WARNING: THIS ONE’S ALSO LONG…The Bad / the Ugly Frustration Emergency physicians work really hard, usually managing more than one critical patient at a time. Some patients will ultimately die in front of them even after they do everything they could; worse still, they will have patients who suffered from abuse, either as a child, sexually or even both, along with other terrible scenarios like car accident victims.  Lawsuits along with other forms of the patient taking legal action against the doctor are common; in fact, they have been ranked the fifth most likely to be sued in comparison to other specialists. It’s commonly thought that they have high rates of “burnout”, which means that they have shorter, less effective careers than other physicians; However, according to the AMA Physician Masterfile, their decline rate, including death, is only decreasing at about 1.7% per year, which is lower than the 2% or 3% average of other specialists.Difficult PatientsAlthough there are patients who got their injuries from tragic incidents, emergency physicians often have to handle more “difficult” patients. 99% of the time, patients and their families are under strain from their severe injuries; and so will treat the emergency physician inappropriately, especially when the two have never met before. Many patients tend to be intoxicated or have serious issues mentally. The homeless, criminals whose heists ended horribly , or even those who have been released from every other medical clinic in the town due to their behavior. The more violent, out-of-control patients often threaten and sometimes even try to attack. As the “safety net,”the Emergency Department treats everyone, no matter their past.Difficult Co-workers Unfortunately, emergency physicians are sometimes also mistreated by their co-workers. EM is 24/7, and many patients need hospital admission. They deal with patients that don’t even have insurance, some of which are dealing with complicated medical or even social situations. For, example, like on one episode of Untold Stories of the ER, a nurse had to deal with a woman who was poorly insured AND was dating the nurse’s ex-boyfriend. In response, they’re sometimes treated poorly by their colleagues, who may be upset about being contacted during off-hours to help manage a patient and/ or manage a patient whom they have some “personal issues” with. CrowdingED patient numbers continue to increases every year; in fact, the National Hospital Ambulatory Medical Care Survey estimated that ED visits have grown from 94.9 million in 1997 to 123.8 million in 2008. That’s a 30% increase! It’s also about double of what they had expected. Instead, EDs are becoming more crowded from the result of an aging population, more regulations, and more advanced testing. In addition, hospital in-patient capacity continues to decrease, whom of which go straight to the ED. In many EDs, patients wait a long time and can even usually be seen on hallway stretchers.Over – overtimeAlthough many emergency physicians enjoy their flexible schedules, they tend to work many evening and night shifts, as the ED is a 24/7 operation with highest patient count usually being in the evening. Many emergency physicians, especially as they get older, find it difficult to work such late hours and often change shift times. In addition, the ED must be staffed on weekends and holidays, so they often miss family and social activities due to their high responsibilities.Lack of continued care for the same patientAlthough it’s a common concern among medical students considering to do EM, few practicing emergency physicians consider this to be a significant drawback. An emergency physician can always follow up on a patient on their own, and their sickest patients tend to make many return to the ED; some to continue their treatment, get treated for something else, or just to say thank you.