Ambulance sirens. Gunshot wounds. Broken bones and bloodied faces accompanied by security guards. That’s the sensational portrayal of the life in the emergency room. For those of us who are either aspiring to become an emergency room physician or are practicing emergency room medicine, you’d better pray that not every one of your shifts will be as action-packed as what we see on television.
The truth is that most emergency room physicians aren’t exposed to a constant barrage of high acuity illnesses. If you are, then you must either love it or are insane. Either way, I hope that you are compensated appropriately.
The Daily Clinical Aspects of Emergency Medicine Are Repetitive.
Just like most careers and jobs, emergency medicine medical practice typically consists of a standard routine. Most full-time ER doctors work in shifts ranging from 6 to 12 hours long. On average, a full-time ER job may include 10 twelve-hour shift per month. I have a friend working 8 twelve hour shifts a month and is still considered full-time! As you a can see, one of the perks of this field is that you do have the opportunity to work fewer hours than most other doctors.
Essentially the duties of an ER physician during that shift is to take care of the patients that roll into the ER and create a disposition for them: treatment and discharge, consultation with specialists, or admission to the hospital. If you can get everyone accounted for, you are done. Depending on the acuity of the clientele, you might have broken bones that need to be splinted, pneumonias, COPD exacerbations, trauma, heart attacks, or strokes—you do have to retain a breadth of knowledge as an ER physician and to identify what conditions need immediate attention. Some ER’s are going to be busier than others—an ER doctor might see anywhere from one to four+ patients an hour. Multiply that by a twelve-hour shift, and you’ve got some hurting.
The Income of An Emergency Room Physician is Good.
ER physicians can make good money. Income is something we don’t often discuss openly, but you can easily find an entry-level position that commands at least $250,000. More often, I see ER docs in the $300,000+ range on a normal schedule. If you like to add on extra shifts, you can go even higher. This is not bad for a typical three or four year residency. You get the most bang for the buck in terms of indentured servitude during residency. In fact, an ER doc’s income/work time is probably one of the highest in medicine.
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Emergency Medicine is High Stress.
There is no free lunch unfortunately. A high income in anything rarely comes easily. Whether you are working at a Level 1 Trauma Center or a sleepy urgent care facility, you still have to be relatively vigilant during your shift. While it is unfair to say that a family practitioner has a less stressful job than an urgent care emergency physician, it is most definitely true in most cases. An otherwise well-appearing emergency room patient complaining of some difficulty breathing may actually have a collapsed lung. It is commonly said that an hour’s worth of work in an emergency room is equivalent to that of approximately 1.5 hours of outpatient medicine. Combine the intensity with unpredictable hours during shifts, and you get a relatively stressful job. Perhaps that is why ER docs command serious coin.
Emergency Medicine Is Not For Everyone.
In any career, you have to make a balance among income, stress, and time. Emergency medicine has a unique compromise with income and stress. Many ER physicians tend to have many hobbies outside of medicine; I’m not sure if the specialty lends itself to doing so or that it attracts those who already have extracurricular activities.
With high intensity during the work hours, there often is a higher burn-out rate among ER physicians. However, options do exist to work in lower acuity settings.
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