• emergency care systems
• psychological
• resilience
• burnout

The last decade has highlighted a need to recognise the impact of working in emergency medicine (EM) on the physician. Rather than this being a narcissistic view, it recognises that occupational well-being has a direct correlation with the quality of patient care, patient safety, occupational longevity, absenteeism and recognises for the first time that physicians, like their patients, are also humans who are worthy of care and attention. An examination of the literature reveals conflicting opinions. The EM consultant is considered at risk for burnout, depression, anxiety, compassion fatigue and leaving the profession.1 2 Alternatively, the EM consultant despite many challenges, continues to achieve, to feel compassion satisfaction, enjoys the dynamic environment of EM and is committed to finding sustainability within the profession.3 4 What is abundantly clear in the literature that focusses on EM consultant well-being is the negative and cumulative impact of administrative pressures, poorly resourced environments, compounded by punitive penalty systems based on time-based targets, which are frequently impossible to achieve. Such policies and organisational factors are consistently reported as the greatest risk factors to the well-being of doctors in EM. Organisations and the published literature have continued to focus on mental health and well-being as an individual problem for EM physicians rather than critiquing the political and organisational constraints that are creating significant challenges. It is time to transparently name these ecological factors that contribute to risks in order to build real interventions and expectations of well-being for EM doctors for the future.

The threat to well-being in an occupation has increased due to the pathogenic society that we now …