This is one of my favorite articles so far. It originally appeared in The Facts and subsequently on the EmCare blog. Here are the top 10 things I learned in my first 10 years of practicing emergency medicine:
1. Don’t underestimate what you don’t know. As a physician, I spent four years in college, four years in medical school, and three years in residency training to learn the art and science of emergency medicine. Despite 11 years of training and 10 years of practice, I am reminded every day of how much I don’t know. Emergency medicine is an extremely broad field that interacts with dozens or hundreds of other disciplines, professionals, and experts. I learn something every day that I didn’t know the day before. I have developed a deep appreciation for not only the knowledge and experience that I have gained but also for the vast amount of information that I do not know – yet.
2. Keep things simple. In my first year of medical school, I learned of the concept of Occam’s Razor. Occam’s Razor asserts that among competing hypotheses, the one with the fewest assumptions is the most likely. With some notable exceptions, I have generally found this to be true. I have developed a passion for simplicity in both my clinical practice as well as ED and hospital operations.
3. Develop a connection with patients. An emergency room can be a very chaotic and time-pressured environment. We are looking for critical information delivered promptly and succinctly. We are often co-managing multiple patients and interacting with dozens of clinicians, patients, family members, and others. A brief attempt at making a personal connection with a patient can make an impersonal ER much more welcoming and warm. Various patient satisfaction and patient experience coaches have developed structured models to help doctors connect. Though a tool may be useful in some circumstances, I have found that a genuine effort to be nice, polite, and develop a personal connection goes a very long way.
4. Change is the only constant. Doctors, advanced practice providers, nurses, administrators, leaders, techs, and janitors come and go with shocking regularity. Clinical paradigms accepted as best practice five years ago may have faded into obscurity today. Department operations change based on changing sign-in patterns, patient acuity, nursing availability and dozens of other variables. As emergency physicians, we should be very comfortable in a highly dynamic environment. Some of the most dangerous words in the English language are “but we’ve always done it this way”. Don’t be afraid to embrace change.
5. What is routine for me is often extraordinary for patients and their families. When people visit a hospital-based physician like and ER doctor or hospitalist, their lives are often in unexpected turmoil. They may have experienced a traumatic event, a sudden illness, or may have just received devastating news. Though ER doctors, nurse practitioners, and physician assistants deal with emergencies as a matter of routine, they are far from ordinary for most patients. I try hard to remember that the patient’s perspective is usually far different than mine.
6. Don’t forget the patient’s family. A patient’s family is often their support system. They ask questions that don’t always immediately occur to the patient. They can help the patient feel comfortable in a situation that is often traumatic or confusing. I try to introduce myself to the family and make sure that they understand the ER plan of care, diagnosis, duration expectations, and how they can help the patient’s experience better.
7. Dress the part. You don’t go to the Kentucky Derby wearing workout clothes and you don’t go to the gym in a seersucker suit. Police officers, doctors, attorneys and other professionals have certain expectations regarding their appearance. Healthcare providers don’t necessarily have to wear a uniform or a tie to appear professional but a little effort towards a sharp appearance goes a very long way.
8. Don’t be afraid to be available. Many doctors seem to have a fear of being “too available”. I don’t share this concern. I think that it is better to talk with patients, colleagues, families, administrators, partners, and others who have questions or concerns or who just want to engage with you. I often give patients my cell phone number and I hope that everyone that I work with knows how to easily get in touch with me. I believe in the value of social media and you can find me on Facebook, Twitter, and LinkedIn. If patients contact me here, I engage with them (for recommendations and a more detailed discussion of how to safely use social media as a healthcare provider, please see EmCare’s article and infographic on the subject).
9. Connect with your coworkers. I strongly believe that one of the secrets of workplace happiness is to connect with your coworkers. Get to know the medical staff, administrators, nurses, techs, and security guards with whom you work. Having a personal connection will make you enjoy your workplace more and it makes effective communication regarding patients and department operations much easier.
10. Have fun. We have an awesome job. They make television shows and movies about the work that we do. Being an ER doctor, nurse practitioner, or physician assistant is interesting, rewarding, funny, sad, and satisfying. Take some time to enjoy the great cases, funny stories, and interesting characters that you come across. Congratulate yourself when you make a great save or pick up a difficult diagnosis. Learn from your mistakes. Enjoy yourself and your work and don’t be afraid to have a great time.
From Dr. Corley’s Facebook page 8/20/2015
https://www.facebook.com/AdamCorleyMD/posts/10207552820607828
Dr. Corley approved this reposting
Russ Ruszczyk