Dear Director: It’s getting harder for me to wake up every day excited to go to work in the ED. I just don’t like what’s happening in the department. I’m not sure I can continue for another 15 years. What do I do?
Emergency physicians love their autonomy, but adopting the right clinical protocols and “pathways” can result in safer, more efficient care.
Non-medical reading material to improve and expand your skills in management
Dear director: I want to hire a former resident colleague of mine. But since we’ve been out of residency, he’s settled two lawsuits and had another quality investigation. My Medical Staff Office tells me I won’t be able to get him credentialed. He’s a great guy and was a fantastic doctor as a resident. Shouldn’t I be able to hire who I want?
Dear Director: It’s a new year and although I’ve been in my chairman job several years, I’ve never done any kind of evaluation on the docs in my group. I give them annual bonuses but have started to wonder if they need more feedback. Do chairman typically do annual evaluations on their docs?
Dear Director: During a recent snow storm I couldn’t get in for a shift and I caught a lot of grief from my medical director about it. What’s my responsibility and what should I do if it happens again?
Dear Director: As part of my New Year’s resolution, I want to focus on being a more successful emergency physician. But I’m a little stuck. How do you define success in emergency medicine, and how do I move in that direction?
Dear Director: My hospital CEO told me to make sure my group is donating to the hospital foundation this year. Don’t I give enough to the hospital every time I take care of an uninsured patient? Why should I be doing this?
Dear Director: I recently had a nurse yell at me in front of everyone at the nursing station because I didn’t clean up after repairing a lac. It was an incredibly busy shift; I threw out the sharps but wanted to get back to work quickly so I left everything else for her to clean up. It had already taken her an hour to get everything out of the locked supplies closet so I could do my work. I think her behavior is inappropriate. What should I do?
My CEO is concerned about our ED’s quality because we’ve experienced a recent increase in our 72-hour returns for admission. As an ED chairman, I know that quality is about more than one metric, so how seriously should I take this?