Lower concentration lol. I used to do the same thing back when I was doing my surgery internship but mostly with carbonated water and if that wasn't available coke zero was the 2nd line =))
I’m now a 4 year retired family doc who was in practice for almost 40 years. This is just so unbelievably accurate and true. Glaucomflecken is definitely a genius. And yes, I could tell which specialty he was talking to on each phone call. Back in 2007 or 2008 at 5:45 pm on a Friday I had a patient with an ophthalmological problem that, while not an absolute emergency, I needed to at least touch bases with the on-call ophthalmologist to make sure my treatment plan was OK till the patient could be seen on Monday morning (I never liked being told “if only you had called me sooner we could have saved the sight in that eye”). Anyway, after 3 unanswered pages and waiting an hour (with the patient still at my office, and since the patient was female having to have a female employee stay late) I was becoming “excited.” The service told me he was at his son’s Little League game up in Chambersburg and was not to be disturbed except for “emergencies.” I asked the service to please tell him the patient and I were now in route to the ball field for his advice. He literally called me back within 3 minutes of that fourth page.
Every time, every single time I've ever called the ophthalmologist listed on call, the conversation went just like that. I launch into my presentation and they go, "Wait, wait? Which hospital? Am I on call there? Really? Oh, okay. Uh, go ahead, start over."
I'm an ER nurse. Last time I worked I had 6 total nurses to run the entire ER. We had a cardiac arrest, a septic 5-year-old, a GI bleed with a hemoglobin of 5, and finally unstable a-fib we couldn't cardiovert and whose pressure was 50 over nothing. I got reported by the floor for not collecting blood cultures before I sent a perfectly stable patient upstairs. I felt this skit in my soul. It is also very true that doctors will have us order some things, and we are happy to because it's not laziness, it's because we are all drowning and everybody is dying and oh God there is yet another demented patient wandering the halls whose patient is that? And yet, we love it. Emergency medicine attracts a very specific kind of crazy that I am happy to live with/suffer from.
Twice, TWICE, I have taken my daughter to the ER and said, "I'm sorry, I just had a simple question and Telenurse sent me here because preemies scare them."
I believe the teacher version is "But Miss [[teacher not within direct reach]] told me that I may!" And yes, that condition too can be cured by a phone call, or with a slightly smarter student, by reaching for the phone.
@@MrScrofulousWhat? You don't like to micromanage the scarcely abnormal values for the properties of the soft squishy part that protects the skeleton?
When I was a medstudent on Internal Med, a dermatology resident came over at 6am to collect history from a patient. You need to know 2 things in order for this story to be believable: -it was for a case report on the rare disease of that patient -sadly, that patient had scheduled himself to no longer be provided life saving blood transfusions and thus to pass away THAT very afternoon. Because he had no quality of life left. I forget which disorder it was, or why it was relevant to Derm. But the point is, Dermatology came over at 6am that day because it was the last day of that patient's life.
There are ER scribes ? I go my own fricken notes. I’ be just been called into my rural hospital at midnight for a constipated child. Yes, it’s midnight here in Oz.
@@MrScrofulousthere are telescribes for some hospitals, Scribe America might be able to hook you up, though I’m not sure if it wouldn’t be easier to dictate it yourself
My brother is a Senior PA in Montefiore in the Bronx and I sent him this and he loved it! He lives all your videos just so you know! I'll also show them to the nurses in my hospital. ALSO my neighbor that just moved away because he's an anesthesiologist. MY 96 yo mother is a retired RN and thinks your hysterical especially the ones when you bring the charge nurse as the threat in the room. 😉💜😉
“He has a history of chronic diastolic CHF so we only gave him 500cc of NSS” “Dude his blood pressure is 80/50 and he’s on 5 BP meds, none of which he took today” Sepsis protocol fluids save lives.
Some days I just wanna say "look, perhaps you guys can just have this fight directly between yourselves... I'm an emergency doctor, I don't care who admits the patient as long as someone does"
I’m an ER doc who just worked yesterday and can confirm this is all true. Esp the part about being on the phone all the time. Please, my consulting bros and gals give us some grace.
After several years in the ER of a german hospital I can confirm that this is just plain reality. Especially medicine and Ortho fighting over phones is sag but true. Only missed radiology 😊
Aye. “Did you get chance to check whether they had an xray of that already doc cause uhhh they did….” Or even better no we wont xray this patient for stupid reason 3838393 just to shut them up lmao
It would be 2 minutes of "I need a CT scan. I need a CT scan. I need a CT with contrast. I need a CT STAT. Hi I need an x-ray to make sure the patient can go to CT. I need a CT scan. Yes the creat values are coming. Can I send the patient over? I need a stat CT scan, the req is coming with the patient." There's a reason why CT is meme'd as "the Donut of Truth".
“I didn’t order a serum osmolality…I don’t even know what that is.” -Non-nephrologists: Amen. Left that behind with my internal med rotation in 3rd year. -Nephrologists: 😢
I noticed that depending on which hospitalist was on duty at the time, our ED docs would gravitate towards either "I've got a very interesting case for you, you'll like it", or "it's a very simple straightforward case, you'll like it"
The "would you rather yell at me in 45 minutes, or now?" was the entire vibe every time the EM residents told me to take the lead on consults while I was doing my EM clerkship. I even spoke with folks in some departments whom I'd met at events for med students. Uniformly incredibly friendly while trying to convince me to pursue their respective specialties. Uniformly absolutely scalding when they found out the reason I had to briefly pause occasionally to look in the chart for details they wanted is that I was a med student learning to make consults. One was a neurology resident I'd had hours of conversations with as he advised me on pursuing neurology, and when I said "Oh, hi Dr. _______, we've spoken before!" he chuckled bitterly and said, "I'm guessing that's a bad thing?" Like, I know having a teddy bear personality is abnormal for potential neurologists, but I didn't think I was *that* abnormal. 😵💫
I'm a doctor and that is one of the things I never really understood or could grasp, like what it actually means or is. I though I was the only but when I saw this, it made me feel soooo much better
I work as an ED nurse at a level one trauma center… I think I’m biased but ER docs are the best of the lot. I think the only thing he’s missing are the ever present Hokas and Patagonia jacket!
Every single one of these is perfect. I think I have had these exact conversations (except dermatology because an on-call dermatologist is the most fantastical thing Dr G has ever come up with)
Oh my lord, what a fine job! As EM, let me just say you *nailed* it in every way. The red-bull into diet-coke while tossing out the snark and asking when general surgery would like to yell at you? Genius, just genius. I tell *everyone* about your videos. (Also, I'd protest the whole bike helmet/glasses/bike shirt thing, except I've shown up to work dressed exactly like that)
oof...flashbacks to my time in the ER. Especially the "You told your patient to come down here to the ER because YouDidntWantToHandleItAndDoYourJobSoYouMadeItMyProblem"
During undergrad, I worked at an answering service/physicians exchange. We ate, breathed, and slept call schedules, which were always a sheer delight (looking hard at y'all, Ortho Indy). The "Yes, you're on call, and no, this isn't a prank" really took me back. 📞😎🤙
Peds EM doc here for 31 years. This is spot on! I laughed out loud harder than I have for almost any of your other videos (as I grab my Nalgene and energy drinks to head in through a hailstorm for a night shift)
1000 bed hospital...medical intern and 1st yr. resident always rotating through the ER to identify the best teaching cases for IM admission. Those ER pts. were very lucky because a layer of docs who the pts. sometimes never saw were certain that the diagnoses and treatments were correct. Letting a potentially great teaching case get past them was really frowned upon their fellow house officers.
My hand to God I needed an Emergency Endoscopy because I had a bolus, big piece of steak, stuck and couldn’t even swallow spit. The Dr comes in, I Should have been asleep but was not yet and scolds the Nurses because he had a Tee Time. 🙄🙄🙄
Potassium is 3.5 hahaha😂 everything can be admission criteria but the broken tibia ! This is absolute gold 🪙 the outfit it's enough to start laughing 🤣
Yes! One former stand up comedian/ED doc character with one current stand up comedian/ED tech or nurse (not certain. sorry @steveioe) . Steve doing all of his ED characters \o/
The call at 1:09 is extremely accurate. Patients are referred from clinic to ED for all sorts of reasons and often some patients show up going all 'my doc told me to come here'. Worst part is when there is no documentation from the clinic side as to why they were referred to begin with
I always call to give a report on the pt and what I am looking for them to do. And then I frantically finish my note so it can be pulled up in the EHR. I don’t understand not calling; it’s unprofessional.
I need to put this on loop in our ED! 😂 There are so many specialties that need to watch this as "cross-specialty education"... Doc Glauc., thank you for this 😎👍
I'm a pediatric ER nurse and I'd love to see your take on a peds ER attending. I absolutely loved the "... or is it Friday afternoon?" I hate Fridays because of that.
this is, in every single way, as accurate as it gets. i have yet to flat out tell ortho no for a medicine consult for straight forwards patients but maybe next time i will.
I remember having a really sick Stevens Johnson in a small rural hospital and the criticall care referral agent on the phone laughed when i asked for dermatology. I had to repeat myself 3 times.
I actually did the hold two phones up to each other when an insurance company asked me for an ICD code for an echo so I called the Echo department and asked them to tell them the ICD code!! Never forgot that particularly frustrating moment!! I do admire my ED colleagues but sometimes their medical diagnoses do boil down to "could be pneumonia on the CXR". And please, don't call during no pants time!!
I work in xray and yep. I SWEAR they give everyone a chest xray on admission just in case… and half of them had one like a couple days ago! Still prefer those the the plain stupid ones that are clearly just to tell the patient they investigated and theres nothing wrong
Today I had a couple of conversations with a Ped ER specialist. His speech was at the speed of light!!! NO time to spare with a non-interventional, Ped ID doc, but he was polite, understanding of my suggestions and willing to put them into place. Just have mercy of this doc with English as a second language! (Never mind that I've been around and about professionally for over 30 years.)
OMG it's Friday and Im working swing. He just described my day. Except, I never call ophthalmology. Their response is" if it's bad enough for you to call me, they need to go to the university." They're usually right.
Oh God, coming home from a shift as a doc in the ER to this feels cathartic. Working in the ER looks pretty much the same on the other side of the ocean. It's crazy down here and I feel like I spent half of the time on the phone.
“No I didn’t order a serum osmolality. I don’t even know what that is.” - me studying for Step 2 right now Taking my boards for med school in a couple weeks, pls send me good vibes y’all 😭
Pffft it's not like your entire career and 7 years worth of time can be decided on one night with one exam That would be ridiculous Anyway good luck and have F.U.N
Ill have to pass that one next year, scary as hell i feel so stupid how can i possibly pass it, i guess the same as step 1, just mindlessly memorise all test that will never actually be clinically helpful to me in the future, wish you luck!
I used to work for Oral Surgeons and we often received phone calls at 5 minutes to 5:00! General dentists were calling because they couldn't get a tooth out. By the time the patient arrived it was almost 5:30, they told us they had been in the dentist office for 4 hours! The dentist and patient were exhausted and the dentist wanted to go home at 5:00! We were sure the dentist could see the long roots on the x-ray and wondered why he had even attempted the extraction. The oral surgeon removed the tooth in less than 5 minutes, why didn't the patient just come to him first? The answer is two fold; the dentist thought he could extract it and the patient didn't want to pay more for the oral surgeon. And no, the dentist doesn't pay the oral surgeon, the patient does! This is why some dentist won't do extractions! But others won't stop trying! Maybe if more got stuck with the oral surgeon's bill, they would finally stop trying the impossible ones! It got to the point where no one wanted to answer the phone at 4:55! Especially on a Friday! The struggle is real on Friday, no matter the field you're in! But you can't go to the emergency room for an extraction, even if an oral surgeon is on call. The ER has no instruments to remove teeth. And it's still cheaper to go to the oral surgeon's office after 5:00! I've also worked for an answering service and had several medical offices we answered after hours. You can quickly tell from paging a doctor, just how congenial they are! I kept a list of the doctors I'd never see as well as the ones I prefer! At times I felt fortunate to talk to the special doctors who accepted being on call. One evening the on-call doctor answered my page. He had gone to a college football game (I almost expected the worst). He was the kindest man I had ever spoken to, he was calm and courteous. He accepted his responsibility with grace! This doctor was so genuine that I switched to him soon after that! Your skits are so accurate! You can't tell me you don't remember anything from medical school! You're too on the nose! 😘
So accurate....I'm an OR nurse and return ER consults for the surgeon when they're paged while scrubbed in. Just the other day the ED physician paged ortho about a patient who fell and had a tibia fracture, some lacerations to the hands from the fall. Ortho doc's response: get a CT scan (d/t a bad xray), admit to medicine.
Sometimes I wonder if there's a way to maintain a continuous IV infusion of diet coke while struggling to balance the nonsense we have to hear on the phone during consults and the incessant stream of non urgent/emergent patients mixed with the real people seeking help😂 Oh, by the way, Ultrasound does wonders even in many ophthalmology cases. And, believe our gestalt/hunch when we say this patient is your even before the CT scan, you'll be shocked when the results come in.
@@yavizsalim Sure, I live on gestalt. I establish probable diagnosis and management plan within seconds for most patients. But the gestalt is not a hunch, it's pattern recognition based on a synthesis of multiple observations about the patient in front of us, cross-referenced with every thing we know. Another way of putting it is that the gestalt is the intersection between everything we see and everything we know. It's an interesting demonstration of the quantum nature of our brain, where we don't search our memory sequentially, like a computer, but we look at all our memories simultaneously. The gestalt is where the waveform collapses.
Veterinary medicine here, again. Just want to mention that I shared this with ophthalmology last night after asking about a case (a chronic ulcer with granulation tissue built up so thick it threw me off and I initially thought it was pannus) and she nearly died laughing. I just shared it with my coworkers (currently at our station there’s two thermoses of coffee, one of iced tea, and one of hot tea, and I’ve got a bag of loose leaf for when I finish my thermos) while waiting for surgery to come in and they also practically died laughing.
Twice, TWICE, I have taken my daughter to the ER and said, "I'm sorry, I just had a simple question and Telenurse sent me here because preemies scare them." Me: I just wanted to know if maybe she should get a different antibiotic bc of vomiting, they wanted her seen. ER doc: Augmentin? UGH I HATE AUGMENTIN. Yeah we're switching that. Me: I say constipation. Telenurse says intestinal blockage. You get to break the tie. (Plot twist, it was gas). ER docs are my favorite. They've seen it all, and you're just not that sick.
I swear Augmentin will make children and babies vomit at least 25% of the time. And then I gotta chase the doc down to get the orders changed and hound the pharmacy and the parents to make sure the new antibiotic is at the pharmacy and picked up before they close.
@@Joy21090 oh definitely!! Sometimes an anaphylactic reaction. Luckily I haven’t personally gotten a call from a parent while a kid was in anaphylactic shock due to augmentin.
Husband is a pulmonary/critical care specialist for 40 years and his group would get a Friday afternoon consult from a local family practitioner who would turnaround on Monday morning and take the patient back. This happened so frequently his group referred to it as a FP special!