4 Myths about Emergency Medicine to Stop Believing

Emergency medicine is at the forefront of any study that evaluates burnout... but that's not the only reason medical students are worried about going into EM. In this post I'll discuss common worries, and why I still think EM is a really valuable field to pursue.

Myth 1: High rate of burnout?

The reality? Well, yes, this is true.

But I'm here to tell you that when this specialty is approached in the right way, it's actually a really good field.

When EM is done poorly, YES, the rate of burnout is high. But I think the narrative is changing. I think our generation is the first to be truly aware of the impending doom of burnout and we are much more ready.

Knowledge is power. Preparation is key. Work-life balance (WLB) is a new fad and I love it. I think burnout can easily happen, but it doesn’t have to. There are so many ways to mitigate it and the WLB that EM offers is so much better than many many other specialties. It also lends itself super easily to going part-time and working on our passion projects, and almost every EM doc I’ve worked with will have 1-2 “side gigs” that they love to do.

Myth 2: You have to work nights (forever)

The reality: You can but you don’t have to. 

A lot of older docs don’t work nights anymore. This is even easier if you’re a locum tenens physician: you can truly pick your schedule. You don’t have to do nights forever. Some people prefer it, and that works great for those who don’t love it.

Myth 3: There will be a surplus of 9000 physicians in the year 2030

The reality: There's more than meets the eye, when it comes to that report.

This article from 2021 made headlines and scared many people away from the field. The report predicted that there will be a huge surplus of EM physicians in 10 years. The following year (2022), emergency medicine underwent a catastrophically poor Match season, with over 500 initial empty slots.

But it recovered.

The thing is, the same thing happened to anesthesia a few years ago. They predicted the same thing… and a few years later, anesthesia has recovered. This describes the constant ebb and flow of medicine.

Mini myth 3: On a slightly related note, there is a worry that PA and NP obtaining full-practice authority could impact physician jobs. I believe that legislation advocating for safe patient care will continue to support physician-lead teams, which is what many NPs and PAs similarly want. Here's an example of a statement from ACEP on the topic, and there are new policies coming out every few years.

Myth 4: AI will take over our jobs

The reality: If you’ve ever gone from intubating a patient at 7:08 am to doing an LP for a febrile infant to stitching up a particularly nasty dog bite, you will realize that this job is not easily replaceable.

Emergency medicine is just the right amount of clinical and procedural that it’s not easy to simply replace us. And if you’ve ever worked with AI (and read its workup and differentials and actually looked at how it “practices” medicine), you’ll know that this is not likely something that will happen in our lifetime. I think AI can be an adjunct, yes, but it won’t be replacing emergency medicine physicians anytime soon. 

If emergency medicine is truly your passion, know that there will always be jobs. But I'm not going to sit here and ignore some of the challenges that you might face during your job search. Here are some tough questions to ask yourself: 

1. Are you geographically limited? The jobs may not be in the most desirable places. There is definite saturation in some of the bigger cities. Jobs in NYC don’t pay very well, that’s true. But if you’re open to moving a little bit outside huge hubs, I can assure you that there will be jobs. 
2. Are you comfortable with the changing expectations of the specialty? EM is an ever-changing field. Every year there are slightly newer expectations as our scope continues to expand, which can be cumbersome and exhausting (and exciting!).
3. Are you okay knowing that you will be at the frontlines of a very broken healthcare system? Part of what I love about EM is that we are the gateway into the hospital. Patients rely on us for a variety of their needs, some of which is the management of chronic conditions, which is difficult in the emergency setting. We’re “availabilists”: I’ve found myself navigating social work issues, securing appointments for patients unable to manage the outpatient world, advocating for the uninsured, impoverished, homeless. All fulfilling work, but can be exhausting when it's not what you expected.

Final thoughts

As someone who’s been an attending for over a year now, I get bombarded by emails/texts almost daily and I promise you: the jobs are out there. I receive a barrage of requests from recruiters for both full-time and locum jobs, and I know that I will always have a job. As a locum tenens doctor, I know that means that some months I may work a job at a site I like a bit less, or one that pays a bit lower than my usual rate. But I will never not have shifts, if I want them.

Emergency medicine is not the highest paid specialty. We're quite comfortable. We don't make surgeon or hyper-specialized specialist salaries...but most of us also don't work those insane hours. Full time in emergency medicine is considered 120 hours/month, or ten 12 hour shifts if you work 12s, and you can quite easily live off that income.

If you're okay with the conditions I mentioned, then do not fear emergency medicine. Our job is not going anywhere.