Burned out because of Consultants
EM resident and absolutely hate consultants at my facility/program. I had a patient with odontogenc deep space infection concerning for ludwigs present some time after extraction with sublingual and submental swelling. Airway intact. Immediately started Unasyn, abx, gave decadron, CT soft tissue neck with IV contrast. I called the ENT service a PA answered and said they don’t deal with that and to contact OMFS. My attending called and asking to speak to the ENT attending who accepted seeing the patient but wanted OMFS for source control. I continue calling OMFS who first weren’t happy with only soft tissue neck even though it got basically head to upper chest without seeing the scans requesting CT max/face then asking if it was a glandular pathology again not looking at the scan and not appreciating the recent dental work. They both work remotely and aren’t on site. She then calls me back saying “oh yeah I see what you’re talking about. Is ENT draining?” I mentioned to her, the fellow, that I wasn’t sure yet as ENTs evaluation was pending because they are also remote but he wanted her on for source control. She then has the hubris to say “I wish I had better communication” … okay dude like me too???? Then she said let me know what their plans are and hung up. I put them in a group chat together and left.
It’s so exhausting, I did my job; Airway assessment, medications, diagnosis, IMU admit for airway monitoring. I’m sorry you’re working remote and that you also have a high census but this is what it is. I spoke to my attending who basically kept it real saying anyone know has to drive to the facility will find anyway to not by punting it to someone else.
I’m partly mad at my naivety for first believing the PA, not getting more information from ENT, and letting the fellow give me an extremely passive aggressive attitude and hanging up in my face. This feels perpetual even with surgical consults that are in house. Appendicitis or SBOs prior to attending evaluation getting punted to medicine only for me to get yelled at.
My feedback today was be more strict with consultants but I always feel like the service I’m contacting are the experts and know best and that they would always do best for the patient. This isn’t universal btw because I’ve gotten to see some really excellent attendings at work from all types of services but find that it’s typically surgical sub specialties that do this. Sorry for the rant??