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An acronym for Success in the ER

Smile: Smile when greeting the patient for the first time

Openness: Project an air of being open and honest

Forward-leaning: Lean in and shake the patient’s hand (if appropriate).

Touch: Establish some physical intimacy by placing your hand on a patient’s shoulder.

Eye Contact: Making eye contact also creates intimacy.

Name: Use the patient’s name. This shows respect and recognition.

Golden Rules of the ER

1.   See everyone.  No one else in medicine can say that.

2.   Consider the worst diagnosis. Know when to let go and either treat, discharge, consult or admit.

3.   Stabilize before you assess

4.   When in doubt, observe, consult or admit.

5.   Don’t transfer sick patients.

6.   Emergency physicians satisfaction with their occupation is tied to their attitude about treating emergency patients.

7.   Patient satisfaction is tied to the Emergency physicians attitude about the patient encounter. This directly affects patient volume and income for the provider.

8.   Administrations satisfaction with contract service provider is tied to patient satisfaction and amount of administrative headaches generated from the patient encounters.

Rekindling enthusiasm for Emergency Medicine

1.   Apologize for the wait, regardless of its length.

2.   Ask how you may help the patient.  It may be that the patient’s present complaint may not be why he is there.  Sometimes they may want a meal, a referral, transfer to a detoxification program, to be reassured, or to be dissuaded from committing suicide.

3.   Remember you can treat symptoms without a diagnosis. Dyspnea, dehydration, fever, nausea, vomiting, pain and anxiety can all be alleviated while the diagnosis is still being formulated.

4.   Inform the patient and family of your plan.  Remember that the patient is part of a national or local community.  As a representative of “Name of Hospital” Health Care, you are inviting them to join our family and the “Name of Hospital” Medical Center –“Name of community” community.

Source: Lecture by Robert Hockberger MD

ACEP scientific Assembly, October, 1997, San Francisco, California.