I'm an M4 (who isn't going into EM) on my EM rotation. I'm not sure what it is, but somehow hanging out in the ED made me realize that I don't usually believe my patient's discomfort. Syncope in a young woman? Vasovagal. Shoulder pain? Patient should have stayed home and just iced it. The overwhelming majority of headaches are nothing. Sometimes I just think, "ARGH people need to chill out, develop higher pain tolerance, suck it up, and then maybe... just maybe... call their PCP." I almost find myself getting annoyed with the patient who comes in "for nothing," even though I cognitively understand that their anxiety, if not pain, is real to them. It's draining to see how resource-intensive the ED can be for these patients with pretty benign complaints and in most cases don't need emergent care. I understand that the mindset of EM is to rule out the worst-case scenario for such patients, and that 1 out of every several thousand presentations will end up actually being a PE... but I am confused and a little angry at the sheer number of CTs I've ordered on patients who seem and end up being FINE. That said, I did have one patient who kept coming in for pain-- she had a drug history and I think that worked against her-- and on her fourth visit we ended up finding out that she had something really serious.
Obviously emergency medicine plays a vital role in our nations' healthcare, and not all patients come in for frivolous and sundry reasons. Since y'all on this forum are interested in or practicing in EM-- can you help me process and possibly reframe these thoughts? Thanks!
Obviously emergency medicine plays a vital role in our nations' healthcare, and not all patients come in for frivolous and sundry reasons. Since y'all on this forum are interested in or practicing in EM-- can you help me process and possibly reframe these thoughts? Thanks!