Then my suggestion would be that you fly EVERYWHERE you ever go, and only to MAJOR cities. Because outside academic hospitals, and about 30 miles outside any MAJOR city, you will usually find yourself at an emergency department staffed by non boarded, non EM trained doctors. Make sure you remind them when you get sick or hurt anywhere along I-80, I-35, I-95, I1-, I-20, that you don't think they should be practicing there. There MAY come a day that we have twice as many EM trained doctors, but my guess is at that time the city jobs will just become more competitive and the semi-rural and rural hospitals will still be wishing for EP's. Academic medicine aside, politics of medicine often has more to do with measuring one's private member than anything else. That said, as I mentioned before, I do not feel that non EM trained doctors should carry the board certification in EM title.
EM physicians inherently love to get the dispo, and get the patient moving to their next destination, but we are often a little less informed than we should be about what actually occurs at those particular destination. ICU medicine is a completely different beast than EM, though along the same lines. ICU medicine is where EM/IM becomes a hybrid type. If I had to actually care for someone in the ICU now, I would need a lot of help. Sure I could intubate them, set some initial vent settings and maybe even make minor adjustments. But the real day to day medicine that occurs on the floors and in the ICU's is better left to those particular physicians. And Bandit by virtue of spending a ton of time in emergency medicine already, is probably now one of the more qualified physicians out there. Probably the most well rounded physician around is a surgeon who does a critical care fellowship for 2 years. Next to that I would place an EM doc with a critical care fellowship. And that is basically what Bandit has done.
Bandit, come work with us any time!
