A blog that was posted last year ago caught my eye. On the KevinMD website, a physician wrote about the trials and tribulations of emergency medicine. The piece was a description of how the author chose her specialty. Looking for balance between work and family, the author picked EM because she “…thought the shift work in EM would allow me to have the best of both worlds.”
 
After she had children, she discovered that juggling career and family responsibilities caused significant emotional and physical stress. It turns out that emergency rooms are open 24 hours per day and seven days per week. This necessitates staffing even in the wee hours of the morning. This “…did not fit well with family life.”
 
She goes on the say “Is the toll that working odd hours [takes] worth it? Is the exhaustion EM physicians experience jeopardizing patient safety?”
 
The author asks, “What are possible solutions to this problem since the highest need for EM clinical coverage is in the evenings and nights when office-based doctors have already gone home?” I can’t think of many.
 
There are two major issues.
 
1. Work hours. Hold on a minute, I thought the fuss was about docs working inordinately long hours, like 30 at a time. Do you mean to tell me that even a 12 hour shift [the longest stretch that any ED MD has to work] causes exhaustion to the point of jeopardizing patient safety? How can this be? Don’t let the ACGME find out or everyone will be working 4-hour shifts. Can we close emergency rooms at, say, 5 pm? I’m not sure the public will buy into that since they are already up in arms about all things related to medical care. And who would order the CT scans?
 
2. Family considerations. With a few exceptions such as dermatology, radiation medicine and rehabilitation medicine, all medical specialties interfere with family life. Either practice one of the previously mentioned “9 to 5” specialties or consider a career change.
 
Can you think of any other solutions to this problem?