Emergency medicine is one of the highest-paying medical specialties, but it’s not for everyone. As with any branch of medicine, working in an emergency department has both advantages and disadvantages. In many cases, particularly in emergency medicine, the pros and cons are interrelated. Some of the major pros and cons in this profession include the exciting yet stressful work environment, the challenge of saving lives in difficult cases and the non-routine yet flexible work schedule.
The Exciting Yet High-Stress Work Environment of the ER
The exciting nature of work in emergency medicine can be a double-edged sword. Some physicians love jumping into each shift without knowing what they’re going to do that day. If that sounds like you, a career as an emergency room doctor would be a much better fit for you than a primary care or specialist physician who spends all day in an office, holding scheduled appointments with patients. Many emergency room doctors enjoy the variety of both the work they do and the patients and medical conditions they treat. They may prefer the unpredictability of the ER over the monotony of a day that is fully scheduled with patient appointments or procedures.
Yet the fast-paced nature of handling emergencies and the large caseloads of patients who may be critically ill can make for a lot of stress. At any given time, an ER doctor is multitasking to handle numerous medical emergencies at once, each of which may require urgent action. There’s never a dull moment, but that can also mean there’s never a moment to catch your breath. It’s a lot to juggle, whereas in other specialties, like general surgery, a physician may primarily focus on caring for one patient at a time.
Part of deciding whether to devote your career to emergency medicine or another specialty is considering your temperament and work preferences. Do you thrive on excitement and become bored easily, or do you enjoy getting into a routine and planning your workday?
The Potential and Pressure of Saving Lives
One factor that contributes to making emergency medicine such a high-pressure specialty is the state in which patients arrive at the ER. Although patients may present to doctor’s offices with acute or chronic medical problems, patients in the emergency department virtually always need, or at least think they need, care on an urgent basis. On a regular basis, you are likely to encounter patients who have been grievously wounded in a terrible accident or assault and those who have suffered a stroke, a heart attack or another debilitating condition that must be treated right away.
Without your help to stabilize these patients, they might not survive. Saving lives is perhaps the noblest goal a doctor can have, but it also puts a lot of pressure on you. No matter how good your skills as a physician are or how much you may want to save a patient, you won’t be able to save everyone. Challenging medical cases appear regularly in the ER, and some conditions are too advanced even for the most cutting-edge medical interventions to resolve. Good emergency room doctors have a lot of wins to celebrate – saving the life of a patient whose prognosis was poor, finding some answers about a mysterious medical condition that has been plaguing a patient for some time – but they also see a lot of death, grief and tragedy.
Another challenging part of working as an emergency room doctor is managing the expectations of patients and family – whether those expectations include saving the life of a patient too far gone or providing an immediate and complete fix for a complex condition.
The Work Schedule
If your first instinct would be that a career in emergency medicine would wreak havoc on your work-life balance, you might be pleasantly surprised. It’s true that, unlike private practice offices that can keep relatively normal business hours, hospitals’ emergency rooms are never closed. Long hours and overnight shifts are part of the reality of life for ER doctors. Working weekends and holidays – even major ones – is inherent in this job.
However, in some ways, emergency room doctors have a better work-life balance than many areas of medicine, according to medical staffing firm Mint Physician Staffing. On average, emergency medicine physicians work 1,200 to 1,500 hours per year, which breaks down to 30 to 40 hours each week, the staffing agency reported. That’s below average for the field of medicine, in which most doctors work between 40 and 60 hours per week and close to a quarter of physicians work 61 to 80 hours weekly, according to the American Medical Association. In a study of mean hours worked by medical specialty, emergency medicine was among the three specialties where physicians reported working the fewest hours, according to JAMA Network, a publication of the American Medical Association.
During many weeks, a full-time ER doctor might work as few as three shifts, the American Medical Association reported. During particularly busy weeks, physicians in this specialty may work as many as five shifts. The workday (or night) of an emergency room doctor is often long, but many doctors prefer working in fewer, longer shifts – often bunched closely together so that they can better adjust to this routine – than to spread out their work over a longer workweek.
Emergency room doctors also have more flexibility than doctors in many other settings, which can allow them to choose to work part-time schedules, take a leave from work or work on a per diem or locum tenens basis, Mint Physician Staffing reported.