Have Pride In What You Do

by Steve Elsbecker, DO
Chief, Emergency Medicine Resident

I want to challenge a saying that we hear far too often from our colleagues in other specialties (and sadly some of our own agree with this).

 "ER doctors are the jack of all trades and the masters of none."

I couldn't disagree more. Emergency physicians are highly specialized with unique training.  You would agree that a cardiologist is an expert at cardiac catheterization and revascularization. You would also agree that a surgeon is skilled at laparoscopy and cholecystectomy. In a similar regard, your emergency medicine training has made you an expert with a very specific skillset.

I argue that well trained Emergency Medicine Physicians are the masters of 4 areas:

1.     Resuscitation:  This is our bread and butter. We perform more initial resuscitations than any other specialty. We publish incredible amounts of research in this field.  We own resuscitation medicine and it's time to recognize it.

2.     Emergent Airway Management: Not airway management, emergent airway management. Anesthesia certainly lays claim to this area as well, however when it comes to the obese patient with micrognathia whose O2 sat is 75%, we're up to bat.

3.     Toxicology: No other specialty knows toxicology like EM. We identify toxicologic emergencies, begin therapy in the ED, and initiate long term care. We own all fellowships in this field and publish nearly 100% of the relevant research.

4.     Coordination of Care: Although this is the least "sexy" of the 4, it is one of the most important things that we do. In an ever-changing medical environment, we are becoming a primary source of medical care. With that added responsibility, we've become masters at coordinating care and emergently getting patients specialty care.

To borrow from one of my colleagues Dr Adam Berkovits, we need to view ourselves as much more than a “jack of all trades.” We are a unique specialty with specific skills. We are specialists in the aforementioned areas. Our patient’s come to us seeking an Emergentologist consultation. We get paged to the floor for a Resuscitationist consult. What we do is magic and we are Emergicians. Take pride in these skills and please don't forget how lucky we are to do what we do.