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What's Your ER Experience?

My name is Anil Menon, and I am a first year resident in the Stanford-Kaiser emergency medicine program; however, this winter I found myself playing the role of the patient, which was less than stellar but eye opening at the same time. This experience caused me to reevaluate my interactions with patients and also taught me a lesson in heeding the advice of my mentors…

Being a health care worker, you’re exposed to many viruses and often become a victim of the very illnesses you are trying to treat. Rhinoviruses, coronaviruses, and the respiratory syncytial viruses (RSV) are the typical culprits that cause the “common cold.” Let’s not forget the enterovirus, which triggers gastroenteritis - in plain English, this means diarrhea and vomiting. The only means of prevention against these viruses is routinely washing your hands, getting proper amounts of rest, drinking fluids, and decreasing your stress levels – easier said than done, especially for a first year resident.

The flu virus is one you CAN nip in the bud by getting the flu shot. This is especially important for people who are at a higher risk of infection, such as health care workers…However, I ignored Dr. Bob’s advice and skipped taking the flu shot. Needless to say, I came down with the flu in February. If I were describing my case to one of my attendings, I might say "A 30 year old male, Emergency Medicine (EM) resident complaining of fever to 104 for 3 days, non-productive cough, runny-nose, decreased oral intake, tolerating liquids - looks like the flu." The compassion I received from my fellow residents helped strengthen me. They could easily commiserate, because a short sentence like that evokes a fear of non-existent down time. However, my experience with my own doctor wasn't as warming. Though I knew I had the flu and I knew the treatment would be oral rehydration and rest, I still scheduled an appointment to make sure I was not missing anything--as I said, I'm still in training. My doctor was behind schedule, when she whisked into the room, trying to catch up. She quickly looked into my ears and throat, before saying hello, and told me I was correct all along and probably should have saved my energy and stayed in bed. I've been there. I understand. Despite knowing the disease and knowing how the system works, I left disappointed and feeling overlooked.

Even more troubling was the fear that I might have treated some of my patients similarly while trying to manage new diseases and new systems. Different patient encounters flashed in my mind as I tried to reevaluate my interactions. My memories also brought me back to a class held at the Stanford Graduate School of Business (GSB) called interpersonal dynamics or nicknamed "touchy feely." In class we practiced giving, receiving, and eliciting feedback. Feedback is something they find hugely valuable in management positions--making it the most popular GSB course--but I thought was overlooked in medicine--spurring me to register. A moderator helped direct this free form discussion that would twist and turn in unexpected ways. It always surprised me how different my perceptions could be from the other people in the discussion group. The only way to find out was to ask them directly, and they were often happy to answer. Most were also receptive to suggestions that were based on feelings. Instead of saying you are a careless doctor, we started saying the speed of your examination made me feel unimportant. Both asking for and giving feedback can be anxiety provoking, but I think it would be worse to head on a trajectory of leaving people unsatisfied than not being able to ask.

I’m interested in hearing feedback and suggestions for improvement from any readers regarding your experience in the ER. I know Stanford Emergency Department is committed to improving customer service and I'm sure more people than myself are interested in hearing what you have to say. This year the Stanford ER staff even participated in a day long retreat focusing on customer service and areas in need of improvement. The role playing and discussion amongst ourselves was an important step toward our commitment to customer service, but nothing beats direct feedback. I also have to say nothing beats the eye opening experience of the doctor being in the patient’s role.

I invite you to leave comments about your ER experience,
Anil Menon, MD
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About the Author

The Stanford Emergency Room is the center of emergency care at Stanford University.