This is a question that has been asked (and answered) countless times, but you seem an earnest person so I'll give you my two cents.
As to whether there are regional differences in the amount of respect that EM receives, I'd guess that there is. I haven't worked in that many places, but my gut feeling tells me that EPs get more respect in places where residency-trained, board-certified EPs have been practicing the longest, giving the medical community a longer exposure to our specialty. In general, that means that larger cities and metropolitan areas with old and multiple EM residency programs will be places that EM gets more respect, while rural hospitals and areas without a lot of residency graduates will tend to denigrate our specialty more often.
Most of the formerly bad reputation of the specialty stems from the age when only the docs who couldn't do anything else went in to EM. The ERs were often havens for physicians who could not succeed in the fields for which they trained, so it's not surprising that many of them couldn't succeed in EM. Add to that the fact that many of these "ER docs" came from such fields as anesthesia, radiology, and psychiatry 😱 where history and/or physical exam acumen isn't even taught, and you can see why in many cases the bad reputation of ER docs was earned.
You say you're working in an ER now, but you don't say it what capacity, so it's hard to know how to frame an answer. You say that you agree that EM's just a matter of knowing how to do an evaluation and call the right consultant. Put in such simplistic terms, any medical specialty can be made to sound like child's play. Surgery is just knowing which part to cut out and knowing how to cut and sew. Big deal, right? Anesthesia is just sticking in tubes and playing with gas. Neurosurgery is just finding the tumor/aneurym and cutting it out/clipping it off. (One neurosurgeon in my family likes to describe brain surgery like this: "schloop! There goes 8th grade. Schlooop! There goes 7th grade....") Internal medicine is just playing with... umm... never mind. But you get the idea. But let me pose you a question: if just doing an evaluation and calling the right consult is so easy, then why was it being done so badly by so many otherwise intelligent people for so long?
The answer is obvious for EM as it is for other specialties. It's never as simple as it sounds. There's a lot of training and knowledge that goes into knowing how to "just do an evaluation". If you think otherwise, then you don't have much of an opinion of clinical medicine as a whole. Knowing who to call isn't always obvious, nor is it always obvious when you MUST call immediately, and what you can treat and tell them to follow-up.
In medicine, as in the world, you'll get the respect you deserve, the respect you earn. There are surgeons that I think are wonderful, and surgeons I think are complete idiots that I wouldn't let cut on my pets. Same with internists, and practically any specialty. No specialty is completely free from derision given the right circumstances. In EM we live in the fish bowl, as everything we do is seen by another physician at some point. Since a lot of what we do is based on short encounters and faulty information, the conclusions we draw are not always going to be correct. For that, we sometimes get undeserved crap from our colleagues.
At the same time, it goes both ways. I just admitted a patient yesterday whose internist had been treating with antibiotics for her "cellulitis". One glance at the lesions on her legs (both of them) told me that there was no way in hell that those lesions were caused by cellulitis. She was handed to me from the previous shift as a patient with possible TIA, presenting largely as loss of vision and headache. A closer history and physical exam revealed what to me was an obvious diagnosis of temporal arteritis. The "cellulitis" on her legs was a result of vasculitis (multiple old scars, and ulcers in various stages of healing). In EM we get to see a lot of the mistakes that other people make as well, and out of the whole medical community, we probably best know which clinicians are good and which aren't.
