Pearls of wisdom from ED leaders
Pearls of wisdom from ED leaders
Emergency medicine has its own unique challenges involving leadership, people skills, time management, and setting boundaries in a job that has none. Each month, ED Management will ask an ED leader to share some words of wisdom with our readers. In this issue, Robert Shesser, MD, MPH, professor and interim chairman in the department of emergency medicine at George Washington University in Washington, DC, discusses his image of the future of the specialty of emergency medicine.
"Emergency medicine has gone through a period during the development of the specialty when we had to look within for development. We had to prove that we were a legitimate specialty to the rest of the world; we had to be a bit hyperbolic and try to define our turf and actively exclude other specialists and generalists from things which were in our area.
This type of behavior has become maladaptive; the future of emergency medicine is brightest to those systems which can effectively integrate themselves into integrated delivery systems. This means looking for ways we can work with and be of service to other specialties. The hospital-based physician is in the weakest position in the new era of managed care; we need to prove our worth every day, not only to the hospital’s medical staff and adminstrators, which we have always had to do but directly to the third-party payers.
Marketing should be done in conjunction with the hospital to managed care plans. Outcomes and resource utilization need to be tracked and objective success parameters defined and monitored. Emergency medicine must prove itself to be cost-effective and must be integrated into the primary care delivery system for afterhours care and backup during the day. In addition to this, it must remain a community resource for the true life- and limb-threatening emergencies experienced by the population."
[Editor’s Note: ED Management is expanding this column to include all aspects of managing and operating an emergency department. If you have any helpful tips, want to share past mistakes or lessons, or can share an experience with other ED managers, please let us know. You may send your suggestions or columns to ED Management newsletter, Attn: Catherine Harris, P.O. Box 740056, Atlanta, GA 30374. Or, fax toll-free, (800) 850-1232.]
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