Disrupting and Leading in Emergency Medicine - Research Paper Example

Disrupting and Leading in Emergency Medicine When sudden illness or acute injury strikes, patients turn to hospital emergency rooms for immediate medical assistance. An emergency medicine doctor, or an ER doctor, is a doctor who specializes on diagnosing and treating illness and injuries in a hospital emergency room or other urgent care setting. Apart from the fact that it comes with the reward of saving lives, emergency medicine is a mouthwatering career that is financially rewarding. The first step in earning a career in emergency medicine involves earning an M.D. or D.O. degree from an accredited traditional or osteopathic medical school. This is followed by a 36-month residency program in emergency medicine before attaining accreditation by the American Board of Emergency Medicine. However, this accreditation occurs only after the candidate has passed the board’s oral and written exams within five years of completing their residency training. The certificate is valid for 10, and physicians must complete continuing education requirements to renew it. From the description above, it is apparent that Emergency medicine is an engaging and demanding career right from the education to the actual practice. A lot of personal sacrifice both in terms of time and resources are therefore inevitable. Like they say “all work no play makes Jack a dull boy”, a career in emergency medicine definitely needs some time out of work for refreshment of mind and career. Practicing emergency medicine is like a “calling” because anytime you are called upon to duty there is somebody’s life at stake. In fact, some doctors have abandoned their personal lives so as to dedicate their fulltime to emergency medicine. In this regard, this paper tries to understand some of the challenges that are experienced by professionals in the field of Emergency medicine. This is why I will be engaging Dr. Billy Goldberg in all round interview in trying to understand this concept. What does Dr. Billy Goldberg says about his 20 year experience as an emergency medical practitioner? Dr. Billy Goldberg (born 1966) is a New York City emergency medicine physician at the Bellevue Hospital and New York University (NYU) Medical Center, where he is also an Assistant Professor and an Assistant Director in the Department of Emergency Medicine. Dr. Billy Goldberg graduated from the Albert Einstein College of Medicine in 1992 after completing his undergraduate studies in Spanish Literature at the University of Michigan in Ann Arbor. In addition to this, Dr. Billy Goldberg completed his residency in emergency medicine at the University of California, LA in the year 1996 before returning to New York. Dr. Billy Goldberg is an all-round doctor whereby his works include public topics on trauma, pulmonary embolism, spine injury, and resident education. Apart from his full time work in emergency medicine, he has also published two bestselling books namely: Why Do Men Have Nipples? Hundreds of Questions You'd Only Ask a Doctor after Your Third Martini (2005), Why Do Men Fall Asleep after Sex? More Questions You'd Only Ask a Doctor after Your Third Whiskey Sour (2006) and Let’s Play Doctor (2009). Dr. Billy Goldberg gives a detailed account of what it takes to be a well appreciated Emergency Doctor. Well, the primary goal of any doctor is to save life. Every doctor will try his/her best to save life in case there is a patient that requires medical attention. However, as revealed by Dr. Billy Goldberg during the interview, emergency medicine involves more than saving life. This is because emergency physicians must be to react quickly and make crisp decisions in an atmosphere of crisis. Dr. Billy Goldberg gives his personal example of how sometimes he has to work in an extremely high-pressure environment, in which lives are on the line. He must be able to multitask and pay attention to detail, as he must provide the appropriate care for patients who may arrive in the emergency room with more than one life-threatening situation. In an interview, Goldberg explains the kind of environment they work on: "We spend every moment walking around in this incredibly well-constructed but hard-to-figure-out machine that is our bodies. Everything we do — when we think, when we hear, when we smell, when we eat — there are these processes that are happening that we don’t understand. You can’t escape from having these moments thinking." this statement tells it all that dedication and specifically vocation is what it takes to be an emergency doctor.  As a young boy, Dr. Billy Goldberg has dreamt of being in a theater helping to save life. His motivation comes from the desire to save life and make the world a better place. Therefore; the decision to pursue a career in the medication field and specifically, emergency medicine was never an “accident” but rather a passionate way of following his dream. Dr. Billy Goldberg has greater career goals. However, the most important one that he aims to accomplish is to establish a rehabilitation center for drug addicted youths. Well, whether he will achieve this goal depends on him but one thing is for sure; that Dr. Billy Goldberg was very serious and optimistic about this goal. This is in line with his career practices because-as he explains-there are quite significant cases of drug abuse patients that they often attend to in the emergency room. As explained by Dr. Billy Goldberg, his main mentor was his high school class teacher who encouraged him to go for whatever he wants in life because everything is achievable through hard work and dedication. He concludes by quoting, “the beginning of failure is the fear to fail.” Any time a patient arrives in an emergency room, the available doctor is faced with the situation whether to treat, discharge or admit the patient. This may comprise a full physical so that he can make proper decision whether emergency treatment should be given to the patient or hospital care instead of a referral to a regular physician. As explained by Dr. Billy Goldberg surgical procedures that alleviate medical crisis are necessary to stabilize the patients in case of severe acute trauma or illness. As the assistant director at the Bellevue Hospital and New York University (NYU) Medical Center emergency team, Dr. Billy Goldberg communicates clearly with other members of the emergency room staff together with paramedics who provide information before a patient arrives through ambulance. This mostly applicable when he admits a patient, Dr. Billy Goldberg has to provide information to other medical specialists and to hospital staff members. Dr. Billy Goldberg has developed to a renowned emergency doctor. As is this not enough, he has engaged himself in various activities that are aimed at passing his knowledge to other people who might not have that privilege to attend medical school and become an emergency doctor. In this regard, Dr. Billy Goldberg shares his unique approach to medical knowledge. His media appearances is a true reflection of this point whereby he has appeared in shows such as; Good Morning America, CNN’s Headline News, the Today Show, The Howard Stern Show and National Public Radio. For the past 5 years, Dr. Billy Goldberg has been heard on SiriusXM channel 81 hosting his own weekly radio on the Doctor channel. As stated by him, “in the emergency medicine field you have to learn how to identify emergency situations, analyze them and then act on your intuition. My hope is to avoid being jaded but to entertain a healthy skepticism”. Not one patient case has failed to intrigue Dr. Billy Goldberg so far. His is an interactive person hence he interacts with patients from all sorts of backgrounds and each with a unique treatment need too. Despite the fact that he acknowledges uncertainty of the outcome during emergency operation, Dr. Billy Goldberg genuinely values his time spent with each patient. This explains his passion that motivated him to pursue career in emergency medicine. Dr. Billy Goldberg explains to me that life should never be taken for granted; as he considers the reality of attending to emergency cases to have the greatest emotional impact upon him. While the 20 year experience helps him and the rest of the emergency crew to react appropriately under such circumstance, Dr. Billy Goldberg solemnly agrees that, “the fearful surge of adrenaline is never something to which anyone in the medical profession becomes accustomed.” For every emergency doctor, the most favorite part is to see a patient leave an emergency theater room in a stable condition but the most difficult part is watching patients struggle to remain alive. Obstacles have characterized the practice of emergency medicine. Dr. Billy Goldberg has encountered several limitations both between the patients (including family members) and colleagues. Notably, conflict of interest forms part of these limitations. I mean these conflicts are everywhere and Bellevue Hospital and New York University (NYU) Medical Center is no exception. However, Dr. Billy Goldberg was quickly to demonstrate that measures have been put into place to minimize these conflicts because the effects of these conflicts undoubtedly negative in most cases. The most common issue Dr. Billy Goldberg faces is when a family member does not understand something but fails to speak up about it later. Despite the fact that these situations are upsetting, Dr. Billy Goldberg has learned to remain professional and not to personalize the situation given the emotional and mental stress that characterizes the patients and their families. This professionalism forms the foundation on which to argue that it is important to savor all of life’s moments, even the most difficult ones, because you don’t expect them to be perpetual. Despite these challenges Dr. Billy Goldberg has remained steady forward and he asserts that, “When you love what you are doing the experience support who you think you are what you are capable of doing, and your values.” Emergency doctors pride themselves on being the one specialty that will not turn patients away. However, Dr. Billy Goldberg categorically states that several factors such as decrease in available impatient beds, increased emergency department use, and falling reimbursements, EDs around the USA are faced with problems of capacity restraints and crowding. Ambulance diversion, crowded waiting rooms and increases in the number of acutely-ill patients have led to concerns that the quality and safety of patients care are at risk. During the interview, Dr. Billy Goldberg also states that emergency doctors are also frustrated with their fellow doctors, who are less and less likely to take call in the emergency department. Dr. Billy Goldberg recalls how some frustrated one time a family member of patient sounded. The patient’s family member was quoted saying; “I have lost count of the number of hours I have spent over my career trying to find specialists to treat my patients, only to be turned down because they fear being sued, or do not like Medicare reimbursement rates. I sympathize, but only to a point, because my patient needs help and is not getting it. It is not unusual to transfer patients between hospitals in order to get them the specialty care they need. It hardly seems like good medicine to put someone on a helicopter to be flown hundreds of miles away, but that's how it is sometimes.” Another challenge that faces Dr. Billy Goldberg and his colleagues is the “futile care” provided to patients who are at advanced age of their lives. Dr. Billy Goldberg acknowledges that it is heartbreaking to see these people admitted to and discharged from the hospital repeatedly over a period of weeks and months. That is, Dr. Billy Goldberg and his colleagues are keeping these patients longer but not healthier. Dr. Billy Goldberg also admitted that being an emergency doctor is engaging and he rarely has time for himself. Things like vacations and weekend outs have become rare in his life. However, despite limited personal time, Dr. Billy Goldberg has managed to bring his family together especially with the most understanding wife he has-he states. I have great veneration for Dr. Billy Goldberg’s commitment to his career as he tells me that 15 years from now, he still foresees herself working as an emergency doctor. According to Dr. Billy Goldberg, emergency medicine is a devotion to the care of others and a commitment to life-long learning. One thing is for sure, Dr. Billy Goldberg was well aware that entering the emergency medicine field will require him to uphold certain principles and mentalities throughout his career. However, Dr. Billy Goldberg never imagined he would far exceed these expectations and come to cherish nursing as a lifestyle rather than just a job. His passion and curiosity to save lives relentlessly drive him to pursue continuing education opportunities, practice emergency medicine, become a renowned writer in the medical field and whole-heartedly dedicate himself as the assistant director at the Bellevue Hospital and New York University (NYU) Medical Center emergency. The field of emergency medicine and specifically becoming an emergency physician is not achievable without some sacrifice coupled with an inherent love and determination towards its central role of treating others. This concept is important especially considering the fact that there is small ratio of emergency doctors to patients across the country. Logically, apart from the fact that he wants to establish an emergency center for drug addicts, Dr. Billy Goldberg also hopes to continue to interact first-hand with students pursuing emergency medicine, through his public lectures and publications. Work cited bagnoli, Dominic. "Disrupting and Leading in Emergency Medicine." Athenahealth (2014): 23-25. DeMerceau, Demand Media. "ER Doctor Job Description." Globalpost: American's world new site 5 February 2014: 32-34. Dr. Billy Goldberg, New York, NY. 2013. < http://www.askdrbilly.com/contact.html > Gardner, Angela F. "Viewpoint: "America's Emergency Medical Care System Is In Critical Condition"." Association of American Colleges (2014): 10-15. Glatter, Robert. "The Evolving Role Of ER Doctors And Emergency Departments In Delivery Of Health Care." Pharmacy and health 17 6 2013: 1-3. Herweck, Diana. Er Doctor. Huntington Beach, CA: Teacher Created Materials, 2013. Print. Overton, David T. "Advice for Emergency Medicine Applicants ." Western Michigan University School of Medicine 18 March 2014: 15-17. Shockley, Lee W. "What to Look for in an Emergency Medicine Residency." Denver health Residency (2014): 76-78. Read More