Ok, sorry, here's a rant: I graduated from my EM Residency in 2006. If I could go back in time and talk to my younger self, I would yell "DON'T DO IT". When I was an academic doc, I told med students to consider something other than EM. In my current job I have scribes who are mentees, and I tell them the same thing. Why? it's not just the night shifts which get harder and harder as you age; it's not just the boarders; it's not just the understaffing; it's not just the lawsuits.It's that we have virtually no autonomy over our professional lives. The majority of EM doctors now work as employees or independent contractors, rather than in democratic groups. Unless you work for the VA you are not in a union. And the saddest part is that we have done this to ourselves. AAEM still focuses on the group model, even as this in in retreat, and ACEP is a subsidiary of TeamHealth. We have not collectively worked to protect our professional autonomy, because that would require working together, and we have all been socialized to be as individualistic as possible. State and Federal governments mandate treatments and even redefine diseases (eg with Sepsis). Hospital administrators cut staffing to meet phantom budgets, even if the hospital in a registered non-profit. I could go on and on. EM will only return to its glory as a medical specialty when we can learn to work collectively to take back our independence and dignity.
I’m an almost completely retired family physician, I don’t know how primary care did in the match, but front page article in the Globe highlights that there are no primary care doctors taking new patients in Massachusetts-- and I know that’s true in Rhode Island as well. It’s a crisis.
Absolutely we need to fix Emergency Medicine, because we all are likely to need it sooner or later! Over the Christmas break I had something that wasn't life or limb threatening, but was quite painful, and that could have been treated by Family Medicine at any other time, but when it struck away from home during the holidays the ER was the only place I could get seen right away. I was able to enjoy the rest of my vacation because the ER docs were there when I needed them.
It was also fortunate that the Chicago hospital used the same Electronic Medical Records system as they use at UIHC, so when I got back to Iowa the Family Medicine docs here in Iowa could pull up the records from Chicago during follow up appointments.
Many years ago I met a young emergency med doc who had retired early. She and her husband became our friends, but her early retirement worried me. It is a simplistic conclusion, but as I got to know her better, I think she had foresight of an increasing problem. Her profession is under paid, over worked and increasingly stressed by capitalistic pressures. Today, it is more so than when she retired twenty years ago.
Only recently, we had another slap in the back of my reality head when the son of another close friend pulled the life planning ripcord and bailed out from emergency medicine. This young man had the best careful training that any patient would hope their doctor would possess if they found themselves being treated for an emergency illness, and he left the field. He was young, had a job at a Center of Excellence hospital emergency medical clinic, had recently married, bought a house and had settled into his career, but he dumped it all because he saw a poor complicated path to a future that no longer looked appealing. He told his doc father that the older more senior docs in management were not moving upward and out to retirement and his future looked very hampered. He decided to move on after more than a dozen years of medical training. This is foreboding for us all.
Ok, sorry, here's a rant: I graduated from my EM Residency in 2006. If I could go back in time and talk to my younger self, I would yell "DON'T DO IT". When I was an academic doc, I told med students to consider something other than EM. In my current job I have scribes who are mentees, and I tell them the same thing. Why? it's not just the night shifts which get harder and harder as you age; it's not just the boarders; it's not just the understaffing; it's not just the lawsuits.It's that we have virtually no autonomy over our professional lives. The majority of EM doctors now work as employees or independent contractors, rather than in democratic groups. Unless you work for the VA you are not in a union. And the saddest part is that we have done this to ourselves. AAEM still focuses on the group model, even as this in in retreat, and ACEP is a subsidiary of TeamHealth. We have not collectively worked to protect our professional autonomy, because that would require working together, and we have all been socialized to be as individualistic as possible. State and Federal governments mandate treatments and even redefine diseases (eg with Sepsis). Hospital administrators cut staffing to meet phantom budgets, even if the hospital in a registered non-profit. I could go on and on. EM will only return to its glory as a medical specialty when we can learn to work collectively to take back our independence and dignity.
I’m an almost completely retired family physician, I don’t know how primary care did in the match, but front page article in the Globe highlights that there are no primary care doctors taking new patients in Massachusetts-- and I know that’s true in Rhode Island as well. It’s a crisis.
Absolutely we need to fix Emergency Medicine, because we all are likely to need it sooner or later! Over the Christmas break I had something that wasn't life or limb threatening, but was quite painful, and that could have been treated by Family Medicine at any other time, but when it struck away from home during the holidays the ER was the only place I could get seen right away. I was able to enjoy the rest of my vacation because the ER docs were there when I needed them.
It was also fortunate that the Chicago hospital used the same Electronic Medical Records system as they use at UIHC, so when I got back to Iowa the Family Medicine docs here in Iowa could pull up the records from Chicago during follow up appointments.
Many years ago I met a young emergency med doc who had retired early. She and her husband became our friends, but her early retirement worried me. It is a simplistic conclusion, but as I got to know her better, I think she had foresight of an increasing problem. Her profession is under paid, over worked and increasingly stressed by capitalistic pressures. Today, it is more so than when she retired twenty years ago.
Only recently, we had another slap in the back of my reality head when the son of another close friend pulled the life planning ripcord and bailed out from emergency medicine. This young man had the best careful training that any patient would hope their doctor would possess if they found themselves being treated for an emergency illness, and he left the field. He was young, had a job at a Center of Excellence hospital emergency medical clinic, had recently married, bought a house and had settled into his career, but he dumped it all because he saw a poor complicated path to a future that no longer looked appealing. He told his doc father that the older more senior docs in management were not moving upward and out to retirement and his future looked very hampered. He decided to move on after more than a dozen years of medical training. This is foreboding for us all.