EM Salary?

[Brigade4Radiant]

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It is an example of the difficulties and pressures associated in EM. Of course every specialty can express how difficult their jobs can be, but in what other specialty are the pressures so fast-paced and time dependent with death, trauma, violent patients, drug-seekers, and difficult patients that you have to see by federal law constantly around you? The point is that even if there are a few specialties that are just as stressful and burnt out as EM, they are not considered lifestyle either. Then throw in circadian disruptions for 10-20 years. Many people do not consider how these shifting schedules will affect their life 10+ years out. Sure, as a single 30 y/o straight out of residency pulling 40h/week with nights and flip flopping schedules you'll probably be fine, for a while. But when you are 45 or 55 with 2.5 kids, working that many hours in EM in a tough shop (read: most shops) is not sustainable for most people.


EM is a fast-paced, high stress field where you can get burnt out if you work too many hours, more so than other fields, which is why they work less hours on average than other specialties. Out of necessity. And even then, many are working more hours than they want. If you're able to work ~30hrs/week and cut down a bit more as you get older, in addition to limiting the sleep disturbances with shifting schedules, then yes it can be very lifestyle friendly. But go over to the EM forums and find a doc who has consistently worked 40 clinical hours per week for 10+ years and you'll find one who has now either transitioned more hours to admin/teaching, left general EM for a sub specialty, or feels burnt out and depressed.


And based on the "stupid" survey of U.S. physicians, it seems like more FM physicians should pick up a joint.

No not really EM is hard no doubt but so is all of medicine. Many Dermatologists work like chickens with their heads cut off to make that high salary. But many would claim that they are a good lifestyle. Also SDN is full of burntout docs. Go to Anesthisia or Radiology and you will find that many are unhappy docs. The unhappy ones are the ones who are most likely to complain. Birdstrike (now a pain doc) makes many posts about the down side of EM but he doesn't say EM is more stressfull than other fields of medicine. Notice that you don't see a lot of Obgyn's or surgeon's complaining about burnout(they are to busy to complain often). Cards, IM, Peds, FM, OB, Surg, Rads, Anesthesia, EM, Neuro all have to work nights or call being a doctor in general is not a lifestyle field but lets be honest in the lifestyle wars with all medical specialites EM wins more battles than they lose.

Most EM attendings work 3 nights a month. They also have those shifts stacked together to minimize sleep disturbance. Also even though EM is busy unless you are working in a level one trauma center in Memphis or Detroit the acuity of your patients are not that high. So while they are busier than most physicians on their shifts they can find time to go to the bathroom and wolf down some food. EM is sustainable for most people because the attrition rate of the specialty is no different from most other fields. In fact about half of the physicians who work in the ED are not residency trained.

I know a FM doctor at 60 who left his practice to work in the ED he did this when he was 50. He does not regret it at all because like most EM docs he is home more times than he is at work. You can work weekend nights only (a couple of EM mothers do this) and make a little more than a pediatrician. Yeah you deal with violent patients, trauma and drug seekers but it's not like it you every have to be called from home because these patient's are acting out. Once you complete signout they are out of sight out of mind (after the 1 hour of charting). You also do not have super high acuity shifts every night unless you are a busy level one in a large rural or urban center.

FM you have to see a lot of patient's deal with their social issues and be a shoulder for your patient's who have cancer to cry on or who lost their loved ones or who are dying. Since you also know them the emotional investment is much greater. You work 8-7 (calling patient's paper work and cordinating care just because you stopped seeing patients does not mean that you stop working) Getting RVU's in FM is hard and stressful (if you do clinic)

I'm not saying EM is easier or FM is harder it is just different you can't look at one and just say one is more stressful than the other.

 

[lesterbarley]

lol let me know the last time you saw a ED attending use a slit lamp (or deliver a baby for that matter unless they're in some truly podunk hospital with no delivery room and no OB in house). Are you sure it wasn't the ophtho resident?

Just because they don't doesn't mean they can't.