re: Do ER doctors earn a lot compared to other drs?

quote:

---

Your statement is ignorant, and very intelligent people think differently than you.

The #2 guy in my class went into EM. He was an adrenaline junkie.

#1 guy did neurosurgery. #3 internal medicine. #4 plastics

---

Our AOA was a heavy mix of psych/peds/IM compared to most.

quote:

---

Imo, it's hard to find a better gig than a hospitalist right now. My SIL makes around $275k, works 7 on 7 off, no call. On her work days she can be there as little as 4 or 5 hours. It would be boring as shite for me, but having half the year off I could suffer through it

---

quote:

---

Our AOA was a heavy mix of psych/peds/IM compared to most.

---

I don’t remember a lot of our AOA but definitely had a good amount of IM, some neurosurgery, some ortho, some anesthesia, a PM&R, and a peds neuro.

quote:

---

Every one of those I have know would have agreed with you up until March of last year. Most of my hospitalist pals are stressed or starting to consider pursuing other gigs since COVID. Volumes have been high, and LOS has been long.


But as a field for the future- it’s still attractive as hell.

---

Yes, they definitely earned their keep this past year.

The other thing for hospitalists is that you can find a job literally anywhere. I feel like even the smallest podunk hospital in BFE is trying to recruit them.

Grass is always greener I suppose.

Orthopedic surgery is not general nor is it considered in the realm. Orthopedics are orthopedics.

Now there are various subgroups of orthopedics: arthroscopy, totals, spine, foot and ankle, hand and wrist, and trauma.

Some orthos do it all minus spine, some specialize in one thing. It all depends. None do anything related to general.

I trained young orthos and residents on procedural techniques/advances in wet lab settings for 5 years to be clear.

quote:

---

How much of this is due to their personality in the first place though?

---

Very little. Yes- there are some folks that went into it thinking it was a cush gig that feel real bent over right about now. But those aren’t the ones I’m talking about. I’ve got a handful of buddies that were pretty bright, hardworking guys. Given the state of affairs and families (and the will of the wife), felt pulled to a bigger health system in an employed gig because hanging a shingle back in your hometown is all but dead, and in a tertiary medical system, it’s a lot easier to feel the value of your work taking care of the sick ones in the hospital vs in the clinic, depending on the population you’re seeing. It’s a different set of headaches, and it’s “higher stakes.” There’s tons of data to apply to patients to get them in, better, and home.
But COVID came with an initial guideline of “forget everythIng you know and do this:” which turned out to be pretty wrong. And that happened about two more times before we really went back to sort of doing what we thought rather than applying broad sets of data to patients. I should point out that there’s a big difference between following a guideline/cookbook/algorithm and having a guideline to fall back on that’s based on quite a bit of data. They didn’t want a set of rules to follow, they got a new disease and didn’t know how to manage it, and they watched a lot more people than normal die, get minimally better to go home and die, suck up a bed for a month or more, and, quite often still (but not as frequently as normal) get better. I don’t want to say that it’s really easy to see someone and know if they’re dying or not. But a lot of the time, you know. And seeing a dying person come in isn’t usually that upsetting when you know they’re going to die. You get sad at the story, you talk about the case with a buddy later, but hospital courses are relatively predictable from early on (pre-COVID. And this is a generalization, of course). But with this, I’ve walked into rooms and seen someone look fine and not even really see why the ED wanted to admit them (first thing the guy did was walk and shower, denied a cough or dyspnea, and didn’t require o2), keep them over night for posterity’s sake, partner saw them the next day, agreed they should go, and 24 hours later see them back and intubate them. I don’t want to pretend like this is a common occurrence, either, but the unpredictability of the patients’ hospital stays/courses like this are far more common than they were with most other conditions. I’m not particularly prideful. I enjoy learning from my mistakes. I go back to see what I could have done different to not repeat mistakes, but I haven’t found a way to predict this. And I haven’t found anyone else who has, either. When your day to day life is making decisions on the sicker/sickest people's health, and you can’t do it reliably, it plays with your brain a bit, particularly when that’s most of your day to day patients.

quote:

---

What job are they going to do?

---

Plenty of stuff. Clinic, urgent care, fast tracks in ERs sometimes.

quote:

---

Is it not one of the easiest MD's positions to achieve?

---

I can’t think of a particularly difficult clinical position to achieve once you’re in a field already. Hospitalists are in huge demand. Clinic docs are in huge demand. Probably the only thing difficult for someone in IM/FM to do is hang a shingle, stay five years, up and move and do it again. You may wind up taking a lower salary in some locations or some different headaches in one system or another, but pretty much any competent IM guy could quit tomorrow, and be employed next month in just about any city doing either hospital or clinic work. Same for FM, though they tend to be more hirable in clinics than hospitals. If you wanted to be an FM hospitalist and leave for an FM hospitalist “anywhere,” it will probably take you longer, there will probably be more blanket “no,” answers, and you may be limited to “any state” instead of “any city,” but it would be pretty easy to up and leave for an employed gig almost on a whim.

Are you trying to ask if IM/FM/Peds has a lower bar for residency entry? If so, generally yes, but most of that is quite overblown. I know some FM guys way higher up in class rank and step scores than some neurosurgeons. I know some moronic ones doing FM, too, that I’m a little embarrassed went to med school with me. I could say the same for pretty much any specialty. A lot more of it comes down to what you like to do rather than what’s harder/easier to do. And plenty of bright people like the variety and acuity in the ER. Plenty of them like the variety of a clinic. Some of them like setting and fixing bones. Some of them like looking at pictures in dark rooms and stabbing people with needles occasionally.



ETA- intra specialty variability is way bigger than you probably realize if I am reading your question right

quote:

---

Companies like the Schumacher group who specializes in running ERs and ER billing are the ones who can pay ER mds the best.

---

Schumacher’s compensation packages have been lacking in recent years. Several other ER staffing companies are offering better rates now.

some of you just like to argue.. yes full scholly for undergad and med...(to make it more interesting...white...male) look those statistics up

yes he considered other options...went in thinking plastic surgery for children with a focus on burn victims...realized his personality was not a surgeon....talked to a lot of doctors for advice...
some of the reasons he went er....

wanted a job that he could make someones life better everytime he went to work

a job that every day was a new experience and challenge

wanted a job that when he left the hospital it was his time.....no calls in middle of night.....

a job with extended days off between shifts to travel the world..

better than average doctor pay and option to make as much or little as he wanted... he is his own company...charges by the hour...

he chose a lifestyle not a paycheck...i remember when he came back from his whitecoat event...he said DAD (you getting this...) ...i was talking to the other med students....do you know hiw much money doctors make!!!!! i said yeah...alot...

he became an er doctor to help others and have a lifestyle ...not just a fat paycheck....

quote:

---

while brain doctors (neurologists) are at the bottom. Well I would say that is just a salary...that doesnt include the surgeries that neuros charge for. I know some nuero surgeons that are raking in 7 figures.....their base salaries are damn near $500k

---

Neurologists dont do surgery. Neurosurgeons are a different specialty.

These docs getting jipped. RNs in Cali and Vegas making 200K/yr with 3-4yrs of college. Ask LSUnurse.