555 EM spots did not fill in Match

[collegestud2013]

Nursing school is also extremely competitive as the word is out. The community college programs that are next to free are a bloodsport trying to get in and I know people who take 3-5 years to get into the program even with good scores. That leaves the private programs where you come out with 100k or more in debt. Not insurmountable and about 1x income depending on where you practice but not the free lunch people are mentioning. Similarly, there is a state school PA program that's pretty good near me. They have over 1000 applicants for around 10 slots, just insane. Or you spend 150k or more on a private program and have similar debt struggles.

My wife did dental at USC, and with the ridiculous student loan burdens for them it pushed the graduating students in some not very surprising directions. A good portion went military to get their loans paid off. 4 years for 4 years and most actually liked it, some posts in rural bad areas, others like Camarillo, CA on the beach, Okinawa, Germany were pretty plush. Airforce if you can get in>>>navy/army. My wife just finished her 10 year PSLF after a long string of public health clinics. Some gratifying work in there but max salary of 150 (175k with benefits), but when you include the benefit of programs that pay your loans while working on an income driven repayment plan and then forgive the rest the effective comp becomes 250-400k in public health if it means your loans go away. I suspect the math could be similar for many physician specialties. I don't know any of her peers who were stupid enough to take out the 500k in loans and then take an associate job in a competitive area for 125k.

Student debt sucks and there is really no reason for schools to be this expensive.

Nursing school competitive? Hard to believe considering the ongoing national shortage of bedside nurses (and in many places having to bring in foreign nurses to fill the staffing needs) and it's by no means an easy job. I suppose pay has gone up for them lately to adjust for the supply/demand. I guess its possible that while less nurses want to do inpatient bedside nursing, many more are willing to doing to to fill other nursing roles, or are doing nursing school as direct stepping stone to NP school without ever actually working as an RN. And nursing school, as an undergraduate level degree, should be cheap at many state schools (in many states there's good amount of scholarships at the undergrad level) so loan burden usually isn't as much of an issue at the undergrad level.

Agree that PA school is surprisingly competitive these days, with acceptance rates in low 30s% which is lower than the annual acceptance rate of USMD med schools. And clinical time during PA school is usually more intense than NP school (which have many programs that are mostly online, less clinical hours than PA school, and can even be done by full-time working RNs if spread out over 3 years).

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[Ho0v-man]

Nursing school competitive? Hard to believe considering the ongoing national shortage of bedside nurses (and in many places having to bring in foreign nurses to fill the staffing needs) and it's by no means an easy job. I suppose pay has gone up for them lately to adjust for the supply/demand. I guess its possible that while less nurses want to do inpatient bedside nursing, many more are willing to doing to to fill other nursing roles, or are doing nursing school as direct stepping stone to NP school without ever actually working as an RN. And nursing school, as an undergraduate level degree, should be cheap at many state schools (in many states there's good amount of scholarships at the undergrad level) so loan burden usually isn't as much of an issue at the undergrad level.

Agree that PA school is surprisingly competitive these days, with acceptance rates in low 30s% which is lower than the annual acceptance rate of USMD med schools. And clinical time during PA school is usually more intense than NP school (which have many programs that are mostly online, less clinical hours than PA school, and can even be done by full-time working RNs if spread out over 3 years).

Nursing school is actually competitive. Qualified applicants can sit on a waitlist for a year or two just waiting for a spot to open up. They don’t have a big standardized test like the MCAT to stratify applicants so most places use pre req course grades +\-some institution-specific test that basically just tests for fundamental reading/writing/math knowledge. After that, it’s basically first come/ first served. So it’s really only competitive in an applicants to spots available way.

There’s a national shortage of doctors always talked about too. That doesn’t make med school less competitive so not sure the logic tracks.

I’ve always kind of wondered if there’s really a shortage of nurses though. A lot burn out within 5 years. Unlike most docs, they’re not saddled with hundreds of thousands of dollars of debt. So in addition to pursuing all of the attractive ways out of bedside nursing that pay more for less work, they can just exit healthcare all together pretty easily.

 

[emergentmd]

Not everybody wants to live on 100-300k a yr as an attending for net expenditures. Everybody has a lifestyle that they want to lead; I lead mine and you lead yours. Not giving too detailed info for privacy and personal reasons. Your posts seem to have an unpleasant tone that's all I got to say man.

Attending without children lives on 45-55k a yr.
Had great student loan program through work leading to 210k a yr of net income.
210-45=165k a yr for annual net worth accrual
165*5 yrs=825k.
Graduate with -100k debt after med school thanks to living close to poverty line for yrs (my choice).
825k-100k=725k plus stock/bond gains. These numbers get you somewhat close to 1 million after 5 yrs.

Man, I applaud you for this. I am technically a 1st gen immigrant but in reality 2nd b/c I was so young and had frugality ingrained in me. But man, once I tasted the comfortable life, I just can't go back. Frugality still creeps in now and then but I rather work alittle harder and be able to ski in/ski out, have an Airbnb with beach steps from the patio, have a boat docked on my lake house lift, cleaners coming regularly.

Now, I will say wait until you feel close to FIRE to start such "wasteful" spending which is what I did. But vacation, for me, means relaxing/comfort living and going skiing with 3 kids where we have to find parking/lugging them to the lift is just not my definition of relaxing.

Kudos to you though

 

[miacomet]

Man, I applaud you for this. I am technically a 1st gen immigrant but in reality 2nd b/c I was so young and had frugality ingrained in me. But man, once I tasted the comfortable life, I just can't go back. Frugality still creeps in now and then but I rather work alittle harder and be able to ski in/ski out, have an Airbnb with beach steps from the patio, have a boat docked on my lake house lift, cleaners coming regularly.

Now, I will say wait until you feel close to FIRE to start such "wasteful" spending which is what I did. But vacation, for me, means relaxing/comfort living and going skiing with 3 kids where we have to find parking/lugging them to the lift is just not my definition of relaxing.

Kudos to you though

I applaud you for living in Texas (I believe) despite the difficult weather and lack of outdoors culture and activities in order to build your wealth. Man, once I tasted living in a ski town I could not go back to just a few ski vacations a year

 

[emergentmd]

I applaud you for living in Texas (I believe) despite the difficult weather and lack of outdoors culture and activities in order to build your wealth. Man, once I tasted living in a ski town I could not go back to just a few ski vacations a year

Unless you live in Texas, you don't really know what it is like. Houston/coast I could not due to the hot humid. But Central to north can be hot but typically dry. Get a pool, kids/you will love it. You have garage and Car AC so little exposure to extended heat unless you want to do activities outdoors. Hot summer typically May-sept but the rest of the colder months are great. I prob can't wear shorts 5 dys a year.

I lived in the NE winter/cold and in no way would I ever live there. I rather trade the hot tx heat wearing shorts than the bitter cold winters bundling up in 3 layers any day. Didn't I hear that a new winter system just blew into the NE, and its almost April. No thank you.

 

[miacomet]

Unless you live in Texas, you don't really know what it is like. Houston/coast I could not due to the hot humid. But Central to north can be hot but typically dry. Get a pool, kids/you will love it. You have garage and Car AC so little exposure to extended heat unless you want to do activities outdoors. Hot summer typically May-sept but the rest of the colder months are great. I prob can't wear shorts 5 dys a year.

I lived in the NE winter/cold and in no way would I ever live there. I rather trade the hot tx heat wearing shorts than the bitter cold winters bundling up in 3 layers any day. Didn't I hear that a new winter system just blew into the NE, and its almost April. No thank you.

"So little exposure to extended heat unless you want to do activities outdoors" yep exactly, also no mountains or ocean (the Gulf isn't ocean IMO)- we all sacrifice something, I guess.

 

[Splenda88]

Nursing school is actually competitive. Qualified applicants can sit on a waitlist for a year or two just waiting for a spot to open up. They don’t have a big standardized test like the MCAT to stratify applicants so most places use pre req course grades +\-some institution-specific test that basically just tests for fundamental reading/writing/math knowledge. After that, it’s basically first come/ first served. So it’s really only competitive in an applicants to spots available way.

There’s a national shortage of doctors always talked about too. That doesn’t make med school less competitive so not sure the logic tracks.

I’ve always kind of wondered if there’s really a shortage of nurses though. A lot burn out within 5 years. Unlike most docs, they’re not saddled with hundreds of thousands of dollars of debt. So in addition to pursuing all of the attractive ways out of bedside nursing that pay more for less work, they can just exit healthcare all together pretty easily.

It's competitive to get in at community colleges and state universities. There is a private nursing school in every single corner now like seven eleven.

 

[collegestud2013]

Nursing school is actually competitive. Qualified applicants can sit on a waitlist for a year or two just waiting for a spot to open up. They don’t have a big standardized test like the MCAT to stratify applicants so most places use pre req course grades +\-some institution-specific test that basically just tests for fundamental reading/writing/math knowledge. After that, it’s basically first come/ first served. So it’s really only competitive in an applicants to spots available way.

There’s a national shortage of doctors always talked about too. That doesn’t make med school less competitive so not sure the logic tracks.

I’ve always kind of wondered if there’s really a shortage of nurses though. A lot burn out within 5 years. Unlike most docs, they’re not saddled with hundreds of thousands of dollars of debt. So in addition to pursuing all of the attractive ways out of bedside nursing that pay more for less work, they can just exit healthcare all together pretty easily.

A lot of the talk about national physician shortages tends to be future predictions, largely based on factors like a growing aging population, retirement of baby boomer physicians, and increased physician burnout nowadays. I doubt there's really a physician shortage in the US right now in terms of absolute numbers across the board, but the issue is always about distribution; a lot more want to work as a cosmetic dermatologist in a urban area and not so many want to do rural primary care for the underserved. Government incentives like loan repayment for the latter group are supposed to somewhat offset the distribution issue. And with the rise of NPs and PAs filling many physician roles, the physician shortage right now is even less apparent.

If nursing school is competitive, they should open up more nursing schools to meet supply and demand. Though it seems like for them it may also be more of a distribution issue than absolute shortage of nurses. It seems like very few want to do inpatient bedside nursing long term, and there tends to be high burnout and high turnover for bedside nursing (especially those working night shifts). But everything else they can do, like outpatient nursing, tele-nursing, and even NPs tend to be saturated now.

Even those with $300-400k in loans should be able to pay it off within 5 years of full time attending salary in most specialties if you're frugal. And there are ways out of clinical medicine for burnt out physicians that still make good money. You see it especially talked about here on the EM forum a lot given the high burnout rate for EM. Most of these options involve taking a pay cut initially, but the problem for most physicians is once they're making $300-500k per year, it's not easy to go back to making $100-200k that many non-clinical options probably end up making (at least initially when getting started).

 

[EctopicFetus]

QFT. working 2 FTE in my field as the end is sooner than anyone imagines and no one is safe. Game over in 2030.

I’m EM it is game over before then. We should be pretty fully staffed in 2026 2030 is 10k too many docs different problem than having a doc for every spot (essentially). All the normal places will be full you will only be able to find jobs in BFE or malignant places. No one will pay for locums travel cause they wont need to. I hope i am wrong but i cant see that. 2026 will be a wake up call like this year was in the match. 2028 will be the pit of despair and it will only get worse and worse.

 

[EctopicFetus]

A lot of the talk about national physician shortages tends to be future predictions, largely based on factors like a growing aging population, retirement of baby boomer physicians, and increased physician burnout nowadays. I doubt there's really a physician shortage in the US right now in terms of absolute numbers across the board, but the issue is always about distribution; a lot more want to work as a cosmetic dermatologist in a urban area and not so many want to do rural primary care for the underserved. Government incentives like loan repayment for the latter group are supposed to somewhat offset the distribution issue. And with the rise of NPs and PAs filling many physician roles, the physician shortage right now is even less apparent.

If nursing school is competitive, they should open up more nursing schools to meet supply and demand. Though it seems like for them it may also be more of a distribution issue than absolute shortage of nurses. It seems like very few want to do inpatient bedside nursing long term, and there tends to be high burnout and high turnover for bedside nursing (especially those working night shifts). But everything else they can do, like outpatient nursing, tele-nursing, and even NPs tend to be saturated now.

Even those with $300-400k in loans should be able to pay it off within 5 years of full time attending salary in most specialties if you're frugal. And there are ways out of clinical medicine for burnt out physicians that still make good money. You see it especially talked about here on the EM forum a lot given the high burnout rate for EM. Most of these options involve taking a pay cut initially, but the problem for most physicians is once they're making $300-500k per year, it's not easy to go back to making $100-200k that many non-clinical options probably end up making (at least initially when getting started).

When it takes 6 weeks to see a doc i would argue we have a physician shortage. Call a derm office and see when is their next appt with an actual doctor not a noctor.

 

[RustedFox]

Yeah I saw some
Tweets early on from him. Oh well just more residents to lead us into collapse.

He like, took pictures of his home office and reiterated a bunch of times that HE was the NEW program DIRECTOR #PDing.

I'm read them and was like: "Does this guy thinks he's an Instagram influencer or something?".

Lol.

 

[EctopicFetus]

He like, took pictures of his home office and reiterated a bunch of times that HE was the NEW program DIRECTOR #PDing.

I'm read them and was like: "Does this guy thinks he's an Instagram influencer or something?".

Lol.

Loser.. what a sad thing to do.

 

[BicepsTriceps]

I’m EM it is game over before then. We should be pretty fully staffed in 2026 2030 is 10k too many docs different problem than having a doc for every spot (essentially). All the normal places will be full you will only be able to find jobs in BFE or malignant places. No one will pay for locums travel cause they wont need to. I hope i am wrong but i cant see that. 2026 will be a wake up call like this year was in the match. 2028 will be the pit of despair and it will only get worse and worse.

It seems like once the market is flooded your salaries might plummet or your work environment will become pure hell.

Why not actually do something about it instead of grieving? Like unionizing. Isn't this the best time to unionize to protect your salaries and work environment?

Your collective power as a union will be unstoppable.

 

[RustedFox]

It seems like once the market is flooded your salaries might plummet or your work environment will become pure hell.

Why not actually do something about it instead of grieving? Like unionizing. Isn't this the best time to unionize to protect your salaries and work environment?

Your collective power as a union will be unstoppable.

Lol. Anyone wanna tell him about the union thing?

 

[Saddleshoes]

Nursing school is actually competitive. Qualified applicants can sit on a waitlist for a year or two just waiting for a spot to open up. They don’t have a big standardized test like the MCAT to stratify applicants so most places use pre req course grades +\-some institution-specific test that basically just tests for fundamental reading/writing/math knowledge. After that, it’s basically first come/ first served. So it’s really only competitive in an applicants to spots available way.

There’s a national shortage of doctors always talked about too. That doesn’t make med school less competitive so not sure the logic tracks.

I’ve always kind of wondered if there’s really a shortage of nurses though. A lot burn out within 5 years. Unlike most docs, they’re not saddled with hundreds of thousands of dollars of debt. So in addition to pursuing all of the attractive ways out of bedside nursing that pay more for less work, they can just exit healthcare all together pretty easily.

I can attest to what Ho0v-man is saying.
The community college in my area requires all candidates to nursing program to have completed a CNA program BEFORE they are accepted.

 

[EctopicFetus]

It seems like once the market is flooded your salaries might plummet or your work environment will become pure hell.

Why not actually do something about it instead of grieving? Like unionizing. Isn't this the best time to unionize to protect your salaries and work environment?

Your collective power as a union will be unstoppable.

I am in an SDG. Many of these forces wont impact me. Salaries will plummet and the work environment will get worse for most. The easier the widget is to replace the less we care about it. Unionizing wont work but someone else can take a stab at it. I’m not grieving im just pointing out the future for those more naive or new to this.

 

[miacomet]

I am in an SDG. Many of these forces wont impact me. Salaries will plummet and the work environment will get worse for most. The easier the widget is to replace the less we care about it. Unionizing wont work but someone else can take a stab at it. I’m not grieving im just pointing out the future for those more naive or new to this.

Certainly has worked for nurses- union nurses do very well

 

[EctopicFetus]

Certainly has worked for nurses- union nurses do very well

Yep. There are structural differences. Hard to get around 2 facts. 1) which i think we can get around is we are essentially managers and managers cant unionize. 2) say at a hospital there are 50 ed beds and 300 upstairs beds. For the 50 ed beds which would be a big hospital thats 75k ed visits. You have maybe 20-30 ED docs. That same hospital Has 500 nurses? Maybe more if they have ambulatory care there as well and outpt clinics.

If it is a system they can hand their contracts to 3 different CMGs. 1099s cant really unionize. Docs have long wanted their cake and to eat it too. This is where it has gotten us. I am all for people unionizing. I dont see it happening in a successful manner. Residents yes to some degree. But attendings NFW.

 

[oldtown]

I am in an SDG. Many of these forces wont impact me. Salaries will plummet and the work environment will get worse for most. The easier the widget is to replace the less we care about it. Unionizing wont work but someone else can take a stab at it. I’m not grieving im just pointing out the future for those more naive or new to this.

You think these overall trends don’t affect you because you’re in a good SDG and you are immune, but they do.

If the market is flooded with EP’s and wages go down, then CMG costs go down. That enables them to bid on contacts more competitively. Your SDG may be well ingrained with the hospital, operating without a subsidy, etc. But, a CMG with cheap labor can undercut you by offering to, say, staff the hospitalists without a subsidy from the hospital (most hospitalist contracts are money losers) in exchange for awarding them the ED contract, for example.

A sinking tide lowers all boats, and no one should feel they are immune to these market forces. If a C-Suite is short sighted enough to buy the CMG BS, or if there is a C-Suite change, then all bets are off and no contract is safe.

 

[bravotwozero]

Physicians are moving to unionize: Where and when

Doc unions are starting to happen. As of right now, many EPs, myself included, still have it pretty good in terms on pay and work life balance, enough to not wanna turn over the apple cart.

When that is no longer the case for the vast majority of us, this is going to change, 1099 or not.

Don’t underestimate the power of disgruntled people in large groups who feel they don’t have much to lose. The job shortage will just add more fuel to the fire.

 

[ribdon]

I am honestly tired of hearing EM docs come to the internet and whine helplessly and complain. What exactly are YOU (as an individual), a.) going to to do, b.) HAVE done. If you are on here whining and refuse to actively participate in these organizations that are supposed to be advocating for the specialty then you, TOO, have let this specialty down. Put your money where your mouth is.

Clearly whining has not done anyone any good, why are you guys still doing it if it is not backed by actions. Just a thought. AND yes, you are right, I am tired of doom and gloom of the specialty. DO SOMETHING ABOUT IT!

How:
1. Join ACEP and any other EP organization and become an active member
2. Write to your your law makers
3. If you do get an offer from these CMGs, you make the right decision.
4. The list goes on….

 

[Birdstrike]

He like, took pictures of his home office and reiterated a bunch of times that HE was the NEW program DIRECTOR #PDing.

I'm read them and was like: "Does this guy thinks he's an Instagram influencer or something?".

Lol.

Who is “HE”?

 

[GonnaBeADoc2222]

I am honestly tired of hearing EM docs come to the internet and whine helplessly and complain. What exactly are YOU (as an individual), a.) going to to do, b.) HAVE done. If you are on here whining and refuse to actively participate in these organizations that are supposed to be advocating for the specialty then you, TOO, have let this specialty down. Put your money where your mouth is.

Clearly whining has not done anyone any good, why are you guys still doing it if it is not backed by actions. Just a thought. AND yes, you are right, I am tired of doom and gloom of the specialty. DO SOMETHING ABOUT IT!

How:
1. Join ACEP and any other EP organization and become an active member
2. Write to your your law makers
3. If you do get an offer from these CMGs, you make the right decision.
4. The list goes on….

1) join ACEP he says lol
2) the "law makers" are bought and paid for by inited healthcare and Cigna
3) some people have no choice but to work for a cmg

You may exit now.

 

[Birdstrike]

Fun fact on what happens when physicians go on strike:

“Nonetheless, the literature suggests that reductions in mortality may result from these strikes.”

Doctors' strikes and mortality: a review

 

[FlaminHotER]

I am honestly tired of hearing EM docs come to the internet and whine helplessly and complain. What exactly are YOU (as an individual), a.) going to to do, b.) HAVE done. If you are on here whining and refuse to actively participate in these organizations that are supposed to be advocating for the specialty then you, TOO, have let this specialty down. Put your money where your mouth is.

Clearly whining has not done anyone any good, why are you guys still doing it if it is not backed by actions. Just a thought. AND yes, you are right, I am tired of doom and gloom of the specialty. DO SOMETHING ABOUT IT!

How:
1. Join ACEP and any other EP organization and become an active member
2. Write to your your law makers
3. If you do get an offer from these CMGs, you make the right decision.
4. The list goes on….

I agree with the principle and sentiment

The big discussion here is HOW we become a force for good change in our field.

Death to the CMGs for sure. Not joining/signing with them is a start. Education of the residents is important. Discussing with them the differences between CMG, SDG, and Hospital employed.

Supporting the AAEM lawsuit against envision is another big step. They need the financial backing and $ donations to keep it going

I’m torn between keeping my ACEP membership vs canceling. I want to me a force for change within ACEP but I also feel that ACEP is too far gone and has too much infiltration from the scum that has ruined our field

AAEM is so small with just 8K members vs Acep’s 40K. More of us need to join AAEM and become active

 

[cyanide12345678]

I am honestly tired of hearing EM docs come to the internet and whine helplessly and complain. What exactly are YOU (as an individual), a.) going to to do, b.) HAVE done. If you are on here whining and refuse to actively participate in these organizations that are supposed to be advocating for the specialty then you, TOO, have let this specialty down. Put your money where your mouth is.

Clearly whining has not done anyone any good, why are you guys still doing it if it is not backed by actions. Just a thought. AND yes, you are right, I am tired of doom and gloom of the specialty. DO SOMETHING ABOUT IT!

How:
1. Join ACEP and any other EP organization and become an active member
2. Write to your your law makers
3. If you do get an offer from these CMGs, you make the right decision.
4. The list goes on….

Join acep lol.

I refuse to pay acep fundamentally because they are silent on cmg proliferation.

 

[Franzd'Epinay]

I am honestly tired of hearing EM docs come to the internet and whine helplessly and complain. What exactly are YOU (as an individual), a.) going to to do, b.) HAVE done. If you are on here whining and refuse to actively participate in these organizations that are supposed to be advocating for the specialty then you, TOO, have let this specialty down. Put your money where your mouth is.

Clearly whining has not done anyone any good, why are you guys still doing it if it is not backed by actions. Just a thought. AND yes, you are right, I am tired of doom and gloom of the specialty. DO SOMETHING ABOUT IT!

How:
1. Join ACEP and any other EP organization and become an active member
2. Write to your your law makers
3. If you do get an offer from these CMGs, you make the right decision.
4. The list goes on….

This is a forum for EM docs to talk and complain about the field. No one is forcing you to come here and read the posts.

For the record, complaining in the forum is not mutually exclusive with any of the other things you mentioned.

 

[miacomet]

Yep. There are structural differences. Hard to get around 2 facts. 1) which i think we can get around is we are essentially managers and managers cant unionize. 2) say at a hospital there are 50 ed beds and 300 upstairs beds. For the 50 ed beds which would be a big hospital thats 75k ed visits. You have maybe 20-30 ED docs. That same hospital Has 500 nurses? Maybe more if they have ambulatory care there as well and outpt clinics.

If it is a system they can hand their contracts to 3 different CMGs. 1099s cant really unionize. Docs have long wanted their cake and to eat it too. This is where it has gotten us. I am all for people unionizing. I dont see it happening in a successful manner. Residents yes to some degree. But attendings NFW.

Physicians are unionized in Canada, Aus, with great results. Attendings are unionized in the NYC public hospital system with less stellar results. I don't think it's impossible.
Agreed there are structural differences, and the 1099 issue is huge. But then CMGs legally need to stop treating 1099s as W2s, which no one is enforcing.
The US is a mess for professionals, and this mess is part of a larger mess.

 

[WilcoWorld]

1) join ACEP he says lol
2) the "law makers" are bought and paid for by inited healthcare and Cigna
3) some people have no choice but to work for a cmg

You may exit now.

Join acep lol.

I refuse to pay acep fundamentally because they are silent on cmg proliferation.

Agreed that "join ACEP" is bad advice. But, to the point, can you provide GOOD advice? Critique has it's place, but it won't fix the problem on its own.

 

[cyanide12345678]

Agreed that "join ACEP" is bad advice. But, to the point, can you provide GOOD advice? Critique has it's place, but it won't fix the problem on its own.

I wish i had any good advice other than save, invest, get financially independent as fast as possible and then just coast by becoming part time.

That’s what I’m doing at least.

 

[GonnaBeADoc2222]

I wish i had any good advice other than save, invest, get financially independent as fast as possible and then just coast by becoming part time.

That’s what I’m doing at least.

Save, invest, quit

 

[cyanide12345678]

Save, invest, quit

Thank you for phrasing it more eloquently.

 

[miacomet]

I'd like to hear from the save, invest, quit success stories. Who has actually done this (@emergentmd aside, we know his successes)?
How much did you save?
Do you have a working spouse? How much do they earn?
Married? Kids? How many?
How much did you pay for your house? Is it paid off?
Do you have a second career?

 

[GonnaBeADoc2222]

I'd like to hear from the save, invest, quit success stories. Who has actually done this (@emergentmd aside, we know his successes)?
How much did you save?
Do you have a working spouse? How much do they earn?
Married? Kids? How many?
How much did you pay for your house? Is it paid off?
Do you have a second career?

More of a fantasy at this point for me than a reality.

In realistic terms, I hope to be able to be parttime in the ED by age 45.

 

[RustedFox]

Who is “HE”?

That goofball PD at that Georgia residency.

 

[Brigade4Radiant]

I am honestly tired of hearing EM docs come to the internet and whine helplessly and complain. What exactly are YOU (as an individual), a.) going to to do, b.) HAVE done. If you are on here whining and refuse to actively participate in these organizations that are supposed to be advocating for the specialty then you, TOO, have let this specialty down. Put your money where your mouth is.

Clearly whining has not done anyone any good, why are you guys still doing it if it is not backed by actions. Just a thought. AND yes, you are right, I am tired of doom and gloom of the specialty. DO SOMETHING ABOUT IT!

How:
1. Join ACEP and any other EP organization and become an active member
2. Write to your your law makers
3. If you do get an offer from these CMGs, you make the right decision.
4. The list goes on….

Wow if only all of these would work

1. Lol ACEP is about CMGs lol
2. We do community advocacy but CMGs
3. Yes go to med school and residency and not work.
4. Complaining is actually productive since USACS and med students can avoid making mistakes

 

[emergentmd]

I am honestly tired of hearing EM docs come to the internet and whine helplessly and complain. What exactly are YOU (as an individual), a.) going to to do, b.) HAVE done. If you are on here whining and refuse to actively participate in these organizations that are supposed to be advocating for the specialty then you, TOO, have let this specialty down. Put your money where your mouth is.

Clearly whining has not done anyone any good, why are you guys still doing it if it is not backed by actions. Just a thought. AND yes, you are right, I am tired of doom and gloom of the specialty. DO SOMETHING ABOUT IT!

How:
1. Join ACEP and any other EP organization and become an active member
2. Write to your your law makers
3. If you do get an offer from these CMGs, you make the right decision.
4. The list goes on….

I agree as many specialties and jobs follow the same path. I am sorry to say that trying to fix the system is futile, I may be wrong but the ones who has the money makes the rules. Hospitals/insurance Co hold the money and power.

You can only control what is in your control on the individual level. Make the money, start a business, you can make the rules.

 

[nVictus]

Hospitals/insurance companies do hold all the power and you don't realize it until you're in the system.

There is no solution. They will squeeze everything out of physicians to the detriment of all except their bottom line.

The game plan is to be loud on social media to help each other out, hit your financial goals as fast as possible, and get out.

 

[Brigade4Radiant]

There are laws forbidding doctors frown being CEOs of hospitals because non doctor CEOs couldn’t compete

 

[miacomet]

There are laws forbidding doctors frown being CEOs of hospitals because non doctor CEOs couldn’t compete

What are you talking about? Our CEO is a doc, so are many

 

[miacomet]

I agree as many specialties and jobs follow the same path. I am sorry to say that trying to fix the system is futile, I may be wrong but the ones who has the money makes the rules. Hospitals/insurance Co hold the money and power.

You can only control what is in your control on the individual level. Make the money, start a business, you can make the rules.

Or, leave the country while it's still an option. Canada and Oz have comparable physician salaries and still have openings for EM docs. Higher QOL on many measures, and also better education systems than most of the US.

 

[cyanide12345678]

Or, leave the country while it's still an option. Canada and Oz have comparable physician salaries and still have openings for EM docs. Higher QOL on many measures, and also better education systems than most of the US.

I don’t think emergency medicine training in USA is sufficient for practice in canada. Correct me if I’m wrong.

 

[bravotwozero]

I don’t think emergency medicine training in USA is sufficient for practice in canada. Correct me if I’m wrong.

Depends on the province - BC you’re out of luck, but most anywhere else, as long as you’re a US grad with ACGME residency training and ABEM certification, you can work there.

The pay isn’t comparable IMO, when taking exchange rate and taxes into consideration. Most docs in Canada end up in the 50% income tax bracket.

 

[Mbekweni]

Depends on the province - BC you’re out of luck, but most anywhere else, as long as you’re a US grad with ACGME residency training and ABEM certification, you can work there.

The pay isn’t comparable IMO, when taking exchange rate and taxes into consideration. Most docs in Canada end up in the 50% income tax bracket.

As of November 2022 BC makes it easier to come in if trained in US, UK etc.

B.C. expanding program that offers international doctors a pathway to be licensed

It’s part of a provincial push to get more doctors working across the province where one in five do not have family doctor

www.theglobeandmail.com

 

[EctopicFetus]

You think these overall trends don’t affect you because you’re in a good SDG and you are immune, but they do.

If the market is flooded with EP’s and wages go down, then CMG costs go down. That enables them to bid on contacts more competitively. Your SDG may be well ingrained with the hospital, operating without a subsidy, etc. But, a CMG with cheap labor can undercut you by offering to, say, staff the hospitalists without a subsidy from the hospital (most hospitalist contracts are money losers) in exchange for awarding them the ED contract, for example.

A sinking tide lowers all boats, and no one should feel they are immune to these market forces. If a C-Suite is short sighted enough to buy the CMG BS, or if there is a C-Suite change, then all bets are off and no contract is safe.

Immune to the pay cuts that are coming. Could be an excess of 1k em
Docs by me and my pay doesn’t budge. Not true for cmg or hospital employed docs.

The expansion of cmgs is on hold to say the least. There is always risk and you are right. Hospitalists, icu etc are all a risk. That being said so be it. I can’t fix the market. The market is broken. I’m gonna make sure I can max out my income.

Em is broken as a field and nothing will fix it imo. Best you can do is insulate by being in an sdg.

 

[EctopicFetus]

Join acep lol.

I refuse to pay acep fundamentally because they are silent on cmg proliferation.

Silence would be better than the reality where they are being complicit in the destruction of our specialty and physicians.

 

[coachB]

As of November 2022 BC makes it easier to come in if trained in US, UK etc.

B.C. expanding program that offers international doctors a pathway to be licensed

It’s part of a provincial push to get more doctors working across the province where one in five do not have family doctor

www.theglobeandmail.com

Pretty sure Iooked at this and it doesn't apply to EM.

 

[Brigade4Radiant]

What are you talking about? Our CEO is a doc, so are many

Opinion | End ObamaCare’s Ban on Physician-Owned Hospitals

A little-known Affordable Care Act provision stifles competition and drives Medicare costs up.

www.wsj.com

 

[Mount Asclepius]

There are laws forbidding doctors frown being CEOs of hospitals because non doctor CEOs couldn’t compete

What are you talking about? Our CEO is a doc, so are many

Opinion | End ObamaCare’s Ban on Physician-Owned Hospitals

A little-known Affordable Care Act provision stifles competition and drives Medicare costs up.

www.wsj.com

There's a difference between owning a hospital and being a CEO.

 

[BoardingDoc]

Opinion | End ObamaCare’s Ban on Physician-Owned Hospitals

A little-known Affordable Care Act provision stifles competition and drives Medicare costs up.

www.wsj.com

Being a CEO doesn't mean that you own the hospital. These are two completely unrelated things.