More on sharing an ED-hospital medicine director

More on sharing an ED-hospital medicine director

Plus, more on bedside rounds

July 2017
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Published in the July 2017 issue of Today’s Hospitalist 

YOUR RECENT What Works feature (“Fighting with the ED? Sharing a medical director can help,” May) highlights Sunrise Hospital & Medical Center in Las Vegas. The article mentions using hospitalists “to do ED shifts either independently or as an assistant to an ED doctor.” While any physician can and should volunteer to help in the ED during a mass casualty event or an internal disaster, it is incorrect to use non-emergency medicine specialists in the ED as an ongoing general policy.

For the last 40 years, emergency medicine has existed as a distinct ABMS medical specialty with ACGME-approved residency programs. The purpose of that training is to give physicians the skills and knowledge they need to care for ED patients.

It would be similarly incorrect to use physicians trained in emergency medicine, not internal or family medicine, to staff open hospitalist shifts as a standard policy. If such a policy was in place, I believe hospitalists would be appropriately concerned.

Joe Shiber, MD 
Jacksonville, Fla.

(Dr. Shiber is triple-boarded in internal medicine, emergency medicine and critical care medicine.)

Scott Scherr, MD, Sunrise Hospital & Medical Center, responds:

There is a separate delineation of privileges for hospital medicine physicians to work in the emergency department. This limits the type and level of acuity they see. If hospitalists see patients outside this scope, they need to staff the patient with a board-certified emergency physician.

More on bedside rounds
I am writing to express my concern that bedside interdisciplinary rounds (BIDR) are not being implemented often enough (“Should you be holding bedside rounds?” April).

Rounds not held at the bedside lack consistent structure, create unnecessary re-work, and miss quality and safety opportunities. While your article showcases opposing viewpoints on implementing BIDR, patients and caregivers need and deserve a multidisciplinary team effort to address their care needs. I strongly urge providers to consider the benefits of conducting BIDRs, which can improve clinical and financial outcomes and enhance the partnership between patients and health professionals.

Fion Ng
San Francisco
(Ms. Ng is in the masters entry program in nursing at the University of California, San Francisco.)

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