EM to family med?

[kumatie]

I need to get out of the ED. I hate it. I’m tired of being treated like a piece of **** by administration, other doctors, patients and society in general. Anyone know anyone or any ways to go into family medicine, specifically outpatient clinic. I do not want to do family medicine residency. The way I see it, if family docs can moonlight in our EDs why can’t I start doing that in a family practice clinic.

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[JacobMcCandles]

Go for it. I don't think there is anything stopping you from doing it besides, you know, you not being trained for it.

 

[RustedFox]

Yeah, you need to be family med boarded to get hired anywhere with a group.
Other than that; there's nothing you from hanging a shingle and doing whatever the eff you want.

 

[Dr Mantis Toboggan]

Yeah, you need to be family med boarded to get hired anywhere with a group.
Other than that; there's nothing you from hanging a shingle and doing whatever the eff you want.

Plus if you live in any kind of decent area insurance probably won’t put you in network/credential you without being boarded. Of course you could try cash only etc. If you’re in the sticks and there’s no other docs maybe they would I dunno.

 

[valianteffort]

I would try creating a concierge service. Depending on your area of living, there are quite of few people willing to shell out a few G's per year to have 24/7 access to a physician. Being ER may be a selling point. I know 2 ER physicians running successful practices in this manner. Take insurance out of the equation and moving this route will save you a lot of headache given you aren't boarded in FM

 

[Birdstrike]

I worked with a EM doc who was extremely good and very smart. After 20 years, he got out of busy EDs and did a couple of years in urgent care. In urgent care, he did a little bit of low acuity EM with some primary care, mixed in. During those 2 years, he read everything he could get his hands on regarding preventative family medicine and outpatient primary care. He then got hired by a multi specialty group of mostly primary care docs, to do outpatient medicine (a practice I also happen to work at, and part own).

He didn't advertise as a Family Medicine physician. He didn't claim to be board certified in it. He was board certified EM and that was his certification. But he built a very busy practice seeing outpatients and did that for about 5 years, until he retired. He was widely accepted by colleagues as very good at what he did and was well liked by patients. I don't know of any competency issues during the 5 years I worked side by side with him in the outpatient setting (or in the years I worked with him in the ED, for that matter).

Anyone who is against this type of practice transition has to ask their self, if CRNAs can do the work of an anesthesiologist, nurse practitioners can have an outpatient practice and PAs can de facto work as Emergency Physicians in busy EDs, why can't a board certified EP have an outpatient practice? Answer: they can.

Tldr: You absolutely can do it, OP.

 

[thegenius]

funny reading these responses. When all of us read a thread about FM or a noctor running an ER, we scream foul with that situation.

 

[The Knife & Gun Club]

I did a bit of what was effectively FM as a “sick call” physician in the local jail last year. Technically I was billed as an EM doc doing urgent care type stuff but in practice lots of times I just did follow ups for the other IM/FM docs working there who didn’t have time for everyone.

It’s actually surprising how NOT trained for it we are as EM physicians. I leaned on my colleagues a lot, looked lots of stuff up, did some good medicine, and learned a lot.

It could totally be a career - they tried to hire me full time - and could probably do reasonable FM type medicine with a few more years there. But we’re definitely not trained for it as EM docs and it only worked because I only effectively saw like 1.5 pph and only 1-2 a day which were truly complex outpatient types. I’d spend an hour plus on those cases doing a good HPI, chart reviewing, and looking stuff up and even then needed help often.

Trying to sort out a diuretic regimen for someone with incompletely worked up liver failure, poorly compensated CHF, and DM2 is not easy at all. I distinctly recall trying to adjust Heart failure meds for a guy with newly diagnosed dilated cardiomyopathy and being too aggressive - he fainted, hit his head, and had to go to the ED for a scan. I felt like an a$$ after that.

 

[timpview]

Do direct primary care.

An experienced EM doc would be more than competent after a few months. It’s not that hard at all.

 

[RustedFox]

We have one doc that used to work with our group that decided to open her own concierge service.
I don't know how it really works when the doc is more high-maintenance than the patients, but hey - her call, man.

 

[EctopicFetus]

Do DPC, Do obesity medicine, do functional medicine, do cosmetics. All these can be learned. All much easier than EM.. Do telemedicine. Do Addiction. There are options. you have to decide what you like and pursue it. I would start it up quietly and as it got bigger and better I would cut back at my main job and replace the income I want / need.

 

[RustedFox]

Do DPC, Do obesity medicine, do functional medicine, do cosmetics. All these can be learned. All much easier than EM.. Do telemedicine. Do Addiction. There are options. you have to decide what you like and pursue it. I would start it up quietly and as it got bigger and better I would cut back at my main job and replace the income I want / need.

Hey, whoah.

Lets not go telling him to teach middle school health classes.

 

[GonnaBeADoc2222]

I need to get out of the ED. I hate it. I’m tired of being treated like a piece of **** by administration, other doctors, patients and society in general. Anyone know anyone or any ways to go into family medicine, specifically outpatient clinic. I do not want to do family medicine residency. The way I see it, if family docs can moonlight in our EDs why can’t I start doing that in a family practice clinic.

Going to offer advice to you as someone who has almost rage quit like this multiple times: stay in EM and figure out how to do the bare minimum while in it. Odds are, you're not going to find another opportunity that matches EM compensation.

Find a job with zero to minimal nights.

Be extremely average. Slip under the radar. No extra unpaid work.

Use your free time to pursue your other interests.

Unless you're willing to compromise your ethics, you're not going to do well in obesity medicine / DPC when everyone is slinging ozempic and TRT to people who really don't qualify. Cosmetics is saturated and any NP or even RNs in some states can open up a shop.

 

[Brigade4Radiant]

EM deals with a lot of medicine and overlaps many things there are multiple doctors doctors who tell you you shouldn’t be treating anything. CHF and CAD should be treated by a cardiologist. Children should be treated by a pediatrician women with gyn complaints should be seen by an OB/GYN.

So on and so on

 

[VA Hopeful Dr]

Do direct primary care.

An experienced EM doc would be more than competent after a few months. It’s not that hard at all.

Totally agree. Those IM and FM residencies are just filler and we all know it.

Yes, you absolutely can do DPC. You would even have some advantages over regular PCP types doing it - likely more procedures and so avoid some referrals. But you're kidding yourself if you think that you'd be more than maybe competent in chronic disease management after a career of EM and a few months of hands on primary care.

You'll notice Bird's example above was an EP who spent 2 years reading up on everything primary care before making the change. That could probably be done faster, but you really don't want to learn everything on the job.

 

[GonnaBeADoc2222]

Totally agree. Those IM and FM residencies are just filler and we all know it.

Yes, you absolutely can do DPC. You would even have some advantages over regular PCP types doing it - likely more procedures and so avoid some referrals. But you're kidding yourself if you think that you'd be more than maybe competent in chronic disease management after a career of EM and a few months of hands on primary care.

You'll notice Bird's example above was an EP who spent 2 years reading up on everything primary care before making the change. That could probably be done faster, but you really don't want to learn everything on the job.

I mean we let PLPs do it.

I doubt a motivated physician would be worse than one of them.

 

[Brigade4Radiant]

I mean we let PLPs do it.

I doubt a motivated physician would be worse than one of them.

This is the reality also you can refer out. EM you must at least do a vague medical screening exam on anyone who comes in so you see some of the worst.

Would they be as good as an experienced doc no. But EM is an outpatient setting and we see acute exacerbation and chronic conditions with specialty help all the time

Similar argument can be made about only pediatricans should see children or a hospitalist that has practiced for 10+ years going into outpatient

 

[RustedFox]

I need to get out of the ED. I hate it. I’m tired of being treated like a piece of **** by administration, other doctors, patients and society in general. Anyone know anyone or any ways to go into family medicine, specifically outpatient clinic. I do not want to do family medicine residency. The way I see it, if family docs can moonlight in our EDs why can’t I start doing that in a family practice clinic.

Hit me like a punch to the high abdomen, for the record.

I'll say it again for any kid reading this: DON'T. DO. EMERGENCY. MEDICINE.

 

[VA Hopeful Dr]

I mean we let PLPs do it.

I doubt a motivated physician would be worse than one of them.

We let them do damned near everything. That doesn't make it a good idea nor should that be your standard if you want to practice primary care.

As for your second sentence, My third paragraph directly addresses that. But I'll state it again: as an emergency physician, if you're willing to put in the leg work to really study up on primary care for a decent bit of time before making the jump into primary care, you will probably be pretty good at it. Go to conferences, do primary care CME, a very high yield thing would be to do a family medicine board review course.

 

[VA Hopeful Dr]

This is the reality also you can refer out. EM you must at least do a vague medical screening exam on anyone who comes in so you see some of the worst.

Would they be as good as an experienced doc no. But EM is an outpatient setting and we see acute exacerbation and chronic conditions with specialty help all the time

Similar argument can be made about only pediatricans should see children or a hospitalist that has practiced for 10+ years going into outpatient

Your last part absolutely has merit. My wife transferred back into outpatient after 3 years of being a hospitalist and the first 6 months were pretty rough. She's openly said she wished she had done a refresher course or reading of some sort before diving in.

If you're a family doctor that has a decent pediatric population, you're going to be fine. For example, I have a partner that gets somewhere around a dozen new patient newborns a month. I think she does a very good job with children as they're around 30-40% of her schedule on any given day. Because of my refusal to see unvaccinated children, I have maybe five patients under the age of three that I'm currently caring for and so I would not be thrilled about taking on a bunch of newborn patients without at minimum doing a fair bit of reading to get caught back up.

 

[smq123]

This is the reality also you can refer out. EM you must at least do a vague medical screening exam on anyone who comes in so you see some of the worst.

Would they be as good as an experienced doc no. But EM is an outpatient setting and we see acute exacerbation and chronic conditions with specialty help all the time

Similar argument can be made about only pediatricans should see children or a hospitalist that has practiced for 10+ years going into outpatient

"I'll just refer out everything that I don't know what to do with" is not a great strategy. You'll a) piss off your patients who don't want to see another doctor or make another appointment (or pay a higher copay) if they don't absolutely have to, b) if you're doing this as part of a DPC practice, some of your patients may not have insurance, and c) you might legitimately piss off the specialists who don't want to do your thinking for you.

 

[RustedFox]

It's.
The.
Patients.

 

[kumatie]

It's.
The.
Patients.

It truly is. I never thought I would become a person who hates peoples and hates human interaction. After working in the ED for 12 years, I can’t stand people. It’s even worse when I am not at work. All I see now is the terrible things in people, because, that all I have ever seen in the past decade.

 

[kumatie]

Thank you all for the responses, it has been extremely helpful. Now I just need my husband to get on board! 😬

 

[RustedFox]

It truly is. I never thought I would become a person who hates peoples and hates human interaction. After working in the ED for 12 years, I can’t stand people. It’s even worse when I am not at work. All I see now is the terrible things in people, because, that all I have ever seen in the past decade.

And THEN, you're DOUBLY mad at them for being ignorant of [this] and [that] because they walk around with no idea about what is wrong with the planet and they have the nerve to complain about [whatever]. DO THEY NOT SEE HOW SOCIETY IS COLLAPSING AND THEY'RE A PART OF IT ?!?!

 

[Mount Asclepius]

I’m going to throw out a different perspective.

I’ve gone through phases of hating people in general just like the rest of many of you. And some people truly are terrible.

We all have really high expectations as physicians. I started to get madder and madder when subcontractors I hired to work on my house didn’t have the same intellect, work ethic and drive to create a job well done as I do. After a countless number of frustrating interactions I started realizing it was me who was unrealistic and creating the drama. My expectations were too high. Not everyone is as smart or works as hard as we do. Sure, I have my concerns regarding American culture, but it’s also not fair to expect the average or below average person to be the same as an above average person. I’m simplifying as we aren’t all good or all bad, or summed up as an above or below average person, but instead a meshwork of different strengths and weaknesses.

Once I started accepting where people were coming from I became better at empathizing with them. The parents raising a 2 year old for the first time don’t always know what to do with croup in the middle of the night. It’s not really an emergency. They are just scared. A majority of ED visits have a component of anxiety and fear often mixed with a little pain.

I agree, there are plenty of other idiots out there. I think it’s just worth realizing that you will go through certain phases of attitudes of disdain or hate towards people as a whole. There are ways to help mitigate the burnout though. I don’t think you can really last beyond 10 years in EM if you can’t learn to mitigate frustrations with people that understandable aren’t perhaps at the same station in life as you.

And for all of the other ridiculous ED chief complaints, just laugh them off and post them online for the rest of us to laugh about.

One homeless, schizoaffective, occasional methamphetamine abuser, frequent flyer we have came in with a chief complaint: I don’t think my penis is my penis. When inquired further he said he thought someone else took his penis and replaced it with a different one 🙃

 

[Mount Asclepius]

You can definitely switch to outpatient primary care (just like you can switch to a lot of things), but if you are going to do it and do it well you need to put in a ton of work. Either through residency training or extensive self-study like the physician @Birdstrike alluded to. Most of us aren’t willing to commit to that, don’t have the interest in chronic disease management, and are really just frustrated with our current practice environment. We are better than MLPs. Just because they do it with minimal training doesn’t mean you should. Don’t hold yourself to that low standard. We aren’t trained as EPs to do outpatient primary care. Just because there is some overlap doesn’t mean it’s an easy transition. We don’t know a lot of the field and don’t know what we don’t know.

 

[RustedFox]

I’m going to throw out a different perspective.

I’ve gone through phases of hating people in general just like the rest of many of you. And some people truly are terrible.

We all have really high expectations as physicians. I started to get madder and madder when subcontractors I hired to work on my house didn’t have the same intellect, work ethic and drive to create a job well done as I do. After a countless number of frustrating interactions I started realizing it was me who was unrealistic and creating the drama. My expectations were too high. Not everyone is as smart or works as hard as we do. Sure, I have my concerns regarding American culture, but it’s also not fair to expect the average or below average person to be the same as an above average person. I’m simplifying as we aren’t all good or all bad, or summed up as an above or below average person, but instead a meshwork of different strengths and weaknesses.

Once I started accepting where people were coming from I became better at empathizing with them. The parents raising a 2 year old for the first time don’t always know what to do with croup in the middle of the night. It’s not really an emergency. They are just scared. A majority of ED visits have a component of anxiety and fear often mixed with a little pain.

I agree, there are plenty of other idiots out there. I think it’s just worth realizing that you will go through certain phases of attitudes of disdain or hate towards people as a whole. There are ways to help mitigate the burnout though. I don’t think you can really last beyond 10 years in EM if you can’t learn to mitigate frustrations with people that understandable aren’t perhaps at the same station in life as you.

And for all of the other ridiculous ED chief complaints, just laugh them off and post them online for the rest of us to laugh about.

One homeless, schizoaffective, occasional methamphetamine abuser, frequent flyer we have came in with a chief complaint: I don’t think my penis is my penis. When inquired further he said he thought someone else took his penis and replaced it with a different one 🙃

Yeah, but the muggles then in turn hold US to an incomprehensibly perfect standard.
It has to work both ways. If you want me to chill out, then they also must in turn, be chill.

 

[Brigade4Radiant]

Mychart messages and prior authorizations Google reviews. Every field of medicine has its crap. You can do a lot in medicine just like how IR and vascular will fight over their turf or how cardiology stole caths and echos from rads.

 

[gutonc]

Yeah, but the muggles then in turn hold US to an incomprehensibly perfect standard.
It has to work both ways. If you want me to chill out, then they also must in turn, be chill.

I feel you both.

I'm not in EM, so I have the luxury of developing relationships with my patients, and my experience is probably only marginally related to yours.

At the same time, I'm an oncologist, so my patients tend to be pretty f***ing amped up about their issues, needs, etc and are constantly crawling up my a** via patient portal messages and calls to my nurse (which you're largely insulated from once you d/c them...until they check in again while you're on shift).

I have definitely found that meeting people where they are and trying to understand what they want and expect, and explain what I can/can't do for them, goes a long way.

But still...a lot of people are just total f*****g trash.

 

[Mount Asclepius]

Yeah, but the muggles then in turn hold US to an incomprehensibly perfect standard.
It has to work both ways. If you want me to chill out, then they also must in turn, be chill.

I don’t disagree. I just haven’t found perpetual dissatisfaction with people and American society good for my overall sanity. I’ve tried to find a better way to harmonize my developed disdain for people, my historic ideal to care for others, and my practical desire to build wealth for myself and my family.

 

[BJJVP]

Here is a previous post of mine from a similar thread:

I am boarded in EM and used to believe some of what everyone has stated above about primary care being an easy transition. I have family and friends in primary care and they told me the same thing. My wife even told me, "They have NPs doing this and YOU feel nervous?" She added, "Just refer whenever you're not sure. It's not like the ER where people die if you get it wrong." However, after having worked at a college campus student health clinic, I have to disagree. I wasn't even working in a bonafide primary care clinic and I felt I was outside my comfort zone. Sure, no one will go home and die within 48 hrs. And after letting a condition or symptom go for longer than it should before referring or taking other measures, for most cases, I would probably eventually "get it right." But the truth is it just didn't feel ideal or fair to the patient.

In the ED, I don't consult for every condition nor do I admit every vague presentation. In that setting, I am quite confident clinically. But in the outpatient setting, I felt woefully unprepared and making up for it by just reading uptodate, doing a literature search or glancing over a review article seemed pathetic and dangerous. I saw young, healthy college kids for the most part and talking to them about pap smear recommendations, birth control options, cholesterol and HgbA1C numbers, weird moles, migraine HAs, unexplained wt gain/loss, etc. couldn't be any further outside the medical world I was trained for. Sure, you can look things up and continue to "practice" until you gain experience but it felt wrong, even if nobody died immediately or suffered significantly as a result of my care.

There is something to be said for having seen experienced physicians before me do things a certain way, give you specific reminders, point out certain red flags, tell you about their experiences. You need to see normal outcomes, expected complications and treatment side effects, see common mistakes and their consequences. You need to do journal club and see if what is written actually applies in real practice settings. A lot of emergency medicine writing talks about orthostatic BP for GI bleeds, auscultating bruits in AAAs, vagal maneuvers for SVT, neck stiffness for meningitis, ultrasounding every body part, etc. In reality, most ER doctors don't practice that way. You need to have the perspectives of many different attendings with different philosophies, tolerances for risk, practice styles. You need to do things over and over again. You need to see the routine stuff thousands of times so you recognize when something is wrong. You get this in residency, NOT when "practicing" in isolation while reading review articles.

The final straw for me was when I thought about the notes I was writing in the pt charts. Could I be proud of my care for these pts? If I stayed at this clinic for 10 years, could I look back on my body of work and feel good? Would the next physician look back and say, "Man, this guy was good!" My own answer to that question was that I wasn't sure because I didn't really know how other PCPs practice. Other than what I've read, I couldn't be sure what was actually standard of care. Because of that, I resigned.

Primary care is not easy. It sounds easy but believe me, it is not. I am not saying don't try it. I do believe that my experience in the outpt setting has made me a more well rounded physician. However, you need to remember that you are not a PCP. You really need to watch yourself closely to be sure you don't cross any major scope of practice lines. As much as I enjoyed my break from the chaos and dysfunction of the ER, I quit the clinic because watching that line day in and day out was not what I wanted to do.

 

[VA Hopeful Dr]

I feel you both.

I'm not in EM, so I have the luxury of developing relationships with my patients, and my experience is probably only marginally related to yours.

At the same time, I'm an oncologist, so my patients tend to be pretty f***ing amped up about their issues, needs, etc and are constantly crawling up my a** via patient portal messages and calls to my nurse (which you're largely insulated from once you d/c them...until they check in again while you're on shift).

I have definitely found that meeting people where they are and trying to understand what they want and expect, and explain what I can/can't do for them, goes a long way.

But still...a lot of people are just total f*****g trash.

Its everywhere. I had a guy just yesterday who told me it was his right to demand and receive any testing he wanted and it was not my decision to not order what he wanted.

 

[greatnt249]

Its everywhere. I had a guy just yesterday who told me it was his right to demand and receive any testing he wanted and it was not my decision to not order what he wanted.

Well, I guess it's also his right to find himself another primary if he's so dissatisfied. Would not be disappointed about being "fired" by such a patient.

 

[Apollyon]

I have definitely found that meeting people where they are and trying to understand what they want and expect, and explain what I can/can't do for them, goes a long way.

I recall something I read on Cracked. It was about things that happen at Disney, from the cast members.

Speaking of Mickey, every single terminally ill Make-a-Wish kid gets to meet him, and that's hard. And because of how often sick kids visit the park, it can be a painfully regular thing. The Fairy Godmother has it hardest: Kids ask her to cure them. If I made it to the second set without sobbing, it was usually a good day.

From here.

 

[thegenius]

Its everywhere. I had a guy just yesterday who told me it was his right to demand and receive any testing he wanted and it was not my decision to not order what he wanted.

Did you tell him it's his obligation to then pay for all the testing too?

 

[VA Hopeful Dr]

Did you tell him it's his obligation to then pay for all the testing too?

There's little I enjoy more than ordering tests with the diagnosis code of "patient requests diagnostic testing". Insurance rarely covers it.

 

[gutonc]

Its everywhere. I had a guy just yesterday who told me it was his right to demand and receive any testing he wanted and it was not my decision to not order what he wanted.

Not sure if it's still around near you, but all the "AnyLabTestNow" locations around here closed because nobody wanted to actually pay for that stuff. Turns out when you're actually responsible for the cost, you may not in fact want "any lab test now".

 

[RustedFox]

There's little I enjoy more than ordering tests with the diagnosis code of "patient requests diagnostic testing". Insurance rarely covers it.

To be fair - the patient pays the premiums.
We all know how insurers are.

 

[rokshana]

Its everywhere. I had a guy just yesterday who told me it was his right to demand and receive any testing he wanted and it was not my decision to not order what he wanted.

they have the right to find someone who may do that...butt i'm not that person...the physician's office is not the burger king...

 

[VA Hopeful Dr]

To be fair - the patient pays the premiums.
We all know how insurers are.

Yep, and for non-jackasses I will do my best to make sure things are coded so insurance will cover them.

 

[cyanide12345678]

It truly is. I never thought I would become a person who hates peoples and hates human interaction. After working in the ED for 12 years, I can’t stand people. It’s even worse when I am not at work. All I see now is the terrible things in people, because, that all I have ever seen in the past decade.

Decrease hours first, drop down to 8-10 shifts before you make any other decision.

8 shifts at my shop gets a FM equivalent salary.

While i absolutely hate the ER, regret picking EM, am absolutely burned out, i would pick working 8 days in the ER over a full time job in family medicine…. At least that’s what i would do today

 

[namethatsmell]

I need to get out of the ED. I hate it. I’m tired of being treated like a piece of **** by administration, other doctors, patients and society in general. Anyone know anyone or any ways to go into family medicine, specifically outpatient clinic. I do not want to do family medicine residency. The way I see it, if family docs can moonlight in our EDs why can’t I start doing that in a family practice clinic.

Rest assured that every doc, everywhere, has to deal with this.

But having transitioned out of EM and now with a wider perspective, NOBODY has to deal with this as much as EM docs. Not even close. But after that, the next most likely to be abused are the PCPs (unless DPC, gawlbless them).
If being "respected" by the groups you mentioned is a priority (no shame in that), than you may want to consider biting the bullet and doing a fellowship of some kind that allows you to work outside of the ED (HPM, hyperbarics, whatever). The amount of sincere "thank yous" I get from admins/patients/other docs in a week = the amount I'd get in a year or two in the ED. And when the **** hits the fan and there's a disagreement with one of the groups you mentioned...well you're a "specialist," so 99% of the time said **** rolls away from you and towards somebody else.
That said, if you do make your way into primary care you will be doing society a solid and will have unlimited business.

Maybe consider something outside clinical practice?

Good luck to you.

 

[RustedFox]

Decrease hours first, drop down to 8-10 shifts before you make any other decision.

8 shifts at my shop gets a FM equivalent salary.

While i absolutely hate the ER, regret picking EM, am absolutely burned out, i would pick working 8 days in the ER over a full time job in family medicine…. At least that’s what i would do today

This is the way.

 

[miacomet]

ABEM is bound and determined to have as few exit strategies for EM as possible, that's for sure. It's like the opposite of every other specialty board that wants as many options as possible for their docs.

 

[Kryptocoin]

It's like jumping from the fire to a hot pan. You'll get burned either way. Primary care ain't it.

Look into occupational med. Less pay but also less stress.

 

[cyanide12345678]

It's like jumping from the fire to a hot pan. You'll get burned either way. Primary care ain't it.

Look into occupational med. Less pay but also less stress.

Do you need further fellowship in it to do this?

 

[Kryptocoin]

Do you need further fellowship in it to do this?

Yes there are fellowships. But I've also seen some people practice without it depending on the job (clinical vs administrative).

 

[Birdstrike]

ABEM is bound and determined to have as few exit strategies for EM as possible, that's for sure. It's like the opposite of every other specialty board that wants as many options as possible for their docs.

People have mocked me when I've posted that EM was and is designed to keep EPs trapped in the ED. Does it make sense yet?

 

[Apollyon]

People have mocked me when I've posted that EM was and is designed to keep EPs trapped in the ED. Does it make sense yet?

Who? When?