I shadowed an ER doc last week and it was a kind of bizarre experience. All throughout my undergrad/grad school so far, I’ve had primary care principles ingrained into me. Going to work on the Mobile clinic was pretty similar. Now I’m in this environment of screaming, bleeding people who get the shotgun approach and probably aren’t see again by these physicians.
It makes sense. I’m not saying that emergency care is the devil that’s draining money from the healthcare system. Aside from never letting it happen in the first place (impossible), how else are you supposed to respond to a true emergency? Of course you’d take several blood samples and stabilize them quick as you can, then make a long list of possible culprits.
I thought I’d be squeamish around blood, but it really doesn’t bother me. (check). But I felt a bit dumb next to these guys, it’s very on-demand, “what do you think’s wrong with this guy?” and I go “uhhh…. ketoacidosis…. or alcohol poisoning…. or….(insert 5 minute pause here)”. So that’s really impressive, the ability to think really quickly on your feet.
I had to do a bit of translation for a very very drunk man, where I learned, you have to be forceful sometimes. Just let go of any inhibitions and social conduct rules in your head. You have a mission to get information, and you can’t just use the same line of questioning over and over again. Don’t worry, it’s not as brutal as it sounds.
I find it weird that an ER doc doesn’t follow up with their patients. Once again, makes complete sense, that’s not their function. Is it that I’m particularly nosy that I want to know what’s going on with people after they pass through my hands? The whole culture is different. I felt that with Primary Care, you’re building a growing relationship with the patient. Here, there was no real relationship, just quick in and hopefully out. I don’t know how connected you could become with a patient, I would guess not at all. Does that add to burnout? In its simplest form, it becomes a job by the hours. Sure, you’re saving people’s lives but what if it feels meaningless because they pass out of your hands so quickly?