Is there anything good about EM?

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susejwodahs

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Hi all,

I'm an MS3 that has wanted to be an ER doc since he was a kid.

I have stayed away from sdn largely because I find it to be unnecessarily anxiety producing and toxic, especially in premedical and med student forums. In thinking about residency applications I ventured on here. What I have found, not surprisingly given my other experiences on this site, is waves of negativity, regret, frustration, and unhappiness written by emergency medicine physicians. I don't want to minimize what these posters feel or experience but....

Is this legit? Or are there some of you out there that actually like this profession?

Thanks all.
 
I make a pretty good living working 12 days and b/w 90-100 hrs a month. My wife is also a physician. Makes 40% of what I do and works at least 6 days and 60hrs a week when you include all the paperwork and charting after her work. There’s a lot of doom and gloom on this board, but, there is doom and gloom in every single specialty. No job or specialty will be perfect. It’s not necessarily an EM problem. With the government, Press Ganey, and the joint commission continuing to tell all physicians and hospitals how to practice, the real question is there anything good about medicine in general anymore.
 
So much has changed, that it's hard to tell.
More insightful post coming soon; I gotta get ready to clean house.
 
TheSingularity said:
It's not an emergency medicine problem.

It's a medicine problem.

Get out while you can.

(Not joking.)

Sent from my Pixel 3 using SDN mobile
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Thank you everyone for your replies.

Again, I understand that there is a lot of dissatisfaction. But I have met plenty of doctors who love their jobs so it's not universal, at least anecdotally. I just am trying to find the truth, and I think there is a lot of sampling bias on SDN. E.g. those that are unhappy enough to post here about it do, and those that love their jobs don't.
 
susejwodahs said:
Thank you everyone for your replies.

Again, I understand that there is a lot of dissatisfaction. But I have met plenty of doctors who love their jobs so it's not universal, at least anecdotally. I just am trying to find the truth, and I think there is a lot of sampling bias on SDN. E.g. those that are unhappy enough to post here about it do, and those that love their jobs don't.
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I say this respectfully and I don't intend to minimize the negative experiences many of you may have had.
 
I still love my job. I will also tell you that plenty of people hate their job but only tell other docs. They may tell their wives but many feel stuck. I think if you go into it with understanding what the job is, what to expect and dont get caught up in needing a ton of income it is hard to imagine you wont be happy. I mean you can work 100 clinical hours a month and make 250k. that doesnt exist in most of medicine. that being said there are some terrible aspects of EM.
 
This place indeed is full of negativity, and a poor outlook on our field in general. This certainly is not representative of medicine and especially emergency medicine. I have been doing this for almost 10 years and still truly love my job. Most of the other physicians I work with feel similarly, though I suspect much of it has to do with our intrinsic work environment, some hospitals are certainly better and keeping us happy than others (such as the nuances of EMR, staffing ratios, metrics, etc.). All in all though, I would choose emergency medicine again if I had to do it over, certainly medicine as a field. It can be frustrating sometimes although can be quite satisfying. A lot of it has to do with the individual themselves, some of us are made for this type of work, others are not, and thus might lead to significant dissatisfaction. Be careful what you read on these forums, the majority of posters here are indeed disgruntled, jaded, burned out, ect. Unfortunately this is still a significant percentage of mercy medicine physicians though not nearly as large as these forums would have you believe. Good luck, and you're making the right choice becoming a physician.
 
Lex81 said:
This place indeed is full of negativity, and a poor outlook on our field in general. This certainly is not representative of medicine and especially emergency medicine. I have been doing this for almost 10 years and still truly love my job. Most of the other physicians I work with feel similarly, though I suspect much of it has to do with our intrinsic work environment, some hospitals are certainly better and keeping us happy than others (such as the nuances of EMR, staffing ratios, metrics, etc.). All in all though, I would choose emergency medicine again if I had to do it over, certainly medicine as a field. It can be frustrating sometimes although can be quite satisfying. A lot of it has to do with the individual themselves, some of us are made for this type of work, others are not, and thus might lead to significant dissatisfaction. Be careful what you read on these forums, the majority of posters here are indeed disgruntled, jaded, burned out, ect. Unfortunately this is still a significant percentage of mercy medicine physicians though not nearly as large as these forums would have you believe. Good luck, and you're making the right choice becoming a physician.
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Lex81 thank you for your insight. Although I appreciate hearing from those with darker stories, my hope is restored when I hear from individuals such as yourself. Can I ask you specifically what aspects of EM you love?
 
Lex81 said:
This place indeed is full of negativity, and a poor outlook on our field in general. This certainly is not representative of medicine and especially emergency medicine. I have been doing this for almost 10 years and still truly love my job. Most of the other physicians I work with feel similarly, though I suspect much of it has to do with our intrinsic work environment, some hospitals are certainly better and keeping us happy than others (such as the nuances of EMR, staffing ratios, metrics, etc.). All in all though, I would choose emergency medicine again if I had to do it over, certainly medicine as a field. It can be frustrating sometimes although can be quite satisfying. A lot of it has to do with the individual themselves, some of us are made for this type of work, others are not, and thus might lead to significant dissatisfaction. Be careful what you read on these forums, the majority of posters here are indeed disgruntled, jaded, burned out, ect. Unfortunately this is still a significant percentage of mercy medicine physicians though not nearly as large as these forums would have you believe. Good luck, and you're making the right choice becoming a physician.
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Again I like my job but look at burnout amongst EPs. higher than average for medicine. you are very right in that much of it has to do with your work environment and just one of the reasons why I am a firm SDG advocate. Much of the crap in medicine is how we treat each other and frankly how we have become cogs in many of the machines. We lack control of our environment and are put in situations where we are afraid of losing our jobs.

My sdg is highly involved in our hospital and we certainly arent the end all be all but it is nothing like the crap i hear about HCA sites. on another note USACS sucks so avoid them at all cost. The only people who like them are the usacs executives.
 
EctopicFetus said:
Again I like my job but look at burnout amongst EPs. higher than average for medicine. you are very right in that much of it has to do with your work environment and just one of the reasons why I am a firm SDG advocate. Much of the crap in medicine is how we treat each other and frankly how we have become cogs in many of the machines. We lack control of our environment and are put in situations where we are afraid of losing our jobs.

My sdg is highly involved in our hospital and we certainly arent the end all be all but it is nothing like the crap i hear about HCA sites. on another note USACS sucks so avoid them at all cost. The only people who like them are the usacs executives.
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Ectopic, thank you for your posts. I am unfamiliar with these acronyms, can I bother you for a rundown of their meanings?
 
Do a search... This topic has been rehashed a million times on this forum. Yes, there are plenty of us that still enjoy EM although it's not a perfect specialty. I still wouldn't do anything else or maybe I'm just too old (read lazy) not to do anything else. The work is interesting (and entertaining), the pace is perfect for docs easily distracted, the money is good and I work far fewer hours than most specialists. I also probably have much greater control over my schedule insofar as how many hours worked out of the month. (Can't control not working nights, holidays,weekends, but I could easily choose to work 6 shifts/mo and still make almost 200K. That's really difficult to do in anything else, if not impossible.

If you feel like you're reading too much doom and gloom, chances are you're reading too many @Birdstrike posts. Learn to cover your eyes when you see that plane avatar. 😉
 
You'll notice that a lot of the "save yourself" posts eventually seem to be coming from the same people. It's not that they're wrong -- medicine is far from perfect, and I struggle with whether I would do this again on more than a few days -- it's that we do still have a good thing in the grand scheme of things. A lot of bull****, but a good thing.

Some bull**** varies on setting. Inner city or not. Independent/democratic group versus mega corporation. Degrees of pushback. Etc.

No specialty is perfect. No place within any specialty is perfect. Pick what gives you most of what you'd like and comes with the headaches you can best tolerate.
 
Groove said:
If you feel like you're reading too much doom and gloom, chances are you're reading too many @Birdstrike posts. Learn to cover your eyes when you see that plane avatar. 😉
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That’s right. Definitely don’t read my posts.
 
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I am a first year attending, I have wanted to be a ER doc since first year of college. I find the job extremely rewarding, challenging, and well-compensated. Just like any job ever there are good days and bad days. I also have ~$250K of student loan debt but don't regret it. Some days I wish that I had more weekends and evenings off, but not at the expense of working a 9-5 desk job.

The first patient I "saved" as an attending recently came back to the ER with family and gave me a hug and cried. Not many things have ever felt that good. The perfect intubation, a smooth sedation and joint reduction, spending time hearing stories from people I would never otherwise interact with are also all good things.
 
susejwodahs said:
Ectopic, thank you for your posts. I am unfamiliar with these acronyms, can I bother you for a rundown of their meanings?
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Anyone considering going into emergency medicine should be at least decently versed in this terminology. It's literally going to 100% affect you in every way. Research contract management groups and what/who they are, small democratic groups, become familiar with the landscape that EM is entering with an over supply of EM physicians entering the field, Google the rape of emergency medicine, etc.

It's very easy for docs on here who have been at the same job for years and years say everything is fine, but there's already negative effects of over supply popping up and it's still early and residencies are opening monthly now it seems like.

Although I do agree that all of medicine is sprinting to the dumpster, EM is doings it's best to keep first place.
 
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Practice environment is key.

Avoid HCA, envision, team health, USACS, vituity... Really any entity with any kind of shareholder / private equity involvement.

I did a few years in the **** pit and now I'm taking a modest pay cut to work someplace functional with a real EMR and real leadership.

Sent from my Pixel 3 using SDN mobile
 
All medicine is challenging, EM does not have the best lifestyle, nor does it have the highest pay, nor is it necessarily the shortest residency, and we definitely don't do the coolest procedures in the hospital, but I think it's a reasonable mix. Fair amount of interesting procedures, livable lifestyle, no fellowship requirement (people do fellowships out of interest, not out of necessity like in IM, surgery or peds).

I think the thing I most enjoy about it compared to other fields of medicine is how undifferentiated patients are and how it's one of the last few specialties where you get to work up patients from scratch. Surgeons don't see a patient with undifferentiated abdominal pain and embark on a workup like William Halsted anymore, they have a patient and a CT handed to them, cardiologists don't see chest pain from scratch, etc.
 
susejwodahs said:
Is this legit? Or are there some of you out there that actually like this profession?

Thanks all.
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EM is great for 2 types of people.
1) True believer humanitarians who enjoy people so much that they don’t mind the majority of EM which is taking care of routine problems in low-functioning patients after 5PM. They want to help people and don’t mind if that means treating their foot fungus on Christmas Eve.

2) People who plan to use EM as a launching platform to something else (fellowship, admin, research, teaching, NASA, FBI, etc.). These types tend to be motivated with a 5-year plan.

Those who plan to pursue EM with the expectation of a career taking care of really sick people need to understand that the price of admission is 5 PGY training years, not 3. Three years gets you the distinct honor of being a primary care doctor to the underserved with an unfavorable schedule.
 
DrGasPasser said:
1) True believer humanitarians who enjoy people so much that they don’t mind the majority of EM which is taking care of routine problems in low-functioning patients after 5PM. They want to help people and don’t mind if that means treating their foot fungus on Christmas Eve.
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Taking care of foot fungus on christmas eve is a fine trade off for never taking call and not having to see clinic patients, you don't go into EM because you want constant acuity 24/7, you go into it because you're fine with taking care of primary care complaints in low functioning patients and the occasional sick patient, not the other way around.
 
susejwodahs said:
Hi all,

I'm an MS3 that has wanted to be an ER doc since he was a kid.

I have stayed away from sdn largely because I find it to be unnecessarily anxiety producing and toxic, especially in premedical and med student forums. In thinking about residency applications I ventured on here. What I have found, not surprisingly given my other experiences on this site, is waves of negativity, regret, frustration, and unhappiness written by emergency medicine physicians. I don't want to minimize what these posters feel or experience but....

Is this legit? Or are there some of you out there that actually like this profession?

Thanks all.
Click to expand...

I like to think that most of us vent on here. I know there is some burnout, maybe more than the average specialty, but how often are you going to find an anonymous forum on anything where people just say "how much they love life, and love their job, and just love everything they do?"

Anonymous forums in medicine, sports, video gaming, golf, weed-whacking, building houses, mazda3, leopard geckos, you name it. Most people vent because it's anonymous.

I'm generally happy with my career choice. Of course there are things that I don't like about it. That is true for any job ever in the history of mankind. All I can tell you is that there isn't an ideal specialty in medicine and the kinds of things we complain about can be equally applied to other specialties as well.
 
Renaissance Man said:
The first patient I "saved" as an attending recently came back to the ER with family and gave me a hug and cried. Not many things have ever felt that good. The perfect intubation, a smooth sedation and joint reduction, spending time hearing stories from people I would never otherwise interact with are also all good things.
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I've had that happen to and it makes your day. It's a great feeling.
 
Good things:

Pay (for now...), no call, can occasionally be fun cases, ER staff, easy to translocate, feel like you can pretty much handle anything.

Bad things:

Weekends and holidays, malpractice looming overhead, nights, lots of malingering/psych illness, lack of gratitude by a large portion of your patients, depending on where you work can have a lot of trouble dealing with consultants and getting what you need for the patients.

I’m sure there are other things. Every job has good and bad. For me, I wouldn’t want to do anything else just because of how many days off I have every month.
 
Yeah, the ability to take large chunks of time off with no call responsibilities is a huge plus and something I take for granted. I'm about to spend 9 days in Vail next month and have an additional 2 days off when I fly back in. I'm doing a similar trip in Jan. There's no way I'd be able to pull that off with any frequency doing IM (w/clinic) or a surgical specialty.
 
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Veil said:
You'll notice that a lot of the "save yourself" posts eventually seem to be coming from the same people. It's not that they're wrong -- medicine is far from perfect, and I struggle with whether I would do this again on more than a few days -- it's that we do still have a good thing in the grand scheme of things. A lot of bull****, but a good thing.

Some bull**** varies on setting. Inner city or not. Independent/democratic group versus mega corporation. Degrees of pushback. Etc.

No specialty is perfect. No place within any specialty is perfect. Pick what gives you most of what you'd like and comes with the headaches you can best tolerate.
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OK - I was a grumpy mc grumperson in my last post. So big honesty time. The thing is, when evaluating what field you want to go into, you need to look at what's likely to be static, and try to ignore what might change. Pay attention to the actual intrinsic nature of the work - this is the most important.

EM at it's core is great. Fast paced, cool procedures, opportunity to make a real difference once in awhile.

The money is great - but likely to decrease with balance billing legislation. Yes, most of us make 300K+ only working around 12 shifts a month. I love the time off EM gives me to be with my wife and kid, play with my dog, travel, etc. I love the financial freedom it's bought me. But don't you think it's a red flag that a lot of posters here are basically like "the work is meh, but the pay and time off are great!" ? Watch what happens when that balance billing legislation kicks in - people will feel pressure to increase number of shifts to maintain their lifestyle in a steady state.

Practice environment is so important. Avoid CMGs at all cost. The extra 30/hr isn't worth it. Look for places with low turnover, low locums/traveler coverage, a real EMR (EPIC, up to date version of cerner), supportive leadership. IT doesn't have to be an SDG. I spent some time in some pretty awful shops to chase the money for a little bit, but I'm making a change to favor practice environment over money now that I'm in a more secure position.

As a corollary to practice environment, find a place where you can pursue what you liked in residency - teaching, admin, EMS - whatever. You need something besides churning through patient encounters to keep you going.

TL/DR: Find a nice shop, money isn't everything, f****** avoid CMGs.
 
susejwodahs said:
Ectopic, thank you for your posts. I am unfamiliar with these acronyms, can I bother you for a rundown of their meanings?
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As mentioned I would google "rape of emergency medicine". You will learn what to avoid, what to look for and the ugly underbelly of EM. Too many EM leaders are getting paid and rich off the sweat of the young.

USACS one of the contract management groups (The worst). Basically if you took a poop and smeared it on your face it would be better than working for USACS.

APP, Envision and Teamhealth are a slight improvement over this BS above.

Next level is Apollo and vituity. Also crappy but 3rd tier crappy.

You have to understand there are 3 types of job models.

1) own your practice aka Small democratic group (SDG). generally the best model but hard to find and some bad actors in this space.
2) work for one of the CMGs above. Basically you are a factory worker, they profit off of your labor and hide a lot of stuff from you that you should know since they use your NPI and you risk your license and status with medicare if they do illegal stuff.
3) employed. This is like #2 but instead of working for a for profit private equity owned/managed entity you work directly for the hospital. This also includes a lot of academic spots. These range from terrible to acceptable.

Note for #2 also some acceptable range in those jobs but note the jobs vary greatly amongst each of these. Good and terrible jobs found in each. Better jobs in #1 and 3. Generally average to below avg jobs in #2.
 
Wow thank you for your replies. Some points of consensus:

—EM is not all bad, but practice environment makes a huge difference
—Acuity is often dramatized; many ER docs are glorified PCP's that occasionally do critical stabilization etc.
—Schedule is good in terms of time off. Schedule is bad in terms of nights/weekends/holidays
—Pay is good, but likely not for long?
—Avoid CMG's like the plague (sounds like physicians should unionize against these leeches)
—One way to survive is to do a fellowship/have another pot on the stove so you're not just grinding shifts your whole career

Sound about right?
 
susejwodahs said:
Wow thank you for your replies. Some points of consensus:
—Acuity is often dramatized; many ER docs are glorified PCP's that occasionally do critical stabilization etc.

Sound about right?
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Oh hell no. Sure, some component of any emergency physicians job is taking care of patients that could have been seen in an office or undergone outpatient management. The appropriate use of midlevels allow urgent care work (minor injuries and low acuity medical conditions) to be managed by midlevels with higher acuity patients managed by physicians. But an EPs job isn’t or shouldn’t be glorified primary care, and if it is, get a new job.
 
EM in the United States except for a few rare instances is essentially 24/7 primary care.

If you are okay with this then you'll probably be happy with the career choice.
 
RuralEDDoc said:
Oh hell no. Sure, some component of any emergency physicians job is taking care of patients that could have been seen in an office or undergone outpatient management. The appropriate use of midlevels allow urgent care work (minor injuries and low acuity medical conditions) to be managed by midlevels with higher acuity patients managed by physicians. But an EPs job isn’t or shouldn’t be glorified primary care, and if it is, get a new job.
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alpinism said:
EM in the United States except for a few rare instances is essentially 24/7 primary care.

If you are okay with this then you'll probably be happy with the career choice.
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I am assuming this difference in experience gets back to the necessity of choosing the proper practice environment....
 
alpinism said:
EM in the United States except for a few rare instances is essentially 24/7 primary care.

If you are okay with this then you'll probably be happy with the career choice.
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I think this opinion is probably meant as hyperbole but I hear it frequently. I think it’s a misunderstanding of what primary care is. It’s easy as a seasoned emergency physician to discount the acuity of patient presentations to the ED, but that’s a distinct form of bias earned after seeing over 10,000 patients and understanding how to quickly sort sick vs not sick.
Consider abdominal pain in a well appearing patients with normal vitals. Clinics send us these patients all the time. Some would complain “why is this healthy 30yo with abdominal pain here, this could be outpatient”, forgetting that a reasonable number of these patients will require time sensitive surgical intervention. Sure the EP isn’t cracking the chest or doing massive resuscitation, but there is a real value add of the work done in this scenario and many other medium acuity conditions.
This type of patient does not bother me at all. I’ll see that all day and feel good about my job. What I HATE HATE HATE is the social dump patient for whom I and the hospital have nothing to offer other than outpatient care coordination. That’s the worst part of any job I’ve ever worked and can really ruin a shift if you let it.
 
SamtheWise said:
Taking care of foot fungus on christmas eve is a fine trade off for never taking call and not having to see clinic patients, you don't go into EM because you want constant acuity 24/7, you go into it because you're fine with taking care of primary care complaints in low functioning patients and the occasional sick patient, not the other way around.
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Yep. I’m just not sure that many students understand that until it’s too late. People going into emergency medicine because they want to take care of a lot of sick people may find that they have a problem once they leave residency.
 
RuralEDDoc said:
I think this opinion is probably meant as hyperbole but I hear it frequently. I think it’s a misunderstanding of what primary care is. It’s easy as a seasoned emergency physician to discount the acuity of patient presentations to the ED, but that’s a distinct form of bias earned after seeing over 10,000 patients and understanding how to quickly sort sick vs not sick.
Consider abdominal pain in a well appearing patients with normal vitals. Clinics send us these patients all the time. Some would complain “why is this healthy 30yo with abdominal pain here, this could be outpatient”, forgetting that a reasonable number of these patients will require time sensitive surgical intervention. Sure the EP isn’t cracking the chest or doing massive resuscitation, but there is a real value add of the work done in this scenario and many other medium acuity conditions.
This type of patient does not bother me at all. I’ll see that all day and feel good about my job. What I HATE HATE HATE is the social dump patient for whom I and the hospital have nothing to offer other than outpatient care coordination. That’s the worst part of any job I’ve ever worked and can really ruin a shift if you let it.
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In many parts of the world those patients are all managed outpatient with greatly reduced cost and identical outcomes. The beauty of working outside the United States in countries without EMTALA is seeing how much money we waste on useless emergency department care in this country.
 
Rekt said:
Anyone considering going into emergency medicine should be at least decently versed in this terminology. It's literally going to 100% affect you in every way. Research contract management groups and what/who they are, small democratic groups, become familiar with the landscape that EM is entering with an over supply of EM physicians entering the field, Google the rape of emergency medicine, etc.

It's very easy for docs on here who have been at the same job for years and years say everything is fine, but there's already negative effects of over supply popping up and it's still early and residencies are opening monthly now it seems like.

Although I do agree that all of medicine is sprinting to the dumpster, EM is doings it's best to keep first place.
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How difficult is it to find a job with a small Democratic group? Does one find these jobs mainly through networking?

Any idea what the landscape will look like in about 5 years? (When I would potentially be graduating from an EM residency)
 
I'd take EM any day over the drawn out rounding for hours on the floors
 
Clockdoc89 said:
How difficult is it to find a job with a small Democratic group? Does one find these jobs mainly through networking?

Any idea what the landscape will look like in about 5 years? (When I would potentially be graduating from an EM residency)
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I don't work for a SDG, so I have no personal experience how to find those jobs, but from what I have heard it is purely through networking, hence why it's beneficial to go to an established EM residency as opposed to a brand new residency in a city with 2 other EM residencies.

Who knows what the outlook will be in 5 years, I would guess it will be relatively similar with good jobs in desirable locations fewer and harder to come by, but who knows we may be speaking russian or worse we may all be employed by USACS and Teamhealth working telehealth remotely signing APP charts.
 
I also wonder what is meant by glorified primary care.

I had maybe 2 patients today that didn't need some combination of IM sedatives/anti-psychotics, CT imaging, broad spectrum antibiotics, specialty consultation, or admission.
RuralEDDoc said:
I think this opinion is probably meant as hyperbole but I hear it frequently. I think it’s a misunderstanding of what primary care is. It’s easy as a seasoned emergency physician to discount the acuity of patient presentations to the ED, but that’s a distinct form of bias earned after seeing over 10,000 patients and understanding how to quickly sort sick vs not sick.
Consider abdominal pain in a well appearing patients with normal vitals. Clinics send us these patients all the time. Some would complain “why is this healthy 30yo with abdominal pain here, this could be outpatient”, forgetting that a reasonable number of these patients will require time sensitive surgical intervention. Sure the EP isn’t cracking the chest or doing massive resuscitation, but there is a real value add of the work done in this scenario and many other medium acuity conditions.
This type of patient does not bother me at all. I’ll see that all day and feel good about my job. What I HATE HATE HATE is the social dump patient for whom I and the hospital have nothing to offer other than outpatient care coordination. That’s the worst part of any job I’ve ever worked and can really ruin a shift if you let it.
Click to expand...
 
susejwodahs said:
Thank you everyone for your replies.

Again, I understand that there is a lot of dissatisfaction. But I have met plenty of doctors who love their jobs so it's not universal, at least anecdotally. I just am trying to find the truth, and I think there is a lot of sampling bias on SDN. E.g. those that are unhappy enough to post here about it do, and those that love their jobs don't.
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There are many replies saying “well the pay is good..” and I caution you to actually consider “what happens if the pay isn’t good ten years from today?” Because if medicare for all is implemented you will be doing something for 50% of the income of today.
 
wamcp said:
There are many replies saying “well the pay is good..” and I caution you to actually consider “what happens if the pay isn’t good ten years from today?” Because if medicare for all is implemented you will be doing something for 50% of the income of today.
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No one knows this. Will they increase Medicaid to match medicare? If so that’s totally not true. I’m staunchly opposed to m4a. That being said the gloom and doom is pure bs. I think maybe 20% if you are at a well heeled ed. For many it might be a pay raise in em. Happy to discuss the details with anyone on this. Again I oppose m4a but the gloom and doom for em is dumb. Over time yes as the govt cuts reimbursement but short term. No.
Now this balance billing thing could be terrible.
 
I agree there will never be a govt program that overnight cuts doctor salaries by 50%. Never gonna happen unless the govt wants a health care system without doctors.

Maybe they want NPs, who have the brain of a doctor. LOLZ
 
alpinism said:
In many parts of the world those patients are all managed outpatient with greatly reduced cost and identical outcomes. The beauty of working outside the United States in countries without EMTALA is seeing how much money we waste on useless emergency department care in this country.
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Citation needed

My ex went to med school in India where as a student she did appendectomies and C sections unsupervised. That doesn't mean that general surgeons in the US are glorified medical students. Likewise, the fact that family medicine doctors in resource strapped countries are managing an acute abdomen does not mean that EPs are glorified PCPs. It's a reflection of an under supply of adequately trained doctors in very poor places - not something to aspire to. Just because something is boring and routine doesn't mean it's primary care.
 
slz1900 said:
Citation needed

My ex went to med school in India where as a student she did appendectomies and C sections unsupervised. That doesn't mean that general surgeons in the US are glorified medical students. Likewise, the fact that family medicine doctors in resource strapped countries are managing an acute abdomen does not mean that EPs are glorified PCPs. It's a reflection of an under supply of adequately trained doctors in very poor places - not something to aspire to. Just because something is boring and routine doesn't mean it's primary care.
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I'm going to call bulls**t on your girlfriend doing appys in med school. Maybe during the early house job years. Definitely not during medical school.
 
cyanide12345678 said:
I'm going to call bulls**t on your girlfriend doing appys in med school. Maybe during the early house job years. Definitely not during medical school.
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Don't really want to derail, but I literally saw pictures of it. Crazy stuff happens in public hospitals in developing countries.
 
slz1900 said:
Don't really want to derail, but I literally saw pictures of it. Crazy stuff happens in public hospitals in developing countries.
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Is that like a "see one, do one, teach one" kind of thing?

giphy.gif
 
Who here, speaking only to BC EM doctors, think they could do an appy by themselves with no other assistance besides the surgery tech help you out? And have a good outcome? It would be in a proper OR and appropriate anesthesia. You can use any tool available in the ER.

I think I could...might take me 2-3 hours though. Definitely open, not laparoscopic. I would make a bigger incision than normal. Estimated blood loss for me? Maybe 50 cc.

Just a thought question and please, for those dinguses out there who would take me seriously like I'm actually gonna do it. PHLUSSEEE
 
DO3 said:
I make a pretty good living working 12 days and b/w 90-100 hrs a month. My wife is also a physician. Makes 40% of what I do and works at least 6 days and 60hrs a week when you include all the paperwork and charting after her work. There’s a lot of doom and gloom on this board, but, there is doom and gloom in every single specialty. No job or specialty will be perfect. It’s not necessarily an EM problem. With the government, Press Ganey, and the joint commission continuing to tell all physicians and hospitals how to practice, the real question is there anything good about medicine in general anymore.
Click to expand...

unless your wife is in peds or FM, she is very inefficient if her goal is to make a decent living
 
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