TheTickets

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I tripped over an air mattress yesterday morning and got a concussion. I hit my head on a brick wall. Anyway, I went to the ED to get my cat scanned and I had a chance to talk with the doctor. Naturally, the question I had was "would you do it all over again?"

About half a second after I finished the question she responded with a no. She added that the health care system is a mess and that reimbursements continue to go down. She was convinced that things will get worse. She continued saying that the department has no sick days or vacation days minus the ones you take. She said you couldn't call in sick. If this isn't enough she said that most of her patients are rude and malpractice is among the highest across the specialty board. She said that school is getting more expensive and it will become difficult to pay off in the future. Lastly, she added that something will have to be sacrificed whether it be your job or family life. However, she did add that there is no call which is nice and to always keep your phone number unlisted. It sounded like the bad things completely outweigh the good.

Needless to say, this scared me straight a little. I was under the impression that emergency medicine was somewhat of a lifestyle specialty. She was a good doctor, friendly and efficient. She just seemed like she wanted a fresh start.

Just putting this out there for what it's worth....
 

EpiPEN

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Everytime I hear ED I think erectile dysfunction.


That said, I like ED. I mean, the whole thing about you gotta love what you do if you want to be a doc right? Stakes are high, so you better be able to say that you are getting someting out of it besides a crappy family and stressful lifestyle.

oh and working in the emergency department is cool too.
 

Dane07MD

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More importantly, how is your cat? Did his scan go all right?

ED work is somewhat of a lifestyle specialty. But you have to deal with many rude, non-compliant, non-paying patients. That takes it's toll. You can work half time however, and still make a adequate lifestyle with a family. Not that I encourage that, but if family/life is important and you go the ED route, it certainly is an option.
 

Bacchus

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For every negative review of the profession you'll find several positive reviews. There are many variables that will affect an EM physician's opinion of the work being done. One major theme that relates to a lot of complaints is location. In the "boondocks" where I am from the doctors seem a bit more laid back because its a bit more easy going. The EM physicians in the area do not deal with the same cases that the level I does 30 miles away. Malpractice is not as high and neither is patient load. The tradeoff is, some of your training, especially if you trained at a level I or II may not be used at my hometown hospital. You still have time to play with the kids after work and there aren't as strict patient requirements. Our ED boasts "zero" wait time because of the less complex cases it receives. I haven't heard of a doctor really complaining about practices in our area (unless you get them started on the lack of tort reform ;)). Overall, it really comes down to where and how you're practicing. Don't let one discussion with a stressed out physician deter you from medicine. Heck, you don't know if this was just a venting session of hers and usually she isn't this lamenting.
 

notdeadyet

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Talk to more emergency docs. I think you'll find that her opinion is pretty much the opposite of most folks.
She continued saying that the department has no sick days or vacation days minus the ones you take. She said you couldn't call in sick.
Very unsuual. One of the things EPs usually love about their jobs is the fact that they get quite a bit of time off compared to most physicians. Your schedule usually amounts to 12-14 shifts a month (depending on schedule). Don't know about her vacation schedule, but the thing EPs usually rave about is that it's quite easy fore the m to take vacations, as they just need to swap a few shifts with other folks and all of a sudden they are looking at two weeks off.
If this isn't enough she said that most of her patients are rude and malpractice is among the highest across the specialty board.
She's right on the rude part. The malpractice thing is a head scratcher. The hospital covers the malpractice insurance for emergency docs. I don't know thesituation if she works at a doc-in-the-box or something similar.
Lastly, she added that something will have to be sacrificed whether it be your job or family life.
If you have a tough time with the amount of hours you'll put in as an emergency doc, you probably would have had a tough time with pretty much any professional career. Truly. My kids will see a lot more of their emergency physician father/mother than they will if their parent is a lawyer, pilot, or any number of careers. If 50 hours a week and a few missed holidays/birthdays rips your family apart, the problem probably doesn't lie with your job.

Anyway, plenty of good reasons not to go into medicine. But talk to more emergency doctors before ruling it out. They are by far the specialty that seems most happy with their choice of careers amongst doctors I've met.
 
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TheTickets

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Yeah, I'm alright. Little unconsciousness. Just rest is all I need.

She said her husband is a vascular surgeon and he wishes he would have done something else too. I don't think she hated her job but I don't think she liked it either.

I would agree that where you work has a lot to do with it. This hospital is full of rude people with rude patients. I got that feeling before I even walked in the waiting room. Oh well. All I can hope for is that other doctors say something different. I think it's much different to read reviews on this forum than to talk to a doctor face to face. Little bit of a wake up call I guess.
 

TheRealMD

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Don't EM docs also suffer from an extremely high burn-out rate? I mean, while it's mostly shift work, you've got to be on the wire for a good 9-10 straight each shift ready for anything.

Of course 20-30 years ago med school admissions wasn't nearly as difficult such that people jumping through hoops today should really want to be doctors and know what they are getting into.
 

JayneCobb

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She continued saying that the department has no sick days or vacation days minus the ones you take..
I'm having a hard time mustering sympathy since i routinely see help wanted ads for EM docs between 300 & 400k/year for 15-18 12 hour shifts a month. Must be rough to only work 26 weeks/year for that type of cash.
 

JayneCobb

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Don't EM docs also suffer from an extremely high burn-out rate? I mean, while it's mostly shift work, you've got to be on the wire for a good 9-10 straight each shift ready for anything.
There was a study not too long ago which pretty well dispelled this rumor. The burn out rate for EM was very similar to pretty much every other specialty. I'll have to see if I can dig that up.
 

scattun

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Don't EM docs also suffer from an extremely high burn-out rate? I mean, while it's mostly shift work, you've got to be on the wire for a good 9-10 straight each shift ready for anything.
No, the burn-out rate for EM docs is right at the average for docs in general. As with any job, there are good EM jobs and bad EM jobs. The very good can include 15 8 hour shifts a month with profit sharing amounting to well over $300,000 a year and bad can be 22 8 hour shifts a month on a salary of like $120,000. It sounds like this doc is in the latter situation. As far as sick days, that is mostly true. In general it is hard to call in sick because that means one of the people from your group has to cover for you (in private practice) and this can be a problem since they might all have plans for that day. So unless you are in the hospital as a patient, you go to work.
 

TheRealMD

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There was a study not too long ago which pretty well dispelled this rumor. The burn out rate for EM was very similar to pretty much every other specialty. I'll have to see if I can dig that up.
Sorry to spread that rumor again.
 

Lion-O

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get my cat scanned

I'm a 4th year going into EM. In my experience, those who say they wouldn't do it over again suffer from "grass is always greener" syndrome. What would you be doing instead? The majority of people dislike their jobs; I think we should be grateful that we were born into circumstances that allow us to do something as exciting and beneficial as medicine. (We'll see if my tune changes in the middle of intern year.)
 

brianmartin

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I was under the impression that emergency medicine was somewhat of a lifestyle specialty.
It is a lifestyle specialty for those who enjoy the lifestyle. Sometimes people like this doc are fed up with it and need to vent sometimes. The EM schedule is not for everyone. However for those who really like it, it's awesome. Flexible schedule, vacations, lots of days off. It's not bad if you can stand the weird hours.