, 13 tweets, 2 min read Read on Twitter
Emergency medicine is dying, and it's the ultimate irony that ER docs will sit idly by as the specialty circles the drain, bradys down, and dies a terrible and dirty death by its own hand.
Fifty years ago the speciality was born. A handful of great men and women--titans--recognized the need for highly-trained, endlessly innovative, and fearless physicians to stand ready for anything that might breach the ER doors---24|7|365.
Over the past five decades, EM has defined itself as much by tending to the critically ill and injured as by serving as the enduring safety net for the marginalized and disadvantaged.
The ER has become the last shining light on the hill for Lady Liberty's huddled masses. We've been the golden door. We've held the lamp for the tempest-tost, the tired, the poor.
What's more, driven by the power of global connectivity+the cornucopia of #meded information sharing, Emergency Medicine trail-blazed in medical education, asynchronous learning, and continuing education. Somehow, lightning struck twice. Another generation of titans came along.
But the tides have shifted. Through corporate influence, the unrelenting medicolegal spectre, and an image problem that would daunt even the most accomplished PR firm, Emergency Medicine has forgotten the culture of compassion and ingenuity that brought us to where we are today
Rather than asking "how can we help," loud voices insist on changing the narrative to "so what," implying that some bar must be met to merit our services+expertise. We focus on+champion rare/invasive actions, when all along the simplest tasks make the greatest difference
But the bar was long ago set as a stepping stool, not a barrier. To continue to restrict our knowledge bases and interventions to life and limb threats is to ignore the greater half of our mandate--to stand ready for the wretched refuse, the tired, the poor.
Our learners are taught too often "that's not our job," as if the letters behind their name mean anything more that the mandate and magic of being our brothers' keeper. Residency program curricula are dominated by liability shifting, over-consulting, and under-treating.
And the patients suffer.

And the consultants suffer.

And the learners suffer.

And we all suffer.

...all because of a generation of entitlement, elitism, and abdication of responsibility.
Emergency medicine is dying, and needs resuscitation. It needs a refocus away from corporate ephemera, whether or not I can have snacks at my desk, and how much Yoga it'll take for me to not blow my head off after yet another shift where the speciality is denigrated...
..or i witness shit medical knowledge passed down to liability share, shift responsibility, abdicate accountability, or perpetuate a bastardized notion of what the emergency department means to our country's most in-need.
Emergency medicine is dying, and it's an enduring tragedy that we band of resuscitationists, we merry band of doctors so enamored with our ability to stare death in the face and live to tell the tale, will stand by and watch until the monitor sounds its final tone.
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