salary in EM

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I think you would be hard pressed to find another field that pays as well as EM, for 3 years of residency. Few FM and Peds or even IM docs come out with the flexibility in schedule and salary that EM does. The fact is EM will be mid-range salary, not as much as the IM-sub specialties or surgery fields, but higher than primary care. If salary is a huge factor for you, I would suggest radiology or plastics or something.
 
officedepot said:
So I'm wondering what you guys think the future holds for the total income of EM docs. One thing that is a drawback for me with the field is pay. It's significantly less than many other fields (I am finding in private groups salaries average $250-300k or so). What's your experience? Will you make more if you work more hours? Any thoughts would be appreciated.
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Everyone just HOLD ON a second...let me at least get my guinness and popcorn, prop my feet up, get SITUATED....before the entertainment starts.

Reminds me of a line from Fellowship of the Ring other night when I re-watched it.... "The've got a cave troll..."
 
officedepot said:
So I'm wondering what you guys think the future holds for the total income of EM docs. One thing that is a drawback for me with the field is pay. It's significantly less than many other fields (I am finding in private groups salaries average $250-300k or so). What's your experience? Will you make more if you work more hours? Any thoughts would be appreciated.
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Dude... anyone looking at your posts can tell you are SO all over the place. You're the typical fickle girlfriend who is let loose in Nordstrom's with dad's credit card. Your posts have you singing about everything from surgery to rads to derm to reproductive medicine to IR. Lots of posts about how much money there is to be made and how easy the lifestyle would be. You're overarching goal seems to be how to maximize your amount of income while being as lazy as possible and having gobs of free time outside of work. I can already tell that you'd be a bad fit for EM.

If you can't be content working "hard" 40hr weeks while making $250-300K, you either need a shrink, or you've got 4 ex-wives, and lots of kids...
 
well, my dad just lost his job and my mom hasn't worked for 30 yrs, so my resident salary at $48k-ish seems pretty good--I can't even imagine what it would be like to make $300k . . .
 
officedepot said:
the posts you are referring to are in the thread about the "best kept secret in medicine" which everyone in there discussed good lifestyle and pay at the same time. But whatever. Please stop posting here if you are not going to be helpful or contribute to the discussion instead of making snide remarks. Thanks.
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"best kept secret in medicine" huh? Sounds like an infomercial...
 
Tiger26 said:
well, my dad just lost his job and my mom hasn't worked for 30 yrs, so my resident salary at $48k-ish seems pretty good--I can't even imagine what it would be like to make $300k . . .
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This is what I like to call "perspective."

OP, I have no idea about the future of EM pay, but I do know that if you hate what you are doing, then pretty much no amount of money can make up for the misery. Maybe for a few years it can, but not long term. If you really like what you do, then the money isn't as important.
 
Wow! Complaining about an EM salary. What are you comparing it to? Keep a few things in mind:

1) Only 3 years of training. Nearly every field that earns more requires more training.
2) Relatively easy to match into. 90%+ of US medical grads who want to get into EM can. Not so with ortho, ophtho, derm etc. It's not FP, but it isn't that hard.
3) Probably the best HOURLY rate in medicine. Divide those salaries out by hours worked and you'll see that emergency docs actually make MORE than most surgeons. It's not unusual for a partner in private group to make $200-300 per hour. Multiply that by 60 hours a week and 50 weeks a year and you get $900,000 a year. Now, I don't recommend trying to do that, but you get my point.
4) Because you work fewer hours, it leaves you opportunities to get another job where you can earn MORE money if you so desire. Know any neurosurgeons with a second job? Didn't think so.
5) Since when is $300K a year not enough money to live on? It seems at that point you'd just want to find what you enjoy doing the most. Trust me when I say you won't be any happier making $400K than $300K.
 
ActiveDutyMD said:
Wow! Complaining about an EM salary. What are you comparing it to? Keep a few things in mind:

1) Only 3 years of training. Nearly every field that earns more requires more training.
2) Relatively easy to match into. 90%+ of US medical grads who want to get into EM can. Not so with ortho, ophtho, derm etc. It's not FP, but it isn't that hard.
3) Probably the best HOURLY rate in medicine. Divide those salaries out by hours worked and you'll see that emergency docs actually make MORE than most surgeons. It's not unusual for a partner in private group to make $200-300 per hour. Multiply that by 60 hours a week and 50 weeks a year and you get $900,000 a year. Now, I don't recommend trying to do that, but you get my point.
4) Because you work fewer hours, it leaves you opportunities to get another job where you can earn MORE money if you so desire. Know any neurosurgeons with a second job? Didn't think so.
5) Since when is $300K a year not enough money to live on? It seems at that point you'd just want to find what you enjoy doing the most. Trust me when I say you won't be any happier making $400K than $300K.
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Homerun!!
 
I do think EM stands to get hit pretty hard with medicare cuts, seeing as you can't turn away patients. Possibly harder than some other specialties.

Future big cuts:

Rads
EM
Gas
Ortho

There's a target on these guys, more so than the rest.
 
👍
ActiveDutyMD said:
Wow! Complaining about an EM salary. What are you comparing it to? Keep a few things in mind:

1) Only 3 years of training. Nearly every field that earns more requires more training.
2) Relatively easy to match into. 90%+ of US medical grads who want to get into EM can. Not so with ortho, ophtho, derm etc. It's not FP, but it isn't that hard.
3) Probably the best HOURLY rate in medicine. Divide those salaries out by hours worked and you'll see that emergency docs actually make MORE than most surgeons. It's not unusual for a partner in private group to make $200-300 per hour. Multiply that by 60 hours a week and 50 weeks a year and you get $900,000 a year. Now, I don't recommend trying to do that, but you get my point.
4) Because you work fewer hours, it leaves you opportunities to get another job where you can earn MORE money if you so desire. Know any neurosurgeons with a second job? Didn't think so.
5) Since when is $300K a year not enough money to live on? It seems at that point you'd just want to find what you enjoy doing the most. Trust me when I say you won't be any happier making $400K than $300K.
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Tiger26 said:
well, my dad just lost his job and my mom hasn't worked for 30 yrs, so my resident salary at $48k-ish seems pretty good--I can't even imagine what it would be like to make $300k . . .
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Ha!! My mom doesn't work either, 48K/year FTMFW!!
 
Jack is Back said:
I do think EM stands to get hit pretty hard with medicare cuts, seeing as you can't turn away patients. Possibly harder than some other specialties.

Future big cuts:

Rads
EM
Gas
Ortho

There's a target on these guys, more so than the rest.
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I hope the big cuts wait until I can pay back my loans, or at least put a decent dent in them.
 
ActiveDutyMD said:
It seems at that point you'd just want to find what you enjoy doing the most. Trust me when I say you won't be any happier making $400K than $300K.
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I am tempted to comment on Active's other points (some of which, I disagree with), but I think the above quoted point is the most important.

If you are a real EM doc, you have already decided that EM is more important than 300K vs. 400K. That is, if money is that important to you, a different specialty has already been chosen.

However (chill out, GV): If you have chosen EM for - what I would call legit reasons - you will find $400K reachable. [just don't do it for the 3y-residency]

HH
 
I guess it just irks me when someone let's a salary that is already over $200K, significantly influence their decision to pursue said specialty. Hell, I've probably got more debt than most other residents on this board, and might have a good case if I had loved FM and was on the FM board arguing that I didn't think $140-$180K was going to cut it for me, but $250-$300K? Really?

I mean, theoretically I suppose you could run out of money to buy milk on a Friday...if you cleaned out Sam's Club of Pamper's to rub down all 20 cars in your cool $1.5 mill house garage on Thursday...but that's kind of stretching it...

I worked 8 years in a career prior to medicine, I was happy as a clam and perfectly content earning $65K as a single bachelor when I started out and every raise over that was gravy. I gave up low 6 digits to go to med school and even that was way more than I would have ever required to be "happy". Now... I didn't have as much debt, but even then... if you're making over $250K and having a hard time... you need to reign in your standard of living. Physicians we are, and should always live comfortably, but CEO's and high profile investment bankers... we ain't, so don't try and live like one.

If you want to earn $500-$600K in medicine...yea you'll be rich, but you probably won't have much time to enjoy the money.
 
As already stated, dollar for hour in the hospital, not many fields beat Emergency Medicine. Any minute I am in the hospital, the clock is ticking (well, theoretically... I am slowly getting involved with some commitees which I am not reimbursed and I electively participate with medical students /EM Interest Group and have lectured to IM residents... thats all 'free', but I enjoy it and would not have to do it).

I am still young and not as jaded as some of the folks on this board. I cannot imagine doing anything different in medicine and the money we make for doing what we do and have the time off we have is insane. I was in San Fran a week last month, baltimore a week the month before that, been off this whole week studying for boards, am off 4 days for thanksgiving and going home.. off a week at New Years...and I'm 'the new guy'...

Aan orthopedics surgeon, neurosurgeon, etc will have a larger bottom line, but I assure you we get to enjoy ours more. As a buddy of mine says "Sure, the orthopedics doctor has a lake house twice the size of mine, but I spend every other weekend at mine and he makes it twice a season"....

I think once you hit the 300Kish mark, life is not much difference until you get in the millions. 300-700K.. you can afford a million dollar house, drive a REALLY nice car, have nice clothes, take nice trips, send the kids to college, etc... it takes a seven figure income+ to have a new Bentley/Lambo every year, rent private chateaus in France for a week and travel there on private jets, etc.. thats a lifestyle that Physicians are generally not going to obtain...unless there is something other than patient care paying the bills.
 
EM_Rebuilder said:
As already stated, dollar for hour in the hospital, not many fields beat Emergency Medicine. Any minute I am in the hospital, the clock is ticking (well, theoretically... I am slowly getting involved with some commitees which I am not reimbursed and I electively participate with medical students /EM Interest Group and have lectured to IM residents... thats all 'free', but I enjoy it and would not have to do it).

I am still young and not as jaded as some of the folks on this board. I cannot imagine doing anything different in medicine and the money we make for doing what we do and have the time off we have is insane. I was in San Fran a week last month, baltimore a week the month before that, been off this whole week studying for boards, am off 4 days for thanksgiving and going home.. off a week at New Years...and I'm 'the new guy'...

Aan orthopedics surgeon, neurosurgeon, etc will have a larger bottom line, but I assure you we get to enjoy ours more. As a buddy of mine says "Sure, the orthopedics doctor has a lake house twice the size of mine, but I spend every other weekend at mine and he makes it twice a season"....

I think once you hit the 300Kish mark, life is not much difference until you get in the millions. 300-700K.. you can afford a million dollar house, drive a REALLY nice car, have nice clothes, take nice trips, send the kids to college, etc... it takes a seven figure income+ to have a new Bentley/Lambo every year, rent private chateaus in France for a week and travel there on private jets, etc.. thats a lifestyle that Physicians are generally not going to obtain...unless there is something other than patient care paying the bills.
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I think it's actually much better than you think. I was listening to a podcast the other day and one guy was saying, "this is the best time ever to be poor. A poor person drives the same car as Leonardo Dicaprio. He drives a Prius. You're doing pretty well if you're poor, you can buy a 15-20k car that has all kinds of options, surround sound, etc. You can buy a pretty sweet flat screen TV for a few hundred dollars...."

Etc on and on, it was an interesting discussion and obviously half joking but it's true that the standard of living of a person making 30-40k (I think they were saying that was "poor" in this scenario) is pretty sweet these days. Obviously, a guy making 150k or 600k, you're doing pretty well regardless.

I hope people don't make specialty decisions based primarily on income, because we're all doing pretty damn well even at 150k+.
 
Truth is I would rather be in a 200k per yr job I enjoy than make 600k and work 80 hours a week and do something I dont.

Thats the end point there.
 
I'm not sure I can separate satisfaction and happiness. Maybe there's some sociology I need to learn.

That being said, I'm happier now than when I was a resident. But I'm not so happy I can go out and just buy a Maserati.
I do get to close on my house this week though, so that makes me happy. I still have 300K in combined student loan debt between me and my wife.
 
I can see where satisfaction and happiness are distinct. For example you could be happy because you have enough of whatever makes you happy (e.g. family, hobbies, evil, etc.) while having poor job satisfaction. Conversely you can be satisfied with your job but are unhappy for other reasons. Often they intersect. If you are so miserable with your job that you can't even be happy at home then you've got a problem.
 
ajp529 said:
Once you reach $75k you don't get happier, just more satisfied with life:

http://blogs.wsj.com/wealth/2010/09/07/the-perfect-salary-for-happiness-75000-a-year/

Making $200k+ a year is not going to help you be a happier person, just a bit more satisfied than that UPS driver who never spent a year in college and makes $75k.
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I am familiar with this but lets not forget the difference between what people on average think and what an individual thinks or believes.

Personally, if I made an extra 100k a year I would be happier. That being said i like my job and am happy. I have over 300k in debt as well and an extra 100k per yr would alleviate some stress and make me happier and allow me to vacation in even nicer places.

Again, what might hold true for a group doesnt necessarily hold true for an individual.
 
EctopicFetus said:
I am familiar with this but lets not forget the difference between what people on average think and what an individual thinks or believes.

Personally, if I made an extra 100k a year I would be happier. That being said i like my job and am happy. I have over 300k in debt as well and an extra 100k per yr would alleviate some stress and make me happier and allow me to vacation in even nicer places.

Again, what might hold true for a group doesnt necessarily hold true for an individual.
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You think you would be happier.

But in reality, if you were making that $ you would probably be just as happy and still say, "if I was making another 100k, I would be happier."

If we can take care of our basic needs and have some additional discretionary spending then financially speaking, that's as happy as you can get.

Like the other poster said above. The extra income at that point is just allowing you to do bigger or more extravagant, but not necessary anything different.
 
In terms of just pure per hour...extrapolating from MGMA numbers and the Dorsey JAMA article for average hrs, I get the below. But the thing to keep in mind is where will you be happiest and how much time will you actually have to spend all of the money you earn depending on which specialty you're in.


EM at 46hrs/week (2300hrs/yr) and $280K => $122/hr
Ortho at 58hrs/week (2900hrs/yr) and $524K => $180/hr
Gen Surg at 60hrs/week (3000hrs/yr) and $360K => 120/hr
 
carml said:
In terms of just pure per hour...extrapolating from MGMA numbers and the Dorsey JAMA article for average hrs, I get the below. But the thing to keep in mind is where will you be happiest and how much time will you actually have to spend all of the money you earn depending on which specialty you're in.


EM at 46hrs/week (2300hrs/yr) and $280K => $122/hr
Ortho at 58hrs/week (2900hrs/yr) and $524K => $180/hr
Gen Surg at 60hrs/week (3000hrs/yr) and $360K => 120/hr
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I've calculated those numbers out too (using similar data). But I also see my group's financial statements and the EM hourly you quote is at least $100 off. Even using the Daniel Stearn survey numbers you get $155 an hour. P.S. I don't know anyone working 2300 hours a year in EM. Do you?
 
carml said:
In terms of just pure per hour...extrapolating from MGMA numbers and the Dorsey JAMA article for average hrs, I get the below. But the thing to keep in mind is where will you be happiest and how much time will you actually have to spend all of the money you earn depending on which specialty you're in.


EM at 46hrs/week (2300hrs/yr) and $280K => $122/hr
Ortho at 58hrs/week (2900hrs/yr) and $524K => $180/hr
Gen Surg at 60hrs/week (3000hrs/yr) and $360K => 120/hr
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Your math is off. Pulling 280K probably only requires about 14 shifts a month of 8-10 hours shifts. I'd say the hourly wage is more in line with what you quoted for the ortho guy up there (upwards of $180/hr).
 
carml said:
EM at 46hrs/week (2300hrs/yr)
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A) as has been mentioned, this is much more than the average physician works
B) I work between 140-150 hrs a month, and my contract only guarantees 120
C) If I did work 2300 hours, I would earn 460,000 that year (gross)
D) I would not be happy nor satisfied doing that.
 
bulgethetwine said:
Your math is off. Pulling 280K probably only requires about 14 shifts a month of 8-10 hours shifts. I'd say the hourly wage is more in line with what you quoted for the ortho guy up there (upwards of $180/hr).
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I only using the numbers provided by MGMA and another survey from JAMA for hours. Those are all just averages. There are exceptions to everything and of course, everyone on SDN is/will be above average 🙂
 
carml said:
I only using the numbers provided by MGMA and another survey from JAMA for hours. Those are all just averages. There are exceptions to everything and of course, everyone on SDN is/will be above average 🙂
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No, it's definitely more than most attendings work. 46 hours per week is approaching how much time per week that I work in the ED as a resident. At both the community hospital and the academic hospital where I've rotated, the average attending works like half the shifts per week that we do, and their shifts are 8s versus our 10s. So there's no way they come anywhere close to 46 hours per week.

I think the main reason for the disconnect is that other nonclinical work-related activities are probably being included in the hour count. For example, as residents, we have five hours of lecture per week, and those count toward our weekly work hours. Many of the academic attendings spend time doing administrative work, teaching, research, etc. So they may work as many or even more hours per week than I do, but they're spending way less time in the ED. Some of the community EPs likewise spend time on administrative or other nonclinical tasks on top of their shifts, while others really do only work around 25-30 hours per week total.
 
Jack is Back said:
You think you would be happier.

But in reality, if you were making that $ you would probably be just as happy and still say, "if I was making another 100k, I would be happier."

If we can take care of our basic needs and have some additional discretionary spending then financially speaking, that's as happy as you can get.

Like the other poster said above. The extra income at that point is just allowing you to do bigger or more extravagant, but not necessary anything different.
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No one knows. Again, like any bit of research just because it applies to the masses doesnt mean it holds true for certain subgroups. I have 300k+ in debt. I doubt those who say that in the survey do.

In the end I have a magic number that I would be happy with. I know it and plan to get there.

If we can take care of our basic needs and have some additional discretionary spending then financially speaking, that's as happy as you can get.
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Thats one persons opinion. Simply, what if being happy was the ability to go sailing for a week every month and not have it impact your overall income?

Again, the data only speaks to the masses and certain subgroups would be excluded. Doctors are in that subgroup based on the people I know.
 
Nervous Ned said:
No, it's definitely more than most attendings work. 46 hours per week is approaching how much time per week that I work in the ED as a resident. At both the community hospital and the academic hospital where I've rotated, the average attending works like half the shifts per week that we do, and their shifts are 8s versus our 10s. So there's no way they come anywhere close to 46 hours per week.

I think the main reason for the disconnect is that other nonclinical work-related activities are probably being included in the hour count. For example, as residents, we have five hours of lecture per week, and those count toward our weekly work hours. Many of the academic attendings spend time doing administrative work, teaching, research, etc. So they may work as many or even more hours per week than I do, but they're spending way less time in the ED. Some of the community EPs likewise spend time on administrative or other nonclinical tasks on top of their shifts, while others really do only work around 25-30 hours per week total.
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Carml, I work in a group of 40 docs and NO ONE works over 150. The problem with those surveys is that they arent well defined. My group prob averages 120 hours a month. This is likely closer to the truth.

Based on the http://www.danielstern.com/2011participantcopy/2011_NationalSurvey2.pdf 50% is 1700 hours and $155 per hour.

No one is working 2300 hours and it is def not an average.
 
carml said:
I only using the numbers provided by MGMA and another survey from JAMA for hours. Those are all just averages. There are exceptions to everything and of course, everyone on SDN is/will be above average 🙂
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I recommend using the daniel stern link to get some more accurate info.
 
EctopicFetus said:
No one knows. Again, like any bit of research just because it applies to the masses doesnt mean it holds true for certain subgroups. I have 300k+ in debt. I doubt those who say that in the survey do.

In the end I have a magic number that I would be happy with. I know it and plan to get there.

Thats one persons opinion. Simply, what if being happy was the ability to go sailing for a week every month and not have it impact your overall income?

Again, the data only speaks to the masses and certain subgroups would be excluded. Doctors are in that subgroup based on the people I know.
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I guess it is all perspective. As doctors, there is a tendency to compare your income/lifestyle to the top 1-2% of income earners on earth. So you think if you just had a bit more you'd be happier because that guy in the 99.5th percentile seems to have it better.

To your point, "those people didn't have 300k in loans...", I still think it's an equivalent scenario. The 75k income earners, lets say they have minimal to zero debt (in reality, they probably have SOME debt). The EM doctor who earns 250k has 175k EXTRA in income. So then the question becomes, would that 75k earner take on 300k in debt to have an increase of 175k in income? The answer is yes, if you plan on working more than 4 years.

Again, it all comes back to your reference point. If you compare yourself to rich guys then you may be unsatisfied. If you look at your quality of life and freedoms compared to everyone then it's really difficult to find a better situation (i.e. 499 out of 500 people on earth would probably envy your position).
 
Jack is Back said:
I guess it is all perspective. As doctors, there is a tendency to compare your income/lifestyle to the top 1-2% of income earners on earth. So you think if you just had a bit more you'd be happier because that guy in the 99.5th percentile seems to have it better.

To your point, "those people didn't have 300k in loans...", I still think it's an equivalent scenario. The 75k income earners, lets say they have minimal to zero debt (in reality, they probably have SOME debt). The EM doctor who earns 250k has 175k EXTRA in income. So then the question becomes, would that 75k earner take on 300k in debt to have an increase of 175k in income? The answer is yes, if you plan on working more than 4 years.

Again, it all comes back to your reference point. If you compare yourself to rich guys then you may be unsatisfied. If you look at your quality of life and freedoms compared to everyone then it's really difficult to find a better situation (i.e. 499 out of 500 people on earth would probably envy your position).
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A few other points. I am years behind in my retirement. I must make that up, I am years behind in saving for my kids school (optional), I also must have disability and life insurance (esp if you are married).

Simply put what that number is depends on the person.

If someone out of college is saving 16.5K per yr over my 7 years I am 100k in the hole (plus interest so close to 160k).

Am I well off.... damn right.. do i think i would be happier with an extra 100k? Damn right.

Docs make a ton of bad decisions which leads to their unhappiness. 1) Doc divorce rate is 65% 2) $$$ is a leading factor in divorce (though I dont know how much of a role this plays in physician divorce).

I feel fortunate. I grew up with nothing and now have something. But I truly believe having an extra 100k would make me "happier". Do I know this??? no... but I would be happy to find out.
 
EctopicFetus said:
A few other points. I am years behind in my retirement. I must make that up, I am years behind in saving for my kids school (optional), I also must have disability and life insurance (esp if you are married).

Simply put what that number is depends on the person.

If someone out of college is saving 16.5K per yr over my 7 years I am 100k in the hole (plus interest so close to 160k).

Am I well off.... damn right.. do i think i would be happier with an extra 100k? Damn right.

Docs make a ton of bad decisions which leads to their unhappiness. 1) Doc divorce rate is 65% 2) $$$ is a leading factor in divorce (though I dont know how much of a role this plays in physician divorce).

I feel fortunate. I grew up with nothing and now have something. But I truly believe having an extra 100k would make me "happier". Do I know this??? no... but I would be happy to find out.
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The divorce rate isn't 65%. In fact, among physician-physician couples it is as low as 11%.
 
Hey folks,

I was recently perusing the "Negatives of EM" on one of the sticky threads and there was a very lengthy, but well-written post by 'Birdstrike' that profoundly described some of the negatives of EM (obviously in their opinion). I don't want to hijack this thread at all, and I apologize in advance if it seems as such, but there is a plethora of EM experience and wisdom in this thread and I was really hoping some of you can comment on this post and perhaps reflect a bit about how Birdstrike portrays some of the negative aspects of a career in emergency medicine. It really seems as though a lot of the things he perhaps first loved about this field are what he ended up loathing about this field.

-Is this at all common in EM as one progresses through their career?
-Is this more a function of one's work environment/setting than EM as a career?
-EM seems to be a really polarizing field, perhaps as much as surgery, it really seems as though people love it or people hate it

I know this information has been touched upon in a myriad of posts throughout the years, but it really helps to revisit these topics as frequently as possible so as to garner as many perspectives/data points as possible.


Thanks so much in advance.
 
ActiveDutyMD said:
The divorce rate isn't 65%. In fact, among physician-physician couples it is as low as 11%.
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Interesting statistics about divorce rate. Can you guys cite sources?

This article stated that divorce rates are 10-20% higher with physicians. Other discussion about the doubled suicide risk was interesting:

http://www.medscape.com/viewarticle/410643_2

This article said the rate was the same for physicians in general, but worse for female physicians. Again, fascinating discussion and commentary:

http://www.nationalreviewofmedicine.com/issue/2006/03_15/3_physicians_life02_05.html

Then, the fourth google hit was an sdn forum discussion that was interesting until it took a rather ironic turn for me as my wife told me to get off student doctor and help out:

http://forums.studentdoctor.net/showthread.php?t=4004
 
ActiveDutyMD said:
The divorce rate isn't 65%. In fact, among physician-physician couples it is as low as 11%.
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Check that.. With divorce rates of the popoulation right at 50%....

http://www.medscape.com/viewarticle/410643_2

Divorce rates among physicians have been reported to be 10% to 20% higher than those in the general population.
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That brings you right to about 65%.

This number of 10-20% higher than the gen population is widely cited.

your stat is also true.. so if you dont want to get divorced marry another doc.. 🙂

A 1999 survey of US docs found 22% of male physicians were married to another working physician. A 2002 study looking at dual physician marriages found they have a relatively low divorce rate of 11%.
 
In the end, divorce, drug abuse, depression are multifactorial. I know people of every mix who both succeeded and failed.

I have a healthy marriage and feel lucky that is how it is. I have seen marriages crumble and way more just get stressed to the max. Our jobs are hard and the hours are weird this leads to marital stress iMO.
 
DreamingTheLive said:
Hey folks,

I was recently perusing the "Negatives of EM" on one of the sticky threads and there was a very lengthy, but well-written post by 'Birdstrike' that profoundly described some of the negatives of EM (obviously in their opinion). I don't want to hijack this thread at all, and I apologize in advance if it seems as such, but there is a plethora of EM experience and wisdom in this thread and I was really hoping some of you can comment on this post and perhaps reflect a bit about how Birdstrike portrays some of the negative aspects of a career in emergency medicine. It really seems as though a lot of the things he perhaps first loved about this field are what he ended up loathing about this field.

-Is this at all common in EM as one progresses through their career?
-Is this more a function of one's work environment/setting than EM as a career?
-EM seems to be a really polarizing field, perhaps as much as surgery, it really seems as though people love it or people hate it

I know this information has been touched upon in a myriad of posts throughout the years, but it really helps to revisit these topics as frequently as possible so as to garner as many perspectives/data points as possible.


Thanks so much in advance.
Click to expand...

Good observations.

I'd say that a few things come into play here. When you're a student/resident/young attending there's this element of novelty and challenge to running the ER. You come in scared but energized trying to climb the mountain and the crazier the ER the bigger the challenge. After you've been doing it for years that goes away. I know I can do it. If it's busy it just means I don't get lunch. It's no longer a rewarding challenge to conquer. It's annoying.

Procedures present a similar situation. We all love procedures starting out. Once you've done them all a thousand times they lose their appeal. When your too busy and a procedure means letting the rack back up and (again) no lunch, then they're downright lothesome.

Throw in some administrative headaches and some medico/legal issues and you've got the reasons why people can start out loving a job and grow very weary of it.

Metaphorically think of how cool skydiving is. It's exciting, on the edge and impressive. Now imagine you will have to make 20 jumps a day for the next 30 years to make a living. What will you think of it in 9 years?
 
docB,

Thanks for the post. I appreciate your candor. Correct me if I'm wrong, but it seems as though EM physician satisfaction is perhaps more closely linked to the level of mid-level/institution/hospital support than a lot of other medical specialties (obviously ALL are hugely dependent on support from others, but in relative terms).
 
docB said:
Metaphorically think of how cool skydiving is. It's exciting, on the edge and impressive. Now imagine you will have to make 20 jumps a day for the next 30 years to make a living. What will you think of it in 9 years?
Click to expand...

Great analogy. For years, you see sky-divers on TV, you talk to people who jump, you yearn for the day you are a grow-up and can participate in the excitement. You don't realize that each patient is metophorically packing your chute for you. After interacting with ER patients you realize that 25% are either crazy, borderline personalities, alcoholics or drug addicts, or just so stupid they are basically incompetent. The jumps stop being so fun when you realize on occasion just how little they care about you. Sometimes you look at the patient/complaint and feel a little trapped as you feel the Federal Government/Lawyer/Hospital CEO push you out the doors, wondering if today is the day the chute doesn't open.
 
Last edited by a moderator:
Jarabacoa said:
Great analogy. For years, you see sky-divers on TV, you talk to people who jump, you yearn for the day you are a grow-up and can participate in the excitement. You don't realize that each patient is metophorically packing your chute for you. After interacting with ER patients you realize that 25% are either crazy, borderline personalities, alcoholics or drug addicts, or just so stupid they are basically incompetent. The jumps stop being so fun when you realize on occasion just how little they care about you. Sometimes you look at the patient/complaint and feel a little trapped as you feel the Federal Government/Lawyer/Hospital CEO push you out the doors, wondering if today is the day the chute doesn't open.
Click to expand...

Sobering, to say the least.
 
DreamingTheLive said:
docB,

Thanks for the post. I appreciate your candor. Correct me if I'm wrong, but it seems as though EM physician satisfaction is perhaps more closely linked to the level of mid-level/institution/hospital support than a lot of other medical specialties (obviously ALL are hugely dependent on support from others, but in relative terms).
Click to expand...

Being a hospital based specialty we will always be stuck with contract maintenence as an imperitive. That does hurt our satisfaction. If you talk to EPs you will also quickly realize that the guys with stable contracts are always happier and more satisfied than those in risky contracts.
 
docB said:
Being a hospital based specialty we will always be stuck with contract maintenence as an imperitive. That does hurt our satisfaction. If you talk to EPs you will also quickly realize that the guys with stable contracts are always happier and more satisfied than those in risky contracts.
Click to expand...

This is an important point and one that doesn't hit home until you live it. As a private group employee you're always worried that the hospital will boot you and bring in EmCare etc. (worked for them too.) You do everything you can to keep your contract. Make everyone happy all the time, bring them blankets and drinks and never miss anything but don't over-order and don't upset anyone? It's impossible but we try and no one understands unless they are an EM doc.

DocB's previous statement regarding procedures is also something you don't realize until you're out. Procedures are loads of fun, but in private practice when you are solo coverage they just back the rack up. I can put in shoulders and do LPs and lines as fast as anyone, but that doesn't change the fact that they still take huge chunks of time, 20 mins in the ER is an eternity. I can see 2 level 5's in that time easily. One of the most important skills as an EM doc is to be as efficient as possible with procedures and multi-task. Numb up a lac, go see a pt, return and sew lac. Give kid IM ketamine, go see someone else, go back do procedure on kid etc etc.
 
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