unhappy?!

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EMIM2011

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Why does it appear as if most EM folks are not happy with their work? I don't feel like any attendings or residents in the field truly, truly enjoy being at work. It appears as if it is more about "getting through a shift", to enjoy the decent pay and free time....a stark contrast to many other specialties (e.g., Peds, Intensivists, Subspecialty Surgeons). I feel like Anesthesiologist often appear to have the same attitude/issues.

Thoughts? Explanations?
 
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Medscape did an extensive physician happiness survey. EM was among the top 3 if I remember.

The complaints of medicineis in all fields. EM isnt a bottom tier happiness specialty.

This sounds like the post I read with EM being sued the most, when in reality it wasnt even top 10 in being sued.
 
JShephard said:
Medscape did an extensive physician happiness survey. EM was among the top 3 if I remember.

The complaints of medicineis in all fields. EM isnt a bottom tier happiness specialty.
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But was this about how much they like their field/being at work or the overall lifestyle...as I said, I don't disagree with the latter, I was talking about how much EPs enjoy WORKING.
 
EMIM2011 said:
But was this about how much they like their field/being at work or the overall lifestyle...as I said, I don't disagree with the latter, I was talking about how much EPs enjoy WORKING.
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Not sure.

I would think It's Individual and that taking an sdn survey is a specific slanted population. Just like an an allo poll is not representative of all med students.
 
I know I'm not happy with the job I currently have. And while it burnt me out to a huge degree, I haven't lost hope that I can enjoy the field, so I'm looking!
Unfortunately it's immensely complex and difficult to change gigs (takes a long time to find good fit), especially with family and young kids!
 
I'm very happy with my job. I like my dept, the nursing staff is responsive, and things get done. The reason so many of us, myself included, get frustrated is because of the other crap we deal with. We have an increasingly hostile population at my hospital, and I was assaulted by a patient in Nov. Between the crap patients and the unrealistic demands by them, it's a neverending storm of garbage. Fortunately, my gig is worth it, but if I had a less responsive administration, I'd have been gone a while ago
 
There are those of us who enjoy our job. A lot of it has to do with your work environment. A lot of us use SDN to commiserate more than to celebrate our profession but both do occur. I have an amazing job that I grow to appreciate more and more as I hear about others' experiences. I'm kind of in the utopia of EM (for me at least). I'm a partner in an extremely well run small democratic group made up of eight EM residency trained docs that I actually like to hang out with. We have the support of administration, the respect and appreciation of our consultants (this fact is helped by having three other less than stellar EDs in town that don't use EM boarded folks), and a very favorable payor mix. We have good pathology and the majority of our patients are working folks who say thanks. We have a healthy pediatric mix which I enjoy. We get the occasional trauma but the majority of the monotonous penetrating trauma goes to the level 1 trauma center in town. Full time for us is 11 ten-hour shifts per month with most leaving on time or a little early thanks to overlap. Collections are variable but even in the worst month we're all making well above $200/hr and on a good collections month it gets pushed over $300/hr. We're not crazy busy either-- we see 2.0-2.5 pts/hr on our own and supervise 1.0-1.5 pts/hr seen by our midlevels.

As a side bonus for me, the job just happened to be in the same city as my wife's family and we get lots of help with our three kids. There, a post about someone in EM enjoying their job.
 
Hercules said:
There are those of us who enjoy our job. A lot of it has to do with your work environment. A lot of us use SDN to commiserate more than to celebrate our profession but both do occur. I have an amazing job that I grow to appreciate more and more as I hear about others' experiences. I'm kind of in the utopia of EM (for me at least). I'm a partner in an extremely well run small democratic group made up of eight EM residency trained docs that I actually like to hang out with. We have the support of administration, the respect and appreciation of our consultants (this fact is helped by having three other less than stellar EDs in town that don't use EM boarded folks), and a very favorable payor mix. We have good pathology and the majority of our patients are working folks who say thanks. We have a healthy pediatric mix which I enjoy. We get the occasional trauma but the majority of the monotonous penetrating trauma goes to the level 1 trauma center in town. Full time for us is 11 ten-hour shifts per month with most leaving on time or a little early thanks to overlap. Collections are variable but even in the worst month we're all making well above $200/hr and on a good collections month it gets pushed over $300/hr. We're not crazy busy either-- we see 2.0-2.5 pts/hr on our own and supervise 1.0-1.5 pts/hr seen by our midlevels.

As a side bonus for me, the job just happened to be in the same city as my wife's family and we get lots of help with our three kids. There, a post about someone in EM enjoying their job.
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When did EM get to be such a well paying specialty? I remember the days were EM barely made over 200k.
 
Residentcool said:
When did EM get to be such a well paying specialty? I remember the days were EM barely made over 200k.
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Aren't there still PLENTY of jobs/places where EM still makes slightly more than 200K? I mean, isn't the average....average....for a full-time EM-boarded doc about 225K...if that.
 
DreamingTheLive said:
Aren't there still PLENTY of jobs/places where EM still makes slightly more than 200K? I mean, isn't the average....average....for a full-time EM-boarded doc about 225K...if that.
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I don't know, I'm not in EM but it seems like I've seen plenty of 300k + EM jobs. And 200$/hr for full time is about 400k, 300$/hr would be well over 500k. That's pretty crazy.
 
Residentcool said:
I don't know, I'm not in EM but it seems like I've seen plenty of 300k + EM jobs. And 200$/hr for full time is about 400k, 300$/hr would be well over 500k. That's pretty crazy.
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All just depend where your willing to live an or travel/commute to work 😉
 
I'm on-pace to take home between 210-220 K in my first year. And there were some months where "I didn't work that much."
 
Hey Hercules and Greanbbs where do you all work?
 
RustedFox said:
I'm on-pace to take home between 210-220 K in my first year. And there were some months where "I didn't work that much."
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210-220 is not 300 or 400k. I'm aware that in the 200's is easy for EM and just about every other specialty to make, but 300-400k is quite a bit of $$, and comparable to many of the hard core surgical specialties so that's why I was wondering. I guess like the other person said it may depend on where you work, as I do recall the ads being in MO and central PA but still. That's not a bad result for a 3 year residency!
 
Residentcool said:
210-220 is not 300 or 400k. I'm aware that in the 200's is easy for EM and just about every other specialty to make, but 300-400k is quite a bit of $$, and comparable to many of the hard core surgical specialties so that's why I was wondering. I guess like the other person said it may depend on where you work, as I do recall the ads being in MO and central PA but still. That's not a bad result for a 3 year residency!
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I could certainly work more, and make a lot more. I choose not to. For many, many good reasons.
 
RustedFox said:
I could certainly work more, and make a lot more. I choose not to. For many, many good reasons.
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Again, we can all work more and make more, but I'm talking generalities here. I think it's great that as an EM doc you can make that kind of $ even in the boonies. How many hours do you work currently?
 
Residentcool said:
210-220 is not 300 or 400k. I'm aware that in the 200's is easy for EM and just about every other specialty to make, but 300-400k is quite a bit of $$, and comparable to many of the hard core surgical specialties so that's why I was wondering. I guess like the other person said it may depend on where you work, as I do recall the ads being in MO and central PA but still. That's not a bad result for a 3 year residency!
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Last job: metro area in the South gross pay ~$340k, working ~16 10s/month.
 
EMIM2011 said:
Why does it appear as if most EM folks are not happy with their work? I don't feel like any attendings or residents in the field truly, truly enjoy being at work. It appears as if it is more about "getting through a shift", to enjoy the decent pay and free time....a stark contrast to many other specialties (e.g., Peds, Intensivists, Subspecialty Surgeons). I feel like Anesthesiologist often appear to have the same attitude/issues.

Thoughts? Explanations?
Click to expand...

Have you ever been driving down the street and passed a runner in an all out sprint, face red and contorted, dripping with sweat, sucking air, chest caving in? If you asked him at that moment if he was "happy," he probably won't say yes. Yet every morning, for some reason, he's on that street pounding the pavement, when he could be in bed, eating a donut and mocha-latte. Why? Because he's driven to do something special, and more than what's easy. Does that make him stupid? Some might say yes. Others might say, "Thank God for people like him."

#thebirdstrikesagain
 
Residentcool said:
Again, we can all work more and make more, but I'm talking generalities here. I think it's great that as an EM doc you can make that kind of $ even in the boonies. How many hours do you work currently?
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Remember, the numbers I'm using are NET (take home) pay. No idea what my gross would be, but it'd be over 300K, I'm almost certain.

I generally work 140 +/- 10 hours a month. Work is "seasonal" down here in Snowbirdland. Summers are slow. Winters are busy. I've never worked more than 161.50 hours (my record to date). That's a 40-hour week.
 
Arcan57 said:
Last job: metro area in the South gross pay ~$340k, working ~16 10s/month.
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So about 4, 10 hour days/week or so? Not bad. It seems like pay in EM has gone up quite a bit just like with IM. I have never liked EM but do think for those who like more hectic type environments and can handle the stress, it's a good gig.
 
RustedFox said:
Remember, the numbers I'm using are NET (take home) pay. No idea what my gross would be, but it'd be over 300K, I'm almost certain.

I generally work 140 +/- 10 hours a month. Work is "seasonal" down here in Snowbirdland. Summers are slow. Winters are busy. I've never worked more than 161.50 hours (my record to date). That's a 40-hour week.
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Like I said to Arcan, I think it's a pretty good return these days. When did EM salaries shoot up like that?
 
The truth is, medicine in general is not what it used to be. With that said, it sure beats working on the assembly line or riding in an ambulance. We deal with the same type of people that cops, medics, social workers have to deal with. In essence we truly are public servants. The difference is, we make about 10 times the salary of any of these other people. So yes, we are cynical, and often complain. It's hard to do this well without those doing so. But if you are the kind of person that values their personal life, their family, and their free time, then there are few other specialties that rival us. All those other docs mentioned above are equally "unhappy". It's all about your frame of reference. If you grew up with the silver spoon like many others in our specialty, then you might not like EM. If you grew up average and understand what it means to live in a middle class world, then you will realize we live like kings.
 
Birdstrike said:
Have you ever been driving down the street and passed a runner in an all out sprint, face red and contorted, dripping with sweat, sucking air, chest caving in? If you asked him at that moment if he was "happy," he probably won't say yes. Yet every morning, for some reason, he's on that street pounding the pavement, when he could be in bed, eating a donut and mocha-latte. Why? Because he's driven to do something special, and more than what's easy. Does that make him stupid? Some might say yes. Others might say, "Thank God for people like him."

#thebirdstrikesagain
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That, or the guy knows that sprinting trumps jogging/running for CV fitness, fat-loss, overall health, joints, GH levels, etc. 10-fold. The research is about 10 years behind. At least, but its finally starting to creep out.

Back to how EM docs should...shockingly...fight for EM docs....
 
RustedFox said:
Remember, the numbers I'm using are NET (take home) pay. No idea what my gross would be, but it'd be over 300K, I'm almost certain.

I generally work 140 +/- 10 hours a month. Work is "seasonal" down here in Snowbirdland. Summers are slow. Winters are busy. I've never worked more than 161.50 hours (my record to date). That's a 40-hour week.
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Ick.
 
EMPD said:
The truth is, medicine in general is not what it used to be. With that said, it sure beats working on the assembly line or riding in an ambulance. We deal with the same type of people that cops, medics, social workers have to deal with. In essence we truly are public servants. The difference is, we make about 10 times the salary of any of these other people. So yes, we are cynical, and often complain. It's hard to do this well without those doing so. But if you are the kind of person that values their personal life, their family, and their free time, then there are few other specialties that rival us. All those other docs mentioned above are equally "unhappy". It's all about your frame of reference. If you grew up with the silver spoon like many others in our specialty, then you might not like EM. If you grew up average and understand what it means to live in a middle class world, then you will realize we live like kings.
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Boom. It comes down to perspective.

That being said, there is A LOT that can be done to improve the specialty for actual PHYSICIANS going forward. Big battles to be fought.
 
Happy 30 something EM doc here... Very happy.

I was working about 140-160 hours per month, and had so much free time that I piled on other activities. I am active now with my state medical society and ACEP/TCEP. I also recently became an EMS medical director and have medical students I mentor closely with.

I dropped my hours to 108 per month; as I have admin time with EMS now and do get paid for that. I am fortunate that I work in a Level 1 Trauma center with 80K visits per year, and see less than 2pph and never work night shifts (we have full time night folks.. They are well compensated and get a GREAT night diff for their work).

We travel every month and have almost hit every major city in the US over the last 2 years. My wife, 2 year old, and I have dinner together nearly every night. My 'professional travel' is the only thing that really gets in the way. That feels good though and I believe we can make a difference.. so why not try?

Fully fund retirement, and more than pay our bills. You wont see me complain...

BTW, on the 10th hour of a BUSY 12 hour a shift, after 2-3 intubations and 40 in the lobby, and a consultant being a jerk... Sure, I'd probably say this jobs for the birds...

Catch me on a day like today, looking at 8 days off before I work another shift... I have a run review to do in that time, and a meeting with a committee. I'll probably grab my radio and jump some calls friday night. Working with EMS has been fun.

Family and I are heading to Barnes & Nobles now to read for a bit. I worked 12 today, had a nice day, and had dinner together tonight.
 
To the OP:
I still really like my job and I work kind of a lot (probably 17 10's a month).

I know there are plenty of salty EPs out there, but I don't think you have to be or that if you become an EP you must become grizzled and frustrated. I think the key is to find a good work environment, one where you like the people you work with and where there are a minimum of work frustrations. Having a fight with ortho and medicine everytime you admit a hip fracture, having to watch an ICU pt for 3 days because there's no room in the Unit, having to call 3 different hospitals to beg someone to take your transfer every shift/multiple times per shift is gonna wear anybody down.

Another thing that I think a lot of people take for granted is the patient population they take care of. When most people think of their population, they think of "payer mix", but I think there's more to it than just that. When I was coming out of residency, most of the hospitals I was looking at were either in some super nice suburb or in the middle of the ghetto. The problems with working in very crime ridden urban areas are obvious. The problem with the super nice suburbs is that the clientele want MRI's for their 14yr old's ankle sprain and stat Neuro consults at 2AM for Bell's Palsy, coupled with the fact that there is a very strong customer satisfaction push- perhaps stronger than other places. Now, keeping in mind pretty much all EDs are gonna see the full socio-economic spectrum, I love the patient population I see. Mostly working class/middle class people who tend to come to the ER to get better or because they think they have an acute problem. I still see the narcotic abusers, the system abusers, the super entitled, the chronic complaints, but that's not the bulk of my population. When you like most of the people you take care of, your job is a million times easier.
 
suckstobeme said:
Another thing that I think a lot of people take for granted is the patient population they take care of. When most people think of their population, they think of "payer mix", but I think there's more to it than just that. When I was coming out of residency, most of the hospitals I was looking at were either in some super nice suburb or in the middle of the ghetto. The problems with working in very crime ridden urban areas are obvious. The problem with the super nice suburbs is that the clientele want MRI's for their 14yr old's ankle sprain and stat Neuro consults at 2AM for Bell's Palsy, coupled with the fact that there is a very strong customer satisfaction push- perhaps stronger than other places. Now, keeping in mind pretty much all EDs are gonna see the full socio-economic spectrum, I love the patient population I see. Mostly working class/middle class people who tend to come to the ER to get better or because they think they have an acute problem. I still see the narcotic abusers, the system abusers, the super entitled, the chronic complaints, but that's not the bulk of my population. When you like most of the people you take care of, your job is a million times easier.
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THIS. Period.

If I had to work "for" or work "with" some of the patient populations that I did when I was a student/resident.... I don't know what I would have done. I love my patient population; they're mostly reasonable people. Mostly.

(They mostly come out at night. Mostly.) 🙂
 
RustedFox said:
THIS. Period.

If I had to work "for" or work "with" some of the patient populations that I did when I was a student/resident.... I don't know what I would have done. I love my patient population; they're mostly reasonable people. Mostly.

(They mostly come out at night. Mostly.) 🙂
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Rotating at Toledo made me want to change my mind about ER.
 
EM_Rebuilder said:
Happy 30 something EM doc here... Very happy.

I was working about 140-160 hours per month, and had so much free time that I piled on other activities. I am active now with my state medical society and ACEP/TCEP. I also recently became an EMS medical director and have medical students I mentor closely with.

I dropped my hours to 108 per month; as I have admin time with EMS now and do get paid for that. I am fortunate that I work in a Level 1 Trauma center with 80K visits per year, and see less than 2pph and never work night shifts (we have full time night folks.. They are well compensated and get a GREAT night diff for their work).

We travel every month and have almost hit every major city in the US over the last 2 years. My wife, 2 year old, and I have dinner together nearly every night. My 'professional travel' is the only thing that really gets in the way. That feels good though and I believe we can make a difference.. so why not try?

Fully fund retirement, and more than pay our bills. You wont see me complain...

BTW, on the 10th hour of a BUSY 12 hour a shift, after 2-3 intubations and 40 in the lobby, and a consultant being a jerk... Sure, I'd probably say this jobs for the birds...

Catch me on a day like today, looking at 8 days off before I work another shift... I have a run review to do in that time, and a meeting with a committee. I'll probably grab my radio and jump some calls friday night. Working with EMS has been fun.

Family and I are heading to Barnes & Nobles now to read for a bit. I worked 12 today, had a nice day, and had dinner together tonight.
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Good to hear.
 
Loon said:
What didn't you like about Toledo? And was it worse than DRH/Ford/Sinai?

Or am I reading this wrong?
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I rotated at a few other places that took teaching more seriously. It wasn't the best experience. The population is as bad as grace. The residents were charting sometimes 3-4 hours after shift.
 
SeekerOfTheTree said:
I rotated at a few other places that took teaching more seriously. It wasn't the best experience. The population is as bad as grace. The residents were charting sometimes 3-4 hours after shift.
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In my experience, how long after your shift you stay is more dependent on your work habits/practice style than on the hospital or charting system. I always stayed several hours after my shift as a resident and I continue to do so now as an attending. In residency, there were always guys who always went home on time and I'm pretty sure they continue to do so as attendings.
 
DreamingTheLive said:
Boom. It comes down to perspective.

That being said, there is A LOT that can be done to improve the specialty for actual PHYSICIANS going forward. Big battles to be fought.
Click to expand...

To this as well as what Birdstrike . I couldn't agree more and those types of things are rather inspiring. However, I have some doubt on it's feasibility going forward at all given that once any group or individual number of docs speak up there's always a big contract ***** to come right in and "bend over"
 
SeekerOfTheTree said:
I rotated at a few other places that took teaching more seriously. It wasn't the best experience. The population is as bad as grace. The residents were charting sometimes 3-4 hours after shift.
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Do you mean University of Toledo, or "The Toledo Hospital". BIG difference. I was a resident from UT. Although the acuity/pathology at "The Toledo Hospital" was great for learning, I'd shoot myself if I had to "serve" that patient population for another day. (To explain: The crowd at TTH is very much the : "Imma shoot summun up in this muhfugga if I aint get me a work note!" the U.Toledo crowd is complicated middle aged/elderly in need of tertiary care; lots of admissions)

If the residents were charting 3-4 hours after shift, then "they're doing it wrong". T-sheets there are pretty simple and straightforward.

PM me for more details if you want.
 
I don't know what changed since you graduated but I rotated at UT. All electronic. T sheets only when system goes down. A great amount of drug seekers, gang bangers, and I am gonna cut you up types. See about 40k a year right at the U? This overstaying was consistent. Residents were all ready to kill themselves. Dude the Michigan programs I rotated through were amazing compared to there. Six other guys with me didn't even put down to interview there. We rotated same time.
 
Simple, you are hanging around a malignant program. Most everyone I know is quite happy. Either you need a change of scenery or EM just isn't for you.
 
UTMC is is no way malignant. That's for sure. Streamlined to teach you EM, not have you being some note-writing automaton for some other service.

We had a small problem with "boarding" (if that's what you mean) back when I was a PGY-2. We opened up the "Transitional Care Unit" to decompress the ED and get rid of the boarders. Worked like a charm. Sorry to hear that gangbangers and narc-seekers are now a problem; we kept the "problematic" patients to a minimum when I was there.

Hmm.
 
RustedFox said:
UTMC is is no way malignant. That's for sure. Streamlined to teach you EM, not have you being some note-writing automaton for some other service.

We had a small problem with "boarding" (if that's what you mean) back when I was a PGY-2. We opened up the "Transitional Care Unit" to decompress the ED and get rid of the boarders. Worked like a charm. Sorry to hear that gangbangers and narc-seekers are now a problem; we kept the "problematic" patients to a minimum when I was there.

Hmm.
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Not sure why the narc-seekers and gangbangers are a problem. If they start yelling or make threats, they are escorted out by security and/or have police "talk" with them.

The idea that we MUST subject ourselves to the abuse of any other person in the performance of our job is one that I am mystified by.
 
I have been out for about 5 years.

I am unhappy for many reasons. The two main reasons:

1. The emphasis on 'customer service' (Press Gainey and the like) is not something I bargained for, not even an issue during residency.

2. Mid-levels have had the effect of diminishing physician demand and, by extension, made jobs harder to find (no longer can you "work anywhere") and pay is flat to decreasing.


Yes, there are still many positive aspects of EM (the schedule, the breadth of interesting cases, etc.) and I can't say that I completely regret the choice, but if I was going to do it again, I would choose something that was more insulated against the onslaught of non-MDs practicing medicine (I consider DO = MD) such as surgery (even anesthesia is more immune because although CRNAs have impacted physician demand, they still don't enter the specialty anesthesia areas like cardiac anesthesia, or acute pain, etc.).

Anyone who goes to the trouble of being a family practice doc or general internist via full medical school and residency is wasting their time despite the pressure that some medical students feel from their medical school encouraging them to go into primary care. It was laudable of the medical schools to push increased interest in primary care 20 years ago, but that was before the government allowed NPs and PAs to assume the scope of practice they have. At this point, don't drink the kool aid: If you WANT to do primary care out of interest sake, just go be an FNP or PA - much more efficient attainment of goals here. I fear EM is going the same direction.
 
GeneralVeers said:
Not sure why the narc-seekers and gangbangers are a problem. If they start yelling or make threats, they are escorted out by security and/or have police "talk" with them.

The idea that we MUST subject ourselves to the abuse of any other person in the performance of our job is one that I am mystified by.
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"Security" is often times a 65+ year old fella with less muscle than a mouse. It was nice, because I remember UTMC ED being largely free of shenanigans like that. I saw plenty of medically complicated cases that taught me the minutiae of management.

As for your second point: right-on, brotherman.
 
bulgethetwine said:
I have been out for about 5 years.

I am unhappy for many reasons. The two main reasons:

1. The emphasis on 'customer service' (Press Gainey and the like) is not something I bargained for, not even an issue during residency.

2. Mid-levels have had the effect of diminishing physician demand and, by extension, made jobs harder to find (no longer can you "work anywhere") and pay is flat to decreasing.


Yes, there are still many positive aspects of EM (the schedule, the breadth of interesting cases, etc.) and I can't say that I completely regret the choice, but if I was going to do it again, I would choose something that was more insulated against the onslaught of non-MDs practicing medicine (I consider DO = MD) such as surgery (even anesthesia is more immune because although CRNAs have impacted physician demand, they still don't enter the specialty anesthesia areas like cardiac anesthesia, or acute pain, etc.).
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I can understand the customer service issue, and we do a great disservice by not emphasizing this during training. Your point on midlevels is just bizarre. What area of the country are you in that you feel like you're being replaced? The places that are hard to break into (Denver, certain parts of Cali, etc) are because of MDs, not because your job got taken by a midlevel.
 
I'm pretty happy, approx 5 years out of residency. I chalk it up to:

1) I didn't ever "fall in love with medicine." I always looked at medicine as just one option among many, and I have always seen medicine as a job. It's a lot easier to be satisfied with your job than it is to be satisfied with your "calling" or your "destiny." There's far less potential disappointment, when you realize that most shifts are just moving the meat. Sure, it's a pain trying to satisfy a bunch of entitled patients (and administrators), but there is no magical job in which you are spared from interacting with *******s.

At least I don't have a supervisor looking over my shoulder all day long, trying to micromanage every decision I make. THAT's what I wanted to avoid in a job, and in EM, I've succeeded. Happy!

2) I like my job because it offers the possibility of continuing improvement and it is difficult to to completely master. I'm a much better ER doc now than I was when I graduated, and this feeling of improvement makes me happy. Every month I can pick an area of my practice and focus on improving it. That part of my job is fun. Since I graduated, my focus areas have included a) dealing with consultants that feel it's OK to act like *******s, b) central lines and intubations, elegance above mere competence, c) diagnosing abdominal pain with H and P, before the imaging comes back, c) efficient, speedy, and effective charting, d) the neuro exam. In the near future I'm going to be focusing on regional ultrasound-guided nerve blocks.

I'm a proponent of Cal Newport's "craftsman mentality." http://calnewport.com/blog/ Forget passion -- job satisfaction comes from autonomy and mastery and stuff like that. EM is ripe with these opportunities.

3) I am happy because I am not an EM doc. I'm a person with varied interests who happens to practice emergency medicine as a career. I like EM, but also politics, athletics, certain kinds of novels, legal issues, financial policy, environmental policy, etc. I do other things besides EM, and in any given month, these things may be (often are) more important to me than EM.

4) I'm happy because I'm not overcommitted financially. Well, sure, I've got humongous student loans that I'm working to pay off, but my monthly financial obligations are easily covered by my professional income. I didn't run off after residency and buy the biggest house I could talk my way into a loan for. I'm still waiting on the M3 BMW I've lusted after for years. I don't have a cable bill, 'cause most of the good stuff on cable, I can watch a day or two later on Hulu or Youtube.

5) I don't work too much. Too much work makes me miserable, so I avoid doing that.

EDIT: oh, and coffee. Lots and lots of hot, black coffee.
 
Replying to Glorfindel (didn't want a 'long-quote').

Cable ? Maaan, if it weren't for NHL network and the History Channel... I'd be there with you. I do like my "local news", too.

Coffee. Double-maaan. I used to be one of these guys that was like - "Starbucks ? Pfft. No way can I justify over three dollars for a cup of coffee... that's for those Seattle d!ckheads that are too cool for everything else. Now, I refuse to drink anything else. Its a clearly superior product.

See, detractors ? I can be wrong. 🙂
 
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