There seem to be a lot of emergency medicine work openings, but there aren’t enough long-term stable emergency doctors to fill them. Most of this is due to the constantly evolving practise climate and, at times, tense relationships with the hospital, consultant medical staff, and regulatory bodies. As a result, except for the most sought-after emergency medicine employment, security is never assured or guaranteed. The author of this article discusses some of the most common practise obstacles that emergency physicians face in today’s healthcare climate. Our website provides info about Advanced Heart And Vascular Of Central New Jersey.
Currently, emergency doctors are operating in a crisis situation. This is partially due to the fact that our country’s emergency departments (EDs) are the only part of the healthcare system where a federal law mandates that all patients be treated regardless of their ability to pay. Consider a rule requiring all of those fast lube shops to accept all motorists, regardless of their financial situation! Between 1994 and 2004, the number of ED visits increased by 18%, from 93.4 million to 110.2 million. Meanwhile, the number of clinics, hospital beds, and emergency departments has decreased significantly. The overcrowding and long waits that arise, combined with a lack of ancillary support, create a crisis work climate.
The remainder of the medical world, unwittingly exacerbating the situation, will also be discovered by emergency doctors. Many financially and medically vulnerable EDs are crippled by hospitals’ perceived need to funnel as many patients as possible into their EDs. Primary medical care provided in the ED is more expensive than in a physician’s office, and the quality of primary medical care delivered in the ED is lower. While emergency physicians are well-versed in medical and surgical emergency response and treatment, primary care is best left to Family Medicine, Internal Medicine, and Pediatrics. In 2004, the National Hospital Ambulatory Medical Care Survey showed that 47 percent of emergency room visits were listed as either emergent (12.9 percent) or urgent (47%). (37.8 percent). On a regular basis, the provision of non-emergent primary care in the ED leads to ED overcrowding, patient boarding, ambulance referral, and delayed ambulance response times. As a result, the system’s ability to plan for and react to a catastrophic medical crisis, natural disaster, pandemic, or terrorist attack has been seriously hampered.
Obtaining much-needed on-call support for patients in need of hospitalisation is becoming more difficult for emergency physicians. This is partially due to uncompensated or undercompensated care offered by on-call specialists, as well as rising medical liability and policy issues that have yet to be addressed. While solo practise was once appealing to new graduates, most new physicians now prefer the financial stability and lifestyle constraints provided by larger, well-established organisations. As a consequence, taking an ED call becomes more of a hassle than a gain.
When other considerations not previously listed are taken into account, the burden becomes even greater. The possibility of medical malpractice, for example, looms large over emergency medicine. Nowhere else in medicine will the behaviour of one expert be constantly questioned by someone who is regarded as a true specialist of another specialty by the general public. Despite being the right person to handle an emergency airway, the ED physician will still be subject to the ‘final’ judgement of the true specialist – the anesthesiologist, as well as the cardiologist, gastroenterologist, neurologist, and others. Similarly, benchmark efficiency, throughput, volume and acuity of patients seen per hour, patient satisfaction, patient concerns, and admission rates are all factors to consider. Not only does the emergency physician balance the patient as the ‘customer,’ but also the medical staff, hospital management, and, to some degree, the nursing staff. Nurses are increasingly having a louder voice in influencing the practise and judgement of physicians in the ED due to supply and demand, while in other fields of medicine where the nurse functions subordinate to the physician; also in the ED, due to supply and demand, nurses are having an increasingly louder voice in influencing the practise and judgement of physicians in the ED (which may in fact be a good thing for many department and physicians). Nonetheless, this has an effect on emergency medicine.