Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Why are emergency physicians burning out?

Michelle Finkel, MD
Physician
May 4, 2013
Share
Tweet
Share

shutterstock_74641645

Emergency physicians experience burnout at a rate of more than three times that of the average doctor and more than anyone else inside or outside of the medical field, according to a study published in the Archives of Internal Medicine. The study surveyed over 7000 physicians in more than two dozen specialties and compared them with almost 3500 working adults in fields outside of medicine. More than 65% of emergency physicians reported burnout, compared to 55% of internists (the next crispiest specialty), and 27.8% of the general population.

What is most striking to me, as a practicing emergency physician and former assistant residency director in emergency medicine, is that while emergency physicians are tired of their work, medical students are competitively vying for it. In the 2012 NRMP® Match, all 1668 of the available Match positions in emergency medicine were filled. This year, too, after the Match and SOAP (Supplemental Offer and Acceptance Program, which replaced the “Scramble”), there were, again, no unfilled emergency medicine residency slots. What explains this strange disconnect?

To solve this puzzle, we must start by exploring why emergency physicians are burning out in the first place. When I started my residency in the mid-1990s, mentors told me that the professional chronic fatigue syndrome (a recognized problem even then) stemmed from the fact that so many emergency physicians had not been trained in the field. Because emergency medicine did not even become a recognized specialty until 1979, many doctors working in the emergency department had not been residency-trained in emergency medicine. The conventional wisdom then was that the people who couldn’t last in this specialty had never anticipated entering it. Thirty years after emergency medicine’s recognition as a formal specialty, this explanation for burnout seems deficient. Today’s burned-out physicians should have known what they were in for.

Alternate reasons I was given for burnout included what a mentor told me were the two worst aspects of emergency medicine: consultants and nights. Here we may be getting closer to the real root of the problem and the disconnect with the field’s medical student popularity.

My mentor may have said “consultants” half-jokingly, but actually, I think identifying consultants as a root cause of emergency medicine burnout really speaks to the lack of autonomy and control in the field. Usually, an emergency physician doesn’t pick whom she works with, whom she treats, how heavy her workload is, or how heavy the emotional toll of her workday might be.

For many medical students, a lack of autonomy is not the first worry on their minds. After all, they have little autonomy already as medical students. Furthermore, it’s hard in one’s twenties to envision what one’s future medical practice should look like to maximize individual happiness and self-determination.

With regard to nights, there is no question that the erratic schedule that full-time emergency physicians manage is exhausting. Shift work has been associated with health problems, including an increased risk of diabetes, depression, heart disease, and breast cancer. It also adversely affects one’s personal life, a problem that may be heightened if someone has a partner and children. Again, though, early in a medical career – when someone is in her twenties – these issues may not be pressing, depending on one’s physical and family state. It’s hard to envision preschool carpools and community barbecues when you are still pulling all-night drives to Vegas on your weekend off.

The best advice I’d offer to prospective medical students is to find someone in the field who embodies the life you envision for yourself. Do you ideally hope to have children and practice part-time? Or do you have an interest in international emergency medicine with plans to practice abroad half the year? Ask your mentors to direct you to practicing emergency physicians in the community who are in these situations and can speak frankly about the pros and cons of their careers. Unable to find a role model who fits the life you hope to lead? While enthusiastic supporters may cheer you on to become the pioneer who beats a new path, the realist in you should take note that if nobody is doing what you’d like to do yet, it may be because it’s impossibly hard to do.

A primary goal of medical education should be to ensure that medical students are choosing the right fields and developing into physicians who lead lives with sufficient balance and satisfaction such that they can be productive and provide excellent patient care. With today’s emphasis on preventive care, the best way for the proverbial physician to “heal thyself” may be to know intimately in advance which individual pitfalls to avoid in the first place.

Michelle Finkel is founder, Insider Medical Admissions.  She can be reached on YouTube, Facebook and on Twitter @Insidermedical.

Image credit: Shutterstock.com

Prev

Should you worry about arsenic in rice?

May 4, 2013 Kevin 7
…
Next

Dzhokhar Tsarnaev and his right to privacy

May 4, 2013 Kevin 7
…

Tagged as: Emergency Medicine

Post navigation

< Previous Post
Should you worry about arsenic in rice?
Next Post >
Dzhokhar Tsarnaev and his right to privacy

ADVERTISEMENT

More by Michelle Finkel, MD

  • We got the new COVID vaccine. It was a whopping $191 per shot.

    Michelle Finkel, MD
  • Why are COVID antibody tests of questionable relevance being marketed to the public?

    Michelle Finkel, MD
  • Made mistakes? How to spin them for your medical school applications.

    Michelle Finkel, MD

More in Physician

  • The physician who turned burnout into a mission for change

    Jessie Mahoney, MD
  • Time theft: the unseen harm of abusive oversight

    Kayvan Haddadan, MD
  • Why more doctors are leaving clinical practice and how it helps health care

    Arlen Meyers, MD, MBA
  • Harassment and overreach are driving physicians to quit

    Olumuyiwa Bamgbade, MD
  • Why starting with why can transform your medical practice

    Neil Baum, MD
  • Life’s detours may be blessings in disguise

    Osmund Agbo, MD
  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions
    • The physician who turned burnout into a mission for change

      Jessie Mahoney, MD | Physician
    • Time theft: the unseen harm of abusive oversight

      Kayvan Haddadan, MD | Physician
    • How one unforgettable ER patient taught a nurse about resilience

      Kristen Cline, BSN, RN | Conditions
    • The future of clinical care: AI’s role in easing physician workload

      Michael Wakeman | Tech

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 16 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions
    • The physician who turned burnout into a mission for change

      Jessie Mahoney, MD | Physician
    • Time theft: the unseen harm of abusive oversight

      Kayvan Haddadan, MD | Physician
    • How one unforgettable ER patient taught a nurse about resilience

      Kristen Cline, BSN, RN | Conditions
    • The future of clinical care: AI’s role in easing physician workload

      Michael Wakeman | Tech

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Why are emergency physicians burning out?
16 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...