Is being an ER doctor as cool as it seems?

(OR - Quit Medicine? Part II)

As a group, doctors are not very good advocates.

Not for themselves, not for their patients, and not for their profession.

Gradually (and not so subtly) everything non-medicine has played increasingly larger roles in interfering with the doctor-patient relationship. Everyone suffers (even those greedy bean-counting executives suffer when they finally succumb to their own illnesses, or as they deal with trying to navigate American healthcare for their families). And instead of demanding a seat at the table, exercising their responsibility to weigh in on all things medicine...they sit on the sidelines and complain.

But this is beside the point.

My point today is to talk about whether or not choosing emergency medicine (or even choosing a career in medicine) is what I thought it would be.

Let’s start with what I thought it would be like.


I knew, as a medical student, that my role was insignificant. I knew residency was hard with long hours and physical exhaustion. I understood that college and professional school would be expensive (and accrue a large debt for a girl from a non-wealthy family) and residency would mainly serve to delay my ability to pay off these debts.

I recognized that I was socially underdeveloped, and had no practical knowledge about anything not in the lecture notes. I expected to wait to have a family, and accepted being continually absent from my own life to undergo this training program.

However, I also expected more freedom once done. I hoped for enough money (which is subjective and constantly changing) to live comfortably. I hoped to reclaim some “lost” time (and hang out with friends, read some novels, get married, have kids). I hoped to mentally *graduate* from student status, and buy a big-girl house, and big-girl clothing.

Most of all, I thought there’d be more appreciation and respect for the sacrifice doctors make in order to do what we do. I hoped for a more powerful voice as a professional. I thought doctors and patients would advocate together for the best possible health-care situation. (Vocal in a 'I am woman, hear me roar' kind of way...sorta like the nurses. I guess medicine is still too male dominated to be very vocal....)

But what I quickly realized was…

…being a physician is not quite what I expected.

But I’m a roll-with-the-punches kinda girl (or at least I try to be), and realize that physicians are *still* quite cool. Saying you’re a doctor does offer a certain degree of legitimacy in conversation…and it is easier to get a ‘seat at the table’ if you bring a medical degree with you. I do acknowledge (and appreciate) that.

Instead of complaining (further) about all the things “wrong” with being an ER doc, let me make it clear…

…it really is a fabulous job.

Not a day goes by when I don’t get some fantastic job solicitation (usually in not-quite-so-desirable places to live) begging me to consider a move to Podunk, Wherever, for crazy sums of money. And even locally, having board certification in a specialty that everyone uses makes finding decent job a small issue. There’s never a shortage of ‘business’ as an ER doctor. As the recession progresses (and the economy slowly recovers) our ‘business’ just increases as people lose their health insurance along with their jobs - which is unfortunate. But single payer would allow everyone to have access to (at least minimal) medical care...and (get this) we'd actually get paid for said care. (I honestly don't know why doctors, especially primary care and first-responders, would be against getting *some* compensation from *everybody* you serve)....

...but I digress.

What I do in the ER, matters. It is meaningful work. And the pay is not bad either.

I often get asked: would you recommend this career for your children (or some variation thereof).

The answer is (still) absolutely yes!! But with caveats.

I think it’s important to go early, go hard, and get done. Doing it this way, you could be done with all your training by age 29. Still plenty of time to “catch up” on everything else in life. After all, what better way to spend your twenties than setting yourself up professionally (and possibly financially) for the rest of your life. All before you have children, get married, or acquire additional responsibilities (such as elderly parents) or in society.

I think it’s important to focus on the practical aspects of choosing any career, medicine included. It is not “a calling” or some sort of “special” state of being. It is a career. A way to make a living and contribute to society professionally. Just like a photographer (with better pay)….or a plumber (with equal pay).

Realize that having a fantastic career (any career) will not adequately replace loving relationships, family, and personal development. Temporary sacrifice is expected of many low-rung staff in any career…but constant/permanent sacrifice is not worth it.

If you put off having a family, miss your grandmother’s funeral, miss your cousin’s wedding…and then, at 35 realize that you cannot conceive…medicine would NOT have been worth it.

Everyone has their own ‘balancing act’ to achieve. Some of us put more emphasis on family…while others lean more towards career. That balancing act is highly personal. I will say, it’s very easy to weigh career more heavily (even when you don’t intend to) because of external pressures and the societal value placed on wage-earning and 'work' – especially for the “liberated woman.”

If you’re not careful, you’ll become imbalanced, convincing yourself that you’re where you want to be…even when it’s not. And…discontent sets in.

But, if you are able to put “everything in its proper place” in the ranking of your life priorities, medicine can be an excellent career. And EM...allows a doctor to do this. To work a lot...or work a little.

There are days, nonetheless, when you think to yourself...

....what *else* might I be good at? Is there anything else I might want to do?


noanalyst said...

Good post but I will say quite candidly, doctors are the most spineless group of people I have ever met. I wonder if it is because we spent so many years trying to be #1 that we do not know how to play the real game. Because in the real world, your MCATs, USMLE and AOA status is as relevant as the type of socks you wear. Bean counters rule and we are the puns they move. My advice to anyone going to medical school is to get an MBA first as that will help choose the right residency and career for you.

Taylor said...

Agreed! Totally agree. However, I'm not sure an MBA is necessary to learn how to speak up and advocate for yourself, and your profession.

Also, medical schools could serve doctors better by teaching relevant lessons...like business acumen. However, being a sophisticated negotiator undermines the entire (current) medical training process - which (almost REQUIRES) one to look down, say nothing, and suffer in silence.

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Well, I'd like to add that I have read in one article that emergency medicine encompasses a large amount of general medicine and surgery including the surgical sub-specialties. Emergency physicians are tasked with seeing a large number of patients, treating their illnesses and arranging for disposition—either admitting them to the hospital or releasing them after treatment as necessary. The emergency physician requires a broad field of knowledge and advanced procedural skills often including surgical procedures, trauma resuscitation, advanced cardiac life support and advanced airway management. Emergency physicians must have the skills of many specialists—the ability to resuscitate a patient (critical care medicine), manage a difficult airway (anesthesia), suture a complex laceration (plastic surgery), reduce (set) a fractured bone or dislocated joint (orthopedic surgery), treat a heart attack (cardiology), work-up a pregnant patient with vaginal bleeding (Obstetrics and Gynecology), stop a bad nosebleed (ENT), place a chest tube (cardiothoracic surgery), and to conduct and interpret x-rays and ultrasounds (radiology).
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Individuals who have less than one year of experience earn an average of $9.48 per hour while those with 1 to 4 years behind them are paid $11.57. Those who have been working as EMTs for 5 to 9 years have a median hourly wage of $11.57 while the ones with 10 to 19 years behind them make $19.03. Senior emergency medical technicians, on the other hand, receive $24.70 per hour. EMT Wage

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