I can only think of one thing to make Emergency Medicine more burnout inducing than it already is: Making EM physicians be "on call" when they're not working. Ever.
Since >75% of patients presenting to EDs are neither urgent nor emergencies, you're taking "call" not to cover emergencies, but to make sure metrics please hospital administrators.
I had an ED job once where every shift you worked, you were on "call" for volume surges the first few hours before every shift. It was especially soul-crushing, because even though getting called wasn't often, when you were called in, not only did it lengthen your shift 2 or so hours, it guaranteed it was going to be an extra brutal level of volume on top of it combined with being 2 or so hours short on sleep. Also, the call never came for some mass casualty incident or actual unavoidable crisis, but for dealing with volume surges of typical non-emergent patients that weren't sick. It was put in place to prop up an ED that was purposefully staffed short, to get supra-maximal productivity out of the nurses and doctors.
Who said that in EM, "when you're off you're off"?
Yeah. Not true. I learned that one the hard way. I had no SDN at prior that point (well, only in its infancy) to easily read called out specialty myths and recruiting lies.
If EM "call" is getting more prevalent, which its sounds like maybe it is based on these thread comments, I find that very ominous but not surprising. I do like the double-pay idea for any unscheduled shift worked, but that's far from standard.
I proposed on this forum several years ago, having an "Emergency Physician Bill of Rights And Responsibilities To Self " with rules like this to promote EM physician wellness and to reduce burnout (and others such as maximum recommend hours per month, maximum patients/MD/hr, minimum time between changes in circadian rhythms to reduce EP burnout) to be backed up, published by, and at least recommend as specialty standard by ACEP but no one took it seriously, here or anywhere else, so I gave up on it. (I even deleted the post and I just searched for it on the internet archive and it's not there, so it's gone).
Like someone else posted recently, EM leadership is so much in bed with the CMGs, hospital administrators and corporate interests of EM, that anything that might impair the sacred and untouchable ED metrics and patient satisfaction movement, gets and will get, no traction without a massive grassroots revolt.
