Where do you see EM going in the next few years?

[typeB-md]

The reason i ask is that i am MS1 and looking to maybe do something like EM. Do you think that there will be a trend in making the specialty more difficult to get into? Will be there still enough jobs around the country for living in a place of your choice? Also, do you think salaries will start to get lower?

anything you can think of please let me know. thx.

-b

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[bartleby]

The competitiveness of the specialty will likely remain stable, as there has been only minor growth in the number of EM programs. The job outlook should remain pretty good, as there are still plenty of spots opening up due to older docs retiring as well as the ability to displace non-EM residency trained docs given the trend in which hospitals are looking to have their ED staffed only by EM trained docs both for prestige and malpractice insurance pressures. Plus, the census in most EDs is only increasing these days, so you're entering a growth industry.

Having said that, there are still places where it is relatively difficult (but not impossible) to find a job in any specialty just because there are a lot of people who want to live in that area. Looking for a job in the northeast this winter, I've had multiple offers...

Salaries are hard to predict, as so much of it is dependent on medicare and insurance reimbursements. But as far as I know, there's nothing big on the horizon.

The reason i ask is that i am MS1 and looking to maybe do something like EM. Do you think that there will be a trend in making the specialty more difficult to get into? Will be there still enough jobs around the country for living in a place of your choice? Also, do you think salaries will start to get lower?

anything you can think of please let me know. thx.

-b

 

[allendo]

Well as far as I can tell this may be one of the specialties that can't be outsourced (rads) or taken over by non doctors( PA's, CRNA's, AA's, Nurse prac, Optom). They will always have to have a Doc in the ER

 

[docB]

PAs actually are having an increasing impact on the field. If this is good or bad is a debate for another thread. I see the field staying about the same for the forseeable future. As more nontraditional, non-gunner types med students graduate and look for specialties with at least some life EM will stay competitive. Residencies will expand and new ones will spring up. The job market will stay about the same as more ERs demand only EM boarded docs and the population ages and grows.
Unfortunately I see us as doing more primary care in the future. Until there is actually a plan for dealing with the uninsured and the fact that almost no one can see their PMD in a reasonable amount of time (<72 hrs) the ER population will continue to swell with those pts.

 

[roja]

I agree with docB. I think the field is pretty stable. It hasn't really grown to much in terms of residency and it isn't a field that people go into unless they really like it. While the most EM people consider the lifestyle to be good, it is usually because we like what we do, don't mind shift work, and find the nights aspect to be worth it.


I think that the increasing utility of PA's will only really affect the 'fast track' aspect of the ED. I still find, IN GENERAL, that most PA's (even really great ones) are not equiped to handle the vast majority of non-fast track type patients.

I have no problem with them in the fast track areas as they significantly decrease the number of these types of patinets in the ED allowing me to focus on the more emergent/urgent patients. They also provide a service for patients that can't access or don't have a primary doc for things like viral illnesses, mild asthma attacks, etc.