ER doctors work on a shift schedule, which has many documented advantages and disadvantages. Health issues are among the disadvantages. In my opinion, they can be pretty serious.
Many medical specialities have concerns with depression and suicide. ER and ICU are among the two with which I have personal experience that face these issues quite acutely. If you have a loved one in one of those departments, the last thing you want to hear is that your physician may be dealing with depression and suicidal thoughts.
Personally, I don't think the advantages outweigh the disadvantages. I suspect removing the shift schedule nature of emergency medicine may have a remarkable improvement. Many ER nurses and clinics have already moved away from a rotating shift schedule, and I haven't heard of any serious repercussions. I really hope emergency physicians follow suit someday. Or, find an alternative model that doesn't incur such health issues.
Can you go into more detail about this? I'm currently a medical student in the US near the end of my training, and I'm weighing multiple specialties (including ED). From my personal experience in the ED, it's actually the best schedule I've worked. Yes, it's irregular, but you're always working a fixed amount of time per shift and a fixed amount of hours per week (seems to be around 40). You know when you're on, and you know when you're off. Working three 12 hour shifts per week felt very doable. Most other specialties have call at least once a week, and there are days where you end up staying several hours longer than you expected. True weekends (Friday evening through Sunday evening off) seemed uncommon in other specialties as well. Not doubting what you're saying—I'd just like to hear more about your side of things.
I guess it depends on the person and your situation.
Before we had kids, my wife's shift schedule wasn't too bad. I owned my own business and could take time off when she was free during weekdays.
Now that we have kids, the shift schedule is tougher on her. Kids don't work on a shift schedule, and when they make demands of her time and I'm unable to help, she ends up sacrificing her sleep. That happens often enough that it makes any jokes about startup founders being sleep deprived, well, a joke.
Somehow, she's able to rally herself and get enough energy to work through a string of night shifts, even after having to take the toddler to the pediatrician during the day if I wasn't able to.
My wife also moonlights at another hospital (something she did back when I was getting my startup going and we needed the extra income). She continues to do this because she enjoys the work there (it's higher acuity).
That's just our personal experience. Colleagues of hers have solved this by hiring help (au pairs, nannies, etc), which we intend to do soon.
She's told me stories about some of her colleagues that don't have kids and have their own share of difficulties. One of them recently dealt with a particular tough case where a 3yo died. There's a culture in the ED where you don't take time off unless you're truly dying. Got the sniffles? Suck it up and come to work. Dealing with a traumatic experience and can't sleep because you've been crying all night? Suck it up and come to work. Hopefully that colleague finds a way to cope, because it's kind of frightening to me, as an outsider, to think of my ED doctor being that person.
I can only speak to the ED specialty. I'm clueless about other medical specialities and any potential health issues around them.
Thanks for the response. I'll definitely keep that in mind as I pick a specialty.
I'm only a med student right now, but I have spent a year rotating through all of the most common specialties. I have to say that the culture you describe isn't unique to the ED. I've seen it throughout the hospital. Taking time off isn't easy in any specialty. I've found this to be especially true in the niche subspecialties (especially surgical subspecialties). I work with a colorectal surgeon who is the only colorectal surgeon at her particular hospital. She's responsible for all of the patients she's ever treated and any emergencies that may need a colorectal surgeon. It's nearly impossible for her to ever take time off or even leave the city for more than a few days. An advantage that I see for ED physicians is that they're not directly tied to patients. Any ED physician can fill in for another when the need arises. I can't speak to whether that actually happens, but theoretically it's possible in the ED.
From what little I know, I would guess any kind of surgical subspecialty experiences what ED physicians experience, times two.
I heard the story of a good neurosurgeon who, one day, made a serious mistake during a surgery and paralyzed his patient. It haunted him so much that he eventually took his own life, after he dealt with the malpractice lawsuit.
Many medical specialities have concerns with depression and suicide. ER and ICU are among the two with which I have personal experience that face these issues quite acutely. If you have a loved one in one of those departments, the last thing you want to hear is that your physician may be dealing with depression and suicidal thoughts.
Personally, I don't think the advantages outweigh the disadvantages. I suspect removing the shift schedule nature of emergency medicine may have a remarkable improvement. Many ER nurses and clinics have already moved away from a rotating shift schedule, and I haven't heard of any serious repercussions. I really hope emergency physicians follow suit someday. Or, find an alternative model that doesn't incur such health issues.