Although I am a pre-med, I have worked full time in a level II trauma center for over a year. I have worked 1st, 2nd, and 3rd shifts, and often work 12 hour shifts. Working along side EM physicians (and all specialties), here is my take on EM:
1. Yes, it's shift work. You work a certain number of hours, and then leave with no other hospital obligations. Most EM docs don't admit patients to the hospital, so they don't do rounds or keep up with their patients after they leave the ED. However, the older EM docs tell me how the shift work gets old after the first 5 years of practice.
2. They work odd hours on holidays and weekends. Yes, I know all doctors work holidays and weekends, but they are usually on call and only come in when they have to. EM docs must cover the ER 24/7, regardless of how busy the department is. I worked all of July 4th weekend, and the docs kept telling me how they wish they were at home with their kids on the lake.
3. Many of the patients that come in don't need to come in. For instance, I am looking at my computer right now that says this patient has been here 64 times THIS YEAR (if you cant tell i am at work right now and it's a slow night, most docs on call right now are at home sleeping). Anyway, this patient probably doesn't have insurance, and is costing this hospital a fortune that will never be paid (which is a whole different issue). We also see many psych patients, alcohol/drug abusers, drug seekers, and many of the patients are not grateful at all. However, the truly grateful patients can make your day.
4. The true emergencies usually are referred to specialists who take care of them. For instance, an EM physician can't do much for a person coming in with an AMI, so he calls the cardiologist and the patient is sent up to cath lab right away. The EM doc never hears anything else about that patient. This type of situation occurs with all specialties.
I am in no way daunting the emergency medicine specialty. These physicians are the first caretakers of patients with true emergencies. These docs must have good judgement to make decisions with very little information at hand. I've seen many patients come out of cardiac arrest due to the work of an EM physician. I have some interest in trauma surgery, just so I can have more time doing procedures. So please don't take this post the wrong way. I just thought I would shed some light.
