Emergency Medicine – Whom Do We Serve?

I give a talk to new employees regarding service in emergency medicine. One of the questions I pose is whom do we serve when we practice emergency medicine? Seems like a simple question. We serve patients that come to the ER desiring care. At the most basic level that is indeed what we do. Like most things in life it is not that simple.

The service we provide in the emergency department is taking care of what ails you. Whether that be the bad pizza you had last night, the unfortunate encounter with the kitchen knife, the unexpected crossing of paths with a semi or the untimely closing of a coronary artery we in the ER are here to take care of you. We have to be expert clinicians and that is what many people will remember as they, hopefully, leave the ER feeling better, have their wounds closed, fractures splinted or blood thinners infused on their way to the cath lab.

The patients, parents and their families will also remember a few things about the process. They’ll remember the wait, the caring shown (or lack thereof), how quickly they get through the system, how well they were informed and whether the place was clean as well as numerous other points of service. So in fact we also serve the families and friends who decide to come along to witness the show we call the ER. It is a place of rare entertainment for many getting to witness the full spectrum of humanity in all its glory.

As an emergency medicine group we also serve the folks who provide the care; the dedicated doctors, physician’s assistants and nurse practitioners who deliver that excellent service every day. They need to have a work environment conducive to doing their best that operates efficiently to their, and their patients, benefit. It also means making sure they have the best compensation and benefits package so they will continue as dedicated employees. Something as simple and as important as scheduling scribes to make their life easier, it is our job is to make sure we have the tools to do our best each and every day.

Just as importantly we must remember that we are both partners and contractors to our hospitals. The hope is over time you are seen as less in the contract role and more as a strategic partner who helps the hospital achieve their goals by helping to solve challenges together. Sometimes getting to this point involves some honest conversations about improvements that need to be made to get to a place of exceptional service. Where many groups have faltered is forgetting that they need to continue proving themselves on a regular basis. The great thing about operating in health care is there is always a major challenge, and a few crises, to face for a great group to prove its worth.

There are others we serve of course. Just as critical to our success (not to mention our patients well being) are our nursing colleagues who have the toughest job in health care and continue to deliver each and every day. There are also the EMS crews who skillfully deliver our patients and routinely operate in chaos on the street to bring us a well ‘packaged’ patient. Lest we forget the referral physicians who have the confidence to send us their patients and receive them back after we evaluate and treat them in consultation.

So a simple question but not so simple answer. The best providers and groups are able to remain cognizant of all of these interested parties as we continue to pick up the next chart, walk into our patient’s room and ask ‘How can I help you today’?