Last night I was contacted by a physician in the local urgent-care.  I like him, and we made polite, but brief, conversation. ‘So, are you guys busy?’
I gave him the status report. ‘Well, yeah. We have about 25 people waiting to be seen the waiting room is full and every patient room is full. Also, we just received a gun-shot wound to the head by EMS.’
‘Wow, sounds terrible! So, here’s what I need to send you…’
What he sent was, in fact, reasonable. A young woman with signs and symptoms of meningitis (who was treated earlier in the day for and upper respiratory virus…with Amoxicillin, of course.)
She needed a lumbar puncture, which I performed and which was negative.
But I had this thought. I could probably have said, ‘an airplane crashed through the roof and half the staff are dead,’ and he might well have still said, ‘bummer, here’s what I need to send over.’
Emergency medicine has risen to such a level of importance, has become so indispensible, that no one pauses to use ED’s no matter how overwhelmed they may be. Another patient went to the local orthopedic office, and was told to come to the ER since he couldn’t afford to pay for his surgical follow-up and pain prescription refill. So in the midst of our chaos, we were treating surgical follow-up…for free.
I’m glad we’re useful, and that our specialty is capable of great things. I’m happy that my department rises to any challenge and that my partners and I can sort through almost any crisis. I consider it a blessing that I can help those who need care but can’t afford it. (And by the way, I do not work for the hospital, but am paid for what I see.)
I worry, though, that due to EMTALA and nationwide financial pressures, due to the ability of others to shield themselves from EMTALA and engage in ‘moral diversion,’ our ED’s will continue to be crushed.
It doesn’t really matter how busy we are, how overwhelmed we are, how understaffed or underfunded, someone else will always be able to send patients our direction.
And as it stands, we’ll always have to deal with it. But something has to change, because the safety net is ripping, slowly but surely.
Mr. Leap I have a question to ask. I don’t know if you remember me but I follow you on twitter. I’m a Christian and a medical student graduate (about 1 year and a half ago) and a wife and hopefully Lord willing a mother sometime in the future. But I honestly love emergency medicine over all other specialties. So my question is what would you recommend me, should I go for something less demanding in a way like family medicine? Would I still be able to be a mother and somehow take care of the children that I have… Read more »
Rita, Thank you for asking a great question! I believe that much of the future of medicine, at least in America, will revolve around emergency departments. For better or worse, we are a kind of ‘lynchpin’ that holds medicine together. The job market is bright…almost too bright! I believe you will have as much work as you need…and this is important…a chance to work less. The somewhat ‘shiftwork’ nature of the specialty makes it a fine specialty for a wife and mother. Work more, work less; most groups are happy to have someone to fill in at times, even if… Read more »
Hello Dr. Leap, My name is Apple Lopez and I work for Freelance MD. We are always on the hunt for doctors who have passion about a particular subject to write on our site. I have read your posts and I believe our members would find your thoughts of interest:-) We are hoping that you would like to write a guest post on our site. Freelance MD is the leading site for physicians interested in improving their income and lifestyle and has tens of thousands of physician visitors each month. Here’s a link that explains everything about guest posting including… Read more »
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Hello! I know this is kinda off topic but I’d figured I’d ask.
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My blog addresses a lot of the same topics as yours and I believe
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interested feel free to shoot me an email. I look forward to hearing from you!
Terrific blog by the way!
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Please let me know if you’re looking for a article author for your site. You have some really great posts and I think I would be a good asset. If you ever want to take some of the load off, I’d
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Mr. Leap I have a question to ask. I don’t know if you remember me but I follow you on twitter. I’m a Christian and a medical student graduate (about 1 year and a half ago) and a wife and hopefully Lord willing a mother sometime in the future. But I honestly love emergency medicine over all other specialties. So my question is what would you recommend me, should I go for something less demanding in a way like family medicine? Would I still be able to be a mother and somehow take care of the children that I have… Read more »
Rita, Thank you for asking a great question! I believe that much of the future of medicine, at least in America, will revolve around emergency departments. For better or worse, we are a kind of ‘lynchpin’ that holds medicine together. The job market is bright…almost too bright! I believe you will have as much work as you need…and this is important…a chance to work less. The somewhat ‘shiftwork’ nature of the specialty makes it a fine specialty for a wife and mother. Work more, work less; most groups are happy to have someone to fill in at times, even if… Read more »
Hello Dr. Leap, My name is Apple Lopez and I work for Freelance MD. We are always on the hunt for doctors who have passion about a particular subject to write on our site. I have read your posts and I believe our members would find your thoughts of interest:-) We are hoping that you would like to write a guest post on our site. Freelance MD is the leading site for physicians interested in improving their income and lifestyle and has tens of thousands of physician visitors each month. Here’s a link that explains everything about guest posting including… Read more »
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