b'well. They believe that if you were to ask mosthe was delayed from entering an ED with a EM physicians what they would change aboutSTEMI in 2003 because they were waiting for the emergency department, it would not havehis electronic health records. The diligence of to do with the pace of work or patients, but athe physical exam is lost, he said about this mismatch they experience between responsibilityencounter and the declining amount of time and control over their work environment. EMphysicians and nurses spend at the patients physicians are held accountable for a variety ofbedside. Some things he attributes this to are the outcomes that may include patient flow, waitpressure of increasing patient volumes, smaller times, safety metrics, and patient satisfaction,hospitals closing, and physician burnout due to but often do not have complete control of factorstraumatizing experiences and fatigue. However, that impact these outcomes, like bed availability,to end on a more positive note, he believes these consult response times, or the growing number ofissues are salvageable and points to pushing for social behavioral health that EDs see by default.primary prevention more than ever. Dr. Burton He says a meaningful solution starts with "aligningis nonetheless proud to have been a practicing accountability with authority. Some ways thatEM physician and said the" For me personally, talking health care systems can enhance this is by treatingfield itself has seen great emergency care as an integrated front-end ofpositive progress forward the hospital rather than an isolated department.since the 1980s. EMto these emergency Shared ownership of throughput across inpatientphysicians have becomemedicine physicians at services, real-time solutions for boarding,recognized as specialists,various stages of their alternative ways of managing behavioral health,and the number of dual and social care for patients who dont benefit fromresidences and fellowshipscareer was very insightful ED treatment could really make the difference.available to EM residentsand has bolstered my He stressed that when emergency physicianshas steadily increased. passion for the specialty. are empowered to influence the systems theyre responsible for, outcomes improve; for patients,Medical Student hospitals, and the clinicians who care for them.Physician Perspective:Emeritus Physician Perspective: To end with some of my own thoughts. I hope this column sheds some realistic light on the Retired Philadelphia EM physician Barry Burton,field of EM for interested students. For me DOs perspective is very unique: In addition topersonally, talking to these emergency medicine being a physician, he also has been a patientphysicians at various stages of their career was as well as a former ED nurse. Throughout hisvery insightful and has bolstered my passion career from nurse to physician, he noticed howfor the specialty. While no system is perfect, much more health record driven emergencyyou can see there are plenty of ways to make departments have become, and how thenecessary changes to better the field for patients, profession has progressively drifted towardpractitioners, and hospital systems. I look forward increased protocolized medicine in some areasto trying my best to push for and implement and with some patient complaints. Personally,changes like these in the future!Winter 2026 13'