FSED

[deleted814217]

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Hey all,

currently looking for my first job out of residency slightly limited in geography due to family reasons. One of the offers I have in a pretty competitive is area is for FSED work. Pay is decent for the area and there is the opportunity to move into one of their main sites (they have several) when they open.
My biggest concern is honestly skills atrophy and working at freestanding ed as a first job as I feel it won’t be a great environment for a new grad in terms of a first grad experience. Currently at a busy academic program in a major metropolis but have done lots of time at community EDs that are really sick as well. Any thoughts on this? In every other way it’s got a great location, great group and great hours just can’t shake the fact I’d be shortchanging my growth as a physician by doing this

 

[GeneralVeers]

Hey all,

currently looking for my first job out of residency slightly limited in geography due to family reasons. One of the offers I have in a pretty competitive is area is for FSED work. Pay is decent for the area and there is the opportunity to move into one of their main sites (they have several) when they open.
My biggest concern is honestly skills atrophy and working at freestanding ed as a first job as I feel it won’t be a great environment for a new grad in terms of a first grad experience. Currently at a busy academic program in a major metropolis but have done lots of time at community EDs that are really sick as well. Any thoughts on this? In every other way it’s got a great location, great group and great hours just can’t shake the fact I’d be shortchanging my growth as a physician by doing this

Definitely you would be harming your ability to work higher acuity later. Is it possible to take a side gig at a real hospital for a few shifts per month?

 

[deleted814217]

there are opportunities within the organization but seem more per diem than anything and less of a guarentee. Leaning towards not accepting for that very reason and not shortchanging myself coming out of residency buts it’s tough for all the other reasons.

 

[cyanide12345678]

there are opportunities within the organization but seem more per diem than anything and less of a guarentee. Leaning towards not accepting for that very reason and not shortchanging myself coming out of residency buts it’s tough for all the other reasons.

If you can do per diem 4 or so monthly shifts at a real hospital and 8 or so at the free standing, you might not lose skills. I think you need a minimum of 4-6 busy shifts to really keep your ER skills intact straight out of residency.

What's the annual volume of the place by the way?

 

[beebermd]

I was in a similar place. I work/have ownership in a couple of FSED. The FSEDs are a breath of fresh air, but i couldnt shake that i was shortchanging myself professionally. I work 8 shifts at the FSED and 5 at my traditional ED. I dont need the income, but it keeps my skills up. Honestly, 90% of the time, when im getting killed, i think "why are you putting yourself through this?" lol. but i just dont have it in me to quit. On the other side, i have partners who only do the freestanding gig..........and they havent intubated in 3 years. One of them is fresh out of residency. It doesnt seem to bother them. I dont know what they plan to do if market changes and the FSED model is no longer viable (its already there in someplaces). At my traditional ED, I am also the medical director for a CMG. I have had resumes come across my desk of good qualified EM boarded docs who worked at FSEDs that have since closed. if they have not worked in a traditional ED in over 2 years, they are considerd not hireable by CMG. Between legislation for the FSED, provider oversupply, and the ability for CMGs to lower rates/be picky on who they hire...............your concerns are valid. I would to do both, diversify your portfolio so you have options either way for the future. EDIT: I am assuming FSED as used by OP is reffering to the physican owned, no medicare/medicaid. If it is a FSED that is actually run and operated by the hospital system that it feeds, then forget what i just said. you will be fine.