A Good ER Doctor
There are lots of metrics by which ER physicians are measured. This has to do with how fast they see patients, how many patients they see per hour, how many patients leave the ER without actually being seen after they check in, how fast patients get their tests done and get discharged or admitted… and there are many more.
I think there are only three metrics that matter:
If nurses see your name on the schedule and they pick up shifts when you’re working or try to work in your area of the ER, if they come to you with personal questions about medical things, and if they bother you when they are worried about a patient.
If your colleagues see your name on the schedule and are happy to work with you. If your patients ask you to be their primary care doctor.
The reason I think these are the ones that matter is that the other things will fall into place as a result. Nurses, by and large, care about patients. That’s why they went into the profession. So if they see you are not taking good care of patients, they won’t want to work with you. They will notice if your skills are not good. They will notice if you are rude to patients, don’t treat them well, or don’t communicate well. They see everything that goes on, not only what the patients see but what goes on behind the scenes: what goes on at the desk, how you treat the other support personnel in the ER, how you talk about patients. A good ER nurse is a very good barometer as to how you are doing as a physician.
In a similar way, your colleagues know if they can trust you. When they have to sign out a patient to you at the end of their shift, they know that you will follow up diligently. When the roles are reversed and you sign out a patient to them, they know that loose ends are tied up as much as possible and you’re not handing off a complete disaster. They know that you have set the stage with the patient so that whatever final details need to be navigated, they have been set up to succeed. They will know when you have the skills to back them up with difficult procedures. They will appreciate your attitude and that you bring a sense of humor and positivity to the shift so that you help create an enjoyable work environment. They know that you will carry your load of patients and, when things get busy, you work hard and don’t retreat. Both your calm and your intensity match what’s going on in the department. You bring order to the chaos and not the reverse.
Lastly, patients desperately want to have good interactions with their doctor. This is often very difficult in the ER. Seeing two patients per hour doesn’t leave a lot of actual time at the bedside when you think about gathering information, ordering tests, following up on those tests, discussing with any consultants, doing any procedures, reassessing the patient, and updating the patient and family, often multiple times. So if, in that limited time, they ask you if you also work in a clinic or if they could see you in an outpatient setting, you have done your job well. There’s very little time for BS in the ER, so it’s not like the doctor who makes patients like him/her is being anything but sincere. There’s no time for playing games and pretending.