Print

Print


Sounds like a great opportunity to evaluate the pediatricians questions
or beliefs that there are differences.  What are the perceived
differences?  What are the "quality care indicators" that you mention?
This study could give us all insight and an objective view of this
question.

Mick Connors

-----Original Message-----
From: Pediatric Emergency Medicine Discussion List
[mailto:[log in to unmask]] On Behalf Of Rick Place MD
Sent: Wednesday, September 04, 2002 7:09 PM
To: [log in to unmask]
Subject: ACEP and PEM

We are having a similar discussion in our hospital. We have a
"pediatric"
emergency section that is incorporated (not separate from at this time)
the
adult emergency department. The section that sees all the children also
sees
less acutely ill adults. This area is staffed by adult EM physicians and
PEM
trained physicians (mostly adult EM with fellowship training) working
side by
side. We have a very respectful relationship and little of the acrimony
in
the previous discussionss

But the perceived difference is creating significant tension OUTSIDE the
emergency department. There is a lot of pressure right now from the
pediatricians to have only pediatric physicians see the kids. Where it
is
real or not there is a perception of differing care from the community.
The
adult EM physicians are feeling threatened by this attitude and maintain
that
if you actually look at quality of care indicators, no difference will
be
noted. I think that Lou Hampers in Denver did a fabulous job of placing
this
entire discussion in perspective.

I believe I have a unique (albiet not exceptional) perspective. After
completing a peds residency I completed an adult ED residency and from
actual
experience, Lou hit the nail on the head. The number of very sick adults
that
the adult ED resident encounters in 3-4 years greatly exceeds the number
that
come through most pediatric EDs. On the other hand, as a pediatrician I
"know" kids in a way that no general ED physician can. I believe my
adult
collegues are very skilled in caring for critically ill children and
would
trust them with my own children. On the other hand, I would bet less
obvious
problems like intussusception more frequently are missed on the first go
around. Both groups have strengths and they are a little different; so
in
some ways it is like comparing oranges and tangerines.

Rick Place
INOVA Fairfax Hospital
Falls Church, Northern VA

For more information, send mail to [log in to unmask] with the
message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
  http://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html

For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
  http://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html