EM Mindset: Jeff Riddell – 2 Crucial Non-Clinical Cornerstones

Author: Jeff Riddell, MD (@jeff__riddell) // Editors: Alex Koyfman, MD (@EMHighAK) and Manpreet Singh, MD (@MPrizzleER)

There is much that has been written about what makes an emergency medicine clinician; what separates us from the rest [1]. We need to think “worst first” (CDEM 2011), be “action geeks” (Nickson 2010), “manage stress” (Levitan 2014), use “deliberate practice” (Ericsson 2008) and possess “grit” (Greenwood 2014). There are, however, two underappreciated roles that reveal who we are in the emergency department. They matter whether academic or private, trauma or medical, busy or slow. They are roles one must grow into as one matures in the specialty. They are the non-clinical cornerstones that underlie the entire emergency department promise to care for anything, anyone, anytime (Zink 2006).

Businesses have chief executive officers, chief financial officers, and chief information officers. Hospitals have chief medical officers. Practice groups call on medical directors. Academic departments boast endowed chairs and deans. In the emergency department, when we are at our best, we are The Chief Believer and The Chief Communicator.

The Chief Believer

We all developed under someone’s watch. In undergraduate, medical school, and residency there were people we chose to follow; people who invested in us. Someone was waving the flag and essentially saying, “Come work with us, think about these things with us.” We did not follow that advisor/leader/guide/mentor person because of their credentials, the size of their house, or the impact factor of their publications. Something about those people made us want to follow them. We followed because they believed in something. And we learned from them how we act, speak, and engage.

In our emergency context we are leading people that want to believe in something. They want to belong to something. Our patients, our staff, our colleagues, our volunteers, and our students want to follow a leader who believes and will lead them in what matters. It may be leading a patient through illness, a mother through the death of her child, a junior learner through her first chest tube, or a volunteer to the cafeteria. But we must tell the story of who we are and what we are about to those that need to hear it. It is not simply enough to show up and order the right tests and treatments. We must also give our teams something to believe in.

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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