EM Mindset: Bob Stuntz – Developing the EM Mindset

Author: Bob Stuntz, MD, RDMS
Assistant Program Director at the Wellspan York Hospital Emergency Medicine Residency
Creator of the EM Res Podcast (www.emrespodcast.org)

Editor: Alex Koyfman, MD

Whether we are working with a medical student, an off-service resident, or even one of our own, most of us involved in the education of emergency medicine have described the mindset of emergency medicine as different from most other specialties. But are we really unique in our approach to patient care and how we think? And if so, can one develop this “EM Mindset?”

To understand the EM mindset, we must first define it. The American College of Emergency Physicians (ACEP) has defined emergency medicine[1]. Included in that definition is the following statement:

“The practice of emergency medicine includes the initial evaluation, diagnosis, treatment, and disposition of any patient requiring expeditious medical, surgical, or psychiatric care. Emergency medicine may be practiced in a hospital-based or freestanding emergency department (ED), in an urgent care clinic, in an emergency medical response vehicle or at a disaster site.”

The definition goes on, but this section encompasses much of what we do, and much of what makes us unique. We care for the undifferentiated patient across a spectrum of acuities and presentations – any patient, anytime, anywhere. We see these patients, often in high volumes, and are required to engage in complex medical decision making with often incomplete information (factors that have been associated with EM resident burnout[2]). We are true generalists, performing a mix of procedures alongside non-procedural medicine, even caring for the psychiatric and social needs of our patients. Our specialty is fraught with interruptions[3], distractions, and stress. We may see incredible tragedy, and yet the next patient is still waiting to be seen. All of these factors contribute to a unique EM mindset.

If you are interested in reading the rest of this and other EM Mindset pieces, please see “An Emergency Medicine Mindset,” a collection evaluating the thought process of emergency physicians. This book is available as ebook and print on Amazon.


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