KK: Those who do not recognize history are doomed to repeat it. Do you see us revisiting history?
GH: We went from, early after the Second World War, seeing 20 million emergency visits to now something around 140 million visits or more. We can’t rest on our laurels. We’ve built a specialty, but the work of the next half century is just beginning. Innovative care models are being contemplated and designed. I think that our people are superbly trained and experienced to handle many of these situations [eg, telemedicine]. If we don’t pursue this with the same vitality, we can be sucked up and blown away with the tide of history by other people who want to get into these areas as well.
I’m spending time with people who are looking at health care in America and why it’s costing us two or three times more to take care of patients than it costs elsewhere. They are asking important questions, which we should be anticipating. We need to be on the side of history, figuring out how to provide better care for less money, with less utilization of expensive technology.
KK: Where do you see emergency medicine in the future?
GH: We are going to have to evaluate the medical educational system. Many countries in the world do not send you for four years to get a degree before you start your medical training. What role will [physician assistants, nurse practitioners, emergency medical technicians,] etc.] play, and how should we guide this? I see emergency physicians of the future being more involved in thinking and providing opinions than just sewing up wounds. For example, physicians don’t need to repair most lacerations. The business world and consumers will continue to pose questions of value that we must be prepared to answer.
KK: Any words of wisdom for younger emergency physicians for a successful and fulfilling career?
GH: The best way that the young physician coming up can handle burnout is to like what you do for a living. I love my work and always have.
I think we need to start programming and help our young docs program themselves to have a logical progression of their career. You start out on midnights wrestling intoxicated patients. You may end up running a telemedicine service that covers half the state of Montana. The way we fight burnout and this feeling that we’re not accomplishing anything is to always have another goal, something we’re going to do to expand and revitalize our careers.