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Hospitalist vs Emergency medicine PA


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what are the pros and cons for both in terms of respect, scope of practice, schedule(Day,night, rotating, fixed), money, and physical and mental stress? plus if someone does a one year residency in hospitalist medicine can he switch to emergency medicine if he has a change of heart or would it be easier to do a one year residency in emergency medicine than switch to hospitalist?  

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they are very different fields. any residency makes you look good for any job , BUT the two couldn't be more dissimilar.

emergency med: 20-30 pts/shift, don't need to have a final dx, just stabilize, treat pt and r/o worst case scenario. first crack at the pt., often figure out problem and needed tx before disposition.

hospitalist: 10-12 pts/shift about who you obsessively know every last detail. often dx is made before they get to you and you are just finishing tx started elsewhere.

 

schedules for both highly variable. most em folks couldn't stand being hospitalists and most hospitalists couldn't stand not knowing every pts entire life story.

EM folks often spend 5-10 min/pt. really sick folks maybe as much as an hr. Hospitalists spend hours with each pt, often > 45 min just to take a hx...

critical care and em would be closer with more overlap.

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what are the pros and cons for both in terms of respect, scope of practice, schedule(Day,night, rotating, fixed), money, and physical and mental stress? plus if someone does a one year residency in hospitalist medicine can he switch to emergency medicine if he has a change of heart or would it be easier to do a one year residency in emergency medicine than switch to hospitalist?  

When I was rotating through EM (3 years ago), many of the EM PAs also worked as hospitalists per diem. I'm not sure how prevalent that is outside of that particular hospital though.

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they are very different fields. any residency makes you look good for any job , BUT the two couldn't be more dissimilar.

emergency med: 20-30 pts/shift, don't need to have a final dx, just stabilize, treat pt and r/o worst case scenario. first crack at the pt., often figure out problem and needed tx before disposition.

hospitalist: 10-12 pts/shift about who you obsessively know every last detail. often dx is made before they get to you and you are just finishing tx started elsewhere.

 

schedules for both highly variable. most em folks couldn't stand being hospitalists and most hospitalists couldn't stand not knowing every pts entire life story.

EM folks often spend 5-10 min/pt. really sick folks maybe as much as an hr. Hospitalists spend hours with each pt, often > 45 min just to take a hx...

critical care and em would be closer with more overlap.

thanks so much for the reply. how about the respect as hospitalist vs emergency medicine pa? and the scope of practice of both for a PA who has done residency in the respective field? in addition it seems like an emergency medicine PA would be more exhausted but doesn't have to deal with continuity of care (may be less mental stress) than a hospitalist, so which one is less stressful overall mentally and physically? which field is easier to find a day shift schedule even if its 12 hours a day?

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With all due respect EMEDPA, I disagree with what you said to a great degree.  EM clinicians may make the simple diagnoses or begin the work up, but it is going to be the hospitalist getting the correct diagnosis in many cases.  It is not impossible for the EM provider to make a complex diagnosis, but this is not the rule, IMHO.  There are plenty of articles to support this - tons of patients coming in with PNA who do not have PNA, with CAD who have some entirely different issue, or GI pain that have MI once admitted, complex problems thought to be one thing in the ED later found out to be auto-immune disorders, etc etc ad naseum.  In fact there are plenty of papers written by EM physicians about "why EM doctors don't make the diagnosis."  The EM clinician's job is to diagnose simple things that can be immediately dispo'd, or stabilize and admit truly sick pts.  The hospitalits job is to then take over all management.  This is not a shot at EM people at all (I work in EM) - but just my opinions.

 

Both jobs are great but very, very different.  My perspective comes from working in the EM.

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With all due respect EMEDPA, I disagree with what you said to a great degree. EM clinicians may make the simple diagnoses or begin the work up, but it is going to be the hospitalist getting the correct diagnosis in many cases. It is not impossible for the EM provider to make a complex diagnosis, but this is not the rule, IMHO. There are plenty of articles to support this - tons of patients coming in with PNA who do not have PNA, with CAD who have some entirely different issue, or GI pain that have MI once admitted, complex problems thought to be one thing in the ED later found out to be auto-immune disorders, etc etc ad naseum. In fact there are plenty of papers written by EM physicians about "why EM doctors don't make the diagnosis." The EM clinician's job is to diagnose simple things that can be immediately dispo'd, or stabilize and admit truly sick pts. The hospitalits job is to then take over all management. This is not a shot at EM people at all (I work in EM) - but just my opinions.

 

Both jobs are great but very, very different. My perspective comes from working in the EM.

Agree. The EM people have 3 hours and no info to start the care with but the hospitalist has 3 days and some info based on the ED work up. Just the nature of the specialities.

 

Sent from my SCH-I535 using Tapatalk

 

 

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I've never worked EM, got my job straight out of school. Respect is highly location-dependent. If you have a culture where PAs are worked into the system and established, there likely won't be a problem whether you're in EM or IM.

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