What was lacking, however, was a vision of emergency medicine as an academic specialty with a core fund of knowledge, a biology, and an organizational structure like the traditional specialties had.
Explore This IssueACEP Now: Vol 38 – No 12 – December 2019
Peter Rosen had become a visionary advocate for the specialty of emergency medicine at the perfect time.
Transforming Emergency Care
From his position, he began his lifelong mission of transforming emergency care in this country. He started a residency in Chicago and then another one in Denver, when he moved there in 1977 to become director of the department at what was then Denver General Hospital (today Denver Health Medical Center).
Sensing the need for a formalized curriculum, he spearheaded the first textbook written by and for emergency physicians, Rosen’s Emergency Medicine: Concepts and Clinical Practice. At the helm of this large undertaking, Peter in essence defined the parameters and the body of knowledge of our specialty. The book is now in its ninth edition, and the 10th is well under way.
After Denver, he built the residency in San Diego and guided the development of the academic departments at the Harvard-affiliated hospitals. He also served as faculty at the University of Arizona in Tucson, completing his career as the senior mentor for three vibrant academic departments.
In 1979, he wrote an influential paper published in the Journal of the American College of Emergency Physicians (today known as the Annals of Emergency Medicine) outlining “the biology” of emergency medicine and defining ownership of an area of basic science that would define emergency medicine. He founded the Journal of Emergency Medicine to further enrich and support academic work in the new specialty.
Despite his academic and educational achievements, however, Peter’s first loyalty was always to the patient.
Peter was also interested in some of the legal implications of practicing emergency medicine and believed that our legal tort system had, in part, triggered the creation of our specialty by compelling hospitals to staff emergency departments with trained providers. In 1990, he wrote about the importance of being a plaintiff expert witness, saying that “physicians who work as an expert for just the defense may appear to a jury to be less objective than physicians who are willing to testify that another physician was negligent.” He believed that impartial experts evaluating cases for plaintiffs’ attorneys would invisibly stop many lawsuits before they were ever filed. But he also felt that validating legitimate claims by injured patients was important as well. “The last guarantee of fairness in the system is to have available the testimony of honest physicians,” he said. “In the long run, this will prove the strongest defense against nonobjective partisan testimony proffered only to further the financial gain of the dishonest expert.” In pursuit of this, he testified for patients and physicians for 40 years and earned a reputation of uncompromising honesty. However, Peter’s testimony against another physician in a case several years ago was criticized, turning his long-held beliefs into a surprisingly public issue. While he was officially censured by ACEP, Peter always maintained that his testimony had been medically justified and that he was simply acting upon the beliefs that he had voiced and practiced for years.