I registered this account (been on this website for over a decade with a different account, and cannot use it due to massive doxx potential) purely to contribute to this thread. EM attending now for a few years. Miss PandaBear's rants and Long Dong's dermatology trolling.
Make no mistake that everything
@EctopicFetus has posted above is 100% true as it stands for community emergency medicine. I think
@gamerEMdoc has a skewed view of EM's future prospects, partly due to his/her position in a residency program that's relatively protected, and (not trying to call out or anything) but also benefits from a steady stream of "fresh blood."
The silver lining of COVID19 is that it has brought the critical problems of EM that would have peaked in the next 5-10 years to the forefront. Due process, private equity, workforce issues (too many new residencies), medmal considerations, and others. They're all reaching an apex now, so it's an extremely scary time to be graduating or even considering emergency medicine as a career if you are a medical student. EM doctors are being FIRED. The reward for your hard work is going to shareholders who share no liability. You are now competing with far more graduates for jobs, whose debts all but require them to work residency hours as attendings for the first few years if they have any hope to pay off their debts soon. And we all know the lawyers and patients get hungrier and hungrier by the day.
I do not think that even with return of volumes will we see any return to normalcy. Midlevels reign supreme, and systems have been clear about this for the last decade. They do NOT value MD/DO expertise in the ED beyond access to the license for billing and displacing risk onto that physician's license.
Also while I agree with
@gamerEMdoc regarding everybody being affected, not just EM, I think that perspective is short-sighted. Many other specialties have options for different practice environments that aren't tied to a hospital. Radiologists can own imaging centers and do outpatient stuff. They have IR, and DR. Various sub-specialty surgeons can have pure outpatient practices with surgery centers. Even FM has a plethora of options that we don't necessarily have access to unless you're one of these intrepid ER docs that's breaking off and starting DPC practices. IM and Peds both have tons of fellowships that result in a variety of outpatient practice options and significantly higher pay. EM is fairly stifling even when considering the fellowship options. And what EM doctor wants to do urgent care full time? Hourly rates aren't enough to pay back significant debt burdens, and urgent care owners don't want physicians that will practice real medicine, they want midlevels who will acquiesce to patient requests for zpacks, xrays, and steroids.
The only "hope" here is that the pendulum swing has been accelerated to now, and perhaps in 10 years we'll have a swing back, just in time for me to pay off all my loans... *dies inside*
