Why do so many people hate ED (EM)?

[kellie]

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I'm a PGY2 (overseas, not US) and have completed a total of ~6 months of emergency medicine. I have loved ED, loved the variety, pace, intellectual challenges, independence, and above all, the teamwork, and can't find many reasons not to pursue it.

Despite this, everyone I gush to about it tries to talk me out of it as a career choice! This includes my supervisors from other terms (geriatrics, gen surg), relatives of mine that are doctors, medical friends of the family, medical friends and even non-medical friends... They warn me that I will burn out, that the thrill will wear out, that it's too stressful, you deal with the scum of society, "glorified triage" etc. etc. Ironically many of these people suggest surgery as a preferable career option! (So I don't give too much weight to their opinions...)

Now I won't let them stop me - I know it's a very rare thing to love turning up to work and I wouldn't walk away from a career choice out of fear that that might change - chances are it will, but that's life. But with so many doctors that I respect warning me against this choice, I can't help but wonder where their vitriol comes from, and whether I'm going to have to put up with this forever?

I don't need reassurance that ED is great, I know it is. I just want to know if any of you have put up with the same disapproval from your own support network? It's almost like having a boyfriend no one approves of - why can't they see what I see?? 😛

Thanks for any replies.

 

[Arcan57]

It's been covered in other threads, but downsides to EM include:
1) no control over selecting your patients
2) it smells
3) shift work seen by some specialties as lack of commitment to patients
4) constantly generating work for other physicians, some of whom are less than gracious about it
5) bias for historical reasons, EDs used to be staffed by burnouts who weren't able to establish/maintain their own practices or surgery residents that got punted under the old pyramid residencies
6) lack of time and familiarity with the patients lead to us ordering too many tests and missing obvious (and usually non-emergent) diagnoses, making us seem "dumb" in some consultant's eyes
7) the only things we are truly experts in are things other specialties don't care about/actively despise. EMS, cardiopulmonary resuscitation (especially since it's usually the gomers with no quality of life that come back and stay forever in the ICU), tox just don't have that much cachet to the rest of medicine. There is a debate to be made about difficult airways, but this is ceded to anesthesia in most hospitals when they are readily available.

 

[Birdstrike]

I'm a PGY2 (overseas, not US) and have completed a total of ~6 months of emergency medicine. I have loved ED, loved the variety, pace, intellectual challenges, independence, and above all, the teamwork, and can't find many reasons not to pursue it.

Despite this, everyone I gush to about it tries to talk me out of it as a career choice! This includes my supervisors from other terms (geriatrics, gen surg), relatives of mine that are doctors, medical friends of the family, medical friends and even non-medical friends... They warn me that I will burn out, that the thrill will wear out, that it's too stressful, you deal with the scum of society, "glorified triage" etc. etc. Ironically many of these people suggest surgery as a preferable career option! (So I don't give too much weight to their opinions...)

Now I won't let them stop me - I know it's a very rare thing to love turning up to work and I wouldn't walk away from a career choice out of fear that that might change - chances are it will, but that's life. But with so many doctors that I respect warning me against this choice, I can't help but wonder where their vitriol comes from, and whether I'm going to have to put up with this forever?

I don't need reassurance that ED is great, I know it is. I just want to know if any of you have put up with the same disapproval from your own support network? It's almost like having a boyfriend no one approves of - why can't they see what I see?? 😛

Thanks for any replies.

Kellie,

Here's one man's 2 cent opinion. If you love EM and need no reassurance then soldier on. If you love it and you're born to be and EM doc, great, consider yourself lucky. I'd suspect, however, that you sense that there is an element of truth to what people are telling you. Having been in your shoes many years ago now, I can understand how irritating it is to have people saying what they are about the field you love. It is true for many people, however, that the way one feels about EM when you're 26, may change when you're 36, 46, and so on. If you want to see the specialty through the eyes of someone who's done it about 10 years longer than you, I'd suggest reading my posts:

--for this one, you know the "pros", read the "cons"

http://forums.studentdoctor.net/showpost.php?p=10445502&postcount=3

--for this one, focus on the "Emergency Physician's Bill of Rights" and follow them like it's your Bible, if you want to last in EM.

http://forums.studentdoctor.net/showpost.php?p=10470244&postcount=1

...That being said, it's just one mans opinion. If you love it, damn the torpedoes and carry on.

 

[deleted65604]

I don't know how anybody could love erectile dysfunction. Maybe if you were a sex addict, it would be a good thing for you.

 

[monkeybutt]

I don't know how anybody could love electro-magnetism. Maybe if you were Magneto, it would be a good thing for you.

 

[kellie]

Thanks for the replies, and especially to Birdstrike for those links - really appreciate the viewpoint of someone who has practiced for a long time. If you're still reading this thread, what would you have chosen if you were to choose again?