Give me a minute to explain. I am surgical subspecialist, and actually deal with the ED "physicians" a lot. To be clear, I do not consider themphysicians, nor do I value any of their clinical judgement, or hold in any esteem any skill sets they claim to have. Lets just start by defining what a physician is. They are an individual that is involved in the diagnosis, prevention, and management of systemic manifestation of pathology.
Lets just take the first part in diagnosis: They do not really diagnose anything. They may be equipped to recognize certain diseases and manifestations of thosediseases, but they are rarely involved at a point in patient care in which they are the diagnosing physician. Theymay have clinical suspicion of an underlying disorder based on a finite, limited differential diagnosis- however, they quite often enlist consultants in the final diagnoses andmanagement of patients that present. The second part-prevention. I think we cansafely say that these individuals do not play a role in anydisease prevention. Finally, management- they are not involved in the continuous care of any patients. They may find a lump, mass, etc- but ultimately the care of the patient is relinquished to a real physician.
People go into ED medicine because they think their lives will be like that 90s TV show ER- a glorified depiction of physicians doing chestcompression, aortic cut downs, and chest tubes. Anyone who has worked in a hospital, will tell you, that traumas are handled by in house trauma surgeons. Walk into any ED in the country, your ED doctorwill be sitting at a desk, typing a note, with a phone in their hand calling a consult. Most of the time, their physical exams are lacking (if they do it at all).
This is all coming fromsomeone who has worked in the ED as part of my training. I can confidently say that was the worse time of my life. Icould not take pride in any of the work that I did. It was adark time, and I had zero job satisfaction. I felt like I took no responsibility or ownership of any patients. I was simply atriage system designed to babysit patients until the real doctors showed up. Do notthink the field is anything more than it is.
Also- there is something that should be said when most of the people that have posted in defense of ED physicians site "Good Money, with Good work hours". Id like to tell you this- ED physicians consistently rank lowest in terms of job satisfaction of all physicians, and have the highest burn out rate. So there is some truth to the fact that they really don't do much, and after a while I think they realize it.
A final thought, if a job can bedone by an NP out in the middle of nowhere or an EDcan hire on an internist, general surgeon, urologist to moonlight in their department- that probably means that the "speciality" is a sham. Ask a physician this, if I were out in the middle of nowhere, and I fell down a mountainside, and I could have one physician with me to take care of me, what type of physician would that be? 100% of physicians would say Trauma surgeon, Orthopod, ENT etc (even the ED docswould have to agree, unless theirs a phone that they can use to place a consult)
Nobody respects ED docs, most of all, other physicians.