VA Hopeful Dr

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Oh, I know. Human nature will never change. People will still b**ch when call to do work, especially if already feeling they're working "hard enough."
Its why salaried work is for suckers most of the time. If each admission means $200 into that hospitalist's pocket, the bitching will go away pretty damned quick. In fact, those easy CP admits become just fantastic.

Hospitalists are group that's greatly underappreciated, in that they're relatively new to the world of Medicine (becoming more commonplace in the '90s) and have greatly improved the work lives of other specialties. Hospitalists have saved countless doctors, not only primary care, from having to deal with the full weight of after hours work, admissions, consults, phone calls and care coordination. All specialites should be appreciated, but EP and hospitalists are a God-send, in how much they reduces the burden upon other specialties, whether they're appreciated for it or not.
If its any consolation, my 68 year old FP uncle routinely talks about how great life has been for him since hospitalists came to town in the mid 90s.
 

Redrox

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Let me chuck in another way of looking at this beyond the whole making bank and having time off schtick ( which don't get me wrong, I absolutely f*cking love these parts of it)

Had me a lot of attendings and fellow med students tell me I was too smart for EM, but they said this for kind reasons. Thought I'd get bored not dealing with super "complex" stuff.

Just wanna reassure the original poster that I don't feel intellectually stunted not at all. See plenty of rare things often, still am learning something on a monthly if not weekly basis, kinda cool to be able to call up a specialist in their field and hear how they do stuff. Everything and everybody comes through the ER, you gonna see some zebras no worries. Gonna see some unusual complications. You gonna **** yourself from time to time, even in a community shop debating what to do. Cocktail party stories for years.

More importantly, ER is good for the social brain. Even if the bread and butter diseases and presentations get routine, the people always gonna be different. Each room, each family a different dynamic. Who needs a friendly doc and how to be funny if they need that, who needs a walking text book with facts and figures. Why are they really here? What's the one thing they're most afraid of?

Challenge for me at this point is anticipating questions the family is afraid to ask, phrasing things the way they needed to be phrased, being the kind of doc they need me to be. It's hard and it's fun.

Same with nursing staff. Fun and a challenge to pick out who's having a hard day and how to get them brighter bout it. Pick up on who's pissed, who's distracted, having a hard day, who's feeling left out of the camaraderie and gonnna be a pill later if not in on the jokes. Who's irredeemable today and needs to be dodged.

Ya gonna have the bank to make up for the years of training, days off to enjoy that bank cash money, and a job worth spending a buncha years on.
 
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TheComebacKid

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You know, I never stated that I could do the work of a hospitalist or a specialist. I sure as hell can't, and I'm glad to death that there are people out there who are better than me at many of things that I can't manage i.e. starting chemotherapy or repairing a ruptured AAA. If anyone appreciates the work that the physicians do upstairs, it's me, trust me, I'm married to one of them.

That being said, I promise you, an IM doc cannot practice bread and butter emergency medicine better than a board certified EM trained physician. I stand by what I said, AKA nobody can do what we can do. As a senior EM resident, one of my favorite things to do is push an off service IM resident rotating through the ED to their limit. The other day I pushed a second year IM resident to manage a patient in hemorrhagic shock from a massive GI bleed. After his shift was over, he said "Don't let any of the other residents ever talk down to you. This place is absolutely insane."

I think pretty much every single person in emergency medicine in this forum has a great appreciation for the work that other physicians in other specialties put in. It's time other specialties do the same with regards to the ED docs that are busting ass and saving lives everyday. Are some of us terrible at what we do? Sure. But as a whole, I really think EM docs play a critical role in the house of medicine.
 

Perrin

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That's a really observant doc. I hope you paid a lot of attention on that rotation. I bet there were a lot of pearls being dropped there.
He was a good attending. He'd occasionally crack jokes with us on rounds and took an interest in each of us students that were on his team. It helped that we had good residents with us and one was doing a prelim year before starting EM. We had a good team that rotation. There was another student interested in EM and I think the rest were a mix of IM and primary care.
 

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More importantly, ER is good for the social brain. Even if the bread and butter diseases and presentations get routine, the people always gonna be different. Each room, each family a different dynamic. Who needs a friendly doc and how to be funny if they need that, who needs a walking text book with facts and figures. Why are they really here? What's the one thing they're most afraid of?
Highly underrated portion of what we do. I routinely point out to medical students that you must always know your audience.

Some people benefit from an attending who doubles as a stand-up comedian -- as a result, they benefit from it, they feel better about things, and you feel better about things as a more enjoyable interaction. The patient/significant other the next room over might file a complaint about the very same thing.

Know your audience. Happily, EM is excellent training for "reading the room" and the people in it.
 

gro2001

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It gets me just a little angrier every time I hear the phrase that ER docs create work for other specialties. It would be like me blaming EMS for bringing me patients. They signed up to take consults and admissions just like I signed up to take shifts in the ER. Nowhere in my contract does it say how many patients EMS is allowed to bring to me on my shifts, and no where in theirs does it say how many consults they are supposed to do.
 

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It gets me just a little angrier every time I hear the phrase that ER docs create work for other specialties. It would be like me blaming EMS for bringing me patients. They signed up to take consults and admissions just like I signed up to take shifts in the ER. Nowhere in my contract does it say how many patients EMS is allowed to bring to me on my shifts, and no where in theirs does it say how many consults they are supposed to do.
mo' money, mo' problems
 

GonnaBeADoc2222

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It gets me just a little angrier every time I hear the phrase that ER docs create work for other specialties. It would be like me blaming EMS for bringing me patients. They signed up to take consults and admissions just like I signed up to take shifts in the ER. Nowhere in my contract does it say how many patients EMS is allowed to bring to me on my shifts, and no where in theirs does it say how many consults they are supposed to do.
I think the smart ones realize this and are good partners to work with.

To the dumb ones I say: Remember that hip I reduced / PTA I drained / Pigtail I placed / horrible facial laceration I repaired at 3am and sent home? Yeah you don't cause I didn't call you about it.
 

VA Hopeful Dr

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It gets me just a little angrier every time I hear the phrase that ER docs create work for other specialties. It would be like me blaming EMS for bringing me patients. They signed up to take consults and admissions just like I signed up to take shifts in the ER. Nowhere in my contract does it say how many patients EMS is allowed to bring to me on my shifts, and no where in theirs does it say how many consults they are supposed to do.
You've never seen an EP get mad at EMS for bringing in patients?
 

Hercules

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You've never seen an EP get mad at EMS for bringing in patients?
Yes. I have seen that at virtually every non-academic non-productivity based shop I’ve been at. For many of the same reasons detailed above about specialists getting mad at the ED doc.


Sent from my iPhone using SDN mobile
 
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TheComebacKid

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It gets me just a little angrier every time I hear the phrase that ER docs create work for other specialties. It would be like me blaming EMS for bringing me patients. They signed up to take consults and admissions just like I signed up to take shifts in the ER. Nowhere in my contract does it say how many patients EMS is allowed to bring to me on my shifts, and no where in theirs does it say how many consults they are supposed to do.
What gets me equally upset is when a cardiologist sends me their asymptomatic hypertension patient from clinic, then gets upset at me for calling them in the middle of the night to evaluate a patient.

This idea that EM is the sole culprit when it comes to dumping on other services is the biggest fallacy. Whenever any patient has any problem that a specialist is remotely unfamiliar with, their response is always "Go to the nearest ED". I'm not saying that this is never appropriate (in fact a lot of times it is), but a lot of times, the ED is a convenient way for other physicians to not have to deal with their patients and get a good nights sleep.

To all the specialists/consultants out there, I'm happy to see your patients in the middle of the night so you can get a good night's sleep. But please think twice before calling me out for "dumping" on you, or "soft" admits.
 
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VA Hopeful Dr

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What gets me equally upset is when a cardiologist sends me their asymptomatic hypertension patient from clinic, then gets upset at me for calling them in the middle of the night to evaluate a patient.

This idea that EM is the sole culprit when it comes to dumping on other services is the biggest fallacy. Whenever any patient has any problem that a specialist is remotely unfamiliar with, their response is always "Go to the nearest ED". I'm not saying that this is never appropriate (in fact a lot of times it is), but a lot of times, the ED is a convenient way for other physicians to not have to deal with their patients and get a good nights sleep.

To all the specialists/consultants out there, I'm happy to see your patients in the middle of the night so you can get a good night's sleep. But please think twice before calling me out for "dumping" on you, or "soft" admits.
The nice thing, as many people here have pointed out, is that out in practice the vast majority of us from various specialties get along very well.

It really does seem to be academics (and occasional Axis 2 jerks out in practice) that overshadow that fact that most of us do just fine day in and day out.

I mean, I've been out of my FM residency for 5 years. In that time, I've only had a problem with a single EM doc. And after talking to multiple other people in the area, that particular guy is just a POS. The other 3 dozen of so EPs I've talked to in that time were very pleasant, professional, and quite understanding even if I admitted it was a dump and I was sorry about it.
 

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You've never seen an EP get mad at EMS for bringing in patients?
I've never had a doctor get mad at me for bringing them EMS patients, but I've definitely had a lot of nurses and techs get grumpy about it.
 

Perrin

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I've never had a doctor get mad at me for bringing them EMS patients, but I've definitely had a lot of nurses and techs get grumpy about it.
I've jokingly reminded them that we aren't the only ED in town when there's 5 crews waiting to unload a patient. The only time I get irritated is when they bring the pt to the wrong hospital. Family requested the hospital across town where the pt's specialists are at. Now I have to apologize and calm down an irate family.
 
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The White Coat Investor

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You've never seen an EP get mad at EMS for bringing in patients?
Clearly that doc doesn't own his job. That would be like a restaurant owner getting mad that so many people want to eat in his restaurant. #residentmentality
 

VA Hopeful Dr

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Clearly that doc doesn't own his job. That would be like a restaurant owner getting mad that so many people want to eat in his restaurant. #residentmentality
Goes back to the original point of "salaries are for suckers"
 

Perrotfish

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I've never had a doctor get mad at me for bringing them EMS patients, but I've definitely had a lot of nurses and techs get grumpy about it.
EMS isn't really a fair comparison, they work on protocols and don't really have a choice about what they do. A better comparison is the primary care doctor sending a patient to the ER. That's when I've seen ER docs get angry (reasonably or not) because they think the other doc should have been able to handle the patient's problem
 

gro2001

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EMS isn't really a fair comparison, they work on protocols and don't really have a choice about what they do. A better comparison is the primary care doctor sending a patient to the ER. That's when I've seen ER docs get angry (reasonably or not) because they think the other doc should have been able to handle the patient's problem
Yes, you are right. That's probably a better comparison. I've seen both (ER docs getting mad at EMS and primary care docs). Both reactions are stupid.

When I was comparing the EMS to the ED doc experience, I was thinking more of the typical situation where the hospitalist sees that a certain patient can't go home because of reasons, and doesn't have any particular reason to go to another service (surgical issue, stroke, badness warranting ICU), but yet gives me a hard time for admitting them. In that sense, it's very similar to the EMS thing: I am passing on the care to the person who is supposed to take over from that point but for some reason they think its worthwhile to complain about it.

The ER docs complaining about primary care docs sending in a patient is also stupid. Like when they send in someone with asymptomatic hypertension. If you really think that it was super straight forward and should not have been sent to the ER, its the easiest dispo in the world. If it isn't super easy to dispo them or you feel you are stuck doing a workup, then maybe it wasn't all that straight forward after all and therefore not a completely inappropriate referral. Basically, ER docs should see a patient sent in from the clinic as a consult. Before getting mad, think about how you would want someone you are consulting to respond.
 

RustedFox

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The ER docs complaining about primary care docs sending in a patient is also stupid. Like when they send in someone with asymptomatic hypertension. If you really think that it was super straight forward and should not have been sent to the ER, its the easiest dispo in the world. If it isn't super easy to dispo them or you feel you are stuck doing a workup, then maybe it wasn't all that straight forward after all and therefore not a completely inappropriate referral. Basically, ER docs should see a patient sent in from the clinic as a consult. Before getting mad, think about how you would want someone you are consulting to respond.
I used to feel this way until it became so common for every physician, NP, and PA in this county and the next to send the patient to the ER at 5:30 PM (Quittin' time! Yabba Dabba Doo!) with their 170/69 pressure and a warning that they'll "have a stroke" if they don't go. First off, I don't want the lie perpetuated that they'll "have a stroke!" as I work in the United States Capital of Old People. The force is already strong with that myth here. Second, when the halls are three deep with snowbirds, the patient would actually be better off chilling out in a cool room at their PMD's office with a dose of that dreaded Clonidine, seeing their pressure go down, and going home - rather than walking into the circus tent that is the ER and waiting for another hour or so just to be told "okay; its down - go home."
 
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BoardingDoc

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I used to feel this way until it became so common for every physician, NP, and PA in this county and the next to send the patient to the ER at 5:30 PM (Quittin' time! Yabba Dabba Doo!) with their 170/69 pressure and a warning that they'll "have a stroke" if they don't go. First off, I don't want the lie perpetuated that they'll "have a stroke!" as I work in the United States Capital of Old People. The force is already strong with that myth here. Second, when the halls are three deep with snowbirds, the patient would actually be better off chilling out in a cool room at their PMD's office with a dose of that dreaded Clonidine, seeing their pressure go down, and going home - rather than walking into the circus tent that is the ER and waiting for another hour or so just to be told "okay; its down - go home."
Are you actually bothering to lower these people's BP? If they're truly asymptomatic, I'm just doing an exam and discharging them. If they are symptomatic, they get labs/CT/whatever and then they go home (I still don't lower their BP). If they have signs of end organ dysfunction, that's a different story.
 

RustedFox

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Are you actually bothering to lower these people's BP? If they're truly asymptomatic, I'm just doing an exam and discharging them. If they are symptomatic, they get labs/CT/whatever and then they go home (I still don't lower their BP). If they have signs of end organ dysfunction, that's a different story.
I don't bother to do anything to lower their BP. My point (politely, in response to gro2001's post), is that this particular bit of PMD/PA/NP behavior is:

1. Lazy (Doctor/NP dipsh!t just wants to go home).
2. Dishonest (the patient won't have a stroke).
3. Harmful (the ancient Ones and Jennie McJennyson the ER-NP just love that clonidine dose).
4. More costly (both to patient, and to the healthcare system at large).
5. Fully unnecessary (and jams up my already short-staffed and over-capacity ER).

If it were just one or two a week, I'd be more understanding. But here, its at least 3-5 visits every day during tourist/snowbird season that I deal with alone.
 

GonnaBeADoc2222

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Yes, you are right. That's probably a better comparison. I've seen both (ER docs getting mad at EMS and primary care docs). Both reactions are stupid.

When I was comparing the EMS to the ED doc experience, I was thinking more of the typical situation where the hospitalist sees that a certain patient can't go home because of reasons, and doesn't have any particular reason to go to another service (surgical issue, stroke, badness warranting ICU), but yet gives me a hard time for admitting them. In that sense, it's very similar to the EMS thing: I am passing on the care to the person who is supposed to take over from that point but for some reason they think its worthwhile to complain about it.

The ER docs complaining about primary care docs sending in a patient is also stupid. Like when they send in someone with asymptomatic hypertension. If you really think that it was super straight forward and should not have been sent to the ER, its the easiest dispo in the world. If it isn't super easy to dispo them or you feel you are stuck doing a workup, then maybe it wasn't all that straight forward after all and therefore not a completely inappropriate referral. Basically, ER docs should see a patient sent in from the clinic as a consult. Before getting mad, think about how you would want someone you are consulting to respond.
A consult is: "I've thought about this issue to the best of my ability and believe it needs some kind of expertise that is beyond my scope of practice." If "consulting" the ER, it SHOULD involve an attending to attending conversation to discuss the concerns of the person making the referral and best steps forward. I really like these conversations when they happen.

A consult is not: "Oh damn it's closing time or it's 2pm on a Saturday and I don't feel like dealing with this (or don't have the basic knowledge and thus, shouldn't be in practice) and taking the 2 minutes to reassure my patient and schedule them for follow up, so I'm gonna scare my patient into going to the ED ("Your BP of 180/100 is going to make your head fall off!"), oh and I'm not even going to bother to call the ER doc."

This is akin to me wheeling an ankle sprain up to the OR, without bothering to get imaging, and not calling the orthopedic surgeon.

Plain and simple it is lazy, uneducated and dangerous medicine (what else are you mismanaging in your office?). It is bad for the "system," frustrates patients and costs them real financial dollars (a $200 ED co-pay may not seem like much to you or me, but might be a lot for that 75 yo on a fixed budget), and contributes to burnout of ED staff and physicians.
 

VA Hopeful Dr

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A consult is: "I've thought about this issue to the best of my ability and believe it needs some kind of expertise that is beyond my scope of practice." If "consulting" the ER, it SHOULD involve an attending to attending conversation to discuss the concerns of the person making the referral and best steps forward. I really like these conversations when they happen.

A consult is not: "Oh damn it's closing time or it's 2pm on a Saturday and I don't feel like dealing with this (or don't have the basic knowledge and thus, shouldn't be in practice) and taking the 2 minutes to reassure my patient and schedule them for follow up, so I'm gonna scare my patient into going to the ED ("Your BP of 180/100 is going to make your head fall off!"), oh and I'm not even going to bother to call the ER doc."

This is akin to me wheeling an ankle sprain up to the OR, without bothering to get imaging, and not calling the orthopedic surgeon.

Plain and simple it is lazy, uneducated and dangerous medicine (what else are you mismanaging in your office?). It is bad for the "system," frustrates patients and costs them real financial dollars (a $200 ED co-pay may not seem like much to you or me, but might be a lot for that 75 yo on a fixed budget), and contributes to burnout of ED staff and physicians.
Admittedly there are lots of ****ty doctors in all of medicine.
 

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I had a similar problem. I thought I was too awesome for EM. Everybody was like, you're awesome, don't go into EM, that's lame. I decided if I went into EM, I could make it less lame, b/c I'm that awesome. Turns out, EM already was awesome. Everybody won--we're like synergentically awesomer.

Turns out I just had too much pride to acknowledge no one is really TOO awesome for EM. Or smart. For any specialty.
 

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I had a similar problem. I thought I was too awesome for EM. Everybody was like, you're awesome, don't go into EM, that's lame. I decided if I went into EM, I could make it less lame, b/c I'm that awesome. Turns out, EM already was awesome. Everybody won--we're like synergentically awesomer.

Turns out I just had too much pride to acknowledge no one is really TOO awesome for EM. Or smart. For any specialty.
What we have here is a modern day example of the Will Rogers phenomenon ("When the Okies left Oklahoma and moved to California, they raised the average intelligence level in both states").

Welcome to emergency medicine!
 

acadianvoyager

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Finally got it today - I'm on my IM rotation and my attending told me I was too smart to go into EM. In so many words, he went to say that other specialties basically look at EM docs like the dunces of medicine and that my job satisfaction would suffer because of this.

I've heard it all before and it doesn't sway my interest in EM but I'm curious from you guys, do you interact with other specialties outside of consulting in the ER? How are those interactions? Do you think you get the respect you deserve?
I spent too much energy listening to the haters in med school, and it almost talked me out of EM. I LOVE my job and would never want to work anywhere else in the hospital. If EM gets you going, don't let anyone take you off that train.
 
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slz1900

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EM is just as intellectual as any specialty, there’s just a lot less pontification and if a patient is admitted another doc will look over everything you did. Look over everything the PGY10 pediatric neurosurgeon does and you’ll probably find stuff to pick at too. If talking about whether 5 or 10 of hydralazine is better for 55 year old diabetic Scandinavians seems ‘intellectual’ then yeah, you’re not going to get much of that. The only reason those discussions don’t happen in EM is because of time constraints and inability to have hour long conferences in the middle of the day. Likewise comb over any specialties’ decision making and you’ll find tons of stuff that seems questionable. If you want to do something truly intellectual do a postdoc or medical genetics research or something. Otherwise clinical medicine in all specialties is about repetition repetition repetition with some reading sprinkled in until you gain competence.
 
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Are you actually bothering to lower these people's BP? If they're truly asymptomatic, I'm just doing an exam and discharging them. If they are symptomatic, they get labs/CT/whatever and then they go home (I still don't lower their BP). If they have signs of end organ dysfunction, that's a different story.
The problem is a lot of PCP's say that you will need to be admitted. So when I try to discharge them family throws a fit even if I do lab work to satisfy them. My blood pressure is still high my PCP told me I need to be admitted for my bp of 180!
 

gamerEMdoc

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The problem is a lot of PCP's say that you will need to be admitted. So when I try to discharge them family throws a fit even if I do lab work to satisfy them. My blood pressure is still high my PCP told me I need to be admitted for my bp of 180!
PCPs always say to patients that they need admitted, until you call them to admit the patient.
 
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BoardingDoc

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The problem is a lot of PCP's say that you will need to be admitted. So when I try to discharge them family throws a fit even if I do lab work to satisfy them. My blood pressure is still high my PCP told me I need to be admitted for my bp of 180!
In an asymptomatic HTN patient, if the family throws a fit, I take a couple of minutes to explain why this isn't an emergency and why they don't need to be admitted. If they persist, I also have no issue throwing the PCP under the bus in this scenario and explain that even being sent to the ED for an evaluation without any symptoms was grossly inappropriate. If they're still throwing a fit at that point I just say sorry, then leave the room and click discharge.
 

thegenius

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When other docs, in other specialties, find out I used to do EM, I almost routinely hear comments more like, "Oh man. ER? Wow. I could never do that. Toughest job in all of medicine."
100% true! Hear that all the time.
 
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There are many ways to think about this. EM requires a very specific personality- confident but not arrogant, with good leadership skills and great people skills to deal with everyone from VIPs to hospital staff to cranky consultants, and it also requires the ability to multitask, take care of multiple sick patients, and a vast fund of knowledge. These are, of course, all forms of intelligence. I don't think anyone is saying (and if they are, well, no point in arguing with a fool) that EM doesn't take a very high level of skill.

EM, however, doesn't necessarily take book smarts (although I would argue much of medicine doesn't), and when people say this what they may mean is that if you get off on discussing the citric acid cycle, this isn't the best way to use your specific form of intelligence and it may not be the field for you if you want really cerebral discussions and cutting-edge basic science research.
 

thegenius

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EM, however, doesn't necessarily take book smarts (although I would argue much of medicine doesn't), and when people say this what they may mean is that if you get off on discussing the citric acid cycle, this isn't the best way to use your specific form of intelligence and it may not be the field for you if you want really cerebral discussions and cutting-edge basic science research.
Yea most of medicine, these days, is written up in textbooks and algorithmic. And when the algorithm doesn't exist, there sure is lots of guessing in medicine.

I think good ER docs feel very comfortable acting first and then getting information second. Kind of the antithesis of every specialty in health care, where they do a thorough H&P and then act.

Of course the problem arises when they act first prior to getting information, when they have time to get the information. Some ER docs, for instance, are intubate BOOM just like that (thus getting a history much more difficult) when in fact they have time to gather information. Anyway a separate topic.
 

OccupyTheED

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I think lots of other specialties don't quite understand what we do and quite frankly I don't care. I make my own schedule, work about 12-13 days a month on average and I'll pull in about 480K this year. I'm quite confident they're even less qualified to do my job than I am to do theirs and most are pretty bad judges of how good we are/aren't in performing our duties.
 
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gamerEMdoc

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Do keep in mind that patients often misrepresent what we (doctors as a whole) tell them
Oh yeah, no doubt. Most of the time the "my PCP told me to come in to be admitted" means they spoke to a nurse on the on call line who tells every person that calls to go to the ED.
 
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I would add that if respect within the house of medicine is really important to people, EM may also not be the right field for them. While our more forward-thinking colleagues may give the ED its due, older colleagues and more traditional areas of the country (hello, NYC and Northeast) continue to malign the specialty, with EM not even having departmental status in many areas.

I'm not knocking people for wanting respect- we deserve it, and sadly we are still one of the newer specialties, and ACEP sure isn't doing much to help our case.
 

The Knife & Gun Club

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Same thing happened to me today.

Attending said “oh you want to do EM? Enjoy being the hospital secretary. Why not do surgery? You can do everything the ER people do but also learn how to be a doctor”

The table of surgery residents and fellows had a good laugh.

Now I know he’s probably just a jackass but damn it sucks to know that’s how some people in academics view EM.
 

VA Hopeful Dr

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Same thing happened to me today.

Attending said “oh you want to do EM? Enjoy being the hospital secretary. Why not do surgery? You can do everything the ER people do but also learn how to be a doctor”

The table of surgery residents and fellows had a good laugh.

Now I know he’s probably just a jackass but damn it sucks to know that’s how some people in academics view EM every specialty that isn't theirs.
FTFY
 

gamerEMdoc

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Why not do surgery? You can do everything the ER people do but also learn how to be a doctor
Hahaha. I love that a surgeon said that. For doctors that can do anything, it sure is odd that they try to admit everything to medicine.
 

Veil

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Hahaha. I love that a surgeon said that. For doctors that can do anything, it sure is odd that they try to admit everything to medicine.
Both true. Happily, most of our surgeons here get that EM is its own thing.

It's all bull**** in the end. Pick what you think will keep you happiest.
 

Mr. Hat

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Same thing happened to me today.

Attending said “oh you want to do EM? Enjoy being the hospital secretary. Why not do surgery? You can do everything the ER people do but also learn how to be a doctor”

The table of surgery residents and fellows had a good laugh.

Now I know he’s probably just a jackass but damn it sucks to know that’s how some people in academics view EM.
And once again I’m so offended and angry at this garbage that I can’t even.... oops hold on.... the cash truck is backing up to my house again, and the UPS guy is delivering the snorkel I ordered for those beach resort trips this winter.

Ok sorry what were we talking about? Crud I forgot. Anyway heading to the gym now and then going out to dinner. I may catch a movie too since I get to sleep in tomorrow, being on a run of days off and all. Ah well, if it comes back to me I’ll let you know.
 

The Knife & Gun Club

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And once again I’m so offended and angry at this garbage that I can’t even.... oops hold on.... the cash truck is backing up to my house again, and the UPS guy is delivering the snorkel I ordered for those beach resort trips this winter.

Ok sorry what were we talking about? Crud I forgot. Anyway heading to the gym now and then going out to dinner. I may catch a movie too since I get to sleep in tomorrow, being on a run of days off and all. Ah well, if it comes back to me I’ll let you know.
10/10 quality post. Much appreciated.
 

VA Hopeful Dr

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Both true. Happily, most of our surgeons here get that EM is its own thing.

It's all bull**** in the end. Pick what you think will keep you happiest.
It really is amazing how much of this goes away as soon as you leave academics.
 
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It really is amazing how much of this goes away as soon as you leave academics.
100% agree.

Too smart for EM? Haha, maybe 30 years ago but game has changed. I had friends at other programs tell me about surgeons saying this kind of bulls*t but the average board scores for my EM class were higher than nearly every other specialty, significantly so for our general surgery residency. In fact, our PD alluded to our class having second highest average board scores amongst all residencies in hospital (hospital had every residency possible I believe). Not a measure of intelligence per say, but allows comparison of apples to apples for medical students/residents.....

General surgeons at every academic center I rotated at or did residency at seemed extremely unhappy with their career choice. This seemed to have profound 'trickle down' effect to their residents. Was actually kind of sad to witness close-up....

At my current hospital all of our surgical specialists LOVE us. They know we do everything we can to minimize BS work for them and they go out of their way to advocate for us and support us.

As alluded to above, if you care what people think of your specialty or allow such comments to influence your potential career choice your setting yourself up for possible lifetime of unhappiness......

TPM
 

TheComebacKid

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Same thing happened to me today.

Attending said “oh you want to do EM? Enjoy being the hospital secretary. Why not do surgery? You can do everything the ER people do but also learn how to be a doctor”

The table of surgery residents and fellows had a good laugh.

Now I know he’s probably just a jackass but damn it sucks to know that’s how some people in academics view EM.
I had the exact same comments. One of the CT surgery attendings in the OR referred to me as a triage nurse when he found out I wanted to do EM and had a great laugh about it with the fellow and OR staff.

In that moment, it became abundantly clear to me. While I'm sure there are "nice" surgeons, why would I want to associate myself with the culture of a specialty that talks that way about other specialties? You have to be a pretty unhappy/miserable person.

At least the dermatologists in med school said "Wow! I could never do that, congrats to you for being so motivated and pursuing EM".

It's amazing how much nicer people are if they are allowed to sleep and spend time with their families.