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Beyond the ED: Holding Onto Why You Became an EP

McWilliams, Jeffrey MD

doi: 10.1097/01.EEM.0000520072.87114.84
Beyond the ED

Dr. McWilliamsis an emergency physician with Leading Edge Medical Associates and is the medical director of Excel ER in Longview, TX. He is a clinical instructor for the University of Texas and Louisiana State University, and has a strong interest in patient-centered care and provider satisfaction. Follow him on Twitter @Erdocjgm.





No child ever wakes up one day and exclaims, “I want to manage people when I grow up!” Or “I want to be involved in contract negotiations!”

Maybe a cherished few have these aspirations, and to them, I say, more power to you. But most of us said, “I want to be a doctor [or nurse or police officer or firefighter].” These childlike dreams and passions were what illuminated the path to our future careers. Long before we had concerns of insurance reimbursement, CMS regulations, or Joint Commission standards, we had aspirations of healing, saving, and making a difference.

As with most industries, health care is riddled with process and regulations that were put in place to replicate prior success and ensure resources are held in good stewardship. Unfortunately, these processes have created an ever-growing mound of regulations and red tape that can sometimes be exhausting. How do we stay motivated in this ever-evolving health care climate? How do we ensure the practice longevity and quality care that our patients deserve while being subject to increasing demands?

I think back to my childhood, moments with my father, and how I was fortunate to have such a wise figure in my life. He was an honorable man raised in modest circumstances that were riddled with poverty, public infidelity, and alcohol abuse. Somehow in the midst of it all, he endured and grew up to be a respected, successful businessman in our community. He never took things or himself too seriously. I can remember countless Saturday afternoons spent with my dad volunteering for Habitat for Humanity, Master's Hands, and other charitable organizations.

He was always going beyond the call of duty, giving time, money, and resources wherever a need surfaced. I often resented this as a young child. My friends were playing ball, watching cartoons, and fishing while I was painting walls, building bathrooms, or mowing grass with my dad.

But I wouldn't trade those lessons for the world. I can remember it like it was yesterday, sitting on a tailgate in the cool Arkansas night air, drinking Coke. You could hear the crickets chirping and the roar at the football stadium a few blocks over. It was at that moment that I understood my father, and gained a priceless gift that would form a foundation for all of my future aspirations. My father, a man of few words, said, “It's nice to get a gift, but nothing compares with the feeling you get when you do something for someone else. That feeling lasts a long time.”

I wish I could say that I applied that principle in my life immediately, but I didn't. My father probably thought I never heard a word he said, but I listened, and those words echo louder now than ever before.

How can this relate to our practice of emergency medicine? How is this relevant? As a physician and administrator, I understand the demanding commitments that go far beyond bedside patient care. These commitments are needed to ensure standards, regulatory process, and sound patient care.

I by no means want to minimize the process. As workloads increase and demands evolve, I go back to the basics of my practice. Why do I practice emergency medicine? What gives me the sense of satisfaction that will fuel my passion and commitment for many years to come?

It's the opportunity to ease the pain of those hurting, help the helpless, and comfort the lost in their times of need. It's the chance to look into the eyes of someone who is hurting and see beyond the chief complaint. It's the feeling you have after leaving it all on the table, walking through the ambulance bay doors into the night air knowing you gave it your all, not for yourself but for someone else. It's those moments when I understand my father's drive, and am forever grateful of the gift he instilled.

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