The Joy and Stress of Being an Emergency Physician

This post is part of a series developed in conjunction with the Career Advisory Program of Albert Einstein College of Medicine’s Office of Student Affairs.

I love my job. I am one of those lucky persons who truly enjoys his work after more than 15 years of practice.

Recently, the National Match Day results showed that every spot in emergency medicine in the country had been filled. With popularity like that, I sometimes worry that students don’t fully understand what an emergency physician’s job is like. Here’s how I see it.

There are some really sick patients. Some you can help and some you can’t. I witness incredible stories—and some horrific images—every day. Everyone deals with these differently.

What helps me is the support I get from the people I work with. The colorful characters who work in and around the emergency department (ED) are a special breed; they are my friends and keep me going. A good sense of humor helps, too, in emergency medicine.

Many students wonder about the stress. There is certainly stress involved in taking care of a very sick person. But it is relatively minor compared to that which comes from the nature of the job itself.

When you start a shift in the ED, there are patients waiting to be seen, patients in the process of being seen, and some waiting for a disposition. I work 12 hours treating patients as fast as I can, with no real breaks, often neglecting meals. At the end of my shift there will still be more patients waiting desperately to be seen. I have always tried to help as many as I can, but there is no end to the line of patients. To me, that is the source of the stress involved in emergency medicine. My job satisfaction comes from doing what I believe is right for each patient.

Some students are enticed by the idea of shift work, but I am not sure they realize what it means. While it’s true that a typical community ED physician will work three or four days a week, that still adds up to about 40 hours. In addition, a bunch of those hours will be weekends, holidays and nights. And recovery time is needed after night shifts, which does not show in the 40-hour total. Often a whole day is lost to resetting your internal clock. Anyone who has worked a schedule that rotates around the clock knows that it can really tire you out.

So what qualities are needed to be an emergency physician? The ability to communicate and connect with patients has always been most important. Each patient encounter starts with a blank slate. You are the first to tackle a problem. Your ability to get a person talking and your understanding of what the patient is really saying can make or break any given case.

An inquisitive nature is helpful. Every week I learn something new. Last week, I saw my first patient with factor 2 deficiency, and that led me to read all about it. Something is always changing in medical care, and I hope that I am continually improving.

Any job in medicine will require that you dive in with your heart and soul. It is incredibly important that you find a specialty that you enjoy doing—something that captures your mind and makes you want to be a better physician. I found mine. I hope you find yours.

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Thomas Perera, M.D.

Thomas Perera, M.D.

Thomas B. Perera, M.D. is associate professor of clinical emergency medicine, Department of Emergency Medicine at Albert Einstein College of Medicine and residency director, emergency medicine, Montefiore Medical Center and Jacobi Medical Center and attending physician, emergency medicine, Montefiore Medical Center

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