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Hope209

Want to Leave EM--Where Next?

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I've been working in Emergency Medicine for a year and a half out of school. I've learned a lot and I love the autonomy and variety of EM, but the hours are crushing my soul. My wife works full time and I have a 3-year-old daughter who goes to daycare most weekdays. If I'm on a 4-day stretch of 1600-0200's, I don't see them at all.

I've been asking friends, I set up filters for sites like Indeed, but I'm not sure where to apply next. I want to have (at least some) autonomy and not feel like I'm just the attending's assistant. But I need more stable hours. I like to work quickly and always have something to do and I love procedures. I'd really appreciate any input/life advice. Thanks!

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Look into wound care. You are autonomous and do procedures daily. Pay is great too. Most companies let you make your own schedule from what I've seen. 

 

You can also pick up an extra 2 ER shifts/month if you want in order to keep your general medicine skills (+$15-20k is always good)

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The wound care jobs I have seen have been terrible.  No benefits, paid 1099 etc.  Am I missing something?

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IR. Have a buddy who works it, fast paced, almost all procedures, if you've got a production based mind set then it's a great field.

I'd rather sit around pondering AST:ALT ratios...🤔

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There are better em jobs out there. Don't give up on the specialty just because of one bad job. Look into Team health positions. There you would be full time with benefits starting at ten 12 hr shifts/month. Overall, pretty nice docs with good teaching and reasonable workflow expectations.

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28 minutes ago, EMEDPA said:

There are better em jobs out there. Don't give up on the specialty just because of one bad job. Look into Team health positions. There you would be full time with benefits starting at ten 12 hr shifts/month. Overall, pretty nice docs with good teaching and reasonable workflow expectations.

Would you say those docs and positions are stable or decreasing with the push to make medicine a retail industry?  I can see metrics taking the humanness out of caring for people in the drive to answer to stockholders and Amazon, etc.  And I'm not being facetious, we (society) seem to have lost our way.  Domo Arigato, Mr. Roboto.

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decreasing, but still out there. The long-term best bet in emergency medicine jobs is to go rural. pretty much everywhere else PAs are being pushed into high volume fast tracks with 3-4 pts/hr expectations.

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1 hour ago, EMEDPA said:

decreasing, but still out there. The long-term best bet in emergency medicine jobs is to go rural. pretty much everywhere else PAs are being pushed into high volume fast tracks with 3-4 pts/hr expectations.

 

So one thing I will say about this.  EMEDPA has a TON of experience and is obviously very good at his job.  I am however very hesitant to recommend rural ER jobs to anyone but the very VERY most experienced among us.  I'm talking 15 years of hard core high volume, seen it all done it all, ER experience.  In the rural setting you almost never have onsite backup, and you must be incredibly strong and experienced.  There is nothing quite so butt puckering as being all alone in an ER...no matter how rural it is.

Edited by Cideous
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15 minutes ago, Cideous said:

 

So one thing I will say about this.  EMEDPA has a TON of experience and is obviously very good at his job.  I am however very hesitant to recommend rural ER jobs to anyone but the very VERY most experienced among us.  I'm talking 15 years of hard core high volume, seen it all done it all, ER experience.  In the rural setting you almost never have onsite backup, and you must be incredibly strong and experienced.  There is nothing quite so butt puckering as being all alone in an ER...no matter how rural it is.

yet ppl are getting mad at AAEM for it's new position statement that it put out? 

Edited by JOhnny888

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16 minutes ago, JOhnny888 said:

yet ppl are getting mad at AAEM for it's new position statement that it put out? 

You lost me?

 

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Each of the major national employers, including TeamHealth, posts lots of open positions on their web sites.  Typically, there are other unadvertized positions at their locations as well.  Team has made less than the 3% 401K match and has eliminated salary reviews over the last 1-2 years, so that may factor into your final choice.

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17 minutes ago, Cideous said:

You lost me?

 

Ppl have been mad that AAEM basically said EM physicians should lead the team in the ER and APP's should be supervised. But here we have experienced members saying only very experienced PAs should work in rural ERs.

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9 minutes ago, JOhnny888 said:

Ppl have been mad that AAEM basically said EM physicians should lead the team in the ER and APP's should be supervised. But here we have experienced members saying only very experienced PAs should work in rural ERs.

Ahh Ok.  Gotcha.  I was just confused by what you were saying.  I do stand by my comments, but will add this.  I don't believe a new doc with little experience should be in a rural ER either.  Hopefully they would of put in 3 years of residency first in a busy ER.  My point being, I've been in a rural ER, and although the volume is usually less, the acuity seems to be REALLY high.  Having said that, I would defer to EMEDPA's opinion on the matter.

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8 minutes ago, Cideous said:

Ahh Ok.  Gotcha.  I was just confused by what you were saying.  I do stand by my comments, but will add this.  I don't believe a new doc with little experience should be in a rural ER either.  Hopefully they would of put in 3 years of residency first in a busy ER.  My point being, I've been in a rural ER, and although the volume is usually less, the acuity seems to be REALLY high.  Having said that, I would defer to EMEDPA's opinion on the matter.

yeah, not a new FP MD. A EM doc should be able to handle any setting, hence the reason for going through residency...

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2 hours ago, Cideous said:

 

So one thing I will say about this.  EMEDPA has a TON of experience and is obviously very good at his job.  I am however very hesitant to recommend rural ER jobs to anyone but the very VERY most experienced among us.  I'm talking 15 years of hard core high volume, seen it all done it all, ER experience.  In the rural setting you almost never have onsite backup, and you must be incredibly strong and experienced.  There is nothing quite so butt puckering as being all alone in an ER...no matter how rural it is.

Thanks for the clarification. I agree that solo coverage is not for new grads. There are plenty of double coverage rural positions out there with 1 doc and 1 pa per shift. My oregon per diem job is like this. We alternate cases. Some of the other PAs there, however cherry pick the easy stuff.

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1 hour ago, ohiovolffemtp said:

Each of the major national employers, including TeamHealth, posts lots of open positions on their web sites.  Typically, there are other unadvertized positions at their locations as well.  Team has made less than the 3% 401K match and has eliminated salary reviews over the last 1-2 years, so that may factor into your final choice.

this is probably site specific. I work per diem for them, got my 3% match and a raise this year(that being said, the raise was less than 50 cents/hr as they moved me to their top step). .

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