It was a legitimately nonprofit hospital and he probably was overpaid, but at least he was a practicing physician at one point and did seem to give a damn about his staff.

I once worked at a hospital in the ER where the department director was a union-busting bastard, but the CEO was pretty reasonable. After I left, one of the other ER techs went to the CEO about our pay being messed up and got everyone $5-6/hour raises to actual market rate. Also, there were a few weeks when we were really understaffed that the hospital encouraged admin folks to volunteer as “candystripers” in the ER to do stuff like help clean/turn over rooms, and answer patient call lights for water, blankets, etc. And the CEO was down in the ER for a couple hours every evening helping out most of that time period. It was encouraging to see the CEO of the hospital putting on some gloves and helping us with basic stuff like cleaning and stocking.

NPs working under a physician with actual oversight is fine. The ones I have problems with are the ones that have a physician sign the hundreds of notes a month while maybe reviewing a handful, and worse, the ones pushing for independent practice without even that sham of oversight involved.

I did my cadaver dissection last year in medical school, and you’ll probably be a better cadaver than you think. The worst one to deal with in the class was in the tank next to ours. The cadaver was 102 years old at time of death without a scrap of fat anywhere. The muscles dried out and fell apart almost immediately on dissection, and started growing mold over the winter break. The lab manager had to keep removing portions of the cadaver to try to limit the spread of the mold until all that group was left with was a head in a bucket of formaldehyde. The head, neck, and brain were the last dissections we did, so it worked out okay-ish, but I will never forget the absurdity of them ending up like a Futurama president.

Taking an ambulance to the ER does not ensure that you will be seen faster. A decent chunk of ambulance patients go right out to the lobby to wait like everyone else because everyone is triaged based on their illness or injury, not their mode of transportation.

I’ve worked in ERs before, and there is more to this story that the article sidestepped quite neatly. Most ERs these days are filled to capacity with dangerously low staffing ratios, and the general public’s definition of an “emergency medical condition” and the medical definition of an “emergency medical condition” are very different. Some nights I’ve worked, we had people with chest pain and a cardiac history wait in the lobby for 5+ hours because there were no beds available and their EKG was mostly okay for the time being. A big contributor to this problem is a lack of mental health resources which results in ERs losing beds for up to weeks or even months at a time to hold psych patients that have nowhere to go. It is heartbreaking when we had to turn away people who mostly needed a social work consult…but when there’s two doctors and twelve nurses for a 40 bed ER and 2 out of 3 resuscitation bays are in use for active codes, there just isn’t anyone or any resources available to help someone who isn’t actively dying.

The inpatient side isn’t a lot better. Skilled nursing facilities and rehab centers are increasingly rare and increasingly expensive, and the hospital can’t keep a patient forever if they don’t meet criteria for hospitalization. The nice thing about inpatient is that they get to enforce their staffing ratios so that each nurse only has so many patients to handle. In the ER with EMTALA, it doesn’t matter that a nurse is caring for 6 patients (3 of which are waiting for an inpatient hospital bed, and 1 is waiting for an ICU bed…), that nurse will have to take on another critically ill patient that is stuck on a bed in the hallway if that’s all that’s available. The inpatient problem exacerbates the ER problem, and then you have people stuck in the lobby for 12+ hours before there’s a physical space for someone to see them, that provider’s capacity to take on another patient notwithstanding. It’s a true crisis and it’s only going to get worse until the full healthcare system (i.e. all the non-ER parts) are as accessible and available as needed.

It depends on why they don’t pay attention to politics. Personally, I kind of have to go ostrich-mode and bury my head in the sand when school gets stressful because I just don’t have the mental bandwidth to deal with both. I’m not going to judge someone too harshly for protecting their mental health from the absolute shitshow that is the American political landscape.

PS: This is not to say that any degree of modern conservatism is okay. Bigots can go fuck themselves and I’d be out punching Nazis and being a medic at protests if it didn’t jeopardize my future so significantly. (Felony convictions make it really hard to get a medical license and I have to pay off my student loans somehow. Besides, I’ll be in a much better position to make a meaningful difference as a physician than as a heavily indebted student or EMT.)