So I made my decision. After talking to some more established emerg docs who have done shifts in the smallish emerg that is courting me to take shifts there, I have decided that I am in NO WAY ready to do emergency medicine. I appreciate all of the points made by commenters regarding rural medicine-- I agree, sometimes you just have to take a deep breath and jump in. But in my case, I don't think I've done enough emerg through my family medicine residency to make that jump.
But that doesn't change the fact that there is debt to be repaid. And after buying a house, the bank balances are looking awfully sparse. And we're faced with some lean times with an impending maternity leave looming. Gah.
So where does that leave me? Well, I could just keep plugging away at residency, Mr. Couz can pick up extra paramedic shifts, and we can hope for the best (financially speaking). But the bills are piling up. And since the Canadian government is holding nearly $7000 of my hard-earned cash hostage while they process all of the reassessments they've slapped me with over the last few years (I mean really... contesting my medical school tuition claims? The government is the whole REASON I paid $15K in tuition a year, and now they think I'm lying about it? The injustice infuriates me) I don't really have much of a choice. I have to moonlight.
Luckily, this month I'm doing nothing but emergency medicine, which makes for a reasonable (although erratic) schedule. So I examine my options. My new town is ripe with walk-in clinics catering to the 30K-odd "orphaned" patients in our region. Perfect. McMedicine at it's finest-- I can practice what I know (family medicine), not have to drive far to do it, and make some extra money. Problem is, I've only had an independent practice license for a couple of weeks, and I haven't even figured out how to go about getting a billing number. And the idea of figuring out billing right now is a little overwhelming.
But then the same little hospital that had been courting me to work in emerg presented another option-- they are currently desperate for hospitalist coverage. I can come in for as long as I want, as many days a week as I want and they'll pay me $130/hr to see as many inpatients as I can. They don't seem to care if I see everyone or only a few people, they just want to take the pressure off the 'on call' physicians. So I wouldn't be responsible for call at all. The on-call doc would follow-up on any tests I order, and since they send anything more unstable or critical than urosepsis or pneumonia to the centre where I am doing my ER training, the patients are usually straightforward. Hmm. Intriguing option.
So I took it. Forget the fact that I hate inpatient medicine, forget the fact that rounding on inpatients was by far the most boring and tedious part of my family medicine rotations, forget the fact that I have to drive 45 minutes each way to this outlying hospital... starting tomorrow, I am Dr. Couz... hospitalist. This has the potential to be exactly what I'm looking for, or a complete disaster. Only time will tell.