Any EM guys 5-10+ years out who still love what they do?

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Necro "love-tapping" this thread.
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Perrin said:
Kickball league every week. That's why.
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When asked why they selected emergency medicine, 85% of matched applicants noted "extracurricular kickball" as one of their top 5 reasons for choosing the specialty. True story. ;)

I wonder if anyone has the stones to throw that down in an interview?

PD: "So what interests you in emergency medicine?"
Applicant: "Kickball mam, kickball."
PD: "Excuse me?"
Applicant: "You know, like baseball except with a rubber ball. I played club level in undergrad."
PD: "...."
Applicant: "Yeah, some attending on SDN said that they had tons of time for kickball. You know what 'they' say, 'If your favorite place in the hospital is the OR, be an anesthesiologist. If your favorite place in the hospital is the kickball field at the local high school, EM is the way to go.' Something like that. Yeah, yeah, that's what they say."
PD: :uhno:
 
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I'm 6 years out and don't love my job. In fact, if I had $5 Mill in the bank, I would retire and not work any more. Although I don't love the job, I don't hate it, and most shifts are "meh". It's a job, it pays extremely well, allows me to travel, and I have job security. I can't think of any other "mainstream" career that allows this kind of lifestyle.
 
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So is it really possible to have a normal life with a stable marriage and some kids in EM? Or will you end up crying to your wife about not getting enough sleep and creepishly envying her while she's sleeping... Like that guy who wrote that book about EM. I think it's called "something for the pain."
 
The only job I ever "loved" was that summer I spent working for the Sports Illustrated Swimsuit Issue crew, brushing the sand off of the models, after they stood up. I didn't do it for the money, just out of a need to give something back to society.
 
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Birdstrike said:
The only job I ever "loved" was that summer I spent working for the Sports Illustrated Swimsuit Issue crew, brushing the sand off of the models, after they stood up. I didn't do it for the money, just out of a need to give something back to society.
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Did you require counseling afterwards? Seems pretty intense.
 
I guess I just feel like I enjoy it. What it really boils down to is that I do enjoy my job but moreso the comraderie of the guys. Its like residency where I work but we work less, earn more and have less stress.
 
Only enjoy shifts where I have critical dead/nearly dead patients. Resuscitations (not "STEMIs" " or code whatever you call a stroke, " as these are cognitively unsatisfying when you just punt them to whatever service ASAP) are what make me like the gig

Otherwise, sucks.


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5 years out

about to leave a job i have known wasn't for me since i started over 2 yrs ago.

the more i have dealt with "corporate" the more i hate the company... though those who are "their type" seem to love "corporate". if you came from a mediocre residency, enjoy bending over and taking a lot of crud, and want sub-par pay -- i can tell you who to work for!

contemplating how much longer to stay in community EM, though not sure academia would cure my ills.
 
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la gringa said:
5 years out

about to leave a job i have known wasn't for me since i started over 2 yrs ago.

the more i have dealt with "corporate" the more i hate the company... though those who are "their type" seem to love "corporate". if you came from a mediocre residency, enjoy bending over and taking a lot of crud, and want sub-par pay -- i can tell you who to work for!

contemplating how much longer to stay in community EM, though not sure academia would cure my ills.
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Sounds scarily familiar! Best to ya!!


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la gringa said:
5 years out

about to leave a job i have known wasn't for me since i started over 2 yrs ago.

the more i have dealt with "corporate" the more i hate the company... though those who are "their type" seem to love "corporate". if you came from a mediocre residency, enjoy bending over and taking a lot of crud, and want sub-par pay -- i can tell you who to work for!

contemplating how much longer to stay in community EM, though not sure academia would cure my ills.
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Are you screwed if you don't train at Cook County or USC or something?
 
Hercules said:
I think la gringa was alluding to their shop being full of mediocre yes men, but that may not have been the intent.
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Really? It looks pretty clear to me (at least) that she was dinging, well, "mediocre residencies", which I believe is any program that she did not attend (like "who is overpaid? Everyone except you and your spouse"). Hell, my program was mediocre, due to less than average teaching, and low volumes.
 
@JackShephard said:
Any EM guys 5-10+ years out who still love what they do?
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Okay, I'm ready to answer this thread without cryptically quoting awesome, classic rock geniuses.

The answer is,

"No."

Nobody "loves" their job after 5-10 years.

Nobody.

There's two kinds of people in this world,

Type 1-Those that say, "Oh, I'd totally keep working even if I won the $150 powerball. Yeah. Wouldn't quit. Nah, bro. Love it. I'd do it for free, man. Seriously."

And,

Type 2-Honest people.

There's a reason Trip Advisor does not have a vacation section titled, "Click here! for 10 straight days of more WORK"
 
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I genuinely enjoy the work that I do for two big reasons:

1. I like the *medicine*. I really enjoy the look of a nice, crisp EKG, a revealing chest x-ray, the poison-antidote science, and the satisfying 'clunk' of a succesful ortho reduction. That will never get old for me.

2. I like the patients. I'm fortunate enough to serve an elderly population that is very appreciative and involved in their care. That makes a big difference to me.

However... if I hit the powerball... yeah - I'm changing my life drastically. I'd still be involved in medicine somehow, but I wouldn't be grinding out overnight weekend shifts and then yo-yo-ing back 24 hours later for a daybreak shift.

I always say - "Work is work; if it were any different... they'd call it 'batting practice'." (I'm a big baseball guy)

My favorite president Theodore Roosevelt said: "When you play, play hard. When you work, don't play at all."
 
So I've been wrestling around this a lot recently. I think EM is a very rewarding field, not for the "I get to save lives," although that is nice, but its variety.

I love how as an EP, what you see is so diverse, whether it's a retinal detachment, a trauma case, or a patient with full blown septic shock. The fact there are lots of opportunities to do procedures seems really exciting as well. And lastly, working with the really sick patients can be very gratifying too.

For me currently, I've been really trying to get around the "risk of burnout" issue the most. My PI is a younger faculty member so he's pretty excited and energized about everything, but the more weathered EPs seem to be far more jaded and likely burnt out.

As Birdstrike mentioned in another thread, litigation does worry me too, but I wonder if it is just as litigious as other specialties such as some of the surgical ones, or anesthesia, for example. Can't lie, for a moment I've been thinking about family medicine and/or internal, but the people I talk to seem to keep telling me that EM seems to fit my personality the most, so I have no idea what to do. I guess I should just keep chuggin along in my MS3 year and see what comes out in the wash.
 
Depends how you define love. Do I feel the same way about work as I do my wife, kids and family. No.. But Do I sit in my car dreading walking into a shift like one of my attendings told me he did in his community job. Def not.

Its a job.. I never lose sight of that. It allows me to have the financial resources to enjoy my life and family. For that I am thankful.
 
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EctopicFetus said:
But Do I sit in my car dreading walking into a shift like one of my attendings told me he did in his community job...
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So other community EPs feel this way???
;) at least I don't feel so bad


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I think there is some fantasy expectation that we are supposed to love our job and every shift we would have a George Clooney ER moment.

The reality is that it can become monotonous. This truth may be slammed by some unknowing recent grad or resident. Those of us who have been at this a while know it is true. I think it really comes down to what motivates you.

I have some great shifts. I have made some great saves. The job can be challenging. The key for me is I enjoy those I work with. I laugh almost every shift. These things make the time go by. I have a great relationship with certain nurses and techs too. These are the things I focus on.

I have found that those who are burnt out focus on the negative. Do not fool yourselves there is plenty of negativity to be found in each shift. Whether it is nurse call offs, telling someone bad news, seeing the system get abused and knowing as long as you are at work you participate in this wasteful abuse of the system.

For me I compartmentalize those things. Breaking bad news can suck the life out of me. I get mentally prepared to give someone bad news much like I used to focus on things before I had a football game. I visualize the conversation, how it will go etc. I dont get bent out of shape dealing with those who abuse the system or the drug seekers.

I focus on the good I do.
 
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EctopicFetus said:
I think there is some fantasy expectation that we are supposed to love our job and every shift we would have a George Clooney ER moment.

The reality is that it can become monotonous. This truth may be slammed by some unknowing recent grad or resident. Those of us who have been at this a while know it is true. I think it really comes down to what motivates you.

I have some great shifts. I have made some great saves. The job can be challenging. The key for me is I enjoy those I work with. I laugh almost every shift. These things make the time go by. I have a great relationship with certain nurses and techs too. These are the things I focus on.

I have found that those who are burnt out focus on the negative. Do not fool yourselves there is plenty of negativity to be found in each shift. Whether it is nurse call offs, telling someone bad news, seeing the system get abused and knowing as long as you are at work you participate in this wasteful abuse of the system.

For me I compartmentalize those things. Breaking bad news can suck the life out of me. I get mentally prepared to give someone bad news much like I used to focus on things before I had a football game. I visualize the conversation, how it will go etc. I dont get bent out of shape dealing with those who abuse the system or the drug seekers.

I focus on the good I do.
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Good stuff and I couldn't agree more. Your work environment plays a huge role in burn out. If you have a positive environment where everyone laughs and gets along for the most part while working towards a common goal, it makes the job a lot more fun.
 
The importance of being well rested cannot be over estimated, and has a huge effect on that overall ability to keep a positive attitude. Chronic sleep deprivation, and horrible circadian low points can make the wine taste like vinegar. When you're rested and clear headed 100 lbs feels like 10.

Sleep. Rest. Then rest some more.
 
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It's not the breaking bad news that causes the low points. It's being forced to work in a system that is literally as inefficient and depressing as possible. Realizing that most people are selfish and could not care less about their fellow human beings. Being forced into a position where the expectation is "the ER will solve all of my problems and fix my previous bad decisions." Being hung out to dry by administration and corporate interests while they try and get that extra 1% of their bottom line. Having to worry every shift that "the big miss" is about to happen. Arguing with the hospitalist and consultants every time you speak with them...

We are ground zero for the American healthcare crisis. That's why EPs are burned out. It's going to work every shift feeling like Dr. Sisyphus. Most of us are trying to do right for our patients but there are innumerable obstacles in our way. Our sick patients are "obstructed" by the worried well and self-entitled. Our admission and consults told "unnecessary" with argumentative tones. We are seeing higher volumes but don't staff accordingly. Document more but make sure you meet each patient soon after they arrive "like waiters do." We're expected to spend less, do more with less, and miss less. The reason we're burned out is because we're being asked to do the impossible.
 
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erdoc00 said:
It's not the breaking bad news that causes the low points. It's being forced to work in a system that is literally as inefficient and depressing as possible. Realizing that most people are selfish and could not care less about their fellow human beings. Being forced into a position where the expectation is "the ER will solve all of my problems and fix my previous bad decisions." Being hung out to dry by administration and corporate interests while they try and get that extra 1% of their bottom line. Having to worry every shift that "the big miss" is about to happen. Arguing with the hospitalist and consultants every time you speak with them...

We are ground zero for the American healthcare crisis. That's why EPs are burned out. It's going to work every shift feeling like Dr. Sisyphus. Most of us are trying to do right for our patients but there are innumerable obstacles in our way. Our sick patients are "obstructed" by the worried well and self-entitled. Our admission and consults told "unnecessary" with argumentative tones. We are seeing higher volumes but don't staff accordingly. Document more but make sure you meet each patient soon after they arrive "like waiters do." We're expected to spend less, do more with less, and miss less. The reason we're burned out is because we're being asked to do the impossible.
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This is a very distinct reality for a lot of people. I can very much identify with many things in this post. There's not something wrong with you. All of the indignation you feel is justified. It shouldn't be this way, for the people who signed up for one of the hardest jobs there is.
 
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I'm very much ok with the job right now. I'm looking at a couple of months of a schedule that's not stupid and relationship destroying, the new docs we hired seem to be acclimating well, and some changes are about to be implemented that are going to make the day to day shiftwork slightly less lucrative but significantly less stressful. Most of our ability to be comfortable with the job is dependent on our perception. We're running down a balance beam with shifting winds over a spiked pit. The docs who can convince themselves that 4" is more than wide enough do fine.
 
erdoc00 said:
It's not the breaking bad news that causes the low points. It's being forced to work in a system that is literally as inefficient and depressing as possible. Realizing that most people are selfish and could not care less about their fellow human beings. Being forced into a position where the expectation is "the ER will solve all of my problems and fix my previous bad decisions." Being hung out to dry by administration and corporate interests while they try and get that extra 1% of their bottom line. Having to worry every shift that "the big miss" is about to happen. Arguing with the hospitalist and consultants every time you speak with them...

We are ground zero for the American healthcare crisis. That's why EPs are burned out. It's going to work every shift feeling like Dr. Sisyphus. Most of us are trying to do right for our patients but there are innumerable obstacles in our way. Our sick patients are "obstructed" by the worried well and self-entitled. Our admission and consults told "unnecessary" with argumentative tones. We are seeing higher volumes but don't staff accordingly. Document more but make sure you meet each patient soon after they arrive "like waiters do." We're expected to spend less, do more with less, and miss less. The reason we're burned out is because we're being asked to do the impossible.
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Preach on!


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Hercules said:
I think la gringa was alluding to their shop being full of mediocre yes men, but that may not have been the intent.
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well i do mean "yes men" and i also mean people coming from residencies i've never heard of, despite being 5 years out of residency. they're generally DO programs in strange locations.

erdoc00 FTW... "Being hung out to dry by administration and corporate interests while they try and get that extra 1% of their bottom line. " and "Dr Sisyphys". combo of those 2 is toxic. i LOVE being a physician... not always an emergency physician. still not sure what else i would have done though, for the reasons Arcan mentioned above.
 
erdoc00 said:
It's not the breaking bad news that causes the low points. It's being forced to work in a system that is literally as inefficient and depressing as possible. Realizing that most people are selfish and could not care less about their fellow human beings. Being forced into a position where the expectation is "the ER will solve all of my problems and fix my previous bad decisions." Being hung out to dry by administration and corporate interests while they try and get that extra 1% of their bottom line. Having to worry every shift that "the big miss" is about to happen. Arguing with the hospitalist and consultants every time you speak with them...

We are ground zero for the American healthcare crisis. That's why EPs are burned out. It's going to work every shift feeling like Dr. Sisyphus. Most of us are trying to do right for our patients but there are innumerable obstacles in our way. Our sick patients are "obstructed" by the worried well and self-entitled. Our admission and consults told "unnecessary" with argumentative tones. We are seeing higher volumes but don't staff accordingly. Document more but make sure you meet each patient soon after they arrive "like waiters do." We're expected to spend less, do more with less, and miss less. The reason we're burned out is because we're being asked to do the impossible.
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Another comment on this.

ERdoc00- You need to make a change. Life's too short to work under these conditions. Whether it's a new job, new state, cutting your hours, doing a fellowship, changing specialties or leaving medicine altogether, life's too short to feel like this. Refuse to be miserable for anyone or anything. Refuse.
 
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i used to love EM... but watching sloppy physicians who are more "efficient" be rewarded while other skills are not valued is extraordinarily frustrating as a physician who was trained to be excellent. feeling like "corporate" would rather people have 2 mediocre visits than 1 which solves their problem. hey, more $$! didn't have similar issues at my first job out.

then there are the reviews done by nurses, whereas we don't formally or anonymously evaluate them. most are fine but when a nurse writes completely disrespectful and unprofessional "reviews"... good luck trying to defend yourself.

all of that being said - i LOVE taking care of patients, and working with about 90% of nurses and consultants. the other 10% you can do NOTHING about and if they decide to make noise against you... you are the easiest to replace. very demoralizing.
 
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la gringa said:
i used to love EM... but watching sloppy physicians who are more "efficient" be rewarded while other skills are not valued is extraordinarily frustrating as a physician who was trained to be excellent. feeling like "corporate" would rather people have 2 mediocre visits than 1 which solves their problem. hey, more $$! didn't have similar issues at my first job out.

then there are the reviews done by nurses, whereas we don't formally or anonymously evaluate them. most are fine but when a nurse writes completely disrespectful and unprofessional "reviews"... good luck trying to defend yourself.

all of that being said - i LOVE taking care of patients, and working with about 90% of nurses and consultants. the other 10% you can do NOTHING about and if they decide to make noise against you... you are the easiest to replace. very demoralizing.
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These factors no longer apply to only EM. Any hospital employed doctor is subject to the same factors. That is the trend nowadays, in all specialties. It's a very dangerous trend in my opinion. Some of these specialties that had it good in private practice, have no clue how much they're going to get burnt. They're getting offered these sweet deals for the first few years after selling out their practice, they they'll get the screws put to them, with Press-Ganey, metrics and the rest
 
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la gringa said:
i used to love EM... but watching sloppy physicians who are more "efficient" be rewarded while other skills are not valued is extraordinarily frustrating as a physician who was trained to be excellent. feeling like "corporate" would rather people have 2 mediocre visits than 1 which solves their problem. hey, more $$! didn't have similar issues at my first job out.

then there are the reviews done by nurses, whereas we don't formally or anonymously evaluate them. most are fine but when a nurse writes completely disrespectful and unprofessional "reviews"... good luck trying to defend yourself.

all of that being said - i LOVE taking care of patients, and working with about 90% of nurses and consultants. the other 10% you can do NOTHING about and if they decide to make noise against you... you are the easiest to replace. very demoralizing.
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Agree!!



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Its always disheartening to hear my fellow EM docs getting used and abused like just another replaceable part. Personally, I would hope however impractical that we would refuse to work in these conditions. We as a collective have power but while we are under the thumb of the hospital our strength is greatly diminished. I dont have a solution and I hope no matter how unlikely that the pendulum which is now swinging toward silliness like PG, patient sat etc goes away.

I hope those of you who are unhappy can find a job where you feel appreciated, are fairly compensated and can enjoy their career. Personally I have a great job but in my time the overall trend hasnt been positive. That worries me since I am still in the first 20% of my career.
 
i agree ectopic - i think we are about the same age. the larger groups really do treat you like a completely replaceable entity, though they mostly will emphatically state otherwise.

i really wish i hadn't had to leave my first job - though many of the benefits i now know in retrospect. i had to relocate for health and financial reasons and this region's options are even less appealing than the last.

for now - doing IC work while i have great COBRA from my most recent FT gig. don't really want to do that long term but if the $$ is right... i guess anything is possible! trying to figure out my longer-term plan.
 
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