I've been a community MD for a few months and I recently came across Dr. Rob Orman's ERCast. This is a great podcast that's supremely relevant for community ED docs. One of his recent podcasts had a discussion on academics vs. community medicine (including Drs. Scott Weingart and Rob Rogers). Dr. Orman ends the podcast with these powerful axioms:
1. When first starting out (6-12 months) think of it as doing an EM fellowship in community medicine.
2. Give service to the group. Devote a chunk of time to group practice by adding value, i.e. develop U/S, clinical pathways for PE, A.fib.
3. Remember, proximity to a CT scanner (or MRI) is not a reason to order the test.
4. You can only see ONE patient at a time. The patient in front of you is the only patient you have. If you focus on the waiting room, the last patient, you might end up spinning your wheels.
5. Be nice to the nurses. They can help and teach you or really HURT you.
6. Take an advanced airway course early on. This will reap huge dividends throughout your career.
7. You are always a student FIRST. Keep on learning and staying current, in addition to LLSA/CME. Be the best emergency physician you can be.
8. Be gracious with your consultants and be congenial. These are people you will be working with for a LONG time. “Seek first to understand, then be understood.” ~ Stephen Covey
9. Go to the monthly meeting. Although you may think they are optional, they are not.
10. The silent chief complaint is anxiety. In addition to the chief complaint, alleviate the anxiety of their symptoms.
11. Always advocate for the patient. When in a bind, ask yourself, “Self, what's best for my patient?”
2. Give service to the group. Devote a chunk of time to group practice by adding value, i.e. develop U/S, clinical pathways for PE, A.fib.
3. Remember, proximity to a CT scanner (or MRI) is not a reason to order the test.
4. You can only see ONE patient at a time. The patient in front of you is the only patient you have. If you focus on the waiting room, the last patient, you might end up spinning your wheels.
5. Be nice to the nurses. They can help and teach you or really HURT you.
6. Take an advanced airway course early on. This will reap huge dividends throughout your career.
7. You are always a student FIRST. Keep on learning and staying current, in addition to LLSA/CME. Be the best emergency physician you can be.
8. Be gracious with your consultants and be congenial. These are people you will be working with for a LONG time. “Seek first to understand, then be understood.” ~ Stephen Covey
9. Go to the monthly meeting. Although you may think they are optional, they are not.
10. The silent chief complaint is anxiety. In addition to the chief complaint, alleviate the anxiety of their symptoms.
11. Always advocate for the patient. When in a bind, ask yourself, “Self, what's best for my patient?”
Listen to ERcast by subscribing on iTunes!
5 comments:
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Wow, great article, I really appreciate your thought process and having it explained properly, thank you!
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I heard a lot of good information about Dr. Orman, I am so glad that I found your blog that contains the lists of his statement, I think I really got the way to to be in his page and that is with you.
-Noah Berkowitz-
Hello there! I'm so glad to stop by your page and to have additional knowledge about emergency care. Thank you for posting this information about emergency care. You have such an very interesting and informative page. I am looking forward to visit your page again and for your other posts as well. Keep it up!
Based on what I have read in an article through web, in 2006, the Urgent Care Association of America sponsored the first fellowship training program in urgent care medicine. This fellowship resulted from collaboration between the Department of Family Medicine University Hospitals of Cleveland / Case School of Medicine, the Urgent Care Association of America (UCAOA), and University Primary and Specialty Care Practices, Inc. in Cleveland, Ohio. The program is partially funded by an unrestricted grant from the Urgent Care Association of America to support the fellowship program. Physicians in the urgent care fellowship program receive training in the many disciplines that an urgent care physician needs to master. These disciplines include adult emergencies, pediatric emergencies, wound and injury evaluation and treatment, occupational medicine, urgent care procedures, and business aspects of the urgent care center. In 2007, the Urgent Care Association of America (UCAOA) sponsored a second fellowship opportunity through the University of Illinois. The one-year fellowships are open to graduates of accredited Family Medicine and Med/Peds residencies.
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Hi there! Keep it up! This is a good read. You have such an interesting and informative page. I will be looking forward to visit your page again and for your other posts as well. Thank you for sharing your thoughts about Emergency Care. I am glad to stop by your site and know more about Emergncy Care.
Emergency medicine (EM) as a medical specialty is relatively young. Prior to the 1960s and 70s, hospital emergency departments were generally staffed by physicians on staff at the hospital on a rotating basis, among them general surgeons, internists, psychiatrists, and dermatologists. Physicians in training (interns and residents), foreign medical graduates and sometimes nurses also staffed the Emergency Department (ED). EM was born as a specialty in order to fill the time commitment required by physicians on staff to work in the increasingly chaotic emergency departments (EDs) of the time. During this period, groups of physicians began to emerge who had left their respective practices in order to devote their work completely to the ED. The first of such groups was headed by Dr. James DeWitt Mills who, along with four associate physicians; Dr. Chalmers A. Loughridge, Dr. William Weaver, Dr. John McDade, and Dr. Steven Bednar at Alexandria Hospital, VA established 24/7 year round emergency care which became known as the "Alexandria Plan". It was not until the establishment of American College of Emergency Physicians (ACEP), the recognition of emergency medicine training programs by the AMA and the AOA, and in 1979 a historical vote by the American Board of Medical Specialties that EM became a recognized medical specialty. The first emergency medicine residency program in the world was begun in 1970 at the University of Cincinnati and the first Department of Emergency Medicine at a U.S. medical school was founded in 1971 at the University of Southern California.
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