"don't call it ER"

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doctorFred

doctorFred

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has anyone else experienced a backlash when using the term ER around residents or attendings? i remember accidentally referring to the specialty as ER (even though i think it's a perfectly appropriate colloquial title) and having an attending make a specific point of telling me "we don't use that term; this specialty is ee em."

before you reply, let's get the obvious out of the way - i understand that an ER is literally a place, and not a specialty, and that no one refers to surgery as OR. but people seem to be specifically peeved by the reference "out of proportion to physical exam", so to speak. my initial theory is that it's some kind of backlash against the popularization of the specialty by the former tv series. is this the case? because if so, it seems really misplaced.
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zahque said:
has anyone else experienced a backlash when using the term ER around residents or attendings? i remember accidentally referring to the specialty as ER (even though i think it's a perfectly appropriate colloquial title) and having an attending make a specific point of telling me "we don't use that term; this specialty is ee em."

before you reply, let's get the obvious out of the way - i understand that an ER is literally a place, and not a specialty, and that no one refers to surgery as OR. but people seem to be specifically peeved by the reference "out of proportion to physical exam", so to speak. my initial theory is that it's some kind of backlash against the popularization of the specialty by the former tv series. is this the case? because if so, it seems really misplaced.
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I think the biggest issue with calling it an ER is that the name is somewhat belittling and ED is more accurate.

Personally, I am a proponent for the use of ER because nowadays the first thing people think of when they hear ED is erectile dysfunction. Thanks Cialis and Levitra advertisements!
 
Augustus said:
I think the biggest issue with calling it an ER is that the name is somewhat belittling and ED is more accurate.

Personally, I am a proponent for the use of ER because nowadays the first thing people think of when they hear ED is erectile dysfunction. Thanks Cialis and Levitra advertisements!
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Cant use ER....backlash
Cant use ED....erectile problems...not good for a guy to being saying...

I use EM...Emergency Medicine!! :thumbup:
 
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How can you use EM? "Oh, I have to go see a consult down in the EM." That doesn't really work.

I like to just call it "The Department," like the way that people from NYC just refer to "the city," and expect everyone else to know that there is only one worth talking about.
 
Correct me if I'm wrong, but I think the OP is talking about the specialty its self. Not the actual department. Or at least that's how I read it.
 
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atkinsje said:
Correct me if I'm wrong, but I think the OP is talking about the specialty its self. Not the actual department. Or at least that's how I read it.
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You're semantically correct, but both issues can land you in hot water as a visiting med student talking to the wrong attending.

Personally, I think we owe it to our specialty to call it by the right name. We practice Emergency Medicine (EM) in an Emergency Department (ED). If you went to the trouble and expense of getting board certified, then you should take care to ensure that the public recognizes EM as a specialty, and thus should take care to use the right terminology. If you do, in fact, practice in an Emergency Room (ER (taking the singular implies you work in a single room)) then you very well might not be board certified, and probaly don't need to care what people call our specialty - so go ahead and call it an ER.

Now, while I take care to use the right words myself, I find it distasteful to correct laypersons on this point (and I consider the average specialist/consultant a layperson when it comes to EM). Students who want to enter the field, however, should learn the terminology and conventions of the field - and they should show no less (and no more) concern for this convention than they do for other conventions.
 
I am a proponent of encouraging the use of ED and EM, as those terms reflect the maturation of the specialty over the last thirty years, but I understand that ER is ingrained in most peoples' minds.

I have had many attendings and other inviewers use ER during residency interviews. I think those who get all worked up about one letter take themselves way too seriously.
 
I like to just call it "The Department," like the way that people from NYC just refer to "the city," and expect everyone else to know that there is only one worth talking about.
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zahque said:
at the risk of sounding juvenile, EM is conspicuously close to BM.
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:laugh:

As a student, I do whatever my attending says.

As a resident and beyond, I'll say whatever collection of syllables, letters, noises, and grunts conveys my meaning.
 
jbar said:
I like to just call it "The Department," like the way that people from NYC just refer to "the city," and expect everyone else to know that there is only one worth talking about.
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exactly! everyone with a brain knows that the purpose of a hospital is to support "The Department".
 
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I'm not really the type to get offended, so I could really care less. On the interview trail, I make a point of saying "EM" or "ED" whenever the wording comes up so as to avoid offending an interviewer, but in general practice I usually say "ER"--that's what everybody else knows it by, and, again, I just don't really care about the semantics of it all.

There's a lot more serious things to get worked up about and whether you replace an "m" or a "d" with an "r" in front of the E is something that doesn't really matter to me.

But then again, I'm also the type of person who could care less about being called "Sir" whenever I put on my Army uniform either. I'd rather be on first name terms because, frankly, I don't really need any other validation of the size of my . . . umm . . . ego other than the mere inner satisfaction of achieving my goals
 
I generally do correct the students, not because I care that much, mainly because they may run into someone down the road who does care. Better to get a slap on the wrist from me than to drop and "ER" at an interview and not get ranked.

I do get a little annoyed when the consultants say ignorant things. I frequently get asked if I'm the guy "on call." No, I'm not sitting at home waiting for the phone to ring. I'm here trying to push back the tidal wave. I am "on duty." Does that answer your question?

If it ever bugs me at all it's because the name "ER" seems to hearken back to the days where ERs were unstaffed and whenever some disaster would come in the nurses would search around the hospital to see if there was a doctor who was willing/available to come down and deal with it. That's definitely not what we're about. It's the same scenario that left EDs called "accident rooms" in England.
 
meh.

I lost interest in this a few years ago. Not really sure why, just didn't care that much anymore. I seem to remember a time when I did care, though.

I refer to myself as an emergency physician or, occasionally, an ER doc.

I refer to the physical location of where I work as either the ED or the ER. Can't for the life of me tell you why I pick one vs the other. I open my mouth and one of the two pours out. Usually with other silly things that get me in trouble.

I refer to my profession as emergency medicine or EM.

Take care,
Jeff
 
Jeff698 said:
meh.

I lost interest in this a few years ago. Not really sure why, just didn't care that much anymore. I seem to remember a time when I did care, though.

I refer to myself as an emergency physician or, occasionally, an ER doc.

I refer to the physical location of where I work as either the ED or the ER. Can't for the life of me tell you why I pick one vs the other. I open my mouth and one of the two pours out. Usually with other silly things that get me in trouble.

I refer to my profession as emergency medicine or EM.

Take care,
Jeff
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This is sort of how it works out for me. Although, I notice that it is sometimes audience dependent -- laypeople get told that I'm an ER doc working in the ER. I expect people at the hospital to understand what I'm saying when I say EM or ED. Either way I never mean nor take offense.
 
Don't call it the ERCC - Emergency Room Coat Closet. They find that especially demeaning.
 
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Jeff698 said:
meh.

I lost interest in this a few years ago. Not really sure why, just didn't care that much anymore. I seem to remember a time when I did care, though.

I refer to myself as an emergency physician or, occasionally, an ER doc.

I refer to the physical location of where I work as either the ED or the ER. Can't for the life of me tell you why I pick one vs the other. I open my mouth and one of the two pours out. Usually with other silly things that get me in trouble.

I refer to my profession as emergency medicine or EM.

Take care,
Jeff
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Ditto. I do warn students, much like I was warned way back when, that on the interview trail to NOT use ER mostly because you can never tell who is going to be that random person who is carrying this as a torch. I personally couldn't care less, I understand the arguement to a point, but really how we will establish ourselves as a field is through our professional and academic behavior and not by what we insist on being called.
 
WilcoWorld said:
If you do, in fact, practice in an Emergency Room (ER (taking the singular implies you work in a single room)) then you very well might not be board certified, and probaly don't need to care what people call our specialty - so go ahead and call it an ER.
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if you want to get literal, taking the singular OR implies a single room too. no one calls it the operating department.
 
zahque said:
if you want to get literal, taking the singular OR implies a single room too. no one calls it the operating department.
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Actually, if you want to be consistent, they *do* operate in an operating room. They are usually referred to as a surgery department, though.

We examine patients in an emergency department examination or treatment or trauma room. We are the emergency department.

That said, I'm part of the group that doesn't really care, but recommends that applicants call it the ED just in case.
 
DrMom said:
Actually, if you want to be consistent, they *do* operate in an operating room. They are usually referred to as a surgery department, though.

We examine patients in an emergency department examination or treatment or trauma room. We are the emergency department.

That said, I'm part of the group that doesn't really care, but recommends that applicants call it the ED just in case.
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Traditionally it's called an "Operating Theatre" implying that the surgeon has such godlike abilities that everyone will watch in awe at his sheer talent.
 
DrMom said:
Actually, if you want to be consistent, they *do* operate in an operating room. They are usually referred to as a surgery department, though.

We examine patients in an emergency department examination or treatment or trauma room. We are the emergency department.

That said, I'm part of the group that doesn't really care, but recommends that applicants call it the ED just in case.
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they operate in an operating room, just as we care for patients in an emergency room. they also (>90% of the time?) refer to the entire suite of operating rooms as "the OR", just like the majority of laypersons and non-emergency medicine physicians refer to the entire suite of emergency rooms as "the ER."

i guess my original point was that the degree to which some people are sticklers on this issue just comes off as so self-conscious.. to the extent that if the goal is to establish some new level of respect for the profession, it's self-defeating. at least it seems that way to me.
 
Allow me to quote myself to avoid being misunderstood:

WilcoWorld said:
...while I take care to use the right words myself, I find it distasteful to correct laypersons on this point (and I consider the average specialist/consultant a layperson when it comes to EM). Students who want to enter the field, however, should learn the terminology and conventions of the field - and they should show no less (and no more) concern for this convention than they do for other conventions.
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If you're going to enter a field of expertise learn its conventions so you can speak intelligently, but remember that they are just conventions and that to lecture disinterested people on the conventions is rude.
 
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WilcoWorld said:
If you're going to enter a field of expertise learn its conventions so you can speak intelligently, but remember that they are just conventions and that to lecture disinterested people on the conventions is rude.
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i guess my original question as to why calling yourself an ER doc is wrong or unconventional in the first place hasn't really been answered, aside from either nitpicking about semantics or falling back on "that's just how we do it." because i do say ER doc on the interview trail, and i'll say it to colleagues in the future.. and if someone doesn't want to deal with me professionally based on that, then i'm the one that probably dodged a bullet!

i should add that as per my OR comparison above, i can't believe that semantics and convention is the entire story. surgery is the old boy's club. they care about prestige and conventions a lot more than the average emergency physician.. so why do some people throw a fit about "the ER" when they don't bat an eye at calling it "the OR?"
 
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zahque said:
i guess my original question as to why calling yourself an ER doc is wrong or unconventional in the first place hasn't really been answered, aside from either nitpicking about semantics or falling back on "that's just how we do it."
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Since we're talking about a convention of language the answer will necessarily be a semantic one.

zahque said:
because i do say ER doc on the interview trail, and i'll say it to colleagues in the future.. and if someone doesn't want to deal with me professionally based on that, then i'm the one that probably dodged a bullet!

i should add that as per my OR comparison above, i can't believe that semantics and convention is the entire story. surgery is the old boy's club. they care about prestige and conventions a lot more than the average emergency physician.. so why do some people throw a fit about "the ER" when they don't bat an eye at calling it "the OR?"
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I've never seen someone "throw a fit" over this issue. If I read back through this thread and others like it what I see is the more senior members trying to educate newer posters, and a whole lot of people making fun of the issue itself - not fits being thrown.

This thread was not started by an EM attending on a mission - it was started by you. And in your original post you wrote "no one refers to surgery as OR" so why are you trying to introduce that into the discussion now?

In summary - the convention is to refer to the specialty as EM. While most people don't care what you call it, if you want to avoid the possibility of being perceived as ignorant during your interviews you would be well-served to use the conventional terms. The issue deserves no more attention than that, so I guess I should stop bothering with this thread.
 
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WilcoWorld said:
I've never seen someone "throw a fit" over this issue. If I read back through this thread and others like it what I see is the more senior members trying to educate newer posters, and a whole lot of people making fun of the issue itself - not fits being thrown.
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you've kind of been throwing a passive aggressive fit this whole thread, including references to my position being "unintelligent" and "ignorant" rather than actually addressing the issue itself, beyond the obvious (which i attempted to curtail in the original post.)

WilcoWorld said:
And in your original post you wrote "no one refers to surgery as OR" so why are you trying to introduce that into the discussion now?
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you haven't answered the question. while the specialty may not be referred to as "OR" per se, there are no qualms about referring to the entire area where they practice as "the OR". so what's with the disparity? why should we care about semantics so much more?

WilcoWorld said:
The issue deserves no more attention than that, so I guess I should stop bothering with this thread.
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yes, that's right. take your toys and go play somewhere else.
 
roja said:
Ditto. I do warn students, much like I was warned way back when, that on the interview trail to NOT use ER mostly because you can never tell who is going to be that random person who is carrying this as a torch.
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right, so what i'm wondering is why people carry that as a torch. there's gotta be something underneath the surface response of just correcting the semantics, no? does it have something to do with the TV show? do people hate the idea of george clooney popularizing the specialty?

i should also add, for the sake of not being misunderstood, that i'm fixated on the point just because it's so antithetical to everything else i've come to know about ER residents and attendings. they are, on the whole, such a fantastic, friendly, laid-back group of people. it strikes me as bizarre that such a point of contention exists.
 
zahque said:
right, so what i'm wondering is why people carry that as a torch. there's gotta be something underneath the surface response of just correcting the semantics, no? does it have something to do with the TV show? do people hate the idea of george clooney popularizing the specialty?
QUOTE]

I think that on some level it has to do with the fact that a lot of people fought a lot of battles (long before most of us were born) to get EM recognized as a specialty. I think that some of those folks--and people trained by them--view it as somewhat disrespectful/ignorant when people refer to the specialty as "ER." I don't think it has much, if anything, to do with the TV show.

I'm with most people on this: I don't much care what you call it but agree that on interviews you're wise to stick to "EM" and "ED." To assume that those that "carry that torch" are people that you don't want to train you is probably a bit short-sighted; I just think that this issue probably stems from an era that you and I can't relate to, which is due in large part to the hard work of our predecessors.
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I think there is a little bit of substance to the debate although it does revolve around some of the lingering inferiority complex that EM has as a field. The most tangible example of that inferiority complex can be seen in ABEM's never ending quest to add every wacky board certification requirement to its list to be able to say "We are one of the most demanding boards."

Some people use EP as opposed to ER doc to denote a difference between a boarded EP and some random doc working in the ER. The ED vs. ER bit definitely refers to the ongoing struggles to gain department status at institutions.
 
Hawkeye Kid and DocB have addressed your question beyond semantics in the last two posts. I would add that to many of the early EP's the terms "ER doc," and "ER" had a derogatory connotation. The "OR" lacks that same effect on surgeons because it was not used to besmerch their work; but, if you referred to them as "butchers" or something of that sort I imagine you might raise some eyebrows. It is not the words that bother people, it is the belittling way in which these words were historically used. I am certain that you can think of other examples.

At my program there are people that an applicant would likely interview with where using these terms could negatively affect your application. I'm not suggesting an application would be summarily tossed, but it reflects of the applicant a general lack of interest and understanding in the history of their prospective field and the battles that have been fought to bring us to our current levels of success. It would be wise of an applicant to steer-clear of this easily avoidable pitfall.

Good luck on the interview trail.
 
iridesingltrack said:
The "OR" lacks that same effect on surgeons because it was not used to besmerch their work; but, if you referred to them as "butchers" or something of that sort I imagine you might raise some eyebrows. It is not the words that bother people, it is the belittling way in which these words were historically used. I am certain that you can think of other examples.

.
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I think the phrase you want is barber-surgeons, since that's how surgery started out. Barbers also drew teeth, so I suppose you could also piss off dentists with some variation of this. Cheers,
M
 
iridesingltrack said:
It is not the words that bother people, it is the belittling way in which these words were historically used. I am certain that you can think of other examples.
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i'd like to point out, though, that in many of those "other examples", the derogatory terms were reclaimed by the group in question as a method of self-empowerment. but i understand your point.
 
This issue (not the comments here) is one of the most ******ed I've come across in medical training. I think it just makes us look insecure when we worry about what other people call us. If you're a good doctor, stand up, be proud, own it, know it (& recognize your weaknesses). It doesn't matter what you call yourself or what others call you.
 
I'm going to disagree. Look at marketing and PR firms. Look at all the time groups spend working on "branding" and "rebranding." In this world of healthcare reform, mid levels carving out their nitch, limited budgets and grants, it matters what other people think of emergency medicine. Now I don't know how important it is to fight this battle with ED vs ER, and how aggressive to get about it. But in this world I don't think you can just put your head down and do good work and assume others are going to figure it out. Because there are other groups and interests that are fighting for their share of the pie.
 
Up here in Canadia we refer to it colloquially as "emerg". That is, "You need to go for a consult in emerg," or, "S/he is an emerg doc." If you were being formal then you would refer to someone as an emergency physician (EP), and the emergency department (ED), not ER or ER doc.
 
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