Why so much hate on EM?

[darkjedi]

This happens ALL THE TIME
I get that your shift is ending but this patient has been sitting in the ed for 10 hours, were you really unable to call me earlier so I can start doing the H&P on one of them instead of having 3 to do right before I was about to sign out like damn

The problem with our hospital, which is probably not a unique problem, is that the floor rounds all morning, makes the plan to discharge, spends the early afternoon getting their discharge stuff ready and finally gets around to discharging them in the late afternoon. Bed management finally gets those beds to open up and lo and behold the floor gets a bolus of patients.

It's to our benefit to put in for a bed as soon as possible since we want the patients moved out early, but ultimately its the floor and bed management that holds them up.

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[Frazier]

Why the EM hate from other specialties?

Painting with a big fat brush:

Most likely you've been exposed to academic EM... in those settings you are just giving everyone more work.

In the community, you might be giving them more work, but at least you're also putting food on their table (so to speak).

Different frames of reference.

Also people tend to hate on other people that have it "better" than they do (read: $$$ and hrs). I can appreciate how a ICU guy cranking 60hr weeks for 250k would be salty at the idea of the other guy (that just added 2 more patients to his roster) is making 350k for 36hrs... I mean have you ever read some of those ICU A&P's vis-a-vis the same patient's A&P from the ED. Jesus, I'd be salty too. No one hates on renal because they are wicked smart and are largely underpaid. No one hates on neurosurgeons, because while they make big bucks, they have a schedule that gives most chest pain.

Also they generally don't deliver more work to other people.

Additionally, it's easy to look down your nose at other people that have less of a knowledgebase than you do... hopefully every consultant that you seek a consult from in the ED has a more thoroughly developed web of knowledge/experience than you do regarding the subject you're consulting about. Easy to hate.

It's all good.

From the "public standpoint", I don't know what OP is talking about. EM docs dont take more flack from Joe Citizen than your average specialty. They take **** in the ED often from very particular patients that would give **** to all, universally.

Disclaimer: going into EM.

 

[HooliganSnail]

What happens if the attending was the same way and not giving you the consult you needed? Or refusing to admit?

I've only seen that ever happen once and the ER doc got the IM's boss to force him to act.

Rare...attendings know where the money comes from, they understand how the system works.

But that stuff has happened.

Answer. Call another ***ologist, or if one isn't available, transfer the patient.

 

[Moose A Moose]

They jelly

 

[CyrilFiggis]

Incoming M1 that has clinical experience / battlefield medicine experience as I was previously a medic in the U.S. Navy with interest in Emergency Medicine. No I am not opposed to other fields, obviously I'm just an incoming M1 at an MD school. Just clarifying all this so my thread doesn't turn into something else.

The question:
Why do other people / physicians hate on EM so much? There seems to be a dislike for EM doctors. At least in regards to my experiences when I tell other physicians what I'm interested in. I just don't get it? I know the ER can be a mess but dang.

There are three services that consult with the entire hospital - EM, Path and Radiology. The first wants the rest of the hospital to confirm what they think is wrong, the latter two help the rest of the hospital confirm what's wrong.