Pros and Cons of Working in the ER as a Physician Assistant

Pros & Cons of Working in the Emergency Room as a Physician Assistant

Emergency medicine is a pretty popular specialty for physician assistants. 

But working in the ER as a PA has both advantages and disadvantages

I’ve worked in emergency medicine as a PA since 2014. In this post, I’ll share several of the pros and cons of working in the ER as a PA. 

Let’s dive in.

Advantages of Working in the ER as a Physician Assistant

Here are several benefits of working in the ER as a PA.

1. Decent to Good Pay

While I don’t have the latest statistics on the tip of my tongue, I know PA’s in the ER get paid pretty well. 

It’s not the highest-paid specialty, but it’s pretty decent–and higher than some.

For example, when I worked in family practice, we definitely didn’t get paid as much. 

On the other hand, a PA working in spine surgery would probably get paid quite a bit more. So there’s a range of possibilities. 

Overall, income for emergency medicine PA’s is pretty decent, and an advantage of this specialty.

2. Hands-On / Procedures

Working in the ER can actually be pretty fun. 

For example, when you suture lacerations, or incise and drain abscesses… 

Most of the procedures are pretty fun to do – as long as you’re not super busy and getting behind, in which case it feels a little stressful (see below). 

suturing a laceration in the ER

But in general, procedures are fun, satisfying, and help break up the monotony by giving you something hands-on to do (even if you can’t do full-blown surgery). 

So working in the ER as a PA has some enjoyable moments.

3. Fast-Paced (Time Flies By)

In general, things move quickly in the ER. 

You’re bouncing around from one task to the next, and before you know it a few hours have gone by, and then the whole shift.

There’s a variety of different stuff to do, from procedures to interviewing patients to charting to talking to other staff… which all together makes the time go by quickly.

In some ways, having all this different stuff to do can be a disadvantage; but it also keeps things interesting, and keeps the time moving.

4. You Don’t Take Your Work Home (hopefully) 

I’ve noticed that a lot of PA’s who work in clinics end up charting from home. 

In other words, if they don’t get all their charting done during the day, they try to catch up in the evening. 

To me, this is a disaster. I would never want to have a job where I have to chart from home. 

I guess that’s because I’ve never had to do that, and it just feels like it would be a never-ending interruption of life outside of work. 

But in the ER, generally speaking, you do all your work while you’re there, and you don’t take it home with you. At least in the sense that you don’t have to physically do the job from home. 

(On the other hand, sometimes you do take your work home with you… in the sense that you keep thinking about something that happened at work… which is kind of a disadvantage of the ER. More on that below.)

5. Collaborating with Lots of Coworkers

Another fun part of the ER is getting to work with lots of different people. 

From the different physicians you work with, to all the nurses, and all the other staff that work in the hospital. 

As a result, you make a lot of friends, and get to work together with a lot of different people. Overall, that makes the workdays more enjoyable. 

And if there’s someone you don’t really like working with… at least you don’t have to work with them every shift. 😉

Disadvantages of Working in the ER as a Physician Assistant

Now, here are some downsides of working in emergency medicine as a physician assistant.

1. Nights and Weekends

In case you didn’t know, the emergency room is open 24/7. 

In other words, someone has to be working there every moment of every day, all year long.

Do you know what that means? 

It means you might be the one who has to work at nighttime, on the weekends, or other inconvenient times. 

Somebody’s gotta do it. So depending on your job, your scheduler, and everything else, you may end up having to work some shifts on the nights and weekends, and it might mess up your sleep schedule or cause other inconveniences.

So that’s a major disadvantage of working in the ER.

2. Holidays

On a related note, the ER is also open on holidays. 

Whether that’s Christmas, Thanksgiving, or some other holiday you’re interested in… you’ll have to take a turn working those holidays. 

Usually it’s on some kind of rotation system, so you might work Christmas one year, Thanksgiving the next year, and so on.

3. Busy / Stressful Days

You never know how many patients are going to come into the ER. 

It can be just a few…or a ton. 

So when it gets really busy, you have a lot of demands, and you have to keep working to keep up with everything. 

When that happens…it’s hard not to feel stressed out. But with some practice, you can kind of be in the eye of the hurricane, and just keep plugging along and taking care of the most important tasks first. 

Emergency medicine PA feeling stressed

But inevitably, when you’re first starting out…sometimes you’re going to feel stressed out when things get busy–or when there are complicated, challenging cases to deal with.

4. Lack of Continuity

As I explained above, you’ll work with a lot of different physicians and other staff during ER shifts, depending on the day. 

This is both an advantage and a disadvantage. 

In other words, it can be nice to see lots of different people, say hi, collaborate… 

pros and cons of emergency room PA infographic

But it also means there will be some physicians you maybe don’t get along with as well, but you still have to work with them when the time comes. 

Whatever physician I work with on an ER shift can make a huge difference in how smoothly things go, and how stressful / not stressful the day is. On those days when you have a more challenging collaboration, it can be a bear. 

But you learn to deal with it. Just like everything else.

Final Thoughts: Advantages and Disadvantages of Emergency Medicine for PA’s

Hopefully this helped you understand some of the pros and cons of working in the ER as a physician assistant. 

I didn’t cover every possible angle, but I did cover most of the big advantages and disadvantages that we deal with as PA’s in emergency medicine. 

Overall, I think the emergency room is a great place to work as a PA. But it’s not all unicorns and rainbows. There is a lot of crap you have to deal with as well. 

If you’re thinking about working in the ER as a PA, pay close attention to what it’s like during your ER rotation. Talk to people, come pick their brain, and get a firsthand look at what it’s really like. 

You may also want to do some shadowing before or after you go to PA school, to get an even deeper look at what things are really like.