According to the National Hospital Ambulatory Medical Care Survey (NHAMCS), less than half of emergency department visits (47 percent) in 2004 were classified as either emergent (12.9 percent) or urgent (37.8 percent).

This statistic is a terrific reality check for the current state of the field that we are choosing to go into. It is wise to come to terms with this information before embarking on a career in emergency medicine.

Expanding the definition of therapy, Dr. Chris Richards, St. Charles ED in Bend, OR

Therapy can be extremely simple, in just providing comfort or a warm safe place for a few hours.

Don’t think that just because you’re not providing medicine or performing a procedure that you can’t help a patient.

Realize that challenging patients sometimes have simple needs, which are easy to provide.

Aspects of the healing influence, Dr. Magnus Lakovics, St. Charles PES Unit in Bend, OR

  1. Confiding relationship – a feeling of trust
  2. Arousal of hope
  3. Etiological explanation – showing that YOU at least know what is going on
  4. Providing alternatives – demonstrating possible ways forward
  5. Emotional arousal – expressing feeling state is therapeutic as illness is distressing
  6. Positive outcome

Music credit: “Better Days” from http://www.bensound.com

Articles cited in this episode:

Frank, Jerome D (July 1971). “Therapeutic factors in psychotherapy”. American Journal of Psychotherapy 25 (3): 350–361. PMID 4936109.

NHAMCS: http://www.cdc.gov/nchs/ahcd.htm

Trent Burgess, MS3 at Oregon Health & Science University

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