My previous post on this topic described long-term cultural and organizational challenges facing emergency medicine (EM) that pose greater threats to the specialty than temporal challenges (e.g., overproduction of emergency physicians (EPs)). Some challenges are not remediable; they are inherent to the specialty:

1. short-term patient relationships
2. unpredictable workload/intensity
3. frequent, rapid fluctuations of stressful and less-stressful periods

However, many detrimental aspects of EM can be substantially …

Read more…

There has been much hand-wringing about the 555 (18.4 percent) unfilled match spots in this year’s emergency medicine (EM) residency match. Several long-standing, excellent programs with outstanding patient pathology and well-known faculty in major metropolitan areas did not fill.

Most hand-wringing has focused not on inherent attributes of the specialty, but temporal issues likely to fluctuate over time, including:

1. An overproduction of 8,000 emergency physicians (EPs)

Read more…

While we appreciate the importance of trust, not all patients have the same windows of opportunity to establish it with their physicians. The nature of each specialty and the severity of the patient’s condition influence how quickly and deeply trust can be created and maintained. The STEMI patient will quickly learn to trust the interventional cardiologist, and the trauma victim, and the surgeon.

Not surprisingly, it’s very challenging for physicians …

Read more…

I was surprised when I began receiving gift cards to a national chain of coffee shops in recognition of positive patient satisfaction comments from my emergency department patients.

Reviewing them in my provider report card genuinely felt good, especially when someone remembered my name in a follow-up phone call while saying something positive. Still, the token incentive met with disapproval for several reasons.

In particular, the most meaningful comments expressed gratitude for …

Read more…