AlmostAnMD

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ERAS season is nearly upon me, ultimately decided on EM (vs EM/IM, I did like critical care a lot).

But, reminded me to ask a Q of you guys:

EM is the number one burnout specialty. Critical care is number two. If you're boarded in both and alternatively practice each, does the variability help with the burnout? Or does it just synergyistically destroy your life (kidding...sort of)?
 

winkleweizen

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ERAS season is nearly upon me, ultimately decided on EM (vs EM/IM, I did like critical care a lot).

But, reminded me to ask a Q of you guys:

EM is the number one burnout specialty. Critical care is number two. If you're boarded in both and alternatively practice each, does the variability help with the burnout? Or does it just synergyistically destroy your life (kidding...sort of)?
I thought the burnout thing was a myth. Wheres your source?
 

emergentmd

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ERAS season is nearly upon me, ultimately decided on EM (vs EM/IM, I did like critical care a lot).

But, reminded me to ask a Q of you guys:

EM is the number one burnout specialty. Critical care is number two. If you're boarded in both and alternatively practice each, does the variability help with the burnout? Or does it just synergyistically destroy your life (kidding...sort of)?
I do not believe EM is any higher. I am in my 15th and still love to go to work. Much happier now b/c the job has become easier, I make more money. I essentially make a top 1% paycheck and maybe have to make a touch decision once a week.
 

Angry Birds

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I'm not an EM/CC, but I can't see how it could be anything but synergistically destructive. CC people say all the time that they thank God they also did that extra year of Pulm which they were complaining about when they did it but later in life they were grateful for the respite it grants them.

It would be wiser to couple EM with something chiller, in my opinion. Like Hyperbaric Medicine, whatever that is.

Be a friend to your future self. Not a jerk. You'll thank your past self then, in the future.
 

TimesNewRoman

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http://www.medscape.com/features/slideshow/lifestyle/2015/public/overview#2

EM and CC are #1 and #2 according to medscape 2015. I mean yeah I know it's a contentious issue, but I was just curious about what EM/CC docs think about burnout when they practice both.
Look at those stats though. EVERYONE in medicine is burned out. Shoot, derm reports 37% burn out. The difference between the highest specialty burn out and the lowest specialty burnout is only 1 in 6 different.

And there are obviously many modifiable risk factors - don't take on crazy debt for med school, save/pay off your loans, marry once, exercise and take vacation!
 

engineeredout

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Look at those stats though. EVERYONE in medicine is burned out. Shoot, derm reports 37% burn out. The difference between the highest specialty burn out and the lowest specialty burnout is only 1 in 6 different.

And there are obviously many modifiable risk factors - don't take on crazy debt for med school, save/pay off your loans, marry once, exercise and take vacation!
Right. Look at the numbers of all of them. Yea EM and CC are top two with 52 and 53%, but if you look at the next three: Internal medicine, family medicine, general surgery all with 50%. This composes the majority of physicians out there. So is EM or CC really worse than the others?

Plus, don't see how doin that extra year of pulm helps avoid burnout when 47% of them are burned out.
 

Angry Birds

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Plus, don't see how doin that extra year of pulm helps avoid burnout when 47% of them are burned out.
I'm just speaking anecdotally here and using common sense, not strictly looking at one survey.

Pulm allows them to work in the clinic, a predictable 9-5 job on those days. That is better for long-term stability and happiness than sporadic shift work that we and CC doc's do for a living.
 

engineeredout

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I'm just speaking anecdotally here and using common sense, not strictly looking at one survey.

Pulm allows them to work in the clinic, a predictable 9-5 job on those days. That is better for long-term stability and happiness than sporadic shift work that we and CC doc's do for a living.
But then still, despite lifestyle appearing "easier" on the surface, why is the burnout rate so close to EM or the other high burnout specialties?
 

emergentmd

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I'm just speaking anecdotally here and using common sense, not strictly looking at one survey.

Pulm allows them to work in the clinic, a predictable 9-5 job on those days. That is better for long-term stability and happiness than sporadic shift work that we and CC doc's do for a living.
If you are burnt out, go work in an urgent care for your 9-5 job.
 

Angry Birds

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If you are burnt out, go work in an urgent care for your 9-5 job.
I don't know if that's meant as a snide comment or not, but I'll answer.

I'm not burnt out... at least not in the fullest sense of the word.

While urgent care is an option for some, it's not an appealing idea for me. I am pursuing another path of diversifying myself. I've heard it from many wise people that it's a good idea in our field to diversify oneself, i.e. EM plus hyperbaric, EM plus tox, EM plus running an urgent care, EM plus admin stuff, EM plus XYZ. I think having something else along with EM--and hopefully something that decreases one's clinical hours in the ER--is a good idea and will actually increase longevity and happiness in the career.
 

emergentmd

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I don't know if that's meant as a snide comment or not, but I'll answer.

I'm not burnt out... at least not in the fullest sense of the word.

While urgent care is an option for some, it's not an appealing idea for me. I am pursuing another path of diversifying myself. I've heard it from many wise people that it's a good idea in our field to diversify oneself, i.e. EM plus hyperbaric, EM plus tox, EM plus running an urgent care, EM plus admin stuff, EM plus XYZ. I think having something else along with EM--and hopefully something that decreases one's clinical hours in the ER--is a good idea and will actually increase longevity and happiness in the career.
That wasn't meant for you nor a snide comment but was throwing it out just as an option for anyone getting burnt out on EM. I think diverifying is fine but Non of the EM + XYZ will replace the money you make with full time EM.

My plan is this at age 40

1. Work full time in my current hospital based EM which for me is 12 shifts/mo + 2 Moon lighting shifts. I plan on doing this for another 3-5 yrs
2. Transition to hospital based EM half time (6 shifts) + FSED (4 shifts) + 2 moonlighting shifts after this. Age 45
3. If I get burnt out from HOspital based EM, then it will be 10 FSED + 2 Moonlighting shifts
4. Once I am ready to retire and can life off $200K/year, then it will be 4 FSED + 2 moonlight shifts a month (I have to keep my skills up)
5. Once I am 60+ and still want to work, it will be UC +FSED for about 4 shifts a month. Still make 120K/year.
 

Hercules

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I don't know if that's meant as a snide comment or not, but I'll answer.

I'm not burnt out... at least not in the fullest sense of the word.

While urgent care is an option for some, it's not an appealing idea for me. I am pursuing another path of diversifying myself. I've heard it from many wise people that it's a good idea in our field to diversify oneself, i.e. EM plus hyperbaric, EM plus tox, EM plus running an urgent care, EM plus admin stuff, EM plus XYZ. I think having something else along with EM--and hopefully something that decreases one's clinical hours in the ER--is a good idea and will actually increase longevity and happiness in the career.
What path of diversification are you pursuing?
 

Angry Birds

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What path of diversification are you pursuing?
Legit question.

Unfortunately, I gotta be like Birdstrike about that one, simply because I don't want to divulge too much online.
 

emergentmd

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I agree that all Docs should look for diversification. I know I am and hopefully will not need to depend on EM work by age 50. Life is too short to work hard past 55
 

Doctor Bob

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It depends on what burns you out in this job.

For me, working in an emergency department but spending most of my time seeing things that clearly aren't emergencies (or even urgencies) wears on me.
So when I go work in the ICU, even if there isn't much being done on a day to day basis, at least the people there are legitimately sick.
And then when I get tired of seeing the same people day after day after day after day, then I go back to the ED and have a few shifts where I just "treat and street".

What irks me about one theater of practice is offset in the other.
 

Mad Jack

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Right. Look at the numbers of all of them. Yea EM and CC are top two with 52 and 53%, but if you look at the next three: Internal medicine, family medicine, general surgery all with 50%. This composes the majority of physicians out there. So is EM or CC really worse than the others?

Plus, don't see how doin that extra year of pulm helps avoid burnout when 47% of them are burned out.
Imagine how much higher it would be without the ability to largely work pulm clinic... When you're older, ICU hours aren't exactly kind to your mind and body.
 
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AlmostAnMD

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It depends on what burns you out in this job.

For me, working in an emergency department but spending most of my time seeing things that clearly aren't emergencies (or even urgencies) wears on me.
So when I go work in the ICU, even if there isn't much being done on a day to day basis, at least the people there are legitimately sick.
And then when I get tired of seeing the same people day after day after day after day, then I go back to the ED and have a few shifts where I just "treat and street".

What irks me about one theater of practice is offset in the other.
Thanks! Was curious how ICU work augments EM. I was kinda thinking it would be something like that, but never having been in your position, all I could do was imagine I guess.
 

Doctor Bob

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Imagine how much higher it would be without the ability to largely work pulm clinic.
I had to go do a day of interventional pulm clinic last year.
By the end of the 4 hour clinic block I wanted to have nothing to do with medicine.
A full day of clinic probably would have made me suicidal. Two days of clinic would probably make me homicidal.
A job where clinic was a regular part of my routine? Soul crushing.

But that's just me.
 

Mad Jack

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I had to go do a day of interventional pulm clinic last year.
By the end of the 4 hour clinic block I wanted to have nothing to do with medicine.
A full day of clinic probably would have made me suicidal. Two days of clinic would probably make me homicidal.
A job where clinic was a regular part of my routine? Soul crushing.

But that's just me.
Interventional pulm clinic is way more depressing than garden variety pulm clinic. Still, the point is well taken.
 

Situasian

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1st year EM resident thinking of entering crit care. I would think CC compliments EM because although you both treat critical patients, in the ICU you can stop to think about the physiology and how you would fix it. In that sense, CC allows you to be more cerebral rather than the treat/street approach. Besides, my favorite patients in the ED are the crashing ones that we send up to the ICU. Some EM docs have told me straight up they can't deal with ICU because of the rounding, but I think it's a nice change of pace to be able to follow a patient for more than a couple hours.

Burnout in general is more a factor of number of shift worked per month. Some single docs can live comfortably by working 12/month, while those with a large family have to pull 20+ to maintain the same lifestyle. I think it's all about living within your means.
 
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AlmostAnMD

AlmostAnMD

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I had to go do a day of interventional pulm clinic last year.
By the end of the 4 hour clinic block I wanted to have nothing to do with medicine.
A full day of clinic probably would have made me suicidal. Two days of clinic would probably make me homicidal.
A job where clinic was a regular part of my routine? Soul crushing.

But that's just me.
Awesome, kinda what I wanted to hear. I was really excited for IM during my pre-clinical years until I discovered what clinic really was. Your feelings basically summarize mine. I just can't do clinic. I can't do it. By the end of my ambulatory rotation (mandatory) I actually, for the first time in medical school, felt nauseated going to school. It made me physically ill. 12 hrs in an ED can fly by but 8 hours of clinic feels like 2 weeks.

Glad everything else is working out for you. Gonna focus on my EM apps now, see how EM goes, and decide from there if CC (or anything else) fellowship is worth it...I'm told it's really easy to make these plans as a student but a bit different as a resident having already sunk 3 years into it. So I guess we'll see!