I appreciate the responses! I am aware of some of the issues. Would you mind expanding on what problems you have encountered and issues you see in the specialty? Thanks!
As an EM veteran (DO that matched allopathic), I kind of agree. Since the mid 2000s, EM reimbursement has been stagnant, DEFINITELY not keeping up with even inflation, and that leads to declining pay year over year. With the primary care shortage, guess who gets to see those patients? Don't want to wait 3 weeks for a PCP appointment? Go to the convenience department (ED). Insurance lapsed? ED. Drunk and the cops don't want to deal with you? ED. With the maturity of the social media experiment, and with attitudes post covid, demands and expectations are becoming worse and worse. Want to go to your kids ballgame? Good luck, you just worked a late swing shift on Friday, slept until 2pm, and you have to work Saturday night. Do you like getting verbally and physically abused at work by drunk, high, and demented patients? You're in the right spot. We used to do a ton of central lines and intubations, and while we still intubate, the number is way less woth the high flow nasal canulas. Using an US IV for peripheral pressors for 24 hours has cut down significantly on the number of central lines I place. If you're in it for procedures, there might be other specialties that would better fill that need.
Now.
That being said, there are some pretty awesome sides of EM as well. I work less than half of the month, 12-13 8 hour shifts. That's full time with my group, and I made partner, so I am pretty well compensated. We get plenty of schedule requests, so if you need to make certain days be off for events, you can. It might make the rest of your month more cumbersome and busy, but its doable if you know about it ahead of time. We have a great group that helps each other out if youre sick or family things come up. For me, the scheduling was enticing, but I was able to work nights for even more schedule control. It works for me and my family, it may not for you. I still find joy in the co.plex metabolic cases. I LOVE me a difficult airway or a crashing COPD patient. I feel like I can turn them around, and I do a good job of both stabilizing and resuscitating them. I like my colleagues both in the ED and my hospital counterparts.
After 13 years, I'm bowing out and working on getting out of the ED. I am applying for fellowships right now. Personally, I want different hours and a different patient cohort. I have multiple docs in my group that have been here for 15-20+ years. If you find the right spot, it's great. You may need to search around to find that, though. Your first job doesn't have to be your last.
