The other guy is crazy

I apparently created a controversy on the emergency physician blogs – DB’s Med Rants slurs EP’s. I have tried to explain my position in his comment section.

I was a resident before emergency medicine became specialty.  In those days, the medical residents ran the medicine ER and the surgery residents ran the surgery ER.  We did not have attending supervision.

When you were running the medicine ER, clearly the residents on the floor were hostile, argumentative, and irrational.  When you were the resident on the floor, the resident in the ER clearly had lost all perspective.  They either admitted without a proper evaulation, or they admitted too late because of an over excessive evaluation.  They admitted when they should never have considered admission.

Was this temporary insanity?  No, this was turf.  We all protect our turf.  I submit that this tendency is the normal human condition.

The problem is exaggerated because emergency physicians and hospitalists represent different specialties, different training and therefore different world and medical views.  We must find common ground, but turf does intrude.

One of the biggest problems in hospital medicine comes when a patient is admitted but the bed is not ready upstairs.  Who has responsibility for the patient staying in the ED?  Another turf battle occurs at most hospitals in the country. 

So if ED physicians feel that I am insulting them, I am not.  I do believe we could both learn from each other.  But our conflicts are inevitable and often not medical.