Em overcrowding

[Aquaman29]

why and how to fix?

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[Dr Mantis Toboggan]

Likely will take a few years of new grads not being able to find work before the message becomes widespread. Obviously we are not there just yet. The vast majority of med students aren’t on this forum and their med schools/home programs likely won’t be preaching that message.

What do we need to do to get MS3 and MS4 to understand how saturated and overcrowded the market is becoming?

 

[Arcan57]

The market isn't saturated or overcrowded though, at least on a national level. The US needs a lot more BCEM docs than it has. A much more productive discussion is "How do we give med students a realistic view of what practicing EM at the attending level is like?" Maybe then we won't be flooded with docs who can only bear to practice emergency medicine if it's for huge $$$ in their 1st or 2nd choice of major cities.

 

[Rekt]

The market isn't saturated or overcrowded though, at least on a national level. The US needs a lot more BCEM docs than it has. A much more productive discussion is "How do we give med students a realistic view of what practicing EM at the attending level is like?" Maybe then we won't be flooded with docs who can only bear to practice emergency medicine if it's for huge $$$ in their 1st or 2nd choice of major cities.

Go tell your employer you'd like a pay cut to 120$ an hour for the greater good.

What a dumb statement. Also, if you're not actively currently looking for jobs, you don't get to say what the market is like.

 

[Brigade4Radiant]

Med students won’t listen to you. It’s that simple you would do better trying to convince pre meds not to go into medical school

 

[skougess]

Go look at all the pharmacy hopefuls on their section of the message board and you’ll have your answer. You can’t.

 

[alpinism]

The market isn't saturated or overcrowded though, at least on a national level. The US needs a lot more BCEM docs than it has. A much more productive discussion is "How do we give med students a realistic view of what practicing EM at the attending level is like?" Maybe then we won't be flooded with docs who can only bear to practice emergency medicine if it's for huge $$$ in their 1st or 2nd choice of major cities.

This is the same magical thinking that ACEP has been using to justify having all these new CMG residencies. The problem is that its not a viable solution for a few important reasons. First, most people have spent their whole lives in large cities and their friends and family are currently living in large cities. They're not going to just drop everything then move to the middle of nowhere where they literally don't even know a single person. Second, most people went into this specialty for the lifestyle and being able to enjoy that lifestyle when not working in the hospital. They're not going to just drop everything then move to the middle of nowhere where there's literally nothing to do with their free time. You'd be essentially asking for people to sacrifice their lives for the privilege of being able to practice emergency medicine which is not going to happen in our current medical system. Instead the job market will continue to become saturated and new graduates will be forced to find other ways to make a living instead of staffing emergency departments.

 

[Arcan57]

Go tell your employer you'd like a pay cut to 120$ an hour for the greater good.

What a dumb statement. Also, if you're not actively currently looking for jobs, you don't get to say what the market is like.

Nice attempt at gate keeping. Just changed jobs actually, after looking at multiple shops in multiple regions. And I didn’t say anything about taking a pay cut for the greater good. So strong straw man also.

But if you’re going into EM to make bank in a desirable city, you’re probably going to be disappointed. And that’s something that’s relatively new to EM and should be communicated.

While I’m sure some grads are going to change to something non clinical after residency, the majority are going to be practicing emergency doctors that are going to be taking jobs either at under market rates or in less desirable locations. There are a ton of shops in less desirable areas, and it’s ACEP’s goal to have emergency care provided by BCEM physicians. So what you see as a bug, they see as a feature.

 

[Arcan57]

This is the same magical thinking that ACEP has been using to justify having all these new CMG residencies. The problem is that its not a viable solution for a few important reasons. First, most people have spent their whole lives in large cities and their friends and family are currently living in large cities. They're not going to just drop everything then move to the middle of nowhere where they literally don't even know a single person. Second, most people went into this specialty for the lifestyle and being able to enjoy that lifestyle when not working in the hospital. They're not going to just drop everything then move to the middle of nowhere where there's literally nothing to do with their free time. You'd be essentially asking for people to sacrifice their lives for the privilege of being able to practice emergency medicine which is not going to happen in our current medical system. Instead the job market will continue to become saturated and new graduates will be forced to find other ways to make a living instead of staffing emergency departments.

That’s what almost every other speciality has been doing for years. What makes us special other than we had an underpenetrated market for decades? And what jobs are available to large groups of graduating EM residents to pay off their loans that’s not clinical EM?

 

[swamprat]

Got a phone call yesterday from comphealth - hospital is shopping around to see what rate ppl are willing to work at for locums. I told them 350 - guy said oh so u must not be hurting for work then - most docs cant find enough work they won't go for that rate. Supply and demand. Glad I don't practice EM full time anymore. Good luck suckers

 

[HemorrhagicShock]

It's mind-boggling to read the APD Ask me anything thread in the EM forum and witness the continued interest in EM.

AND these are the students that are exposed to the SDN level of realism/pessimism. I wish I could grab them all by their collars, look them in the eye, and let them know the kind of life-altering mistake they're about to make.

Triple so if they have anything more than six figures of debt.

 

[DeadCactus]

I really like my EM rotation but strangers on the internet who regret their life choices think I should reconsider because I’ll compete for their high-paying jobs or jobs in desirable cities.

Yea, I can’t imagine why that pitch isn’t working.

 

[DeadCactus]

You should ultimately make the choice where you can live with the outcome no matter what, and that you believe is the right choice for you. The strangers on the internet you speak of though already have those jobs. They aren’t competing with you. You are the one taking the risk. Some of us didn’t fully take to heart prior concerns regarding the future of the speciality, but those concerns did come and are coming true. I don’t regret my life choices, but you would be wise to listen to folks that have walked in the same path before you.

I'm well past residency but I'll take your post as aimed at the prototypical medical student interested in emergency medicine.

I disagree that they are not competing for jobs. We don't build practices. They will come in and work for lower wages and with less expectations and force established physicians to match them or find a new job. Maybe there are small groups that care about longevity and tenure but the major health systems that control many jobs will not. For many of us, this was a perk of emergency medicine. We can leave work at work and we can uproot whenever we want with no real loss of career momentum. But either way, the point was that much of motivation to "warn medical students" seems to stem more from trying to maximize economic opportunities for current emergency physicians than any real reason why it's not still a good career so it's not too surprising they don't listen. It seems comical that people are complaining about how great EM was until other people started pursuing it and then wondering why they can't get people to not pursue it.

I think it's reasonable to warn students to expect lower salaries in the future and that they will have to make compromises on geography. The doom and gloom goes well beyond a reasonable warning and seems completely out of touch with the realities of the rest of medicine and particularly the reality of other 3 year specialties.

 

[HemorrhagicShock]

I really like my EM rotation but strangers on the internet who regret their life choices think I should reconsider because I’ll compete for their high-paying jobs or jobs in desirable cities.

Yea, I can’t imagine why that pitch isn’t working.

Come on!

Medical students always love their EM rotations because it's one of the few left where they finally get to "do things." Sew up lacerations, do incisions and drainages, and all sorts of other "fun" stuff.

Yes, I remember when all of that was fun as a medical student. The amount of autonomy given to medical students on EM is far more than I ever had on any other rotations, and when it's fresh and new it's fun. Also, they have no concept of what it's like to hold the responsibility of the entire department as opposed to 1-2 patients at a time.

They're 100% shielded from the metric-burdened and medicolegal issues. They're shielded from malignant contracting, threats of losing their jobs/due process, and a variety of other VERY REAL practice concerns which only become clear as an attending.

Just because I get to retract a few times, use the argon laser for 3 seconds, and close half the wound on my surgery rotation doesn't mean I'll enjoy being a surgeon for the next 30 years of my life.

Ultimately we are suggesting the same thing but phrasing it differently. Here we are actually doing the job day to day and giving medical students our experience and warnings. It is up to them to make the decision, and it looks like many of them still are. We all will deal with the consequences of our actions and decisions, good and bad.

 

[HemorrhagicShock]

Oh and any medical student thinking they'll compete with me (and the rest of us who have "secured" a position) in our "high paying jobs" is welcome to do so. I will have 10+ years of experience by the time they're looking for their job, and it's highly unlikely I'll be bumped to make room for them in an already crowded practice!

 

[Prehealth1011]

You can't. Google EM doc salary = see the $ = apply. That's the current practice of choosing a specialty.

Applications will continue to pour in until the salary or job market implodes like what happened with rad onc, nephrology etc.

 

[Porfirio]

We just had a doc leave. 10 applications within 1 week, 5 interviews. Only 1 job. It is going to start to be like residency interviewing for jobs.

 

[DeadCactus]

My apologies. This typo or yours implied to me initially that you were a medical student on an EM rotation. I should have remembered you are well beyond that point in time.

‘Unicorn’ jobs in competitive cities are controlled by SDGs. You don’t just come in and offer to work for lower wages to take these jobs. Those in these positions have worked hard to get and keep these positions.

Maintaining a contract involves more than just showing up for a clinical shift. You have to be involved in the hospital including politics and committees. You want a good job, then you build roots and don’t up and leave. You want a position at a good SDG, then you sacrifice for 1-3 years to make partner later on reaping back the rewards. Uprooting and leaving frequently burns your long term financial success.

My intent was to post a somewhat caricatured representation of the thought process a medical student might have in response to the warnings here, doesn't seem like it worked well.

Students need to have realistic expectations about the economic realities of the field and some of the frustrations/challenges of a career in emergency medicine. The field is currently in a state of economic decline but doing so from a previously unsustainable golden age and is reasonably expected to plateau in a comparable position to most other primary care type specialties. This still represents a very comfortable quality of life that will be and should be enticing to the medical student interested in emergency medicine for the medicine. The idea that it is or will be a dismal and terrible career choice filled with regret is overly dramatic and often relies on an overly rosy picture of other careers.

Yes, there are unicorn jobs that involve much more than clocking into a shift but I don't see these aren't the norm and they will be even less of the norm going forward. And while these new grads may not compete for the specific job currently held by those in practice now, their abundant and cheaper labor will fuel attempts by healthcare systems and CMG's to take those contracts. Yes, hospital and community engagement can protect against these attacks but I think we should all realize by this point that no one is above finding themselves suddenly pushed out and replaced by people who just want to clock in and out.

 

[12jas]

The focus should not be on discouraging med students to pursue EM but instead on stopping the expansion. Plenty of students are heading the warnings for EM and bailing for other fields. However, as long as there are spots they will continue to be filled. There is no short supply of FMG or IMG's desperate for a spot. It is already happening where these less desirable programs are being filled with IMG's.

 

[Arcan57]

The focus should not be on discouraging med students to pursue EM but instead on stopping the expansion. Plenty of students are heading the warnings for EM and bailing for other fields. However, as long as there are spots they will continue to be filled. There is no short supply of FMG or IMG's desperate for a spot. It is already happening where these less desirable programs are being filled with IMG's.

How do you stop expansion when our national society advocates for all care being provided by (or under the supervision of) EM trained docs? There’s a huge pool of less desirable community sites that would need to be filled before ACEP would start to consider residency expansion a bad thing. “We want to make a lot of money while living in a nice place” is individually compelling, but it’s a tough slogan to market broadly. Also, more EM docs means more money from Acep dues. Good luck convincing them that more money is a bad thing.

 

[Mushdoc]

How do you stop expansion when our national society advocates for all care being provided by (or under the supervision of) EM trained docs? There’s a huge pool of less desirable community sites that would need to be filled before ACEP would start to consider residency expansion a bad thing. “We want to make a lot of money while living in a nice place” is individually compelling, but it’s a tough slogan to market broadly. Also, more EM docs means more money from Acep dues. Good luck convincing them that more money is a bad thing.

The best maybe we can hope for is stricter accrediting criteria. Its one thing to say that we want less EM docs. Its another to say that many of these HCA residencies are subpar and shouldnt be accredited and are smearing the name of EM training

 

[GeneralVeers]

The best maybe we can hope for is stricter accrediting criteria. Its one thing to say that we want less EM docs. Its another to say that many of these HCA residencies are subpar and shouldnt be accredited and are smearing the name of EM training

They are sub-standard. How can you get accredited without a proper trauma rotation all ready set up? Most of these programs are shipping residents to other cities/states to smaller-tier trauma centers for training. Shady.

 

[MedScat]

You guys really do make the EM world seem horrible but for some reason at my home institution they feel the absolute opposite. I like EM not cause of the $$ (although it doesn't hurt) but because of its kind of like primary care with procedures, shift work (good for kids), and no call or rounding. I'm sure theres bureaucratic crap that you guys have to deal with but what specialty doesn't? Like someone said, even if we stop applying, there will always be IMGs ready to take whatever they can get so as long as more residencies keep popping up, more people will be applying.

Now I guess I'm ready for you guys to attack and tell me why I'm dumb for wanting EM lol

 

[sloh]

You guys really do make the EM world seem horrible but for some reason at my home institution they feel the absolute opposite. I like EM not cause of the $$ (although it doesn't hurt) but because of its kind of like primary care with procedures, shift work (good for kids), and no call or rounding. I'm sure theres bureaucratic crap that you guys have to deal with but what specialty doesn't? Like someone said, even if we stop applying, there will always be IMGs ready to take whatever they can get so as long as more residencies keep popping up, more people will be applying.

Now I guess I'm ready for you guys to attack and tell me why I'm dumb for wanting EM lol

No call but you have to work nights, weekends, and holidays. And deal with the circadian disruptions and how the recovery bleeds into your “off” days. Not sure rounding is all that bad if you still have humane hours with no calls, nights, weekends, holidays.

 

[Rekt]

You guys really do make the EM world seem horrible but for some reason at my home institution they feel the absolute opposite. I like EM not cause of the $$ (although it doesn't hurt) but because of its kind of like primary care with procedures, shift work (good for kids), and no call or rounding. I'm sure theres bureaucratic crap that you guys have to deal with but what specialty doesn't? Like someone said, even if we stop applying, there will always be IMGs ready to take whatever they can get so as long as more residencies keep popping up, more people will be applying.

Now I guess I'm ready for you guys to attack and tell me why I'm dumb for wanting EM lol

Is your institution HCA? Also why would you have any idea how your "institution" feels about EM? What does that even mean? I can still really like EM (I do) and can also say that it's a terrible choice to persue until they decide to do something about the physician oversupply.

 

[Dr Mantis Toboggan]

You guys really do make the EM world seem horrible but for some reason at my home institution they feel the absolute opposite. I like EM not cause of the $$ (although it doesn't hurt) but because of its kind of like primary care with procedures, shift work (good for kids), and no call or rounding. I'm sure theres bureaucratic crap that you guys have to deal with but what specialty doesn't? Like someone said, even if we stop applying, there will always be IMGs ready to take whatever they can get so as long as more residencies keep popping up, more people will be applying.

Now I guess I'm ready for you guys to attack and tell me why I'm dumb for wanting EM lol

You’re not dumb. Those are exactly all the reasons we went into it. But over time the minuses begin to outweigh those pluses. And the economic landscape has begun to tilt against us, and no one knows for sure how much it will continue to do so.

 

[MedScat]

Is your institution HCA? Also why would you have any idea how your "institution" feels about EM? What does that even mean? I can still really like EM (I do) and can also say that it's a terrible choice to persue until they decide to do something about the physician oversupply.

Sorry my word choice wasn't great - let me rephrase. The EM attendings at my institution love EM and always tell me they would never choose anything different and they are a big part of why I like it too. I'm not sure what HCA is, but I'm not usually secretive about my institution - I go to Temple.

Now, in terms of the minuses beginning to outweigh the pluses..what happens when you're a med student and you do all your rotations and you just like EM the best? Are you supposed to choose something else because people say the job market sucks even if that's what you would be happy doing? I'm really asking here, not being curt.

 

[Dr Mantis Toboggan]

Sorry my word choice wasn't great - let me rephrase. The EM attendings at my institution love EM and always tell me they would never choose anything different and they are a big part of why I like it too. I'm not sure what HCA is, but I'm not usually secretive about my institution - I go to Temple.

Now, in terms of the minuses beginning to outweigh the pluses..what happens when you're a med student and you do all your rotations and you just like EM the best? Are you supposed to choose something else because people say the job market sucks even if that's what you would be happy doing? I'm really asking here, not being curt.

Yeah that’s a great question. I’m middle aged and somewhat facing a midlife crisis so doubt I’d be any happier having gone into another field. I guess I’d say you are better off choosing it for the non economic reasons since the economic ones might be vanishing soon.

 

[RustedFox]

EM at Temple would be a freaking nightmare.

 

[Apollyon]

Sorry my word choice wasn't great - let me rephrase. The EM attendings at my institution love EM and always tell me they would never choose anything different and they are a big part of why I like it too. I'm not sure what HCA is, but I'm not usually secretive about my institution - I go to Temple.

Now, in terms of the minuses beginning to outweigh the pluses..what happens when you're a med student and you do all your rotations and you just like EM the best? Are you supposed to choose something else because people say the job market sucks even if that's what you would be happy doing? I'm really asking here, not being curt.

Some animals have to live in the zoo, because they can't survive in the wild.

Academic EM is a VERY easy place to hide, and is not representative of the vast majority of departments in the US.

 

[RustedFox]

I'm not sure what HCA is, but

HCA is evil.
Pure, concentrated evil.

 

[Tenk]

Sorry my word choice wasn't great - let me rephrase. The EM attendings at my institution love EM and always tell me they would never choose anything different and they are a big part of why I like it too. I'm not sure what HCA is, but I'm not usually secretive about my institution - I go to Temple.

Now, in terms of the minuses beginning to outweigh the pluses..what happens when you're a med student and you do all your rotations and you just like EM the best? Are you supposed to choose something else because people say the job market sucks even if that's what you would be happy doing? I'm really asking here, not being curt.

Where do you want to end up? Go on job websites and look at that area. They are open to anyone.

 

[Aquaman29]

Some animals have to live in the zoo, because they can't survive in the wild.

Academic EM is a VERY easy place to hide, and is not representative of the vast majority of departments in the US.

Medscat-Temple is great and I know many of the attendings are there and they are awesome, the number of attending that burn out there from low pay, high work and or poor academic performance is higher than you realize. Your sampling the cream of the crop: the attending syou love to teach socially interact and publish at high rates, with lowish pay. Many end up in community shops nearby that you never hear from again. You need to understand that 95% of EM is NOT that, and everyone has to deal with the consequences of Academias decisions to over expand.

 

[Lexdiamondz]

Sorry my word choice wasn't great - let me rephrase. The EM attendings at my institution love EM and always tell me they would never choose anything different and they are a big part of why I like it too. I'm not sure what HCA is, but I'm not usually secretive about my institution - I go to Temple.

Now, in terms of the minuses beginning to outweigh the pluses..what happens when you're a med student and you do all your rotations and you just like EM the best? Are you supposed to choose something else because people say the job market sucks even if that's what you would be happy doing? I'm really asking here, not being curt.

Of course your attendings are happy. They do an academic gig in a place with good pathology and strong residents.

As for your second point - nobody is saying you absolutely need to give up your ambitions if this is what you want to do. But you do need to strongly consider the possibility that you may graduate in 3-4 years and there may not be any opportunity for you to actually practice as an EM attending. I'm a current PGY4 and the doom and gloom about the job market is very, very real and will likely get much worse given that your graduating class will likely have far more residents and ergo far more competition than mine does.

 

[Arcan57]

Of course your attendings are happy. They do an academic gig in a place with good pathology and strong residents.

As for your second point - nobody is saying you absolutely need to give up your ambitions if this is what you want to do. But you do need to strongly consider the possibility that you may graduate in 3-4 years and there may not be any opportunity for you to actually practice as an EM attending. I'm a current PGY4 and the doom and gloom about the job market is very, very real and will likely get much worse given that your graduating class will likely have far more residents and ergo far more competition than mine does.

Do you mean there will not be any opportunity to practice as an EM attending or that it will be more difficult to practice for a very high hourly wage in the city of your choice?

 

[bravotwozero]

Do you mean there will not be any opportunity to practice as an EM attending or that it will be more difficult to practice for a very high hourly wage in the city of your choice?

If I may, the latter is a given. But even the former remains a real possibility, given the supply of available docs has already outstripped demand...

 

[Arcan57]

If I may, the latter is a given. But even the former remains a real possibility, given the supply of available docs has already outstripped demand...

Citation?

 

[Lexdiamondz]

Citation?

Seriously? Just ask anyone looking for a job right now.

 

[emergentmd]

EM medicine is fine, will be fine, and the sky is not falling. I have done this for 20 yrs and taken in a vacuum, it still is a great field compared to many others.

Current EM state - Still easily find 200/hr jobs in the vast majority of the country. Yes, remove the top 30-50 cities but most specialities are like this. You get to take long vacations, take off when you want, and don't have to deal with big up front costs/staffing/insurance carriers. Again, most EM docs can take a week off every month to do whatever they want. Still can work 30/hrs a week to be called full time.

Problem is most of us lived in the glory days and this is what we compare it too. Of course some will think the sky is falling and most are financially sound who would not work for 200/hr.

I would still not choose another specialty b/c I did not have the grades to do Derm or Optho. Every other hospital based practices all complain about the same thing. Trust me. Even in my golden years of EM, most specialist that came to the ER were all beaten complainers. I am sure it is worse now.

But I have to admit, the crappy places that used to pay me 500+/hr and would have the most difficult times giving up shifts now these new grads snatch the overnights up like candy at base rate. I would never do an overnight in these places for $275/hr but if you are a new grade, 3k a shift is a pretty good amount of $$.

 

[Rekt]

Citation?

https://www.jem-journal.com/article/S0736-4679(20)30006-8/abstract

Plus, you know, people actually looking for jobs right now.

 

[alpinism]

The crazy thing is it will be even worse since they haven’t even included all the envision programs opening in the next few years.

 

[Arcan57]

https://www.jem-journal.com/article/S0736-4679(20)30006-8/abstract

Plus, you know, people actually looking for jobs right now.

Thank you for the citation, would need to see their assumptions in regards to oversupply in 2021 but at least it’s something

In regards to current challenges with job searches, one word:COVID. It’s artificially reducing demand in a way that is likely not sustainable. A tight job market when volumes are at 50% of budgeted isn’t necessarily indicative of the EM market going forward.

I understand things suck for those seeking a job right this moment (I was in that category recently). Hopefully volumes bounce back (which they seem to have in a lot of places) and this doesn’t rollover into 2021.

 

[wamcp]

EM medicine is fine, will be fine, and the sky is not falling. I have done this for 20 yrs and taken in a vacuum, it still is a great field compared to many others.

Current EM state - Still easily find 200/hr jobs in the vast majority of the country. Yes, remove the top 30-50 cities but most specialities are like this. You get to take long vacations, take off when you want, and don't have to deal with big up front costs/staffing/insurance carriers. Again, most EM docs can take a week off every month to do whatever they want. Still can work 30/hrs a week to be called full time.

Problem is most of us lived in the glory days and this is what we compare it too. Of course some will think the sky is falling and most are financially sound who would not work for 200/hr.

I would still not choose another specialty b/c I did not have the grades to do Derm or Optho. Every other hospital based practices all complain about the same thing. Trust me. Even in my golden years of EM, most specialist that came to the ER were all beaten complainers. I am sure it is worse now.

But I have to admit, the crappy places that used to pay me 500+/hr and would have the most difficult times giving up shifts now these new grads snatch the overnights up like candy at base rate. I would never do an overnight in these places for $275/hr but if you are a new grade, 3k a shift is a pretty good amount of $$.

Out of curiosity - how would you rate this gig, given its location (looks like middle of nowhere Kentucky?), and whether this makes it seem like the sky is falling or not?

"TeamHealth is seeking an emergency medicine physician to join our team at Baptist Health Corbin in Corbin, Kentucky.
Average 2.19 patients per hour. The EMR is Epic. $215/hr days; $225/hr nights. "

Emergency Medicine Physician job in

Emergency Medicine Physician job in

www.practicelink.com

 

[Apollyon]

Out of curiosity - how would you rate this gig, given its location (looks like middle of nowhere Kentucky?), and whether this makes it seem like the sky is falling or not?

"TeamHealth is seeking an emergency medicine physician to join our team at Baptist Health Corbin in Corbin, Kentucky.
Average 2.19 patients per hour. The EMR is Epic. $215/hr days; $225/hr nights. "

Emergency Medicine Physician job in

Emergency Medicine Physician job in

www.practicelink.com

2.2/hr? Pass.

 

[CliveStaples]

I would not consider that job for less than 275/285 and I suspect for many, it would take more than that.

 

[BoardingDoc]

Out of curiosity - how would you rate this gig, given its location (looks like middle of nowhere Kentucky?), and whether this makes it seem like the sky is falling or not?

"TeamHealth is seeking an emergency medicine physician to join our team at Baptist Health Corbin in Corbin, Kentucky.
Average 2.19 patients per hour. The EMR is Epic. $215/hr days; $225/hr nights. "

Emergency Medicine Physician job in

Emergency Medicine Physician job in

www.practicelink.com

As an IC? At 2.2/hr, you should be getting paid 240+ at a minimum. And that assumes that management is skimming ~20% off the top in expenses.

 

[turkeyjerky]

Out of curiosity - how would you rate this gig, given its location (looks like middle of nowhere Kentucky?), and whether this makes it seem like the sky is falling or not?

"TeamHealth is seeking an emergency medicine physician to join our team at Baptist Health Corbin in Corbin, Kentucky.
Average 2.19 patients per hour. The EMR is Epic. $215/hr days; $225/hr nights. "

Emergency Medicine Physician job in

Emergency Medicine Physician job in

www.practicelink.com

Good lord. The fact that they're publishing that rate on a job board is frightening. All of their other jobs with "excellent" reimbursement are probably paying 180/hr.

Also, what a **** job. I was making more in a major (read, not known for high pay) city straight out of residency, w/ far better coverage. Supervising 3 midlevels during the day....eesh. Doesn't kentucky suck for malpractice too?

Thank you for the citation, would need to see their assumptions in regards to oversupply in 2021 but at least it’s something

In regards to current challenges with job searches, one word:COVID. It’s artificially reducing demand in a way that is likely not sustainable. A tight job market when volumes are at 50% of budgeted isn’t necessarily indicative of the EM market going forward.

I understand things suck for those seeking a job right this moment (I was in that category recently). Hopefully volumes bounce back (which they seem to have in a lot of places) and this doesn’t rollover into 2021.

If you look back onto this forum to last year before covid, there were already major signs the job market was tightening. I just got off the job hunt too and it was rough. I was expecting it to be bad, but it was way worse than I anticipated. With your background, you probably have more insight into the market than most, but I wouldn't recommend anyone go into this field unless they're cool working in BFE or an urgent care.

 

[Fox800]

Out of curiosity - how would you rate this gig, given its location (looks like middle of nowhere Kentucky?), and whether this makes it seem like the sky is falling or not?

"TeamHealth is seeking an emergency medicine physician to join our team at Baptist Health Corbin in Corbin, Kentucky.
Average 2.19 patients per hour. The EMR is Epic. $215/hr days; $225/hr nights. "

Emergency Medicine Physician job in

Emergency Medicine Physician job in

www.practicelink.com

Garbage. This job needs to pay $250 minimum. $270-275 if no benefits. And it’s not even in a remotely desirable area lololol.

But nothing to fear, some thirsty new grad from a “powerhouse“ HCA residency program‘s first graduating class will jump on it when they have to pay off $500,000 in loans from a Caribbean medical school.

 

[12jas]

Garbage. This job needs to pay $250 minimum. $270-275 if no benefits. And it’s not even in a remotely desirable area lololol.

But nothing to fear, some thirsty new grad from a “powerhouse“ HCA residency program‘s first graduating class will jump on it when they have to pay off $500,000 in loans from a Caribbean medical school.

Getting real tired of this forum constantly sh**ing on new grads or medical students like it is our fault the current market is the way it is or it is their fault for attending a new program that never should have existed in the first place. How about chasing the root cause of the problem and advocating for stricter ACGME accrediting standards that would shut down or prevent these lower quality training sites from existing in the first place. How about we address the fact that there is a large number of non- EM boarded docs working in EM across the nation or a rise in midlevel presence in EM. Can we stop fighting amongst ourselves and put our energy towards worthwhile causes? Because at the end of the day if I am at a shop where my colleague is a Caribbean grad who is HCA trained I don't give a sh** he/she is still my colleague who I will treat with respect.

 

[Fox800]

Getting real tired of this forum constantly sh**ing on new grads or medical students like it is our fault the current market is the way it is or it is their fault for attending a new program that never should have existed in the first place. How about chasing the root cause of the problem and advocating for stricter ACGME accrediting standards that would shut down or prevent these lower quality training sites from existing in the first place. How about we address the fact that there is a large number of non- EM boarded docs working in EM across the nation or a rise in midlevel presence in EM. Can we stop fighting amongst ourselves and put our energy towards worthwhile causes? Because at the end of the day if I am at a shop where my colleague is a Caribbean grad who is HCA trained I don't give a sh** he/she is still my colleague who I will treat with respect.

The horse is already out of the barn. We can tell you not to take these jobs, but you’ll do it anyway. Same as the folks that take $140/hr to work in Denver for USACS.

You won’t get the ACGME to revoke accreditation for the ridiculous new cohort of lackluster HCA-sponsored programs. It’s too late.

The proliferation of non-EM boarded physicians and NPPs in emergency medicine is simple economics. Hospitals could pay for a BC/BE emergency physician, but they refuse because of money. Funny how this doesn't happen in surgical specialties.

Until the ACGME-RRC changes their mentality from "do they meet the bare minimum requirements" to "is there a need for this program", things won't change. Why aren't we following the example of dermatology, orthopaedic surgery, etc? We can't keep flooding the market with more and more EPs and Jenny McJennyson, FNP-BCs at the same time...

In an ideal world, we'd mint EPs until there are no more non-EM boarded docs or midlevels left in the ED. But you and I know that will never happen.

Hospitals choose NPPs and non-EM docs due to greed -> "shortage" exists -> more programs approved that will exist forever -> wages fall, permanently.