Just joined the site to ask a serious question. PE management is becoming an increasing concern to me. At first the PE was small, then submassive, and now massive. Tried heparin with no improvement. Then called interventional cardio but they had no experience with PE management. The hospitalist who admitted the patient suggested I give up and let the PE take over all my administrative concerns.
Just kidding, this isn't about pulmonary embolism PE, but the other PE. Private Equity. I'm just over halfway through fellowship and started looking at jobs. It seems like nearly 50% of the jobs on NEJM and JAMA website are HCA or ICC. I have no personal experience with either, but my former coresidents who work at HCA facilities or for PE groups like Sound and Envision seem less than happy. A hospitalist friend of mine had, no joke, 100% serious, 36 patients to see one day including 11 new admissions. I am increasingly concerned that these large groups are going to eventually take over critical care and offer rock bottom salaries with sky high patient census. It looks like this has already started to happen with hospitalists and EM, while other specialties like cardio are still not affected. (See my story above made sense about the cardiologists not knowing about PE) I've also seen, surprisingly, dermatology job offers through PE.
Bottom line, I guess my question is about the future of CC. I realize every specialty has their own version of "sky is falling" whether is radiology and AI or FM and midlevel encroachment. But I have not seen too much discussion on PE and the future impact on critical care and really medicine as a whole. It seems like we sacrificed a lot of autonomy wanting shift work without as much administrative responsibility, and unfortunately missed the opportunity for real change in medicine. With PE groups, it seems that staffing ratios get lower, work hours increase, patient safety/outcomes decrease, liability increases, and salaries decrease. The patients and physicians don't benefit. What options do we have going forward?
Just kidding, this isn't about pulmonary embolism PE, but the other PE. Private Equity. I'm just over halfway through fellowship and started looking at jobs. It seems like nearly 50% of the jobs on NEJM and JAMA website are HCA or ICC. I have no personal experience with either, but my former coresidents who work at HCA facilities or for PE groups like Sound and Envision seem less than happy. A hospitalist friend of mine had, no joke, 100% serious, 36 patients to see one day including 11 new admissions. I am increasingly concerned that these large groups are going to eventually take over critical care and offer rock bottom salaries with sky high patient census. It looks like this has already started to happen with hospitalists and EM, while other specialties like cardio are still not affected. (See my story above made sense about the cardiologists not knowing about PE) I've also seen, surprisingly, dermatology job offers through PE.
Bottom line, I guess my question is about the future of CC. I realize every specialty has their own version of "sky is falling" whether is radiology and AI or FM and midlevel encroachment. But I have not seen too much discussion on PE and the future impact on critical care and really medicine as a whole. It seems like we sacrificed a lot of autonomy wanting shift work without as much administrative responsibility, and unfortunately missed the opportunity for real change in medicine. With PE groups, it seems that staffing ratios get lower, work hours increase, patient safety/outcomes decrease, liability increases, and salaries decrease. The patients and physicians don't benefit. What options do we have going forward?
