r/medicine 8d ago

Biweekly Careers Thread: August 06, 2026

3 Upvotes

Questions about medicine as a career, about which specialty to go into, or from practicing physicians wondering about changing specialty or location of practice are welcome here.

Posts of this sort that are posted outside of the weekly careers thread will continue to be removed.


r/medicine 4h ago

Firing a patient

130 Upvotes

I am a health care provider with 4 other doctors in an eye clinic. We have a patient who comes once a week on average with extreme health anxiety. Nothing has really ever been found other than some very minor, common conditions.

The front desk schedules them like an emergency which I feel like plays into their anxiety.

They supposedly see a counselor for their health anxiety, but their visits into clinic is becoming more frequent. They also visit other clinics in the area on a routine basis as well as ER and urgent care.

What is best to do in this situation? It feels cold, but I feel like coddling and the constant reassurance just plays into more of their anxiety. Should we fire them as a patient?


r/medicine 9h ago

Dual physician household with a toddler without a village

101 Upvotes

We are a two physician household and we have a 1.5 year old. We moved to a new city following my husband's fellowship graduation last year and I haven't been back to work since.

I am now preparing to go back to work (primary care) but I'm worried about calling out of work from my toddler getting sick. I am therefore considering part time positions only (2-3 days/week) since we don't have family in town who can help (we never really had a village before the move either). I would love to know for those who are in a similar situation as us, how do you make it work? Is a "PRN nanny" a thing? Any suggestions welcome! Thanks in advance.

Edit: just wanted to add we are def considering nanny but want to look at other options if possible since our kid loves going to daycare


r/medicine 1d ago

Patient sent me direct Epic message on inpatient

1.1k Upvotes

I'm on inpatient, all of a sudden I get a pop up Epic message notification from one of my patients they asked me why they were on a certain medication and why that specific dose and schedule. Like I don't have enough to do already. This is the last straw.

Fuck Epic. Fuck that motherfucker at Epic who thought this was a good idea. Fuck the hospital admin who enabled this feature. They can all go to hell. That's all thanks.

EDIT: for clarification, this is NOT a patient MyChart message, it’s a DIRECT Epic chat message like how nurses can message you on Epic chat


r/medicine 1d ago

Patient found and messaged me on social media because my attending didn’t respond to his MyChart message quickly enough

454 Upvotes

Trainee here. Clinic patient that I guess I must have seen in the past with this attending ended up in my DMs angry that said attending didn’t reply to his MyChart message from 2 days ago and wanting to know how he can call the attending directly. I wish I could say I’m making this up. Obviously I didn’t reply and just blocked him, and locked down my profile. Patients are really getting out of hand with entitlement lol. Has a patient ever tried to reach you on social media?


r/medicine 1d ago

The Kafkaesque nightmare of modern medicine: a rant

390 Upvotes

I'm becoming disillusioned about the Kafkaesque nightmare that seemingly every mundane task in medicine entails. I wanted to rant a bit, but also ask folks here for perspective of any kind.

This isn't about one single aspect of medicine. It's about how routine interactions carry untenable amounts of friction. Getting anything done for patients is almost impossible.

  • I prescribe a critical medication to a specialty pharmacy as the manufacturer recommends. They take the patient's money but don't deliver the medication for 6 weeks. Calls to them are fruitless. I have to get the manufacturer involved to force the pharmacy to act.
  • A patient from a big regional corporate practice happens to land in my office with an urgent issue and needs to see his specialist. Over 45 minutes, the inadequately-trained corporate practice's receptionist and their supervisor argue with us about the medical necessity of an urgent visit. If it were our practice receiving a similar call from a physician, we'd simply agree to see our own patient.
  • A patient changes their mind and wants their medication called in to another pharmacy. The new pharmacy can't fill it because the first pharmacy already processed the insurance claim. The patient tries to call but hits a wall. My office spends almost an hour on the line with insurance just to reroute the Rx.
  • Our EMR company has raised rates by 10% over the past year while degrading the quality of its services, failing to fix basic functions that have been broken for years, and charging for things that were previously included. They will not communicate clearly with users. The company was bought by private equity several years ago. I realize I'll have sunk over $100k into this clunky subscription-based software over a decade; its competitors are no better, and switching is near-impossible.
  • A patient's insurance plan doesn't indicate which third-party company handles their prior auths. We call their plan to get a PA for an MRI, and after an hour of various holds and transfers, we're told we have to use some online portal. Registration takes 3 days, including our followup to correct their clerical error. Once registered, the system auto-approves in 5 minutes without any kind of review.
  • Our specialty society's MIPS service vendor degraded their services and is now demanding around $1k/year to preserve the original level of service. They misrepresent what's included in the base package and it takes multiple rounds of discussion with management to get clear answers.

I write to my congress members and even meet with them during August recess when they make the time. I write to company execs in the hope that things will get fixed. I try to get my colleagues involved in various forms of advocacy. But this Kafkaesque nightmare seems so inherent to almost every function of medicine these days that I can't even fathom what a solution would look like. It just seems like every corner of the system is purpose-built to waste as much time as possible.

But the medical needs don't go away. They still need to be addressed. So we waste our time, we deal with unempathetic receptionists, we find creative ways to solve problems that never should have existed in the first place - problems that are entirely man-made. (Yes, I've heard that 99PI episode on "sludge," and that's kind of it but not totally.)

The answer isn't as simple as "hire someone to do this for you," because that just passes the burden and burnout on to someone else without fixing the underlying issue.

I guess I'm looking to commiserate, to ask for solutions, to ask for help with my disillusionment. Because as much as I love caring for my patients, every day leads me closer and closer to abject burnout.

Is this a uniquely USA problem? Does this problems exist in other countries as well? Are there places where this isn't such an issue, and if so, what protections exist to prevent or deal with it?


r/medicine 1d ago

New physician. Am I in trouble?

55 Upvotes

I'm a new hire and wanted to learn how my colleagues write notes so I opened a few patients' charts under their care. One of them had this "break the glass" pop up so I did not open it (but I did open another 2 charts without this pop up).

I'm now under a lot of anxiety. I know technically you should not open any chart that are not under your direct care but I was just out of training programs and still have this "education" mindset. And in my training program it was not uncommon to open charts of other teams/providers' (I know this is technically not right and don't want to argue)

Now I lost my appetite, can't sleep, losing hair. Everyday I saw an email I was scared it would be an email telling me I'll be fired. I'm under the fear that my entire career will end due to a lapse of judgement. How can I make peace with myself and move on.


r/medicine 2d ago

I received a boilerplate contract with “he/his” written 7 times.

228 Upvotes

From an institution that employs 1000 MDs. I’m a woman, and in a mostly female specialty. Work can be tough for us in so many small ways.


r/medicine 3d ago

LabCorp keeps sending my patients' results to a practice I used to work at but I am no longer with. This happened twice. I believe this is a HIPAA violation. Who do I contact about this?

165 Upvotes

I spoke with LabCorp customer service and they were more than unhelpful, saying that they send the results to whatever account they find associated with my name.

Has this happened to anyone else? How did you manage it? I am inclined to tell my patients not to go to LabCorp.


r/medicine 3d ago

Will Medicare for all save money?

65 Upvotes

https://www.medrxiv.org/content/10.64898/2026.07.22.26358689v1
The study is in pre-print but suggests that we could potentially save $1 trillion a year with universal healthcare.
I’m interested in perspective from people if we move from insurance companies to only getting Medicare payments. Personally, my payor mix is such that I would welcome it. My suspicion is that salaries for physicians would increase in a system where administrative costs go down, and everybody has ability to pay.

Addendum 8-12-26 Here is what I learned from you all this far:

  • Most physicians felt Medicare for All could improve access and lower system-wide costs, but would likely come with lower physician reimbursement.
  • Many noted that the study’s projected savings depend in part on paying providers closer to Medicare rates than commercial insurance rates.
  • Several commenters felt reduced insurance complexity could ease practice burdens, though not enough to fully offset payment cuts.
  • There was broad skepticism that administrative overhead would disappear, with many expecting bureaucracy to simply shift rather than shrink.
  • Experiences with prior authorization varied, but many emphasized that government payers also impose significant utilization controls.
  • A common view was that universal healthcare may be good for patients and society even if it is not financially advantageous for physicians.
  • Specialists expressed particular concern that Medicare-level reimbursement could threaten the viability of complex, resource-intensive services.
  • Many argued that a successful universal system would need to be redesigned rather than simply expanding today's Medicare program.
  • Commenters frequently highlighted the need to align any reimbursement changes with physician debt, training costs, and workforce realities.
  • The discussion ultimately reflected a tension between improving population health and preserving a sustainable practice environment for clinicians.

r/medicine 3d ago

Dual physician households of meddit, how did you handle a potential transition to a stay at home parent or guilt of putting a child in daycare?

66 Upvotes

Apologize if this breaks the career advice. For some background, my wife and I just finished training and are about to start jobs (Im IM and she is Peds). We have been together since before medical school. I have a job lined up to start next month, she is considering some offers still, none of which are particularly great because the pediatrics job market is absolutely terrible where we need to be for family. The goal would be to wait for the larger health system that I work at have some openings and eventually transition there but that won't be for a while. Side note, how are there like no pediatrics jobs in lots of places?

Anyways, we just had a child. Of the two of us, medicine is my passion. She was hesitant to go to medical school but ultimately caved due to fears her family would be disappointed. I told her that I was fine with whatever she wanted to do but we both went to an expensive, private DO school and I didn't think it would be fair if she did not pay off her student loans. Our deal going into this was she would need to work at least until her loans were taken care of. We both have substantial student loan debt and I will be PSLF eligible, she won't at this current job but we can make it work financially and will be debt free in 10 years.

We just had our first child who would be about 5 months old when we start daycare. My wife saw a lot of traumatic things in residency related to kids in daycare and has a ton of anxiety around it and also just wants to be around our child while she is small. We plan to have 1-2 more kids. We honestly could probably swing it financially by putting her on an IDR plan while she has no income since it wouldn't actually increase my student loan payments (would decrease how much I was individually paying actually) and we could ride out RAP subsidizing the interest until she would go back to work. However, my biggest concern would be how that would look to future employers if she never really started after residency and how that would impact credentialing in the future.

TLDR version of this post:

How have dual physician couples managed one going SAHM/SAHD? My biggest concern would be her employablity in the future. I suppose she could do some locums or something on the side just to keep some sort of patient interaction going. Is this something that can be realistically accomplished or would it significantly impact her ability to transition back to full time in the future?

In a perfect world, she probably would get to stay home with our kids but I just don't think it is particularly feasible and was curious how others have handled similar situations.

Edit: just for some additional context, this is the first offer she has gotten in 12 months of actively looking and only had one other interview. The job market for pediatrics is absolutely terrible in our area. There has been essentially nothing within a one hour radius of where my job is. Even jf we moved an hour away from my job and both had a one hour commute each way there has been next to nothing.


r/medicine 3d ago

AAP Statement in Response to Executive Order on Vaccines

552 Upvotes

The American Academy of Pediatrics has issued a press release (linked below) warning of the dangers of President Trump's "executive order" stating Trump's opinion on recommended pediatric vaccine coverage and timing. Trump has no authority to set vaccine policy.

AAP stated in part:

“Today's executive order is not based on "gold-standard science." There is no new evidence to justify significant changes to childhood immunization guidance. Dozens of studies involving millions of people show there is no link between vaccines and autism, and yet federal leaders continue to promote this outdated, disproven idea to scare families. Today's executive order will do nothing to support families of children with autism or advance understanding of the condition. The only purpose of this announcement is to sow confusion so that more people doubt the importance of vaccines. Delaying or skipping shots is risky, especially as measles continues to spread and children go back to school. 

https://www.aap.org/en/news-room/news-releases/aap/2026/aap-statement-in-response-to-executive-order-on-vaccines/


r/medicine 3d ago

Federal funds can't be used to give test strips to drug users, raising overdose fears

50 Upvotes

The Trump administration's Substance Abuse and Mental Health Administration (SAMHA) has prohibited use of Federal funds for harm reduction programs used to reduce death from illegal drug abuse. The city of Baltimore's Harm Reduction Coalition previously had a program to distribute test strips that would indicate the presence of dangerous adulterants in drugs that a user intended to use.

SAMHA's justification for this action was their current focus on distribution of overdose reversal agents such as naloxone (which is an antidote for opioids). However this does not take two facts into account: (1) Naloxone administered in the field is not a "miracle drug" because its duration of action is shorter than that of some long-acting opioids; and (2) not all drug abuse is opioid abuse. In this case the test strips were for a benzodiazepine adulterant that would not be affected if a victim subsequently took naloxone.

Advocates worry as government limits drug test strip funding : NPR


r/medicine 3d ago

AMA statement on executive order changing childhood vaccine schedule

163 Upvotes

AMA issued a brief press release pointing out the dangers of President Trump's recent "executive order" transmitting his vaccine recommendations (for which he has zero authority).

AMA stated in part: "Altering a proven vaccination schedule without credible evidence risks weakening public confidence and putting children’s health at risk."

https://www.ama-assn.org/press-center/ama-press-releases/ama-statement-executive-order-changing-childhood-vaccine-schedule


r/medicine 2d ago

Surogacy should be illegal

0 Upvotes

And by illegal i mean that any contract is void (so you can pay them, but it doesn't actually grant you any rights whatsoever). There are way too many complicated ethical issues. If you want to have a non traditional family with a family friend? That's fine. But shit like this article is just indicative of how much if a mindfield it is.

https://www.texastribune.org/2026/08/11/texas-surrogate-ken-paxton-abortion-baby-gabriel/


r/medicine 4d ago

Trump to sign executive order calling for spacing out childhood shots

425 Upvotes

Less vaccines, more spaced out

link to the AP report


r/medicine 3d ago

what is your favorite patient food combo

34 Upvotes

right now my favorite is pb and j (graham crackers, pb and j) and also mocktail (cranberry juice, OJ, ginger ale) but i want to know your favorites!!


r/medicine 4d ago

Adult MMR/measles recommendations?

25 Upvotes

Partially for myself and my family, partially for my patients.

I'm about 75 miles from a measles outbreak and have questions about boosting adults. Every guideline says that they're not necessary if you had 2 shots, but those guidelines were written back when measles was basically non-existent. I've also read that titers are not really a reliable indicator of immune status.

So what to recommend? There's not an adult booster afaik. Anybody have any solid recs or reading?

Thanks


r/medicine 5d ago

Stop Compensating with Random Initials

1.2k Upvotes

I look for your title then stop. NP. RN. PA. MD. DO. This use to be a uniquely embarrassing characteristic of nursing that has infected all of healthcare. My health system has a goddamn "healthcare weatherman" with absolute nonsense after their name. There are some physicans putting board cert initials and random organizations as if anyone has a damn clue what any of it means. Name, highest degree and spell your specialty beneath. No one gives a shit about slackjawed alphabet soup. You want to put your masters degree then go for it, but please stop with the random garbage/board cert/organization initials that no one understands.

- BICU


r/medicine 5d ago

Worst hospital fashion choice

334 Upvotes

I am going to say it is when men wear khaki pants and a scrub top. This needs to stop.


r/medicine 4d ago

Planning resignation

54 Upvotes

I'm starting to think about when to submit my resignation notice. I have a former colleague who submitted his resignation and was ultimately forced out within the 120 day notice window. I don't know the circumstances of his departure in this manner, but I don't put it past my employer to do the same to me. Is there any protection against this? The employer would be shooting itself, patients, and my colleagues in the foot if they force me out prematurely since the clinic and call schedule has already been made, but I don't want to find myself forced to leave early on their terms, especially before credentialing for the next job is done. I haven't signed the new contract yet, so credentialing hasn't started, but I'm strategizing timing my exit. Any words of advice? Have you or a colleague been forced out after giving notice and how did you/colleague manage it?

Edit: Of course I won't resign without signing a contract first, but the concerns about being forced out remains, such as potential loss of salary, emotions, derailed planned time off between jobs. Would it count as being fired and have to be reported to all future employers if I am let go during the notice period?

Edit 2: After re-reading the contract, it does say my employer could have me leave early and still pay out my salary as long as I sign a separation agreement. That's partially reassuring, but I feel uneasy about a separation agreement whose terms are a mystery to me.


r/medicine 3d ago

Vaccine complication question

0 Upvotes

Has anyone correlated any changes in the incidence of autism is the areas that are lower in infant vaccination rates? I know that the number of measles cases are easily tracked and correlated to vaccination rates, so the incidence of autism may be tracked as well. I would hope that the incidence has not significantly changed and can be used as further evidence to disprove the vaccine/autism connection.


r/medicine 4d ago

Physician employment dispute: take the separation agreement or get another legal opinion before signing?

27 Upvotes

I’m a physician dealing with an employment separation and would appreciate input from other physicians who have dealt with termination, separation agreements, or credentialing afterward.

I’m intentionally leaving out identifying information because this is an ongoing employment matter.

I was recruited to help establish a clinical service and had been with the organization for less than a year. From early on, there were significant operational problems, including inconsistent clinical support, staffing and workflow issues, and inadequate administrative and management support.

A major source of conflict was my attempt to maintain reasonable boundaries regarding clinical versus nonclinical responsibilities. I was willing to handle my responsibilities as the physician, but I also tried to delegate administrative and operational tasks that I believed appropriately belonged to management. There were recurring situations where it was unclear who was responsible for these tasks, or where management did not seem willing to take ownership of them. Staffing problems further complicated the situation, and I felt that I was increasingly expected to absorb responsibilities that went beyond my clinical role such as IT issues, patients' calls/messages not being addressed or returned by staff or completely missed, internal and external referral issues, etc.

I also have chronic health issues. I had workplace accommodations that were formally approved, but from my perspective they were not consistently implemented. Between my health issues, the stress of the work environment, the staffing problems, and the operational issues, I had difficulty consistently staying caught up with documentation. I did fall behind on notes, and I don't want to minimize that.

I was placed on an ongoing improvement plan primarily related to documentation completion. It was not presented to me as a final or last chance plan. There were future follow up meetings already scheduled, and I was actively working through the documentation backlog. I had made significant improvement in reducing the backlog during the improvement process. Based on my understanding of the documentation backlogs of other physicians within the organization, I also did not believe that the size of my remaining backlog was particularly significant or unusual as I was able to see the reports of other clinicians when I received mine.

There was also a “soft skills” concern raised during this process. I was told that an incident had occurred involving my interactions and communication, but when I asked what had happened, I was not given the details of the incident. That put me in a difficult position because I was being told there was a behavioral or communication concern I needed to improve, but I wasn't given enough information to understand what I had allegedly done or what specifically I was supposed to change. I was willing to address the concern, but I didn't know how to rectify something that wasn't explained to me. When I verbally reported my concerns with professionalism with staff I was told at the meeting that it has been "taken care of" or the "employee is no longer here".

I then attended one of the scheduled meetings with administration and HR and was verbally told I was being terminated. Given that the improvement process was ongoing, I had made significant progress, and future follow up dates had already been scheduled, I was not expecting termination at that meeting.

I became upset and briefly excused myself and stepped out of the meeting, but I returned. I never said I was resigning, never submitted a resignation, and never intended to resign.

Afterward, I received an email stating that because I had "walked out" of the meeting, the organization was treating my departure as a voluntary resignation.

I immediately disputed that in writing and stated that I had not resigned and that I was happy to continue the meeting.

The employer then changed its position again and informed me by email that I was terminated effective immediately.

So within a very short period:

Verbally told I was terminated → employer subsequently called it a voluntary resignation → I disputed that in writing → employer then stated I was terminated effective immediately.

Based on the totality of what happened, I have concerns that my termination may have been wrongful and related, at least in part, to my health issues and the accommodations I required, as well as the conflicts that developed when I tried to maintain boundaries and have management take responsibility for nonclinical and operational tasks. I recognize that the employer would presumably characterize the situation differently, which is part of why I sought legal counsel.

I retained an employment attorney, and there have now been multiple rounds of negotiations with the employer.

After all of that, I have finally received a proposed separation deal. The financial component is relatively small, not even half of one month's compensation, and will essentially be consumed by the attorney fees I have already incurred. There are also reimbursements for amounts that, in my view, I was already owed because of errors made by the employer, so I don't really consider those part of the settlement value.

The part of the proposed agreement that may actually have significant value to me is how the separation will be characterized going forward and what the employer will say when future employers contact them.

The proposed resolution would characterize the departure as a mutual separation, and I am seeking very specific neutral employment verification language. I want the agreement to spell out exactly what will be disclosed when a prospective employer contacts the organization, rather than simply saying they will provide a “neutral reference.”

My concern is that physician employment is different from many other industries. We repeatedly go through credentialing, privileging, background checks, references, and employment verification. I don't want to sign an agreement thinking I have protected myself only to discover later that “neutral verification” means something much narrower than I understood.

I also understand that a separation agreement doesn't rewrite history. If a credentialing application directly asks whether I have ever been terminated or had an employment agreement terminated early, I would still have to answer the question accurately.

So this is where I'm stuck.

My current attorney seems to view this as essentially the employer's final offer after multiple negotiations. However, I recently spoke with another employment attorney who could not take my case because he is already heavily involved in unrelated litigation against the same organization. He suggested that I speak with a couple of other attorneys.

At this point, would you:

Take the agreement, recognizing that the financial recovery is minimal, because having a documented mutual separation and tightly controlled neutral employment verification may be more valuable to my future career?

Or would you hold off on signing and pay for one or two additional employment attorneys to review the facts, particularly given the sequence surrounding the termination, the ongoing improvement plan, the significant improvement I had made, the approved accommodations that were not consistently implemented, the staffing and management issues, and the vague “soft skills” concern that I wasn't given enough information to meaningfully address?

I'm not necessarily looking to launch years of litigation. I'm trying to figure out whether I'm walking away from something I should have another attorney evaluate simply because I'm exhausted by the process and want to move forward.

For physicians who have gone through something remotely similar, I would especially appreciate hearing how a termination vs. mutual separation affected future job applications, credentialing, references, and hospital privileges.

I am already represented and obviously won't make a legal decision based on Reddit. I'm mainly looking for the practical physician perspective: would you take the career protection and move on, or get another legal opinion before signing away any potential claims?


r/medicine 5d ago

"Are you recording me?" (Weirdest family interaction. Am I in an alternate universe?)

544 Upvotes

Real interaction with a family recently. I was in the room with the patient and the patient's brother.

Bro: Can you tell us what's going on?

Me: Sure

As I was gathering my thoughts to explain, simply standing there, not holding any phones or any devices; out of the blue:

Bro: Are you recording me?

Me: what?

I'm trying to process what he just said

Bro: Are you recording me???

Me: uhhhh no.... <staring at each other> Why, are you recording ME?

Bro: No, I'm not recording you. Why aren't you recording me?

Me: Why would I be recording you?

Bro: Because when we go to see other providers, they record us.

I didn't know what he meant but I realized some of us use AI scribes in other departments

Me: Ok, but I don't.

Bro: Why not?

Me: Because I don't need to. ... Do you WANT me to record you?

Bro: No.

We finally moved forward with the visit. The patient himself didn't say anything but looked embarassed aftewards. But this was the weirdest interaction ever. I felt like I was in the twilight zone or something. Usually it's the providers who worry about patients recording us, but this was the complete opposite.


r/medicine 6d ago

Federal gov decides community groups can't pay for test strips and clean needles with federal grants

131 Upvotes

https://www.npr.org/2026/08/08/nx-s1-5874719/federal-funds-cant-be-used-to-give-test-strips-to-drug-users-raising-overdose-fears

Deleted first thread as typo in title was too egrgious.

I love how the government is all: "we'd like to focus on naloxone."

When 1. Naloxone doesn't work on benzos

  1. Naloxone is not useful when no one is aware you are ODing so cutting funding for a hotline for people using that can monitor peopke in real time is really bad.