Topics For Interviews

These are the topics to review before residency interviews – high-yield information to discuss with your interviewers.

Institute of Medicine (IOM) Report

Institute of Medicine. The Future of Emergency Care in the United States Health System. Annals of Emergency Medicine. 48(2):115-120, 2006 August
A seminal Institute of Medicine report in 2006 calling attention to problems in the emergency care system. This article outlines the major barriers to effective emergency care in the US from the IOM report, including fragmentation of services, lack of specialists, & lack of disaster preparedness. It provides recommendations from the IOM to improve the system.

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Chisholm CD. Institute of medicine report “The Future of Emergency Care”: “Too much, too little, too late?” What is the Society for Academic Emergency Medicine’s answer to the message? Academic Emergency Medicine. 14(3):259-260, 2007 March
This spirited and potentially incendiary perspective faults EM associations for not responding vigorously enough to the IOM report and suggests that organizations will not be prepared for the deluge of ED patients on the horizon, especially with our aging population.

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Legal, Policy Making

Napoli AM, Jagoda A. Clinical policies: Their history, future, medical-legal implications, and growing importance to physicians. Journal of Emergency Medicine. 33(4):425-432. 2007 November
This article examines the evidence base, uptake, and legal role of clinical policies and practice guidelines.

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White FA, French D, et al. Care without coverage: is there a relationship between insurance and ED care? Journal of Emergency Medicine. 32(2):159-165, 2007 February
This study found that fewer uninsured ED patients were admitted to the hospital, though when standardizing a subset for acuity, admission rates were similar.

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Finances

Baumann MR, Vadeboncoeur TF, et al. Financing of emergency medicine graduate medical education programs in an era of declining medicare reimbursement and support. Academic Emergency Medicine. 11(7):756-759, 2004 July
This article covers technical information on hospital funding formulas from legislative changes to Medicare.

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Weeks WB, Wallace AE. Differences in the annual incomes of emergency physicians related to gender. Academic Emergency Medicine. 14(5):434-440, May 2007
This study found that female EPs made $48,000 less per year than male EPs, which was only partly explained by lower patient volume, less board certification, and fewer years in practice.

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Pines JM. The economic role of the emergency department in the health care continuum: Applying Michael Porter’s five forces model to emergency medicine. Journal of Emergency Medicine. 30(4):447-453, 2006 May
This article examines emergency care from the perspectives of supplier& buyer power, threat of substitution, barriers to entry, and internal rivalry, proposed by business expert Michael Porter.

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Emergency Physician Demographics

Moorhead JC, Asplin BR. Distribution of emergency medicine residency graduates. Annals of Emergency Medicine. 32(4):509-510, 1998 October
This article observes that the majority of board-certified EPs practice in urban settings, and provides suggestions to make rural settings more personally and economically appealing to graduating residents.

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Wear D. The House of God: Another Look. Academic Medicine. 77(6):496-501, 2002 June
This re-analysis of Samuel Shem’s classic novel suggests that the real value of House of God is in forcing us to re-evaluate the purpose of hospital hierarchy and our response to the incredible breadth of disease that we see every day.

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Li SF, Haber M. Patient attitudes toward emergency physician attire. Journal of Emergency Medicine. 29(1):1-3, 2005 July
This study found that there was no difference in patient satisfaction between ED physicians wearing formal attire and white coats, and those wearing scrubs.

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Boarding

Moskop JC, Sklar DP, et al. Emergency Department Crowding, Part 1—Concept, Causes, and Moral Consequences. Annals of Emergency Medicine. 53(5):605-11, 2009 MayPart 2
An updated review of ED crowding that defines, explains how it is measured, identifies the most important causes, and discusses its consequences.

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Olshaker JS, Rathlev NK. Emergency department overcrowding and ambulance diversion: The impact and potential solutions of extended boarding of admitted patients in the emergency department. Journal of Emergency Medicine. 30(3):351-356, 2006 April
This is an excellent review of ED overcrowding—one of the biggest political topics in EM. The authors conclude biggest driver of ED overcrowding is inability to transfer patients to inpatient beds in a timely manner.

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Asplin BR. Hospital-based emergency care: a future without boarding? Annals of Emergency Medicine. 48(2):121-125, 2006 August
This editorial published in response to the 2006 IOM report includes recommendations on financing, research, and regional organization of emergency care, and most notably calls on hospitals to develop improved systems to admit patients more quickly out of the ED and continue care on the inpatient ward.

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