clc8503

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I am posting this thread out of sheer curiosity so please forgive me if it is a dumb question. Do Emergency Medicine Physicians actually perform surgery or do they mostly just perform noninvasive procedures? If so, how much time do they actually spend in the OR? I know that's what fellowships in trauma surgery are for, but do EM’s actually learn to perform emergency trauma surgery in their residencies? Someone asked me this and I could not accurately answer their question, so I'm turning to you guys.
 

EctopicFetus

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No "surgery" per se but we do perform invasive procedures. Chest Tubes, thoracotomy, crics. We put in central lines and intubate as well. Most EM docs dont enter the OR once they get into residency.
 
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roja

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Concur with above. In residency, I have done two crics, multiple chest tubes, an ed thoracotomy. thankfully, no perimortem Csection- would be happy to never have to do one of these ( I can survive without that grail)
 

docB

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I usually answer that question (Do ER docs do surgery, deliver babies, ect.) by saying that I occasionally cut people open and deliver babies but if I'm doing it it means that there was a severe breakdown somewhere in the system.
 

The White Coat Investor

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By definition, No. If it's surgery, I'm not doing it. If I'm doing it, its not surgery. Despite all the lac repairs, abscess I/Ds, thoracotomies, crics, circs (j/k), chest tubes, LPs, central lines, venous cut-downs (OK..OK...you got me, only in cadaver lab), nothing I do is surgery, because if it was, I'd have a surgeon doing it. Just like with procedural sedation, if it was anesthesia, I'd have an anesthesiologist doing it ;) .
 

WilcoWorld

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The answer to what I think was the intended meaning of the OQ is that OR time is not in EM Docs' job descriptions, and that very few, if any, have OR privileges at US hospitals.

The more accurate answer to the OQ requires a clarification of "surgery".

dictionary.com, surgery:
1. The branch of medicine that deals with the diagnosis and treatment of injury, deformity, and disease by manual and instrumental means.

EM Docs certainly spend a substantial amount their time diagnosing surgical conditions and performing manual and instrumental interventions to treat general, orthpaedic, and cosmetic conditions.
Some may reply that to do surgery is to do operations.

websters, operation:
4. A procedure carried out on a living body usually with instruments especially for the repair of damage or the restoration of health

Which again, is encompassed by many of the above-mentioned tasks. If you believe that "to cut is to cure" and that it is definitiveness of therapy that defines surgery, than I'll tell you that I "cured" two abscesses last week.

So if you are asking if EM Docs perform surgery, I would say yes. But if you are asking if EM Docs work in the OR, than the answer is no.
 

tcp03

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The answer to what I think was the intended meaning of the OQ is that OR time is not in EM Docs' job descriptions, and that very few, if any, have OR privileges at US hospitals.

The more accurate answer to the OQ requires a clarification of "surgery".

dictionary.com, surgery:
1. The branch of medicine that deals with the diagnosis and treatment of injury, deformity, and disease by manual and instrumental means.

EM Docs certainly spend a substantial amount their time diagnosing surgical conditions and performing manual and instrumental interventions to treat general, orthpaedic, and cosmetic conditions.
Some may reply that to do surgery is to do operations.

websters, operation:
4. A procedure carried out on a living body usually with instruments especially for the repair of damage or the restoration of health

Which again, is encompassed by many of the above-mentioned tasks. If you believe that "to cut is to cure" and that it is definitiveness of therapy that defines surgery, than I'll tell you that I "cured" two abscesses last week.

So if you are asking if EM Docs perform surgery, I would say yes. But if you are asking if EM Docs work in the OR, than the answer is no.
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i'm currently studying in trauma surgery as an add-on to my EM ...i've got a year to go and i'm about $120k in debt. i've done pericardium windows and emergency aortic clamp-offs in a dissecting triple A also femoral cut-downs in drug users because every vein is blown.
 

bizurk

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For what it's worth, I have heard of EPs helping out once in awhile with surgeries. My guess is this is something along the lines of 'mixing it up' and they are performing the first assist-type duties. I would imagine they'd get paid something like PAs.
 

tkim

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For what it's worth, I have heard of EPs helping out once in awhile with surgeries. My guess is this is something along the lines of 'mixing it up' and they are performing the first assist-type duties. I would imagine they'd get paid something like PAs.
I have never heard of this. Where is this a practice?
 

bizurk

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Heard about it from a guy who practices in Chester, PA..... But he could have been referring to anyone.
 

Groove

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Let's not kid ourselves, we're not surgeons. To the OP, yes... we do PLENTY of invasive procedures. Likely, you're definition of "surgery" tends to lump most invasive procedures under the surgical specialty branch. If so, and if that is your interest, then you need to broaden your knowledge about the various specialties so that you can pick the most appropriate one that will bring you satisfaction. You can "use your hands" by doing procedures that bring instant gratification within a hell of a lot more specialties than surgery alone.

However, if you want to sit over a bright light and use your hands for hours on end with a jam box playing and a big drape up at the head of the table with occasional snoring behind it, then you definitely need to do surgery.

If there are any gas heads reading this post, that's a joke! We all know you guys are awake back there.... playing words with friends and checking stock quotes, or walking room to room kicking awake the CRNA's... Ok, 2 jokes.. I'll stop! :D
 
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