Eve- Don't get me wrong, you should still be anal and a perfectionist but after a couple years out of training it will probably be focused in a different direction, i.e.- wanting all your patients to be up to date on their vaccines and wear bike helmets and sunscreen and not drive in the hay tractors and not be allowed around smokers.... I remember writing overly complete, extensive transfer notes-- basically all the resident had to do was dictate my History and Physical-- they were too perfect and part of the perfection was that I didn't want them to think of me as a the local yocal PMD out in the boonies who was out of touch with medicine in the big city, but you know what, as I developed a good relationship with a group of subspecialists whom I trusted and trusted me, I stopped worrying- sure I still like to shine and I still worry about my patients and I'm still a perfectionist but I really don't care about whether the resident on the receiving end will be impressed with me anymore. I sure hope this is part of getting older and not getting burned out :) Regards Kim Burlingham, MD ---------- > From: Eve, Seth and Amina Switzer <> > To: Pedtalk <>; Dogwood Ridge <> > Subject: Re: Seizures > Date: Tuesday, June 30, 1998 9:43 PM > > > So, sure, I still remembered how to run an > > insulin drip and sure it was great to see a child I knew get better > > directly because of what I did but I'll never keep another DKA here in > our > > rural hospital if I have to work the next day. To make a long story > short- > > I would have sent your baby with seizures to a Children's Hospital-- > > actually after the first seizure since I can't do an EEG here. Let us > know > > what the final diagnosis is. Regards- Kim Burlingham, MD FAAP Rural > Peds > > > Thanks Kim - I guess just being out of residency and actually practicing > for less than a year makes me a little insecure at times. I knew I was > doing the right things, but being in private practice in a small town is so > different than residency in a large city. Coming out from under that > "attending umbrella" was tough too. You're right, of course, about > transferring kids out when the need is obvious. There is really no need to > kill myself, I suppose, like during residency. It's hard to change that > type A personality though!! I can't (and don't need to) be as anal and > perfectionist as I was during residency. I would like to keep some of that > though. I think the resident in the city that I spoke to about my patient > just about died when I sent the kid out with a very detailed transfer note > and copies of everything that was done. He was appreciative and I KNOW > what that feels like so I was happy to do it (especially after a really bad > call night as a resident!). Thanks for your input. > > Eve Switzer, M.D. > > >