American Emergency Medicine: Hindsight and Advice

[wanderlustin]

So, we all have major issues and concerns with the state of Emergency Medicine in the US. As a 4th year reading about these concerns, I admit, I'm kinda freaked out. The whole idea of practicing "their" EM really worries me--like it may steal my soul. The expectations of thorough/excessive care at bottom dollar prices, the seemingly receding trend away from EBM, our ridiculously litigious society.

I'm on the cusp of becoming a doctor and starting an EM residency here in the US. I hear a lot of people on here complain about American Healthcare, but it seems that we are all powerless or unwilling to change it. Does anyone ever think about leaving medicine or leaving the US for EM in another country? I've read in various posts that the training is so varied across international borders, that it seems a challenge, but I guess I'm wondering with hindsight, does anyone think they would have been happier practicing EM in a different country? Would you have done anything differently as a medical student entering the real world?

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[EM_Rebuilder]

All this legislation effects medicine as a whole and not just EM. I would not let that scare you away from the specialty.....

I am still very much a newbie in all this, but I am extremely satisfied with my career decision. I probably would not consider leaving medicine until my salary was cut in half or even a bit more. I would not be happy about my salary decreasing, but life would still go on. If EM gets cut, so will most likely everything else.....

I would not let uncertain political agendas get in the way of you choosing a specialty..... Nobody knows what the future holds.... And let's face it, the public must have doctors...if our salary decreases too much, we all go home...something WILL change at that point.

You asked specifically about leaving the country... I was born an American and I will stay here and dig ditches before I leave my country....

 

[leorl]

Each country has its problems. The feeling of being underpowered to "fix" the system for the patient's benefit and to increase your sense of efficiency isn't US-specific. I worked briefly for a time in an NHS (UK)-like system and while they have a much larger scope of social/ancillary support, there are definitely things that put you down in daily practice too. I have considered working in Australia (somewhat NHS model), but want to develop a firm practice as an attending before making a move. It would be great if there was someway to meld different systems together... I don't necessarily believe that socialized medicine / NHS can work in this country, but some aspects of their system would definitely improve our ability to care for patients.