April 2, 2011

What Makes the ER Attractive

In case you are one of the four people who has not read it yet - the NYT had an article this morning called "More Physicians say No to Endless Work Days" about how physicians are shifting their career choices more towards ER and hospitalist jobs, where they care for patients in the hospital, but when they leave the hospital, their obligations to their patients leave with them. This is attractive as a lifestyle because it allows time with ones family to be sacred, instead of interrupted by phone calls about their patients.

I'm had a bunch of conversations about this exact topic with friends lately and I can say it is very true. I think about a third of the fourth year class at my medical school matched to ER residencies - one third (of about 100 people)! At dinner last night, Chris and I were talking about the pros and cons of being this type of doctor. You see your patients get better immediately, but a lot of them never get better, and the goal is really to just stabilize them until you can transfer their care to someone else. The ER doctor is the "jack of all trades" - broad knowledge, but not deep. A lot of this is incredibly appealing now when we all want to know and do everything, but I still can't shake the feeling that I want to have relationships with my patients. Not necessarily relationships that often trump those that I have with my friends and family, but maybe sometimes?

here's a quote from the article, which you should totally check out and let me know what you think!

“Look, I’m as committed to being a doctor as anyone. I went back to work six weeks after my boys were born. I love my job,” said Dr. Kate Dewar. “But I was in tears walking out of the house that first day. I’m the mother of twins, and I want to be there to feed them, play games with them or open presents with them on Christmas morning. Or at least I want the option to do those things without fearing I’ll be called back to the hospital.”


  1. I have mixed feelings about this. On the one hand, of course no one wants to work 120 hrs/week. And I don't even think that is feasible for a majority of folks now a days. But I also think people going into medicine need to realize that it is, by nature, not a 'lifestyle' specialty. It seems to me to be inherently a service job which demands emotional involvement and sacrifices on the part of the provider. Sometimes you are going to miss Christmas or a kid's play and that is just a reality of being a medical provider.

  2. @catswym: I think you're right. I shadowed the most wonderful doctor in the ER a lot my first year of med school. She told me that her kids parents thought she was a stay-at-home mom because she was able to show up for games and did school wide vaccinations at their schools. But, she said, the nature of working somewhere open 24/7/365 is that someone works on Christmas, someone works on New years and someone works at 2am. I haven't ruled out ER by any means, but I think a lot about the trade-offs