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How to Find Your Niche in Emergency Medicine

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Medical Director Banner Samaritan Regional Poison Control Center ... Death Clock. Longevity. Happiness. I will die at age 96. 43 less years! I will die at age 53 ... – PowerPoint PPT presentation

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Title: How to Find Your Niche in Emergency Medicine


1
How to Find Your Niche in Emergency Medicine
  • Glenn C. Hamilton, MD
  • Professor and Chair
  • Wright State University
  • CORD Academic Assembly
  • Las Vegas, NV 2009

2
Full Credit for Use of slides to
  • Frank LoVecchio, DO, MPH, FACEP
  • Medical Director Banner Samaritan Regional Poison
    Control Center
  • Research Director, Maricopa Medical Center, Dept.
    of Emergency Medicine
  • Associate Prof., AZ College of Osteopathic
    Medicine
  • Making yourself Invaluable CORD Academic
    Assembly, 2007

3
  • The 3 levels of faculty/
  • attending performance
  • Baseline level of activity competency/attitude
  • What you uniquely give to the organization that
    you also enjoy
  • Whatever pertinent or tangential topics you want
    to pursue.

4
  • What happens if you dont
  • cover these three tiers in the Department?

5
  • Lets redefine Niche
  • Its not the Bun or the
  • Toppings
  • Its the MEAT of your career!

6
  • Finding the Niche is when
  • youve identified specific personal
  • characteristics, strengths, and
  • interests that DEFINE your
  • position in the Department
  • (academic or clinical)But
  • that alone may be insufficient.

7
Linkage Between the Layers
  • Importantly, you will have several niches over
    the course of your career
  • Individually and collectively, these niche
    performances PLUS a steady fulfillment of the
    Baseline Level of Activity will secure your
    position and likely advancement in the group
  • THIS IS HOW YOU BECOME INVALUABLE!

8
Even in the toughest times, employees can be in
charge of their own destiny by seeking ways to
make themselves more valuable to those they work
for
9
Making Yourself InvaluableAlternative Titles
  • Giving Back to Our Field
  • How to be a Team Player
  • Follow the Golden Rule
  • Infamous vs. Famous?

10
Baseline Level of Activity Competency/Attitude
  • Be Positive
  • Be Competent
  • Embrace Common Sense
  • Be Human
  • Dont Be Afraid
  • PLAN HOW TO MAKE
  • YOURSELF INVALUABLE!

11
Studies on Attitude
  • Death Clock
  • Longevity
  • Happiness

12
I will die at age 96
13
43 less years!
I will die at age 53
14
58 years difference
I will die at age 37
15
Invaluable Available
  • Among the most effective becoming invaluable
    strategies is to volunteer to take on additional
    daily responsibilities or to chair task forces
    assigned to tackle cost-cutting or
    customer-service improvements.
  • That alone won't be enough to emblazon your name
    on management's "must-keep" list. Workers
    sometimes must go out of their way to remind
    supervisors of their accomplishments, i.e.
    reports
  • Don't be a braggart, but be assertive in
    outlining what you have done for your colleagues.

16
Available Time Management
  • Time can be saved by eliminating unnecessary
    meetings, grouping tasks, minimizing downtime,
    and making use of electronic tools
  • Time is more valuable than money, and cannot be
    replaced

17
  • Keep the following summary BASICS OF TIME
    MANAGEMENT
  • List goals and priorities.
  • Keep first things first.
  • Make and use a daily to-do list, and weekly
    summary.
  • Start with the A tasks and not with C tasks.
  • Ask yourself, "What is the best use of my time
    right now?"
  • Handle each piece of paper only once.
  • Treat time as the valuable resource it is.
  • Do it now! Complete one task per day minimum!

18
Academics vs Clinical Pathway
  • Baseline of both defined as above.
  • is differentiator actual/philosophical
  • Both begin with the End in Mind, but
    ClinicalAcademic
  • Lets examine 3 Niches in each broad area
  • High
  • Medium
  • Low

Upward mobility in group
19
Academics Research Emphasis (High)
  • High impact, Highly sought, High risk
  • Mobility potential, but only if successful, and
    desired
  • In EM, almost everything counts
  • Find an area and stay with it

20
Preparation for Research
  • Heritage
  • EMBRS in Residency
  • Fellowship 2 year minimum, with
    added degree
  • Coat-tailing, mentorship
  • Seek supportive environment

21
Emergency medicine research directors and
research programs characteristics and factors
associated with productivity.
  • METHODS A survey of EM RDs Three measures of
    research productivity were empirically defined
    research publications, grant awards, and grant
    revenue.
  • RESULTS Responses were received from 86 of 123
    EM programs. Productivity was associated with the
    presence of nonclinical faculty, dedicated
    research coordinators, and reduced clinical hours
    for research faculty. Programs with an RD did not
    have greater research productivity, using any
    measure, than those without an RD. The majority
    of RDs cited pursuing their own studies,
    obtaining funding, research mentoring, and
    research administration to be major
    responsibilities. The majority characterized
    internal research funding, grant development
    support, and support from other faculty as
    inadequate.
  • CONCLUSIONS Research productivity of EM
    residency programs is associated with the
    presence of dedicated research faculty and staff
    and with reduced clinical demands for research
    faculty. Most RDs are professionally satisfied.

Karras DJ Kruus LK Baumann BM et al, Acad
Emerg Med. 2006 Aug13(8)911
22
Academics Educator Emphasis (Medium)
  • Basic bedside teaching , if none or poor ?
    negative
  • Two main tracks Medical Student, Education
    Director in Residency
  • New opportunity Simulation Master
  • Bonus Education Research

23
Preparation for Education Emphasis
  • Teaching Fellowship ACEP, early alignment with
    CORD, elements of SAEM, AAMC
  • Pursue Faculty Development 1 year Fellowship
  • Scholarly writing reviews
  • Experience Technology Simulation, US

24
Be it Research or Education-Parlay!
  • Never do anything once!
  • If asked to do a Q/A project
  • Make it a study
  • Write up the experience
  • If giving a talk
  • Submit a review article
  • If you think a certain method of teaching
    works
  • Test it

25
Roles in Academics With Less Direct Career Path
  • Unless research/education involved
  • Clinical Services Chief
  • Specialty Services linkage Peds, Crit Care,
    Geriatrics, Trauma
  • Ultrasound
  • Clinical practice roles (QA/RM, Billing) in
    academic dept.

26
  • Toxicology / Sports Med / Hyperbarics
  • EMS / Disaster Preparedness
  • Professional outsider
  • IT guru

27
Academic career development for emergency
medicine residents a road map.
  • Enhance his or her "academic marketability"
  • 1) involvement in research
  • 2) establishment of a track record of
    productivity via scholarly writing
  • 3) awareness of the literature in the specialty
  • 4) involvement in specialty organizations and
    hospital committees
  • 5) competition for national awards
  • 6) gaining education skills
  • 7) developing an academic niche
  • 8) fellowship training.

Stead LG Sadosty AT Decker WW- Acad Emerg Med -
01-MAY-2005 12(5) 412-6
28
Clinical Group Environment
  • More important to have the end in mind ?
    Medical Director
  • Opportunity at one site is dead end at another
  • More serendipity Luck of the Draw
  • Few bad tracks still some higher yield

29
High Yield Tracks
  • Chief of Staff track representative to hospital
  • Reimbursement
  • Complaint management, incorporates QA, patient
    satisfaction, risk management

30
Medium Yield, But Important
  • EMS/Disaster varies with setting, competition
  • CME support
  • Longevity support social and wellness
  • IT moving up scale if geek quotient low

31
Bottom Line Triple Threats Still Win!
  • Old Teaching/Research/Service
  • New Admin/Leadership/Attitude

32
7 habits
  • Habit 1 - Be Proactive
  • Habit 2 - Begin with the End in Mind
  • Habit 3 - First Things First
  • Habit 4 - Think Win Win
  • Habit 5 - Seek First to Understand
  • Habit 6 Synergize
  • Habit 7 - Sharpen the Saw

Bottom Line Its all About You! But only to
the degree youre all about everyone else!
33
Habit 7 - Sharpen the Saw
  • In this habit, you are the saw and to Sharpen
    the Saw is to become better, keener and more
    effective.

34
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