Door to doctor. Door to discharge. The metrics used to define my value as an emergency medicine physician. I entered this specialty as a bright-eyed adrenaline junkie and I am leaving as burned-out physician looking for source of humanity.
Burnout is not unique to emergency medicine, but mid-career EM physicians are experiencing disproportionately higher rates of burnout. Burnout for EM physicians is multifactorial. Shift work, stressful cases, depersonalization, and lack of autonomy are all major contributors. The idea of changing specialties is never one we think about on match day, but a decision physicians ponder when they are burned out but not ready to desert medicine completely. So where do these EM physicians go?
Palliative care programs across the country are being filled with EM doctors leaving understaffed departments. The motivations for entering palliative care as a mid-career change are diverse, but they always come down to patients. For many of us, the brief encounters we have with dying patients in the emergency department are small moments that give us purpose. EM physicians have been on every side of a death and dying conversation. We witness human suffering and miracles. We can provide heroic but futile measures or we can be a source of comfort care at the end. Emergency medicine physicians witness the power of palliative care. We see palliative care as an opportunity to give patients autonomy, a voice, and the ability to take control of their own healthcare.
Transitioning to palliative care is not without its challenges. The financial and time commitments to learn a new specialty are no small feats. Rural hospitals are not knocking down doors for palliative care physicians. Like emergency medicine physicians, palliative care physicians often have to prove their worth. Both specialties are asked to navigate delicate situations, difficult families, and heartbreaking cases. I am leaving the rat race of emergency medicine in search of something new. A new specialty, a new calling, and a new adventure. Ready for the challenges and speed bumps ahead. I’m so thankful for the years I had as an ER doctor. Those years shaped me into the doctor I am today. I am looking for a new metric. The door to lives changed.
