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Secular Citizen MD @secularcitizen2
, 21 tweets, 4 min read Read on Twitter
With national shortages of emergency room physicians, the most vulnerable communities are the most impacted. Instead of earning a median $230K a year, I opted to go to work for under $90k, seeking to make a difference to the most in need communities.
( 1 of 21 )
I've never asked for nor accepted a wage increase, and in my 10+ years, the bonds I've forged with many in the community and their gratitude, and my co-workers, have been more impactful to me than my wage potential.
( 2 of 21 )
Many of the patients I encounter in the emergency room are poor and either uninsured or underinsured, and they often visit the ER for care typically provided through primary care physicians, or when their untreated condition becomes critical.
( 3 of 21 )
Patients feel blame & shame for their circumstances, faced with absurd stereotypes. Free clinics are underfunded, understaffed, and experience high turnover rates. Patients often feel they have to start all over again with each new provider.
( 4 of 21 )
These stereotypes often impact the treatment of patients, with providers wary of drug seekers, and unintentionally making patients feel like criminals, afraid to talk to their provider about issues that might raise suspicions, so they suffer in silence instead.
( 5 of 21 )
These clinics were intended to serve these communities, but the level of care is lacking, in large part because of the increasing demands and lack of resources to meet them. Physicians are often allocated only 5 to 10 minutes to spend with patients.
( 6 of 21 )
Making referrals is near impossible, as few specialists accept uninsured patients or those on Medicaid or Medicare, and those that do are typically booked out several months. While they wait, patients get worse, some die.
( 7 of 21 )
There always to seems to be an abundance of physicians who seek out these clinics, wanting to make a difference, but when faced with real-life impediments, they burn out after just a few months, few make it a whole year.
( 8 of 21 )
This repetitive cycle of neglect leaves millions of Americans with inadequate healthcare. Illnesses often make their living situations worse as they can't afford to call in sick, and can't afford to get the treatment they need.
( 9 of 21 )
Patients with chronic conditions requiring regular treatment or medications often skip treatments and take their medications every other day to make it last longer, all of which is detrimental to their overall health.
( 10 of 21 )
All of these problems eventually funnel down to me, as patients head to the emergency room because they have no other options, and know that they can't be denied care - which isn't quite accurate.
( 11 of 21 )
This is why I choose to work in the emergency room and ones that directly serve the most vulnerable patients. What is lacking at clinics, I have in abundance through the resources of the hospital, such as laboratory testing, imaging, and diagnostics.
( 12 of 21 )
I dispell the typical stereotypes, and have worked to cultivate an environment that prioritizes care, treats all patients with respect and dignity, and providing a level of care that helps to bypass the many impediments.
( 13 of 21 )
Because of this approach, I've been able to form relationships with my patients, something rare for an emergency physician. I've created a database of care providers & organizations willing to see patients.
( 14 of 21 )
I helped to get grants to hire a social worker and assistant who focuses only on finding & applying for other grants. I work with local nonprofits, businesses, and local agencies to find solutions and raise awareness.
( 15 of 21 )
I'm fortunate to be in a position where I can make this possible, with an understanding, supportive, and like-minded wife who, as a surgeon, is the primary breadwinner.
( 16 of 21 )
Due to health issues of my own, I'm on medical leave for what will be several months, leaving a void in the emergency room as contracted physicians are brought in to cover shifts. I'm worried about my health condition, but also about the patients & my team.
( 17 of 21 )
Yesterday, when that Texas Judge ruled the
ACA unconstitutional, I felt a mighty blow that knocked the wind out of me. I'm angry, upset, sporadic fits of crying, and despair. This is personal for me.
( 18 of 21 )
It enrages me that we have a government with such depraved indifference and an electorate that continues to vote for the absolute worse human beings to ascend power and wage war against people in need, unmoved by the human carnage they leave in their wake.
( 19 of 21 )
So, please, forgive my emotional outbursts, I feel entirely defeated, exhausted, and burned out. For the first time in my life, I presently have a hatred for Republicans, not just the elected ones but the voters who choose them. I hope this fades.
( 20 of 21 )
Given where things are now, my wife and I have begun to look at moving to another country where we can practice medicine where a more humanistic system of care that takes profits our of medical care. None of this makes me happy.
( 21 of 21 )
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