EM in a Rural setting

[shaggybill]

I once read somewhere (cant remember where) that nobody likes to practice EM in rural areas because a.) the pay is very bad, and b.) it's quite boring. Is this true? Does anybody here practice in a rural area. I have always wanted to live in the rural Southeast, and now, be an EP, but Im getting negative vibes from what I'm reading...
Thanks

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[stoic]

Unless you're REALLY rural, the pay is actually better the furthur you get from major cities. But you're right, even less acute stuff and even more primary care stuff when you're in a smallish town.

 

[jpgreer13]

I personally plan to practice rural EM. There are many reasons for this. One, if you're working solo, often you're the only doc in the hospital, and anything acute that comes in is all you. There's no giant code team that shows up to make a cluster out of anything you get involved in. It's you. It's your save, or it's your blown save. You'll deal with lots of crap, but you'll occasionally get the sick one, and it'll be you who sees and diagnoses and stabilizes. Three, the pay is generally better. Four, you don't have to deal as much with our good buddies, "Two Dudes" and "Some Dude", who are responsible for most violent crime in America these days.

 

[shaggybill]

Do you think you will have to work more hours as a rural ER doc?

 

[docB]

I work some of my shifts in a rural ED and it's not boring when they bring in the critical traumas and it's just me with no trauma team back up.

 

[Sheerstress]

I work in the ED of a medium-sized hospital in a town with a large surrounding rural area.

We get 20-25K patients a year, and it can vary as to how busy things are on a given day. However, I cannot think of many days where things were "boring." In general, you'll be occupied, whether patients are trickling in or whether you're getting slammed left and right. You might get a free hour here and there to read journals, but never count on it.

At the smallest rural hospitals (e.g. 10-15K per year) you might get a few lazy shifts (10-20 patients over 12 hours), more during the night than the day, but most of the time you'll have something to occupy your time, whether getting caught up on charts, working up new patients, or contacting consultants and/or receiving hospitals.

As far as the number of hours you will have to work, that is dependent on how scarce providers are in the area (from the staffing perspective, it's actually pretty difficult to find docs to staff rural EDs), and whatever number of shifts for which you contract. Most of the time you can work as much or as little as you want.

That's been my experience, although things certainly may vary from region to region.

 

[Emergency!]

I don't think that the location of an ED really contributes to the number of hours worked. At the two hospitals I spent a lot of time at as a rural EMT, the hospitals contracted ED physician staffing out to a physicians group. The group was responsible for staffing. At the one hospital, the docs were scheduled to work 10 twelve hour shifts a month. I believe more hours were available if they wanted them. I'm sure pay was competitive as this group also held the contract at a level I trauma center in a midsized city. Many of the physicians periodically picked up a shift there, as well.

Coming from a rural area, I can attest to the fact that we still see most things that are seen in a bigger ED, just not as often.

Amy