EM a "lonely" specialty?

[GoodmanBrown]

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So, the doctor I've been shadowing is an academic doc who's a dual-cert in IM/EM. While shadowing him yesterday, I asked if he'd worked at a PP EM dept., and he said he had, but only for a brief period and that he found it to be lonely (his words).

Now, he's a fairly gregarious guy, so I'm not surprised that he wanted to spend more time talking with colleagues. He takes quite a bit of satisfaction in carefully talking through cases with residents and explaining in detail stuff for me.

So, my question for PP attendings is, do you ever get lonely on your shift? I guess this to mean, do you have any time to stop and chat through cases with another doctor, or are you just going to all out and too busy to really converse with anyone in anything other than 10 second orders, etc.? Just curious. Thanks!

 

[colforbinMD]

Pp?

 

[opb]

I'm thinking they mean Private Practice.

 

[ccfccp]

Pp?

Private Practice. As for the OP's question, I have no insight.

 

[Arcan57]

Frequently,there isn't time for more than a quick "What would you do with this patient?" or bitching about a consultant. Most community jobs revolve around moving the meat and the rack doesn't stop filling up during higher level discussions. This is frequently a big adjustment from residency, and there are people that need that component to have job satisfaction. These people usually wind up in academics or miserable. Because the ugly truth is that no one cares if you're cool or gregarious if there are 20 patients waiting to be seen.

 

[GeneralVeers]

Frequently,there isn't time for more than a quick "What would you do with this patient?" or bitching about a consultant. Most community jobs revolve around moving the meat and the rack doesn't stop filling up during higher level discussions. This is frequently a big adjustment from residency, and there are people that need that component to have job satisfaction. These people usually wind up in academics or miserable. Because the ugly truth is that no one cares if you're cool or gregarious if there are 20 patients waiting to be seen.

I usually just chat with the nurses about stuff. Along the lines of:

"Did you check out the drug-seeker?? He actually thought I was going to give him percocet, when really all he's getting from me is tramadol and a kick out the door."

 

[Arcan57]

I usually just chat with the nurses about stuff. Along the lines of:

"Did you check out the drug-seeker?? He actually thought I was going to give him percocet, when really all he's getting from me is tramadol and a kick out the door."

Cool nurses definitely help get you through a shift. On the other hand, you always know your shift is going to suck when none of the nurses have a sense of humor.

 

[GeneralVeers]

Cool nurses definitely help get you through a shift. On the other hand, you always know your shift is going to suck when none of the nurses have a sense of humor.

I'm lucky in that probably greater than 50% of the nurses are "cool" which makes my shift easier. We have a lot of nurses from Canada, and they are usually very smart, hardworking and have sense of humor.

 

[GoodmanBrown]

Yeah, if that's the case, I can totally see him disliking private practice. He loves to talk through cases and hang out and chat.

 

[DrQuinn]

I switched from academics to community ~ 4-5 months ago, and I work in two settings, one a busy comunity hospital (40k), the other a non busy rural ED (10k a year). Sometimes in the rural hospital I am bored and lonely, as it is obviously single coverage 24 hour sa day, but I am either on facebook, surfing the net, reading, or sleeping, and getting paid a sweet per hour rate doing it. So, I generally don't get too lonely. Most people that work in EDs are prety cool with a good sense of humor.
Or you can just post on SDN to talk about yoru cool cases.
Q

 

[AmoryBlaine]

Relative to what? I think most careers in community or private practice medicine are going to be fairly lonely in the sense that most interaction will be with patients/nurses rather than colleagues.

If anything EM would be a little better since the line between doctor/nurse/tech is usually less formal and most shifts are full of alot of ribbing and joking.

That said from what I hear it is not uncommon for someone to graduate residency and take a high-paying community job only to feel isolated and miserable. Like someone said -- your job is move the meat.

 

[jazz]

not all private practice er is solo practice. once the volume is above 20-25,000/year, there is double/triple coverage. so you're not necessarily by yourself. plus, ER nurses tend to be cooler and often you have PA's or NP's working along side you. i suppose if the volume is under 10,000, you could get lonely. but in a 35-40,000 volume er, there are a lot of other people around.

 

[Eric714]

By PP, I'm assuming you mean single coverage.

If that's the case... I went from residency with multiple attendings, multiple residents, and 60K volume at my hospital, to a community hospital with single coverage, one midlevel, and 40K volume. I cover all the codes in the hospital, so I'm basically in the doc in-house at night.

I don't know if I get "lonely", there is staff to chat with and patients to deal with. Obviously, I do miss the comarderie that comes with working with another doctor. But that comes with the territory being a physician, I don't think it's any different from a family practice doc working in his own office all day long.