1 / 36

Introduction to Emergency Medicine

Introduction to Emergency Medicine . Slides Courtesy of American College of Emergency Physicians. Everything you want to know about Emergency Medicine-and dare to ask. John Cunha, DO Attending Physician Holy Cross Hospital Ft. Lauderdale, FL. Lecture Objectives.

stu
Télécharger la présentation

Introduction to Emergency Medicine

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Introduction to Emergency Medicine Slides Courtesy of American College of Emergency Physicians

  2. Everything you want to know about Emergency Medicine-and dare to ask John Cunha, DO Attending Physician Holy Cross Hospital Ft. Lauderdale, FL

  3. Lecture Objectives • Convey an understanding of the field of Emergency Medicine • Discuss pros and cons of specialty • Describe emergency medicine residency training • Monetary considerations

  4. History of Emergency Medicine • Emergency Departments • Staffed by physicians of various backgrounds • No specialty training • American College of Emergency Physicians • Established 1968 • ACOEP • Established in 1975

  5. Emergency Medicine Residency • First “resident” - 1969 • First residencies - 1970 • University of Cincinnati • Emergency Medicine Residents’ Association - 1974

  6. Emergency Medicine Residency • Emergency Medicine Residencies • 1983 - 66 programs • 1990 - 84 programs • 2007-36 AOA programs, 138 AMA programs • Multiple “combined programs”

  7. Specialty Selection Top Ten Leading Causes of Death in the U.S. • Heart Disease: 726,974 • Cancer: 539,577 • Stroke: 159,791 • Chronic Obstructive Pulmonary Disease: 109,029 • Accidents: 95,644 • Pneumonia/Influenza: 86,449 • Diabetes: 62,636 • Suicide: 30,535 • Nephritis, Nephrotic Syndrome, and Nephrosis 25,331 • Chronic Liver Disease and Cirrhosis: 25,175

  8. Exciting Patient Encounters • Motor vehicle versus pedestrian accident • Acute myocardial infarction • 24 yo with GSW to chest • 66 yo with CPR in progress

  9. What’s Your Diagnosis ?

  10. What’s Your Diagnosis ?

  11. Not So Exciting Patient Encounters • 5 yo with Asthma • 75 yo with Emphysema • 45 yo alcoholic vomiting blood • 3 week old with fever of 104 • 37 week pregnant female with vaginal bleeding

  12. Everyday Non-emergent Patient Encounters • 25 yo with a rash • Homeless patient with no other physician • Back pain for 3 months • Migraine headache • Ran out of medicines

  13. Employment Opportunities • Urban, rural, or suburban hospitals • Teaching or community hospitals • Trauma or not-trauma • Traveling (Locum tenens) physicians • International opportunities • Third world opportunities • Cruise ship

  14. Appeal of Emergency Medicine • Make an immediate difference • Life threatening injuries and illnesses • Undifferentiated patient population • Challenge of “anything” coming in • Emergency / invasive procedures • Safety net of healthcare

  15. Appeal of Emergency Medicine • Team approach • Patient advocacy • Open job market • Academic opportunities • Shift work / set hours • Evolving specialty

  16. Downside to Emergency Medicine • Interaction with difficult, intoxicated, or violent patients • Finding follow-up or care for uninsured • Work in a “fishbowl” without 20/20 hindsight • Working as a patient advocate • Contract management groups • Malpractice targets

  17. The Lifestyle:Two Sides of A Coin • Well defined shifts • Usually not on call • Part time employment possible • Evenings and nights • Weekends • Holidays

  18. Subspecialties in Emergency Medicine • Pediatric Emergency Medicine • Toxicology • Emergency Medical Services • Sports Medicine

  19. Areas of Expertise • Toxicology • Emergency medical services • Mass gatherings • Disaster management • Wilderness medicine

  20. Upcoming Areas of Emergency Medicine • Observation units • ED ultrasound • International emergency medicine

  21. Research Opportunities • Broad range of subjects • Limited amount of work published in our relatively new field • Limited number of research mentors • Limited number of clinical trials

  22. Number of EM Physicians • 4,945 Emergency Departments • Need 32,000 - 37,000 ED physicians to staff • In 2000, 20,164 ACEP members • In 2000, 16,149 EM Board certified physicians

  23. Emergency Medicine Organizations • American College of Emergency Physicians • American College of Osteopathic Emergency Medicine • Society for Academic Emergency Medicine • American Academy of Emergency Medicine • Emergency Medicine Residents’ Association

  24. Where to find more information • www.acoep.org • www.acep.org • www.emra.org

  25. Emergency Medicine Journals • Annals of Emergency Medicine • Academic Emergency Medicine • Journal of Emergency Medicine • American Journal of Emergency Medicine • Pediatric Emergency Care • Several other Monthly Journals

  26. EM Interest Groups • Student run organization • “Shadow Shifts” • Journal club • Suture clinic • Radiology lab • EKG clinic • Lectures on EM topics

  27. What to do to get in to Emergency Medicine for First and Second Year Students • Observe in ED • Summer research projects with EM staff • EM interest group affiliation • Be open to any medical specialty

  28. Emergency MedicineThird Year Students • See patients in ED on various rotations • Obtain EM physician as mentor • Start selecting fourth year rotations • Try to rotate where you want to be • Even for your “other rotations” • Do a Radiology rotation in one of your earliest electives

  29. Emergency MedicineFourth Year Students • Mandatory/Elective EM rotation • Rotate where you want to be • Make sure they know why you are there • Consider extramural rotations • Community experience • Opportunity at a residency program • SAEM maintains list of extramural EM rotations • Letters of recommendation

  30. Combined EM Residency Programs • Emergency Medicine / Pediatrics • Emergency Medicine / Internal Medicine • Emergency Medicine / Internal Medicine / Critical Care

  31. MONEY $$$$$ • Emergency medicine is very variable • Just about the middle of the physician pay scale • “Academic” situations are less lucrative • “Private groups” are most lucrative • $150,000-400000 is the norm • Also varies on how much you work • “Contract groups” can be very tricky

  32. How you get compensated • Straight Hourly Rate---$90-150/hour • Rural (slow) ED=less money • RVU—relative value units (fee for service) • You see a patient you get paid • Points based on Medicare tables for how valuable an intervention you have made • Combination Hourly and RVU • becoming the most common in private groups • Unique “employee” set –up vs. being self-employed

  33. Choosing A Specialty • Fit your personality • Decide between general or specialized field • Look at all areas of interest • Ignore gossip and commentary from outside the specialty you are investigating • Commit to specialty you choose

  34. American College ofEmergency Physicians Member Services Department PO Box 619911 Dallas, TX 75261-9911 1-800-798-1822 Touch 5 www.acep.org

  35. Emergency MedicineResidents’ Association 1125 Executive Circle Irving, TX 75038-2522 1-972-550-0920 www.emra.org

  36. ACOEP • 142 East Ontario Street • Suite 1250 • Chicago, Illinois 60611 • phone 312.587.3709 • 800.521.3709   • fax 312.587.9951 • www.acoep.org

More Related