This is a very sad video. We are seeing very high numbers of physicians retire while young physicians are trying to 'FIRE' (becoming Financially Independent and Retire Early) while seeing a steady rise in the volumes of unhealthy patients. Going into medicine is no longer seen as a glory and is increasingly being perceived as a burden. The number of unhappy physicians that are 'burnt out' is staggering.
right? i keep seeing more and more videos about people leaving medicine or medical school. something is so deeply wrong with the medical system worldwide.
I was residency trained ER physician for 20 years. As a mother I missed out a lot. Swinging shifts was killing me. I left for occupational medicine for 14 years and hospitalist for 11 yrs. I retired 4 years ago and now go to doctor appointments with 3 elderly people. Medicine is far afield from what it was 40 years ago.
Hey John, just stumbled upon this video. I’m a 56 yr old ER physician and I’m in the exact same situation. Your video was spot on! I love emergency medicine for all the reasons you stated in the beginning, and now I can’t stand it anymore for all the reasons you stated later on. But you also left out one of the big reasons: the endless stream of psychiatric crisis that come in to the ER day in and day out. That’s another population who we cannot fix in 10-15 minutes of talking to them at the bedside. After 20 years of EM, I am so done. Night shifts were cool when you’re young, but not anymore. Fighting with on call consultants in the middle of the night who don’t want to come in, angry family members, patients with entitlement issues, and on and on. I too am looking for my exit plan, but I have no idea what to do if I walk out the door forever. I celebrate you on your courage to say “I’m done and time to move on”. My time will be coming soon. Wishing you the best of luck. I will be following your saga.
I left the dysfunctional place years ago in my prime as well. We need to unionize and take emergency medicine back for ourselves and for the patients that need the ED
Three weeks ago, My sister, 72 year old quadriplegic, newly diagnosed cancer and a rectal bleed waiting for an ED berth for 12 hours in a hallway. 143 other patients waiting with her. Emergency departments are completely overwhelmed with people who need care-often routine care-and cannot wait months for an outpatient appointment. This is a mess. I was an ER chaplain in the 80s and 90s, and we thought things were getting dicey back then. I have nothing but empathy for ED professionals in this situation now. Medicine is sooooooo broken.
Dr Stanton! I’m truly sad to see you go, because I knew that every time I saw your name on the orders for patients here at MB on the weekends, I knew they were in good hands and you never ordered CT exams that were nonsense! I know it sounds selfish, but it won’t be the same without you! I do wish you all the best on your future endeavors and hope that everything works itself together for good. Keep us posted as we will be watching your journey from here on out!
John, as a now emergency medicine PA, you have taught me plenty of medicine but importantly compassion in my time of working as a scribe in the ED! Best of luck in your future endeavors!
It was always a pleasure to work with you at PCMH/Vidant. I concur with your thoughts. Our healthcare system is in a sad state and I’m not sure it’s going to recover. My best wishes to those who choose to the stay in the medical field. And I wish you the best in your future endeavors.
Thanks for sharing all that - really good video ❤ While we all need doctors so badly, your family needs you now!! Lucky kids :) Canadas system is a disaster as well. My grandma had to wait with a broken hip, possibly due to stroke, for 3 hours for an ambulance, and then another 6 at the hospital before seeing a doctor. Like you said, the emergency room is full of chronic illness instead of emergency injuries, and out ambulances are used like taxis for drunks and drug users. It’s actually scary to me that if a family member gets hurt they might not get help in time. Thankfully when I’ve had to take my son in, the wait for children was less. Anyway thank you for your content, we use some of your videos for our homeschool 👍🏼
I always enjoyed working with you John because I knew the patients were getting the best care available. And you're right. It's not burn out. It's moral injury caused by caring dedicated people working in a shitty healthcare system. That's why I'm not in the ED anymore too.
Great video! Sad to see you leave the system, but completely understand your mentality. I never minded the rotating shifts, holidays, evenings, weekends, and general frustrations of working healthcare until I got married. Quickly realized the negative impacts my work as a hospital pharmacist was on my personal life. 13 years in, I've put in my notice & found a new opportunity. Excited for the next chapter! Congrats to you. I'll be following your videos & your journey.
Hey John, just stumbled across your video and may I say I'm happy you are choosing a life that fits you now. Life throws us in all sorts of directions, we may be drifting in an everlasting sea it feels like, the wind blowing us to and fro with no certain direction it seems. We may see whales, and wonders at night at the stars, or an analogy that has long overstayed its welcome. Besides that, we only truly know what we want to do or what we should do until we truly feel it in our spirit, and I'm happy for you, to guide yourself to what you feel is right for your life. Some so many people are proud of you and I feel very inspired by this video. Thank you for posting, God Bless.
My dad was an ER doc, he switched over to occupational health towards the end. I remember he was always gone for work, so that’s what I grew up expecting a dad needs to do. I’ll be starting med school this summer, EM is still one of my top choices
Med student - I am highly interested in Emergency Medicine for the exact reasons you described and loved my time rotating through the ER. I really can't tell whether the drawbacks are too much nowadays
Don't just take my advice, look at the attitudes of your ED attendings that have been doing it for more than 5 years. Get their opinions. They might disagree with me, who knows??? Best of luck to you.
Always enjoyed working with you over the years in the EC (even though I was back in BHU.) I left after 8 years back in November for the exact same reasons. I miss it, but haven’t regretted it once. The first holiday working after kids came into the picture was enough for me to realize that wasn’t where I needed to be any longer. You’ll do great at whatever you choose moving forward.
I am so sorry to hear that. EM physician are literally my heroes; I always fantasized about being one. To be there for anyone that walked through those doors, no matter where they stands in society. Stablelizing the most critically ill patients no matter type of conditions they show up with. Literally the coolest cowboy in the west. I'm sorry that the Healthcare system have failed you, and most prominent of all, the patients. Thank you very much for your point of view of the story. Believe me when I say I will take this into serious consideration. As a naive and young idiot, I thank you again doc.
Amazing video, so much wisdom through experience, my only question would be, considering all of the facts, who is going to do the job after all? Somebody has to do it right?
How can healthcare fix the problem if they have to let chronic patients into the ER? Can they just triage them to a Monday - Friday practice? How can healthcare take care of people who won’t take care of themselves? It’s a difficult problem. Our hospital and all the Atlanta metro area hospitals were often at threat of going bankrupt. We had just a very few patients who would get into street fights and come in for Factor VII because they were hemophiliacs. This costs so much, and they couldn’t pay and didn’t carry insurance, even when it was illegal not to have insurance. How do you fix that? I remember too one time a nurse came back and she had accidentally dropped the little 5mg box of Factor VII and wanted a new one. Just that one box was worth ~3 months of my salary. Big oops. I retired when my first baby was born, and I’m never going back to hospital work.
As a PCP, I cant agree with you more! just curious about your thoughts about other options to deal with 2 biggest issues that you mentioned: 1) why wont you consider working part time or PRN or locum and cover only day shifts weekdays ? of course it wont be as steady and you will make less but it is better than nothing. 2)Why dont you consider a hospital with strong primary care resources ? I trained as a FM doc in a community hospital where ED doc consult with us to follow up a pt as OP and establish with them for chronic medical condition and that reduced their ED visit significantly. Thanks for sharing this :)
good thoughts, I have gone part time. I work about 3-5 shifts a month (but only to avoid having to explain to a credentialing committee why the long time off should I decide to go back).
My suggestion is don’t get married or have kids. And yes, the US health care system is broken. The only alternative now is working weekdays and no holidays at an urgent, or better named, convenience care clinic. Yikes!
Fellow ER doc here feeling exactly the same as you did. Would love to hear what you are doing now to pay the bills as that is my biggest barrier to moving on to something else. I just don’t know what to do next. Thanks!
you can't win with women. you have to do what makes you happy. gf or wife, they won't be happy if you quit your job to pursue what makes you happy because you need to support the family and make her feel comfortable, buy her a nice car, live in a big house, take her shopping, buy her gifts, dine her at fancy restaurants etc. and if you work too much and bring home a big check, she's still not happy, because you are spending too much time at work, not enough time with her or the kids.. bish will leave you whenever the f she wants. so don't ever rely on women. you just do what is right for you and you stick to it. you knew what you were getting into. so you keep doing what you knew was right. f the h's
I havent been able to find a husband and so no kids and I am 35 and still in training. So yes...i am depressed. Even more, the only hospital that took me right now is far away in the mountains. I have to sublet my countryside appartment and find a place for my cats. If i had a family. I would give up.
Now I see why doctors are more inclined to give you medication. Because patients aren't going to try to self heal, exercise and eat right. Medicine is a quick and easy way to do it
this is why EM specialty was never needed in the first place. FM would've been much better at handling primary care and emergencies at the same time. system was never broken, and they tried to fix it. this is the result. the only solution we have now is to do away with most residencies and only keep pertinent field of MD, DO alive like radio, surgery, neurology, nephrology. primary, EM, anesthesia, derm, and all other bs should be eliminated delegated to NPs and PAs. this will bring the healthcare cost down significantly, and solve this over crowding problem. MD = glorified pharmacist. except for the ones mentioned as pertinent above.
Hold your horses. Although CRNAs, NPs, and PAs have proven their self to have a role in anesthesia and emergency med I have never met one that is a substitute for a residency trained physician in that field. I’m sure there are a few that are extremely high performing just like there are some poor performing docs but pound for pound, I have observed physicians perform much much better in the ER and OR when things go to hell. In fact, generally I see is CRNA/NP/PAs correctly using their judgement and avoiding the critically sick or difficult patients and passing them off to the board certified anesthesia / ER docs.
It was, and is, absolutely needed. My mom was the head Emergency Room nurse at Mary Hitchcock Hospital back in the 40s. Back when the “Emergency Room” was, literally a room. This is what she would do: Patient would arrive. She would do a quick assessment to figure out what system needed attention. She would then RUN through the hospital looking for the right physician with the correct specialty, give them (usually a him) a brief synopsis of what she saw, and then the two of them would RUN back to the Emergency Room so the patient could be attended to. She said if the patient got there alive, usually they could save them. Now, imagine that scenario today. Someone arrives in Emergency Medicine. Yes, it’s easier to get hold of other people in the hospital through phones. Yes, we can send images and labs electronically. BUT, there still needs to be somebody qualified to look at them. There still needs to be somebody trained in the effects of acute medical crises on the body. Can you imagine a cardiologist or a nephrologist allowing themselves to be constantly interrupted by pings from the Emergency Department? Of course not! If I lop off my finger with a table saw, I want somebody who knows what they’re doing in that emergency situation to preserve blood vessels, etc. I don’t want first aid until orthopedic can do something. I want a physician to assess the situation and provide appropriate medical care until orthopedic can do something. It took from the time my mom was running the hallways of Mary Hitchcock in the 40s, looking for an available cardiologist until the 70s to get a specialty in Emergency Medicine. Millions of lives have been saved in the intervening years because of Emergency Medicine. We need this specialty for true emergencies.
This is a very sad video. We are seeing very high numbers of physicians retire while young physicians are trying to 'FIRE' (becoming Financially Independent and Retire Early) while seeing a steady rise in the volumes of unhealthy patients. Going into medicine is no longer seen as a glory and is increasingly being perceived as a burden. The number of unhappy physicians that are 'burnt out' is staggering.
right? i keep seeing more and more videos about people leaving medicine or medical school. something is so deeply wrong with the medical system worldwide.
“perceived as a burden” bingo!
I was residency trained ER physician for 20 years. As a mother I missed out a lot. Swinging shifts was killing me. I left for occupational medicine for 14 years and hospitalist for 11 yrs. I retired 4 years ago and now go to doctor appointments with 3 elderly people. Medicine is far afield from what it was 40 years ago.
Hey John, just stumbled upon this video. I’m a 56 yr old ER physician and I’m in the exact same situation. Your video was spot on! I love emergency medicine for all the reasons you stated in the beginning, and now I can’t stand it anymore for all the reasons you stated later on. But you also left out one of the big reasons: the endless stream of psychiatric crisis that come in to the ER day in and day out. That’s another population who we cannot fix in 10-15 minutes of talking to them at the bedside. After 20 years of EM, I am so done. Night shifts were cool when you’re young, but not anymore. Fighting with on call consultants in the middle of the night who don’t want to come in, angry family members, patients with entitlement issues, and on and on. I too am looking for my exit plan, but I have no idea what to do if I walk out the door forever. I celebrate you on your courage to say “I’m done and time to move on”. My time will be coming soon. Wishing you the best of luck. I will be following your saga.
Same here…and those damn patient satisfaction scores. How can you practice good medicine and please everyone? It’s not possible…
I left the dysfunctional place years ago in my prime as well. We need to unionize and take emergency medicine back for ourselves and for the patients that need the ED
May I ask what you now do? Good job making such a courageous move.
U ionizing won’t stop pts with chronic health issues from coming into the ER and you having to deal with them.
Three weeks ago, My sister, 72 year old quadriplegic, newly diagnosed cancer and a rectal bleed waiting for an ED berth for 12 hours in a hallway. 143 other patients waiting with her. Emergency departments are completely overwhelmed with people who need care-often routine care-and cannot wait months for an outpatient appointment. This is a mess. I was an ER chaplain in the 80s and 90s, and we thought things were getting dicey back then. I have nothing but empathy for ED professionals in this situation now. Medicine is sooooooo broken.
Dr Stanton! I’m truly sad to see you go, because I knew that every time I saw your name on the orders for patients here at MB on the weekends, I knew they were in good hands and you never ordered CT exams that were nonsense! I know it sounds selfish, but it won’t be the same without you!
I do wish you all the best on your future endeavors and hope that everything works itself together for good. Keep us posted as we will be watching your journey from here on out!
John, as a now emergency medicine PA, you have taught me plenty of medicine but importantly compassion in my time of working as a scribe in the ED! Best of luck in your future endeavors!
Good to hear from you Andrey! I'm glad to find out everyone is going well with you!
It was always a pleasure to work with you at PCMH/Vidant. I concur with your thoughts. Our healthcare system is in a sad state and I’m not sure it’s going to recover. My best wishes to those who choose to the stay in the medical field. And I wish you the best in your future endeavors.
You're a fantastic physician and we miss you! Good luck on your future adventures!
Thanks for sharing all that - really good video ❤
While we all need doctors so badly, your family needs you now!! Lucky kids :)
Canadas system is a disaster as well. My grandma had to wait with a broken hip, possibly due to stroke, for 3 hours for an ambulance, and then another 6 at the hospital before seeing a doctor. Like you said, the emergency room is full of chronic illness instead of emergency injuries, and out ambulances are used like taxis for drunks and drug users. It’s actually scary to me that if a family member gets hurt they might not get help in time. Thankfully when I’ve had to take my son in, the wait for children was less.
Anyway thank you for your content, we use some of your videos for our homeschool 👍🏼
I'm glad you get use out of the homeschool videos, my next one will be homeschool themed, I hope you enjoy it.
A common sentiment among those of us 10+ years out....good luck on your future endeavors!
I always enjoyed working with you John because I knew the patients were getting the best care available. And you're right. It's not burn out. It's moral injury caused by caring dedicated people working in a shitty healthcare system. That's why I'm not in the ED anymore too.
@billmoore3757. Thank for the kind words Bill. Moral injury, I like that. Good to hear from you.
Great video! Sad to see you leave the system, but completely understand your mentality. I never minded the rotating shifts, holidays, evenings, weekends, and general frustrations of working healthcare until I got married. Quickly realized the negative impacts my work as a hospital pharmacist was on my personal life. 13 years in, I've put in my notice & found a new opportunity. Excited for the next chapter! Congrats to you. I'll be following your videos & your journey.
Hey John, just stumbled across your video and may I say I'm happy you are choosing a life that fits you now. Life throws us in all sorts of directions, we may be drifting in an everlasting sea it feels like, the wind blowing us to and fro with no certain direction it seems. We may see whales, and wonders at night at the stars, or an analogy that has long overstayed its welcome.
Besides that, we only truly know what we want to do or what we should do until we truly feel it in our spirit, and I'm happy for you, to guide yourself to what you feel is right for your life. Some so many people are proud of you and I feel very inspired by this video. Thank you for posting, God Bless.
My dad was an ER doc, he switched over to occupational health towards the end. I remember he was always gone for work, so that’s what I grew up expecting a dad needs to do.
I’ll be starting med school this summer, EM is still one of my top choices
Med student - I am highly interested in Emergency Medicine for the exact reasons you described and loved my time rotating through the ER. I really can't tell whether the drawbacks are too much nowadays
Don't just take my advice, look at the attitudes of your ED attendings that have been doing it for more than 5 years. Get their opinions. They might disagree with me, who knows??? Best of luck to you.
Always enjoyed working with you over the years in the EC (even though I was back in BHU.) I left after 8 years back in November for the exact same reasons. I miss it, but haven’t regretted it once. The first holiday working after kids came into the picture was enough for me to realize that wasn’t where I needed to be any longer. You’ll do great at whatever you choose moving forward.
all the best on your new route whatever you end up choosing and thank you for being honest in the video!
I am so sorry to hear that. EM physician are literally my heroes; I always fantasized about being one. To be there for anyone that walked through those doors, no matter where they stands in society. Stablelizing the most critically ill patients no matter type of conditions they show up with. Literally the coolest cowboy in the west. I'm sorry that the Healthcare system have failed you, and most prominent of all, the patients. Thank you very much for your point of view of the story. Believe me when I say I will take this into serious consideration. As a naive and young idiot, I thank you again doc.
thanks for the comment, you might be young and naive, but I doubt you're an idiot. be well!
One good thing is that you’re in a position to quit your job. Just imagine if you don’t. Just wonder how many physicians who can’t afford quitting…
Amazing video, so much wisdom through experience, my only question would be, considering all of the facts, who is going to do the job after all? Somebody has to do it right?
I always enjoyed working with you at SRHS and remember how empathetic and kind you were with staff and patients. This healthcare system sucks.
That was the cutest little Batman I've ever seen!!!😊❤
How can healthcare fix the problem if they have to let chronic patients into the ER? Can they just triage them to a Monday - Friday practice? How can healthcare take care of people who won’t take care of themselves? It’s a difficult problem.
Our hospital and all the Atlanta metro area hospitals were often at threat of going bankrupt. We had just a very few patients who would get into street fights and come in for Factor VII because they were hemophiliacs. This costs so much, and they couldn’t pay and didn’t carry insurance, even when it was illegal not to have insurance. How do you fix that?
I remember too one time a nurse came back and she had accidentally dropped the little 5mg box of Factor VII and wanted a new one. Just that one box was worth ~3 months of my salary. Big oops.
I retired when my first baby was born, and I’m never going back to hospital work.
As a PCP, I cant agree with you more! just curious about your thoughts about other options to deal with 2 biggest issues that you mentioned: 1) why wont you consider working part time or PRN or locum and cover only day shifts weekdays ? of course it wont be as steady and you will make less but it is better than nothing. 2)Why dont you consider a hospital with strong primary care resources ? I trained as a FM doc in a community hospital where ED doc consult with us to follow up a pt as OP and establish with them for chronic medical condition and that reduced their ED visit significantly. Thanks for sharing this :)
good thoughts, I have gone part time. I work about 3-5 shifts a month (but only to avoid having to explain to a credentialing committee why the long time off should I decide to go back).
My suggestion is don’t get married or have kids. And yes, the US health care system is broken. The only alternative now is working weekdays and no holidays at an urgent, or better named, convenience care clinic. Yikes!
Fellow ER doc here feeling exactly the same as you did. Would love to hear what you are doing now to pay the bills as that is my biggest barrier to moving on to something else. I just don’t know what to do next. Thanks!
I'll explain what/how I did it in an upcoming video....stay tuned.....and hang in there!
you can't win with women. you have to do what makes you happy. gf or wife, they won't be happy if you quit your job to pursue what makes you happy because you need to support the family and make her feel comfortable, buy her a nice car, live in a big house, take her shopping, buy her gifts, dine her at fancy restaurants etc. and if you work too much and bring home a big check, she's still not happy, because you are spending too much time at work, not enough time with her or the kids.. bish will leave you whenever the f she wants. so don't ever rely on women. you just do what is right for you and you stick to it. you knew what you were getting into. so you keep doing what you knew was right. f the h's
quit 2 years into being an EM attending, it be like that sometimes
I havent been able to find a husband and so no kids and I am 35 and still in training. So yes...i am depressed. Even more, the only hospital that took me right now is far away in the mountains. I have to sublet my countryside appartment and find a place for my cats. If i had a family. I would give up.
Hang in there!
WE LOVE YOU DR STANKIN
This is how broken the health system is.
Thanks for the video
Now I see why doctors are more inclined to give you medication. Because patients aren't going to try to self heal, exercise and eat right. Medicine is a quick and easy way to do it
Be a paramedic
becoming a doctor cant even pay your bill properly
this is why EM specialty was never needed in the first place. FM would've been much better at handling primary care and emergencies at the same time. system was never broken, and they tried to fix it. this is the result. the only solution we have now is to do away with most residencies and only keep pertinent field of MD, DO alive like radio, surgery, neurology, nephrology.
primary, EM, anesthesia, derm, and all other bs should be eliminated delegated to NPs and PAs. this will bring the healthcare cost down significantly, and solve this over crowding problem. MD = glorified pharmacist. except for the ones mentioned as pertinent above.
Hold your horses. Although CRNAs, NPs, and PAs have proven their self to have a role in anesthesia and emergency med I have never met one that is a substitute for a residency trained physician in that field. I’m sure there are a few that are extremely high performing just like there are some poor performing docs but pound for pound, I have observed physicians perform much much better in the ER and OR when things go to hell.
In fact, generally I see is CRNA/NP/PAs correctly using their judgement and avoiding the critically sick or difficult patients and passing them off to the board certified anesthesia / ER docs.
It was, and is, absolutely needed. My mom was the head Emergency Room nurse at Mary Hitchcock Hospital back in the 40s. Back when the “Emergency Room” was, literally a room. This is what she would do: Patient would arrive. She would do a quick assessment to figure out what system needed attention. She would then RUN through the hospital looking for the right physician with the correct specialty, give them (usually a him) a brief synopsis of what she saw, and then the two of them would RUN back to the Emergency Room so the patient could be attended to. She said if the patient got there alive, usually they could save them. Now, imagine that scenario today. Someone arrives in Emergency Medicine. Yes, it’s easier to get hold of other people in the hospital through phones. Yes, we can send images and labs electronically. BUT, there still needs to be somebody qualified to look at them. There still needs to be somebody trained in the effects of acute medical crises on the body. Can you imagine a cardiologist or a nephrologist allowing themselves to be constantly interrupted by pings from the Emergency Department? Of course not! If I lop off my finger with a table saw, I want somebody who knows what they’re doing in that emergency situation to preserve blood vessels, etc. I don’t want first aid until orthopedic can do something. I want a physician to assess the situation and provide appropriate medical care until orthopedic can do something. It took from the time my mom was running the hallways of Mary Hitchcock in the 40s, looking for an available cardiologist until the 70s to get a specialty in Emergency Medicine. Millions of lives have been saved in the intervening years because of Emergency Medicine. We need this specialty for true emergencies.