EM Collective Wisdom: David Spain
Author: David Spain, MBBS, FRACGP, FACEM // Edited by: Alex Koyfman, MD (@EMHighAK) and Brit Long, MD (@long_brit)
1) Why still Emergency Medicine?
Having witnessed the transformation of quality of care from before EM existed as a specialty, it is a no brainer to stay for the continuing journey as increased knowledge and skills just get better and better. The collegiality is fantastic at my institution, making it hard to ever leave.
2) Most impactful case?
My favourite is diagnosing the often-subtle cases of subarachnoid haemorrhage when they are GCS 15 with no neurology.
3) Most important career decision leading to satisfaction?
Returning to do EM training against a valued mentor’s advice.
4) What does future of EM look like?
It remains dynamic. Lots of good new safer procedures and treatments emerging for the critically ill in ED. Research is value adding to what we do. Concern we need to resist pressure to do more “inpatient care” in short stay environments. Concern senior supervision is not fully recognized as value by administrators and resourced.
5) Greatest achievement / why giving back is important?
Confronting, negotiating, and working collaboratively to help fix psychiatric access block at our hospital while the boss was away. My boss is usually a fixer but he had tried and was very very frustrated by this so was great to pull the trigger in his absence. Especially, for this disadvantaged group of patients. Made for a fun handover on his return.
6) Favorite failure?
“Killing and being killed” by a corporate CEO.
7) One thing you would change about our field?
Clearer admission rights agreed with inpatient teams.
8) Something that you love that has indirectly impacted your EM career?
Shift work combining with hobbies/pastimes that allow you to use time off in the week productively with passion when opportunity is better as many places are uncrowded.
3 people you’d like to see fill this out
1) David Green
2) Phillip Kay
3) Graham Jay