Spring has sprung, summer is almost here, moods and pool covers have been lifted. Residency is flying by, and like seasons, the more I know and the more experiences I have, the more my goals and priorities as an emergency physician seem to change. Intern year was spent navigating the system and soaking up as much knowledge as possible, second year’s focus was improving efficiency and work flow, and this upcoming year will undoubtedly present an entirely new set of challenges with increased responsibility and higher stakes.
I recently spent a day in my own emergency department with a close friend who was in town visiting for the weekend. She had had a “seizure” on the plane, and while she was completely back to her baseline after what sounded more like a syncopal episode, she was terrified. We discussed the pros and cons of going to the emergency room, and she ultimately opted for peace of mind. The view of my own emergency department through her eyes that day was astonishing.
As she was taken back to her room, a man in the hallway was marching back and forth while repeatedly counting to four, the woman next door was actively vomiting, a man in severe respiratory distress rolled by on biPAP. “Welcome to my workplace,” I thought. While I was able to sit in the room with her and talk her through an entire workup, I realized nobody else around us had that luxury. And while I knew the residents outside were running at top speed, the clock inside the room ticked slowly. The registration person came in, her nurse placed an IV, a man arrived to empty the sharps container, a tech performed an ECG. She was seen by a medical student, a resident, and an attending physician, and despite being the most dedicated Grey’s Anatomy fan I know, she was still overwhelmed by the entire process. Meanwhile, I found myself asking the same question dozens of patients had asked me in the past – which I could never answer: “Is parking validated?”
While she went on to have a completely normal workup, and while the team taking care of her that day was phenomenal, it really made me think about the importance of patient experience. I did not want to be the physician who sacrificed good communication for the sake of “productivity.” After a year of working on efficiency, other aspects of patient care suffered. I realized that for some patients, being in the emergency department is absolutely terrifying. And while the environment is incredibly familiar to me, it seems like an entirely different planet to others. Furthermore, I realized that managing time expectations, setting goals for the visit, and providing the opportunity for questions are absolutely priceless when it comes to patient experience and satisfaction.
As the years go by and as we all advance through our training programs, we must constantly re-evaluate our priorities as residents and as emergency medicine providers. Each year of our 3- or 4-year programs will be transformative in ways we could have never imagined.
In the same way, it is my goal that EM Resident magazine will continue to address your needs as you advance through training, as EM pushes boundaries within the house of medicine, and as our health care infrastructure becomes increasingly complex. Within this issue, I am proud to showcase a few ways in which our residents and specialty continue to grow and change: an introduction to EMRA’s first-ever MedWAR (p.14), an announcement regarding ABEM’s launch of a combined EM/Anesthesia residency program (p.36), and a new way for medical students to interact virtually with PDs and leaders in real time.
It is my hope that the magazine will continue to be a great resource for both the intern starting his/her first month in the emergency department, and the senior resident about to graduate. Have a great summer, and happy reading!