July 1 - Avoid the ER?

[freelancewriter]

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There is a New York Times article today titled "Their Coats Are White, but Their Hands Are Green."
http://www.nytimes.com/2004/06/29/health/29case.html

The article subtitle/photo caption is "New doctors begin residencies in July. Is that a reason to avoid visiting the E.R.?"

Thoughts? Opinions?

 

[Febrifuge]

One pre-med and tech's opinion: an article like this one, published once per quarter, could be a good thing. It could possibly turn more people toward their primary care physician, or encourage them to go out and get one, rather that use the ED* as a substitute.

The truth is, the ED is a poor venue for the ongoing type of care most people need, most of the time. I need to read the NYT article (thank you for the link), but I hope that few people with true emergencies would be discouraged from coming in. I'd almost be happy about it, if people thought of the ED as a place with even more limited staff and resources than are actually there. A perception of scarcity or (as a distant 2nd place) inexperience could act as a buffer against too-casual use.


* 'ER' = TV show; 'Emergency Room' = pop culture term and outdated industry term; 'Emergency Department' = current industry term

 

[Seaglass]

Perhaps you should avoid busy County ED's where supervision by attendings is a bit less, but otherwise there shouldn't be a difference in care.

C

 

[ortho2003]

* 'ER' = TV show; 'Emergency Room' = pop culture term and outdated industry term; 'Emergency Department' = current industry term

Honestly, does it really matter. I am willing to bet that if you took a poll on the streets, far more people would recognize the term ER than ED. For an article such as this written for the public, it is quite appropriate to use the term ER, which everyone will recognize. As far as the industry standard, that industry stadard is only among ER docs. Most other physicians, who are also part of the "industry" of medicine, including myself, use the terms interchangably.

 

[devildoc2]

I dont understand the article. What are they advocating?

Are they advocating that nobody should be treated by newbie residents? How's that going to work when the current crop of experienced docs retires?

 

[DrQuinn]

Honestly, does it really matter. I am willing to bet that if you took a poll on the streets, far more people would recognize the term ER than ED. For an article such as this written for the public, it is quite appropriate to use the term ER, which everyone will recognize. As far as the industry standard, that industry stadard is only among ER docs. Most other physicians, who are also part of the "industry" of medicine, including myself, use the terms interchangably.

If you were interviewing for an EM spot and used the phrase "ER," I can assure you it would be viewed as a negative.

And I believe the EM-field would be the "inside industry," and hence would know the correct terms. Don't get me wrong, if I'm talking to the layman, I'll use ER... but a glial cell or two will twinge in pain.

Q, DO

 

[Febrifuge]

Honestly, does it really matter. I am willing to bet that if you took a poll on the streets, far more people would recognize the term ER than ED. For an article such as this written for the public, it is quite appropriate to use the term ER, which everyone will recognize. As far as the industry standard, that industry stadard is only among ER docs. Most other physicians, who are also part of the "industry" of medicine, including myself, use the terms interchangably.

I realize 'ER' is the term people recognize in the public at large, which is why I made the distinction between 'popular culture' and the 'industry term.' And I never suggested it wasn't the right term for the NYT to use in the article. Naturally I'm not going to suggest I know better than the New York Times, so to be honest I'm a little annoyed (in that tiny little way that Internet misunderstandings make people crazy) at your suggestion that's what I was doing.

This here is a series of message boards for healthcare-type people, and the nice gentleperson with the ID of 'freelancewriter' was coming in to share something interesting.

Seeing this person isn't a posting machine, and figuring he/she might be, oh I dunno, a writer, I thought it might be a gesture of thanks for the article to point out a little word-nerd sort of handy factoid. I know several writers myself, so I know how it's cool to know little details other people don't have a reason to know. And now you're saying it's not important, there is no such term except among EM docs, etc. Which, all due respect for the professional behind the words, is a lame thing to say.

If you're a working physician who refers to his/her Emergency Medicine colleagues as "ER Docs," or the field as "ER," then everyone knows what you mean, but I'm willing to bet there are at least a few who think you either don't know or don't care that there's a more precise and correct term.

Kind of like when 'Ortho-' and 'Osteo-' are used interchangably.

 

[edinOH]

It's funny. I used to get all bent, at least in my mind, when someone would say "ER" or "ER doc" instead of ED or EM physician.

Now I truly don't care. I say ER and ER doc all the time. That's where I work and that's what I am.

 

[Febrifuge]

Good enough. But 'EP' sounds more hoity-toity, doesn't it?

Hey, whatever. Within a subculture, people get to name their own labels. I have friends for whom "geek" is a compliment and "nerd" is an insult.

 

[Apollyon]

Honestly, does it really matter. I am willing to bet that if you took a poll on the streets, far more people would recognize the term ER than ED. For an article such as this written for the public, it is quite appropriate to use the term ER, which everyone will recognize. As far as the industry standard, that industry standard is only among ER docs. Most other physicians, who are also part of the "industry" of medicine, including myself, use the terms interchangably.

Ironically, do you spell it "orthopedics" or "orthopaedics" (which, as an apparent rule, orthopedists do)?

The ER doc/EM physician is akin to the police car driver - is he a police car driver, or police officer?

Also, be wary of speaking for "most other physicians". I myself have been successful in changing people's ways of referring to the ED (and not that ED is "erectile dysfunction").

 

[Cassidy61]

in my opinion, the most dangerous time is in september. this is when everyone stops keeping a close eye on interns and they start to get a little autonomy.

 

[Foxxy Cleopatra]

Heh, as a surgery resident I could think of a few reasons to avoid the emergency room; however none of which would be the "new doctors!"

Some places (here, for example) interns do NOT start on July 1. Slick, eh? The poor suckers have already started. Plus, new interns aren't going to be composing the vast majority of emergency providers (or medical providers, for that matter) so I highly doubt that July 1st implies any major health threat.

 

[edinOH]

Where you are really in trouble is as a pt. on one of the med/surg services. That is where things can get scary at 1 a.m. the morning of July 2nd.

 

[neutropeniaboy]

It's funny. I used to get all bent, at least in my mind, when someone would say "ER" or "ER doc" instead of ED or EM physician.

Now I truly don't care. I say ER and ER doc all the time. That's where I work and that's what I am.

Similarly, I used to answer calls as "Otolaryngology on call. . ." since I thought the term "ENT" was so pedestrian. But after after all the "huh?" or "say that again" replies, I started using "ENT" as a term. Now I really don't care either way. I'll put "otolaryngology" on my white coat or on paper/progress notes, but why bother with the "industry standard?"

 

[Apollyon]

Similarly, I used to answer calls as "Otolaryngology on call. . ." since I thought the term "ENT" was so pedestrian. But after after all the "huh?" or "say that again" replies, I started using "ENT" as a term. Now I really don't care either way. I'll put "otolaryngology" on my white coat or on paper/progress notes, but why bother with the "industry standard?"

Like being an applicant for EM, saying "ER" is anathema, I read and heard the same thing about otorhinolaryngology - that, when you're interviewing, "ENT" is a four-letter word.

Here, it's OHNS, which took me a while to figure out, but I still say OMFS by habit, and I get the strange looks. (For those who may not know, OHNS = otolaryngology/head and neck surgery, and OMFS = oral and maxillofacial surgery.)

 

[scutking]

As a surgery resident, and having just finished another month of June with another July 1 tomorrow, I would argue that May and June are much more dangerous months than July. In July, everybody is new, scared to death of making a mistake, and excited about their new role. By May and June, everybody is burned out, thinks they're ready for the next year, and generally complacent about patient care. I'd much rather get sick in July than in June.

 

[Molly Maquire]

What was the deal with that intern not knowing how to start an IV?

Aren't you supposed to learn this as a third-year medical student?

He was probably one of the people who spent the whole rotation in the library. These are the people who make July and August miserable months for the rest of us.

ps: Anyone who gives a **** about ER vs ED or ENT vs otorhinowhatever is a freaking tool.

 

[Apollyon]

What was the deal with that intern not knowing how to start an IV?

Aren't you supposed to learn this as a third-year medical student?

He was probably one of the people who spent the whole rotation in the library. These are the people who make July and August miserable months for the rest of us.

ps: Anyone who gives a **** about ER vs ED or ENT vs otorhinowhatever is a freaking tool.

You're a bundle of joy - you must be the life of the party. Lighten up.

Or, alternately, if people discussing ER vs. ED and ENT vs. whatever, we may be 'tools', but the only "freaking tool" is you.

 

[dbiddy808]

The attending will spend more time interviewing, discussing and thinking about a patients case than they might with someone who they assume is competent. Just a thought. Not many places let green interns run wild with no supervision.