Gilakend

So at the moment I am considering a career in Emergency Medicine but, I have a few questions. My first question is I have heard that some ER Doctors are employed directly by the hospital and others are employed by other companies and just work at the hospital and I don't really understand how being employed by another company would work. If someone could please explain it that would be great. Another question I have is about how their schedules are. How many hours a week would an ER Doctor work and would it be possible to have day shifts 90% or more of the time or do you HAVE to alternate? Basically I have a huge amount of questions and your answers will make me think of more questions but I figure just starting off with a few questions will be best. Any information you have on ER Doctors is greatly appreciated. Thanks.

Gilakend

I thought of another question. How does an ER Doctor's malpractice work? Is it paid by the hospital/company that employs them or is it paid by the doctor?

BusyBeeh

I've personally met an ER doctor working as a teller. She came in to deposit a check for nearly $29k. It was her un-taxed monthly paycheck. Although I can't quite remember our conversation because it was a while ago, she was complaining about as an ER doctor she was required to pay to take care of her patients. I can't quite remember the reason why but she also said she didn't work directly for the hospital. She belonged to a formed union of ER doctors. I wouldnt want to discourage you from being an ER doctor so I would recommend you attend a Med School conference or panel and ask them these questions because the best answers you can get are from them directly.

suzy100

ER docs are just like any other hospital-based physician. Some are employed by the hospital, some are employed by companies/partnerships (some of which are physician-owned) who contract with the hospitals to staff their emergency departments. Malpractice insurance will be paid for by whomever the employer is. Scheduling will be different everywhere you go, but generally you'll have to pull nights as well as days. There are a number of professional associations for ER (actually, it's typically "ED" - Emergency Department) docs. One I know off the top of my head is ACEP - American College of Emergency Physicians. You can browse their website. I'm sure they have resources and info that can answer your questions.

WayOutWestMom

My MS2 will likely specialize in EM. She's already done a couple of early clinical rotations thru EM and has worked closely with a number of ER docs during those experiences.

You are correct that ER docs are either employed directly by the hospital or can be employed by a medical group who in turn contracts (sells) that doctor's services to a specific hospital or group of hospitals.

In both cases, the hospital pays the ER doc's malpractice. In the first case, the hospital pays the malpractice insurance premium directly as an employee benefit; in the second case, the cost is paid indirectly. The contract for services includes an amount that goes the medical group which in turn uses it to pay for malpractice insurance.

An EM physician typically works 45-60 hours/week. Most seem to work 3 12-hours or 5 8-hour shifts each week in direct patient contact time, but then they have to stay and finish patient charts and situation writes ups--which must be done before they can leave the premises. Occasionally if there are multiple critical patients, the doc has to stay on duty until all patients are handed off--either to another ER doc or to the appropriate IM or surgical dept. Doing the paperwork can take an additional 1-3 hours per shift. (Paperwork time is unpaid since in theory it's supposed to done while the doc is on duty. However, there's usually not enough time to get it done.)

You will always have night shifts at some point in time since everyone rotates hours every week. (ER docs share the pain. Everyone works nights.) You will also work weekends, usually once a month as the shifts rotates. You may have a week of working just night or just days, but you're also likely to have weeks when you work both day and night shifts. However, there's a legal requirement that you may not work more than 24 hours continuously without a rest period and you must have a 10 hour break after any 24-hour shifts.

But EM docs never are on-call. Once you're done your shift, you're done and cannot be called back unless you volunteer for it. Many ER docs who need/want extra cash moonlight by working at other ERs or Urgent Care Centers on their days/nights off. (D says typical pay to cover a ER or UCC shift is $2000/8 hours plus malpractice. Starting salaries for EM are around $225,000, but unlike many other specialties salaries in EM are flat and do not increase much with beyond the starting salary over time.)