Letter: Reflections on 40 Years in Emergency Medicine
Dear Emergency Physicians International,
Have been reading your publications for years. I have identified with so many of the articles and opinions about the changes in Emergency Medicine over the years.
Having practiced in community emergency departments for almost 40 years in Ohio I have felt the pleasure of being a partner in small physician-owned practices as well as the frustration of working for large groups. I have lived through pain becoming a vital sign, and patients becoming customers. I have been told to practice “paranoid medicine”to prevent malpractice suits. I have lost my job with 24 hours notice because of what I do when not working in the ED (correctional health care ). I was offered a position with a large EM group one year and turned down when applying for the same job a year later.
I found myself out of work for four months and now am working locums positions in Iowa. Four months without working convinced me that I was not ready to retire yet. I still love what I do, feel that I still can do a good job. At this point in my career I still enjoy teaching .
My career has been based on something I was told while shadowing in the ED as a medical student- it’s the obligation of those that know more to teach those that know less.
I have always been on the low end of the bell curve when ordering tests as I was taught to only order tests that change either my treatment or disposition of the patient. And the best advice I give my students is that it’s more important to know what you don’t know than what you do know.
I think one of the most important things I do after every shift is to thank the ED staff for their help. Working in the ED is a team effort and everyone’s job is important and should be valued. I thank the nurses when they have suggestions or have a question about my patient care, and often their findings will prevent problems later on.
Thanks for sharing your stories.
Arnie Feltoon, MD
