Emergency Medicine Collective Wisdom: W. Richard Bukata
- Feb 6th, 2018
- W. Richard Bukata
- categories:
Author: W. Richard Bukata, MD (Medical Director, The Center for Medical Education, Inc.; Adjunct Professor of Clinical Emergency Medicine, University of Southern California, Keck School of Medicine, Los Angeles, California) // Edited by: Alex Koyfman, MD (@EMHighAK) and Brit Long, MD (@long_brit)
1) Why still Emergency Medicine?
It’s all that I know how to do. It is an honorable profession, and the specialty of emergency medicine is particularly challenging to master.
2) Most impactful case
A really close call. Gave morphine to a young, admitted ureteral colic patient. Code Blue called. He had stopped breathing on the floor. Was noticed by his mother. Was absolutely shocked when I went into the room and it was my kidney stone patient. Almost killed the kid.
On a more positive note. Bad adult asthmatic. Gave here everything. These were pre-ketamine days. Gave her heliox. Gradually got better and the patient swore the heliox is what did it. As a result, became a major donor to the hospital and she thought I was the world’s best ER doctor.
3) Most important career decision leading to satisfaction
Creating Emergency Medical Abstracts.
4) What does future of EM look like?
The future is bright – there will always be patients to see (despite urgent care centers, freestanding EDs, NP clinics in pharmacies, and telemedicine). We need to do better at learning to work smarter in order to have more time to enjoy the experience with our patients. Our compensation will always be more than adequate.
5) Greatest achievement / why giving back is important
Realizing that tens of thousands of physicians have chosen our educational courses and products over the last 40 years, and I absolutely know we have made an impact on the care of their patients.
6) Favorite failure
Creating a “can’t miss” educational video series for new parents regarding the care of their infants and toddlers. A huge flop and I still have no idea why – which is very frustrating.
7) One thing you would change about our field
I would strive to make the EDs where we work very “pack” oriented. Ones in which there was great physician and nurse leadership and ones in which the people who work together become true friends and socialize outside of the ED environment. Ones in which the environment was such that people looked forward to going to work. EDs in which everyone was driven to create a great experience for the patients – EDs that sustain, support and nurture all who work there and, by doing so, minimize the risk of burnout and create happy, satisfied clinicians and staff.
8) Something that you love that has indirectly impacted your EM career
I love the EM literature. I have, for 40 years, each week, reviewed the table of contents of over 600 journals by use of a publication called Current Contents. From there I find all of the papers in EM that are leading edge and then I can have them electronically pulled from the University of Southern California medical library. Reading the EM literature has been my passion and pleasure and business for 40 years.
3 people you’d like to see fill this out:
- Jerry Hoffman
- Jim Roberts
- Al Sacchetti
- Mel Herbert
- Kevin Klauer
- Dominic Bagnoli
- Diane Birnbaumer
Fabulous meaty comments from one of the really great iconoclastic wise owls of EM.
I just reread what I had written and fundamentally stand by what I said. EM is a terrific specialty in that intellectually it is within the reach of most people to be excellent EPs. But the specialty has career ending dangers in that burnout is real and must be actively avoided by knowing the causes and striving to practice in an environment that will nurture a 30+ year career.