Do you enjoy EM or just the lifestyle it affords?

[shishka32]

LOL $75? Nahhh.

It'll most likely be what they are paying PAs + $10-15 give or take while the CMG dudes and administration take a cut out of your check every month.

Hospitals are a business after all. Get ready to lube up because this EM bubble is finna burst soon son!

I though PA's made about $50-60 an hour but I honestly don't know. I am somewhat worried there is a bubble and I would be entering the job market just as it bursts.

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[emergentmd]

I would answer, "Both." to the original poster's question. I genuinely enjoy EM for the most part and love the lifestyle.

Currently 2 hrs away from being done with a 5 night stretch. Single coverage, community ED. Tonight had a GI bleeder w/ an INR >15 hct 19, a DKAer w/ AMS, HR 150, and ph 6.8, and a uroseptic pt w/o IV access BP 70/30 all come in at the same time. Dispo'd them all to the ICU down the road in around an hour, made a 3 y/o w/ a bad lip lac look great, hematoma blocked and reduced a displaced MC fx in like 15 minutes, played anesthesiologist and orthopaedist for a slightly more difficult than usual shoulder dislocation, and had a lady literally cry tears of joy when she finally had pain relief from her dry socket after paste and an inferior alveolar block. Never consulted anyone or needed help other than an accepting physician for the ICU patients.

Oh yeah, and managed to get about 2 hours of sleep while getting paid. Worked with a bunch of great people and to be honest, it was actually kind of fun..

Also make a couple hundred thousand dollars more than most of my friends and have about 3x the time off.

No job is perfect but even at my middle-of-the-road CMG job it seems kind of ridiculous to complain..

Sounds like a common day for me too but without the transfers. I think if EM docs were honest with themselves, it would drive them nuts working 8-5 making 250k/yr and having 2-3 wks off a year. I know I would.
And the hospital based docs (gas, rad, OB, Surg) all work more hours, on call, and make less per hr. Next time you see an OB doc on call, ask him what he did before call. And Ask him what he did after call. The answer is seeing pts in clinic. I did my 30+ hr straight in residency, I would never want to repeat this again.

 

[emergentmd]

I though PA's made about $50-60 an hour but I honestly don't know. I am somewhat worried there is a bubble and I would be entering the job market just as it bursts.

50+ an hr is the bottom end. I know some making 100/hr.

 

[TheOther]

I though PA's made about $50-60 an hour but I honestly don't know. I am somewhat worried there is a bubble and I would be entering the job market just as it bursts.

You can't let the fear of job market changes dictate what you go into. Example: despite the "hell > primary care" and fear of NP/PA crap on SDN, a good friend of mine is making 200k/yr as an FM doc in the midwest, works 4 days a week with pretty stable hours, and is really happy. In our 30-40 years of practice, there are so many factors that can make a field go to ****: regulations, billing, mid-levels (eg. cRNAs), etc. You'll drive yourself mad trying to predict how it all pans out.

If this is really what you're afraid of and can't help but let it influence your decision on specialty, you can also go crazy niche. Or psych.

 

[DetectiveAlonzo]

You can't let the fear of job market changes dictate what you go into. Example: despite the "hell > primary care" and fear of NP/PA crap on SDN, a good friend of mine is making 200k/yr as an FM doc in the midwest, works 4 days a week with pretty stable hours, and is really happy. In our 30-40 years of practice, there are so many factors that can make a field go to ****: regulations, billing, mid-levels (eg. cRNAs), etc. You'll drive yourself mad trying to predict how it all pans out.

If this is really what you're afraid of and can't help but let it influence your decision on specialty, you can also go crazy niche. Or psych.

Or don't pursue medicine at all.

It's about actually loving what you do or TOLERATING what you hate.

Lifestyle always changes. I don't get how med students don't understand this.

 

[TheOther]

Or don't pursue medicine at all.

It's about actually loving what you do or TOLERATING what you hate.

Lifestyle always changes. I don't get how med students don't understand this.

Dude, I'm going to be real with you -- you don't sound nearly as "chill" as you self-proclaim yourself to be. Your posts come off very condescending.

From what I've gathered, it seems like you're an older, non-trad med student like me. The reality is, most med student are not. In fact, I'd venture to guess that a majority of med students are neurotic (guilty) 22-25 years old who've never held a real job in their lives and have no framework to base their perception of the physician job market off of.

Again, a lot of your points are valid. But you could try to sound like less of a jerk getting those points across.

 

[Strider_91]

The emergency medicine thread is by far the most entertaining specialty thread on SDN and for that reason alone EM is going on the short list


....can't even look at derm without falling asleep

 

[FootballFoot]

I've come to the realization that I would not have chosen EM if I had to do this over again. Everyone is different and there is no right answer, but I personally find EM to be (1) too stressful, (2) too irregular schedule-wise, and (3) not rewarding enough.

Tomorrow I have a Monday evening shift, and I am absolutely dreading it.

What field would you have chosen instead (assuming derm is off the list)?

 

[DetectiveAlonzo]

Dude, I'm going to be real with you -- you don't sound nearly as "chill" as you self-proclaim yourself to be. Your posts come off very condescending.

From what I've gathered, it seems like you're an older, non-trad med student like me. The reality is, most med student are not. In fact, I'd venture to guess that a majority of med students are neurotic (guilty) 22-25 years old who've never held a real job in their lives and have no framework to base their perception of the physician job market off of.

Again, a lot of your points are valid. But you could try to sound like less of a jerk getting those points across.

Which is the problem with many of these young cats... that is why they will be getting owned when it comes to the real world.

Can't handle my truth over text on the internet? Wait til y'all get bitched at by an attending on rotations. I can't wait lol

Take my tone however you want bro. I'm jus' chillin' sippin on my PSL like a basic bish.

 

[shishka32]

I'm not sure if you guys are referring to me or not, but I'm actually in my late 20's with a family. I worked for four years after graduation in jobs I hated. I also worked anywhere from 25-50 hours a week in high school and college. I know a thing or two about working a job, which is exactly why I'm asking those that have been through the EM path their opinion on the future of the field.

 

[TheOther]

I'm not sure if you guys are referring to me or not, but I'm actually in my late 20's with a family. I worked for four years after graduation in jobs I hated. I also worked anywhere from 25-50 hours a week in high school and college. I know a thing or two about working a job, which is exactly why I'm asking those that have been through the EM path their opinion on the future of the field.

No, not you specifically. I have no idea who you are so I'd have no reason to target you. I'm speaking about the demographic I see at my school and talking with friends at other schools.

But nonetheless, I'm pretty sure the EM docs will tell you the same thing. They can't predict the future of the field any more than you can.
Example 1: the cries of cRNAs taking over every anesthesiologist's job has been going on for 15-20 years, yet there seem to be plenty of jobs on gasworks with solid pay.
Example 2: the explosion of radiology residency spots made a huge impact on their job market in the last decade.

It's a fluid market with government regulations expanding and constantly changing the game of medicine.
For now, EM seems pretty stable. In 10, 20 years? Who knows.

 

[alpinism]

If the idea of working in a hyper expensive urgent care clinic that dabbles in emergency medicine from time to time sounds appealing then you'll probably love EM.

The future will probably consist of more emphasis on customer service and less emphasis on patient care.

Patient satisfaction, efficiency, and flow are the benchmarks of a great "EM doctor" these days.

 

[DetectiveAlonzo]

If the idea of working in a hyper expensive urgent care clinic that dabbles in emergency medicine from time to time sounds appealing then you'll probably love EM.

The future will probably consist of more emphasis on customer service and less emphasis on patient care.

Patient satisfaction, efficiency, and flow are the benchmarks of a great "EM doctor" these days.

Couldn't have said it any better.

Be careful... people will get butthurt lolz

 

[GeneralVeers]

If the idea of working in a hyper expensive urgent care clinic that dabbles in emergency medicine from time to time sounds appealing then you'll probably love EM.

The future will probably consist of more emphasis on customer service and less emphasis on patient care.

Patient satisfaction, efficiency, and flow are the benchmarks of a great "EM doctor" these days.

I have no problem with this as long as they pay well.

 

[DetectiveAlonzo]

I have no problem with this as long as they pay well.

That's what I'm talking about!

 

[Angry Birds]

What field would you have chosen instead (assuming derm is off the list)?

I don't know. I'd have to really think about it. Maybe Endo. I dunno, something super chill, where I could become a master of my domain. I realize now that my medical student assessment was all wrong. I had thought EM was fun because of all the variety and fast pace, and Endo was mind-numbingly boring: to me, it seemed like Endo really only focused on five diseases--or maybe even just diabetes--how boring! But now I realize that enjoyment as an attending may not come from pathology, acuity, variety or volume. Rather, it comes from the patient-physician interaction, the clinical encounter. So, I'd rather be a dentist or an endo doctor, who sees a patient in the clinic for something, and then enjoy that patient-physician interaction, i.e. "how's it going? how are the kids? etc." rather than take any enjoyment from how sick patients are.

I'd appreciate being the master of my domain, knowing those few disease states inside out...instead of constantly having to look things up or consult for help.

Additionally, now I realized I was a fool for not liking the 9-5 schedule and thinking that EM would be better, ha!

I don't know if it would be Endo I'd pick... I'm not sure. But something where I could have all the things above, and especially one where I wouldn't feel nervous the night before or in the parking lot before coming to work.

 

[dchristismi]

I'd appreciate being the master of my domain, knowing those few disease states inside out...instead of constantly having to look things up or consult for help.

I suspect our answers will vary a great deal depending on a lot of factors... (including how many shifts worked in a row, how tired we are, and how long since last vacation.)

I AM the MASTER of my domain... because I had 8+ critical patients today, septic shock left and right, strokes, codes, disaster-city. Intubated a 24 yo in septic shock right before I left. And I am the master of disaster. (Or so they say.) So I didn't know exactly why my newly-diagnosed cirrhotic (who is my age) has a hgb of 3. So what. I recognized, stabilized and fixed what I could.

Now, catch me after a back-pain-fibro-storm sort of shift, (and perhaps less wine) and I'd probably bitch that I should have gone into derm. Or anything but EM. (Hell, ask me tomorrow after what will surely be a doozy of a night shift, and you might get a very different answer.)


Oh, and FWIW, I worked a hellish job between college and med school - lots of travel, horrible long hours, for... 8.50/hr. I still have an old paycheck (with about 20 hours of overtime) that I look back at every so often. I make more than that in 1 shift now. And I think, damn, I'm glad I'm not doing that anymore. I had some dark days in residency, and had been battling a lot of burnout - and perspective really does help.

 

[RustedFox]

I don't know if it would be Endo I'd pick... I'm not sure. But something where I could have all the things above, and especially one where I wouldn't feel nervous the night before or in the parking lot before coming to work.

If you're tachy and hypertensive in the hospital parking lot prior to your shift.... then something is wrong with your job/work environment. Time for a new gig, amigo.

 

[emergentmd]

You can't let the fear of job market changes dictate what you go into. Example: despite the "hell > primary care" and fear of NP/PA crap on SDN, a good friend of mine is making 200k/yr as an FM doc in the midwest, works 4 days a week with pretty stable hours, and is really happy. In our 30-40 years of practice, there are so many factors that can make a field go to ****: regulations, billing, mid-levels (eg. cRNAs), etc. You'll drive yourself mad trying to predict how it all pans out.

If this is really what you're afraid of and can't help but let it influence your decision on specialty, you can also go crazy niche. Or psych.

I wou

I don't know. I'd have to really think about it. Maybe Endo. I dunno, something super chill, where I could become a master of my domain. I realize now that my medical student assessment was all wrong. I had thought EM was fun because of all the variety and fast pace, and Endo was mind-numbingly boring: to me, it seemed like Endo really only focused on five diseases--or maybe even just diabetes--how boring! But now I realize that enjoyment as an attending may not come from pathology, acuity, variety or volume. Rather, it comes from the patient-physician interaction, the clinical encounter. So, I'd rather be a dentist or an endo doctor, who sees a patient in the clinic for something, and then enjoy that patient-physician interaction, i.e. "how's it going? how are the kids? etc." rather than take any enjoyment from how sick patients are.

I'd appreciate being the master of my domain, knowing those few disease states inside out...instead of constantly having to look things up or consult for help.

Additionally, now I realized I was a fool for not liking the 9-5 schedule and thinking that EM would be better, ha!

I don't know if it would be Endo I'd pick... I'm not sure. But something where I could have all the things above, and especially one where I wouldn't feel nervous the night before or in the parking lot before coming to work.

I have great respect for your perspective eventhough it is a neg view of EM. I have worked in the busy of busiest EDs and never lost sleep at night/sat in my car stressing out before walking in. I think you just picked the wrong field, which many do. Good thing for you is EM allows you to have many options for easier work where you can do a 9-5 schedule seeing generally healthy patients.

 

[gutonc]

If you're tachy and hypertensive in the hospital parking lot prior to your shift.... then something is wrong with your job/work environment. Time for a new gig, amigo.

Could be the job. Could be the career.

It's a whole lot easier to change the job right now.

 

[FootballFoot]

I don't know. I'd have to really think about it. Maybe Endo. I dunno, something super chill, where I could become a master of my domain. I realize now that my medical student assessment was all wrong. I had thought EM was fun because of all the variety and fast pace, and Endo was mind-numbingly boring: to me, it seemed like Endo really only focused on five diseases--or maybe even just diabetes--how boring! But now I realize that enjoyment as an attending may not come from pathology, acuity, variety or volume. Rather, it comes from the patient-physician interaction, the clinical encounter. So, I'd rather be a dentist or an endo doctor, who sees a patient in the clinic for something, and then enjoy that patient-physician interaction, i.e. "how's it going? how are the kids? etc." rather than take any enjoyment from how sick patients are.

I'd appreciate being the master of my domain, knowing those few disease states inside out...instead of constantly having to look things up or consult for help.

Additionally, now I realized I was a fool for not liking the 9-5 schedule and thinking that EM would be better, ha!

I don't know if it would be Endo I'd pick... I'm not sure. But something where I could have all the things above, and especially one where I wouldn't feel nervous the night before or in the parking lot before coming to work.

Thank you for your honest response.

My line of thinking is very close to your past med student assessment, and it's pretty frightening to hear of your situation.

I really hope you find a more tolerable position.

 

[Arcan57]

Thank you for your honest response.

My line of thinking is very close to your past med student assessment, and it's pretty frightening to hear of your situation.

I really hope you find a more tolerable position.

Most EM physicians don't worry routinely going into their shift. That's not that being worried/stressed out is an inappropriate response to what we are asked to do, it's just not the response of most EM physicians who enjoy a long term successful career working clinically. The perception of risk is so subjective that it really is a matter of viewpoint regarding what is/isn't tolerable. Very few of us have ideal nursing/ancillary resources, a complete call panel staffed with physicians who's first priority is your patient, a completely trust-worthy patient population, and physician staffing that allows us to not stress about volume while at the same time be completely satisfied with our paycheck. Most of us understand the lack but are able to redirect those thoughts by focusing on the litany of our past successes. Sometimes things happen that strip away that buffer and suddenly what you used to do everyday without a problem becomes completely intolerable. As posters above have mentioned, there are other (typically less lucrative but not always) careers available that don't include the chaos that defines our practice setting. If it helps, I've known all sorts of EM docs that stepped away from the department but don't know any that've committed suicide.

 

[canigetawhatwhat]

I love my job.

Best job in world.

Seriously, if i could take any of it back, I wouldnt.

Young attending btw

 

[GeneralVeers]

I love my job.

Best job in world.

Seriously, if i could take any of it back, I wouldnt.

Young attending btw

This will change. Both your youth and positivism.

 

[RustedFox]

This will change. Both your youth and positivism.

Yep. First year out - I had the "best job in the world", too.

 

[Angry Birds]

I think my statements may convey a hyperbolic view of my feeling before work. It is only a mild sense of nervousness I get. I was speaking to a colleague who has worked as an ER doctor for 30 years and is now retiring. He said that feeling never goes away. Maybe not everyone feels it. I'm not saying I get tachycardic and diaphoretic. Just a little bit nervous due to (1) how at some point in time in the shift crap hits the fan and (2) at that moment, when the ER is exploding around you, a crashing patient comes in, your mind is in seven places at once, and now you are dealing with life and death.

Having said all of that, I think I not only picked the wrong specialty for myself, but even the wrong career (i.e. medicine overall). Fortunately, I have a viable career plan that will allow me to minimize clinical work load (and focus on research, teaching, etc.), and also, I am not a weak ER doctor. If I were, things would have been much worse.

 

[WilcoWorld]

For any ER doc who judges him or herself for getting worn down by the job, I'd highly recommend reading Frank Huyler's The Blood of Strangers. Here's a sample: https://www.theguardian.com/books/2001/jan/06/extract

A couple years back I felt bad about feeling bad about my job. I read this book and it helped me to see that, in fact, EM is an incredibly hard job, and this allowed me to stop judging myself for feeling worn down by it. The job is still tough, but now that I allow myself to recognize that, I can handle the toughness much better.

 

[DetectiveAlonzo]

How much liability is there for you EM dudes? The ED seems like a nasty place and quick way to get a malpractice case for some reason dealing with all those patients and on a timely manner..?

 

[Doctor_Strange]

For any ER doc who judges him or herself for getting worn down by the job, I'd highly recommend reading Frank Huyler's The Blood of Strangers. Here's a sample: https://www.theguardian.com/books/2001/jan/06/extract

A couple years back I felt bad about feeling bad about my job. I read this book and it helped me to see that, in fact, EM is an incredibly hard job, and this allowed me to stop judging myself for feeling worn down by it. The job is still tough, but now that I allow myself to recognize that, I can handle the toughness much better.

The EM doc I shadowed told me that reading this book would give me a clearer idea of whether or not to I would like EM and, if anything, it made me more aware of the emotional, physical, and personal toll that EM docs endure which likely are not apparent during a rotation (the book absolutely turned me off to neurosurgery lol). Still, I enjoyed the 30 or so hours I shadowed him at a university hospital, but reading this thread does give me pause to continue learning more about EM before I begin med school. Any other good book recommendations?

 

[hundreddaysoff]

The EM doc I shadowed told me that reading this book would give me a clearer idea of whether or not to I would like EM and, if anything, it made me more aware of the emotional, physical, and personal toll that EM docs endure which likely are not apparent during a rotation (the book absolutely turned me off to neurosurgery lol). Still, I enjoyed the 30 or so hours I shadowed him at a university hospital, but reading this thread does give me pause to continue learning more about EM before I begin med school. Any other good book recommendations?

Just reading lots and lots and lots of SDN archives is the main thing that helped me go into it with eyes open.

 

[shoal007]

How much liability is there for you EM dudes? The ED seems like a nasty place and quick way to get a malpractice case for some reason dealing with all those patients and on a timely manner..?

yup very easy to get sued depending on the legal enviornment. certain states far worse then others.

Sent from my VS986 using Tapatalk

 

[TooMuchResearch]

How much liability is there for you EM dudes? The ED seems like a nasty place and quick way to get a malpractice case for some reason dealing with all those patients and on a timely manner..?

Overall liability is above average but not near the highest.

 

[FootballFoot]

Most EM physicians don't worry routinely going into their shift. That's not that being worried/stressed out is an inappropriate response to what we are asked to do, it's just not the response of most EM physicians who enjoy a long term successful career working clinically. The perception of risk is so subjective that it really is a matter of viewpoint regarding what is/isn't tolerable. Very few of us have ideal nursing/ancillary resources, a complete call panel staffed with physicians who's first priority is your patient, a completely trust-worthy patient population, and physician staffing that allows us to not stress about volume while at the same time be completely satisfied with our paycheck. Most of us understand the lack but are able to redirect those thoughts by focusing on the litany of our past successes. Sometimes things happen that strip away that buffer and suddenly what you used to do everyday without a problem becomes completely intolerable. As posters above have mentioned, there are other (typically less lucrative but not always) careers available that don't include the chaos that defines our practice setting. If it helps, I've known all sorts of EM docs that stepped away from the department but don't know any that've committed suicide.

Thank you.

From your experience, is it common for EM physicians to want to step away from the department? Are people still energized by the work 10, 20 years into their career? What other paths do they go into? Urgent care? I have seen some posts on here saying that urgent care is even more unpleasant than the ED.

 

[FootballFoot]

It also seems like EM is trending towards CMG takeover with worse conditions for the physicians. 8+ years down the line, do you all think that salaries will get cut and hours will be increased? Do you think that the market will be saturated with all the increased interest in EM as a supposed "lifestyle" specialty? Is there a trend of residency spots opening up unsustainably?

 

[DetectiveAlonzo]

It also seems like EM is trending towards CMG takeover with worse conditions for the physicians. 8+ years down the line, do you all think that salaries will get cut and hours will be increased? Do you think that the market will be saturated with all the increased interest in EM as a supposed "lifestyle" specialty? Is there a trend of residency spots opening up unsustainably?

Nobody can answer this but thanks to that douchecanoe Obama, all of medicine will take salary hits... everybody currently is.

What happens when you make less per hour worked? You work more hours... or you deal with it. Such is life.

OR you absolutely love your job and will do it for whatever they pay you besides wondering when your next day off is.

If you are only interested in EM for shift work and $ per hour... you are in for an awakening.

Seeing that you are pre-med... I wouldn't even be considering the burden and hassle for 6-7+ years with a $250K loan on your head.

Only go down this path if you REALLY REALLY REALLLLLYYYY want to. You have been warned.

 

[GeneralVeers]

Nobody can answer this but thanks to that douchecanoe Obama, all of medicine will take salary hits... everybody currently is.

What happens when you make less per hour worked? You work more hours... or you deal with it. Such is life.

I dislike Obama's policies as much as anyone, but in EM it is certainly not true. I'm making twice as much as I used to make pre-Obama. Although he has had disruptive policies, we are making more due to other factors, like Freestanding EDs, and the nationwide shortage of EPs.

 

[Got Em]

Nobody can answer this but thanks to that douchecanoe Obama, all of medicine will take salary hits... everybody currently is.

This is absolutely not true. Obamacare has been in effect for 6 years already. In fact, most specialties have had increases in their salary over the past few years, especially Emergency Medicine.

"Obamacare" is such a vague/horrible term that often confuses the public. The Affordable Care Act basically created systems for more insured patients with the theory that costs will come down (remains to be seen). However, how most physicians get paid doesn't have anything to do with ACA. ACA created measures and rules for Medicare/Medicaid and some private insurers with payment criteria/rules that affects healthcare systems and hospitals.

Most physicians are employed. Since hospitals/clinics in general are making more money (or staying the same), physician salaries have not decreased. For private physicians, they bill more and get paid less if compared to 10-20 years ago, but this is not due to ACA. It's due to the pre-determined rates set by insurers such as Medicare/Medicaid and private companies.

 

[uhhhh]

I don't know. I'd have to really think about it. Maybe Endo. I dunno, something super chill, where I could become a master of my domain. I realize now that my medical student assessment was all wrong. I had thought EM was fun because of all the variety and fast pace, and Endo was mind-numbingly boring: to me, it seemed like Endo really only focused on five diseases--or maybe even just diabetes--how boring! But now I realize that enjoyment as an attending may not come from pathology, acuity, variety or volume. Rather, it comes from the patient-physician interaction, the clinical encounter. So, I'd rather be a dentist or an endo doctor, who sees a patient in the clinic for something, and then enjoy that patient-physician interaction, i.e. "how's it going? how are the kids? etc." rather than take any enjoyment from how sick patients are.

I'd appreciate being the master of my domain, knowing those few disease states inside out...instead of constantly having to look things up or consult for help.

Additionally, now I realized I was a fool for not liking the 9-5 schedule and thinking that EM would be better, ha!

I don't know if it would be Endo I'd pick... I'm not sure. But something where I could have all the things above, and especially one where I wouldn't feel nervous the night before or in the parking lot before coming to work.

If I were to have to do medicine again, I'd switch to either ENT or GI. I also would not consult for the ER. Good mix of clinic and procedures. Good pay. I agree with all your points.

 

[BJJVP]

I don't know. I'd have to really think about it. Maybe Endo. I dunno, something super chill, where I could become a master of my domain. I realize now that my medical student assessment was all wrong. I had thought EM was fun because of all the variety and fast pace, and Endo was mind-numbingly boring: to me, it seemed like Endo really only focused on five diseases--or maybe even just diabetes--how boring! But now I realize that enjoyment as an attending may not come from pathology, acuity, variety or volume. Rather, it comes from the patient-physician interaction, the clinical encounter. So, I'd rather be a dentist or an endo doctor, who sees a patient in the clinic for something, and then enjoy that patient-physician interaction, i.e. "how's it going? how are the kids? etc." rather than take any enjoyment from how sick patients are.

I'd appreciate being the master of my domain, knowing those few disease states inside out...instead of constantly having to look things up or consult for help.

Additionally, now I realized I was a fool for not liking the 9-5 schedule and thinking that EM would be better, ha!

I don't know if it would be Endo I'd pick... I'm not sure. But something where I could have all the things above, and especially one where I wouldn't feel nervous the night before or in the parking lot before coming to work.

The low level of anxiety has never gone away completely for me either and I completely agree with Angry Bird's post. It is almost scary because it's almost as if I wrote it myself. I've thought about sports medicine (primary care) as a late career alternative.

HOWEVER, when I've had some time off from work, AND I think long and hard about it, I do have to admit that I would probably be unhappy with another field as well...just in a different way. I would probably complain about how I get the same boring patients day after day and nobody is truly sick. Everything has to be done in 15 minutes or less. I would hate being called by the ER. I would hate that I have to be at work 5 days a week. I would probably be out of shape and pick up my kids from school far less often and I would probably be less involved as a parent. Also, I would likely be stuck to a job, not likely to be a solo practitioner who owns my own practice. I would probably work for Kaiser or some other large medical entity. I would be pissed about something an administrator or the government wants. At least this is what I tell myself....that the grass isn't necessarily greener. But who knows?

But that anxiety though....it can't be good for me.

Having said all of that, I think I not only picked the wrong specialty for myself, but even the wrong career (i.e. medicine overall). Fortunately, I have a viable career plan that will allow me to minimize clinical work load (and focus on research, teaching, etc.), and also, I am not a weak ER doctor. If I were, things would have been much worse.

I am not a weak ER doctor either. The fact that you, I and a lot of others always feel we have to put that out there whenever we report distaste for the ER speaks volumes.

 

[DetectiveAlonzo]

This is absolutely not true. Obamacare has been in effect for 6 years already. In fact, most specialties have had increases in their salary over the past few years, especially Emergency Medicine.

"Obamacare" is such a vague/horrible term that often confuses the public. The Affordable Care Act basically created systems for more insured patients with the theory that costs will come down (remains to be seen). However, how most physicians get paid doesn't have anything to do with ACA. ACA created measures and rules for Medicare/Medicaid and some private insurers with payment criteria/rules that affects healthcare systems and hospitals.

Most physicians are employed. Since hospitals/clinics in general are making more money (or staying the same), physician salaries have not decreased. For private physicians, they bill more and get paid less if compared to 10-20 years ago, but this is not due to ACA. It's due to the pre-determined rates set by insurers such as Medicare/Medicaid and private companies.

For now.

 

[Old_Mil]

Your profile says that you're a pre-med, though. At this stage of the game, you are best served by figuring out whether you really like medicine or not enough to commit to it for 7 years (minimum) and 200,000 USD.

Pssst.

I can hear your thoughts.

You're thinking: "Pffft. Sure, I do. I like it enough."

If you haven't spent at least 2-3 months in heavy exposure, then you have no idea.

I made this mistake. Hard. I volunteered/shadowed for "like a month or so".

Reality is far, far different than what you think it might be.

Listen to this. It is probably the best advice you are going to get as a premed.

Monday, go to your advisor's office and change your major.

 

[Angry Birds]

I think my statements may convey a hyperbolic view of my feeling before work. It is only a mild sense of nervousness I get. I was speaking to a colleague who has worked as an ER doctor for 30 years and is now retiring. He said that feeling never goes away. Maybe not everyone feels it. I'm not saying I get tachycardic and diaphoretic. Just a little bit nervous due to (1) how at some point in time in the shift crap hits the fan and (2) at that moment, when the ER is exploding around you, a crashing patient comes in, your mind is in seven places at once, and now you are dealing with life and death.

Having said all of that, I think I not only picked the wrong specialty for myself, but even the wrong career (i.e. medicine overall). Fortunately, I have a viable career plan that will allow me to minimize clinical work load (and focus on research, teaching, etc.), and also, I am not a weak ER doctor. If I were, things would have been much worse.

Wow, I'm reading this post of mine from a couple years back. Gotta say I feel a bit differently now. I realize now that I was feeling that way due to the working conditions of my job at the time. (Incidentally, that shop has since shut down and been taken over by another group--that's how bad it was.) I've since moved on and felt much happier. I specifically chose a place with lower volume and acuity. This really improved my happiness level, and I don't have any level of anxiety at work any more.

Looking back at it, I can guess why I felt that way in 2016: (1) the place I worked in was a zoo, and (2) Despite what I thought then, I still hadn't reached my peak performance and clinical acumen. I've felt I've become a much better doctor in the last couple years... I've heard it takes five years out of residency to reach that peak, and I'm one year away from that mark... Also, (3) I made sure to negotiate a good salary, and for once, I feel adequately compensated for my efforts.

Bottom line is: Even though I *still* wouldn't have gone into medicine if I had to do it all over again, I am now in a much better place in life... and happy.

My advice to people is this: you have a lot of freedom and flexibility as an ER doctor. Take advantage of that. Find what works for you. For me, working in a rural ER as my primary gig has increased my happiness level. If you want to see 3 pt's/hr at an urban Level 1 trauma center, by all means... But, consider all your possibilities, including packing up and moving if need be. Find that sweet spot.

 

[Tenk]

Wow, I'm reading this post of mine from a couple years back. Gotta say I feel a bit differently now. I realize now that I was feeling that way due to the working conditions of my job at the time. (Incidentally, that shop has since shut down and been taken over by another group--that's how bad it was.) I've since moved on and felt much happier. I specifically chose a place with lower volume and acuity. This really improved my happiness level, and I don't have any level of anxiety at work any more.

Looking back at it, I can guess why I felt that way in 2016: (1) the place I worked in was a zoo, and (2) Despite what I thought then, I still hadn't reached my peak performance and clinical acumen. I've felt I've become a much better doctor in the last couple years... I've heard it takes five years out of residency to reach that peak, and I'm one year away from that mark... Also, (3) I made sure to negotiate a good salary, and for once, I feel adequately compensated for my efforts.

Bottom line is: Even though I *still* wouldn't have gone into medicine if I had to do it all over again, I am now in a much better place in life... and happy.

My advice to people is this: you have a lot of freedom and flexibility as an ER doctor. Take advantage of that. Find what works for you. For me, working in a rural ER as my primary gig has increased my happiness level. If you want to see 3 pt's/hr at an urban Level 1 trauma center, by all means... But, consider all your possibilities, including packing up and moving if need be. Find that sweet spot.

I actually was fortunate enough to find this out moonlighting as a third year and my dream job fell in my lap by some random recruiter as my first full time gig out of residency. Haven't even looked at other full time jobs. I moonlight in busier level 1s occasionally just to remind myself how much it sucks and how good I have it.

 

[dchristismi]

I love how random bumps make one reflect on the passing time.
I have also left the (s#itstorm) job I referenced above and although I know I can hack it, I don't want to work in that environment anymore... for several reasons.

I've found a couple of freestandings and boy are they fun. I have one medium acuity shop with good staffing. I am cultivating a side gig that I'm going to segue into retirement with.

Glad it's improved for you AB. I'm happier too now.

 

[Dr.VanNostrumvsDeath03]

I love how random bumps make one reflect on the passing time.
I have also left the (s#itstorm) job I referenced above and although I know I can hack it, I don't want to work in that environment anymore... for several reasons.

I've found a couple of freestandings and boy are they fun. I have one medium acuity shop with good staffing. I am cultivating a side gig that I'm going to segue into retirement with.

Glad it's improved for you AB. I'm happier too now.

Would you and possibly Angry Bird be willing to share specifics about your jobs that burned you out the most? I feel like I am in the exact same position. Thanks!

 

[Angry Birds]

Would you and possibly Angry Bird be willing to share specifics about your jobs that burned you out the most? I feel like I am in the exact same position. Thanks!

Happiness = salary / (volume + acuity)

 

[pandahunter]

I enjoy the lifestyle it affords.

 

[RoyBasch]

The future will probably consist of more emphasis on customer service and less emphasis on patient care.

Patient satisfaction, efficiency, and flow are the benchmarks of a great "EM doctor" these days.

I would say this is already true for any job outside of academics.

 

[miacomet]

I dislike both the clinical work and most of the lifestyle- I'm tired of endless weekends, nights, and holidays, most of all the nights. I'm also tired of P-G, administrators, moving quickly, and no LT relationships. It was totally the wrong field for me, but I can't seem to find a way out. UC sounds like hell, not interested in occ med.

 

[bravotwozero]

I don't like the 'patient satisfaction' and ******ed metrics that comes with the field, but who does? The actual clinical side of it though - i think it's great, and I actually do enjoy it. So many times, the diagnoses are made right there in the ED, so if there's some badness going on with the patient, you're more often than not likely to catch it before anyone else does.

My group has a nocturnist, so I don't work many nights, if at all. I also get at least 2 weekends and some holidays off, in addition to not working for almost 2 weeks out of the month. Not 100% optimal but still a pretty sweet deal if you ask me.