Being an EP is an Honor

Emergency medicine has many perks, and it is important to remind those contemplating a career in emergency medicine about those. We rarely get a balanced depiction of problems like being able to be fired on a whim (which isn't often true). Being independent contractors definitely contributes to the expendable nature of EM, but many protections still exist, including interprofessional alliances and contracts.

Work that is hourly instead of salaried can create anxiety for some, but it also means unparalleled flexibility. You can work 10 shifts one month and only five the next. You can decide to prepare financially for an extravagant vacation or save more for a down payment on a house by increasing your shifts for a few months, knowing you can come back down later, all with certain job security.

Emergency physicians are never on call. They may choose to help a colleague who needs coverage, but they are never obligated to do so. Your time is yours.

The most amazing part of the specialty is you are the master of saving life and limb from the widest breadth of causes. You are often the most valuable person around if someone collapses in public, if his airway goes out, if she has a cardiac arrest, if a leg gets run over.

A cardiologist will have run a tenth of the cardiac arrests you have, an orthopedist a fraction of the emergent joint reductions, an anesthesiologist just some of the emergent airways.

The EP is who you want around when anything can happen. It's not “jack of all trades, master of none,” but rather “master of most with the occasional need for backup or a specialist.”

What the emergency physician is capable of doing is growing, and we should hopefully require specialists less and less (i.e., we probably don't need a hand surgeon for every digital felon). With the breadth in skill comes the confidence and feeling one maintains while on shift when helping the team navigate a chaotic situation and transform it into relative order with clear step-by-step goals to save a life.

In which other field do you bring people back from the dead on a regular basis? Or pull them up and out from circling the drain? It is quite the experience when you get pulses back or watch someone come back to consciousness.

The job also pays well. You will be paid $200-$400 an hour and never really do any of the billing; your department does all that for you.

And you will never be bored. You will meet an unending blend of fascinating personalities. You will find brotherhood, sisterhood, and general camaraderie in EM like no other specialty. It is not for everyone, but you will have found your people if you love the work and find humor in many of the absurdities.

We do watch “patients die in front of us, sometimes without having the proper equipment.” (EMN. 2024;46[7]:2; https://tinyurl.com/4hfntnhd.) No one can argue with this being a (surmountable) challenge because we bear the brunt of immense responsibility.

Breaking bad news to the parent who loses a child is one experience I will never get used to. But it is also an honor. The team—and society—look to us to take on this role, knowing we have the competence and compassion to carry it out as tactfully as humanly possible.

Look to this rare position as an honor that only the grittiest, most charming, creative, and capable pursue.

Special thanks to Monet Martin for her invaluable editing contributions.

DR. TAICHER is an emergency physician at Ventura County Medical Center in Ventura, CA, and an executive board member and the secretary at Westside Regional Center in Culver City, CA.