Factors associated with career longevity in residency-trained emergency physicians.

Abstract:

STUDY OBJECTIVE:To test the hypothesis that residency-trained emergency physicians who left the practice of emergency medicine do not differ significantly from those who continue to practice. DESIGN:A retrospective cohort study using a mailed questionnaire. TYPE OF PARTICIPANTS:Eight hundred fifty-eight emergency medicine residency graduates from 1978 through 1982. METHODS:A mailed questionnaire was used to obtain data from the study population. Individuals who did not respond to the first mailing were sent a second survey six weeks later. A sample of 10% of nonrespondents was contacted by telephone and compared with respondents on five variables. Respondents were divided into physicians who continued to practice emergency medicine and those who had elected to leave the specialty. The variables used to compare the two groups included personal and professional demographics, career satisfaction, and satisfaction with training. chi 2, Fisher's exact t-test, and logistic regression were used to analyze the data with an a priori level of significance set at .05. MEASUREMENTS AND MAIN RESULTS:There were 539 complete responses for a response rate of 62.8%. No statistical differences between responders and nonresponders were identified. The ten-year survival rate of respondents was 84.9%. Those who left emergency medicine were less likely to be board certified in emergency medicine (P less than .001), were more likely to be board certified in another field (P = .001), were less likely to work with residents during their emergency medicine practice (P = .009), and were more likely to report an annual gross income of less than $100,000 per year (P less than .001). Emergency physicians who have left the field were less likely to report being satisfied or very satisfied with their initial choice of emergency medicine as a specialty (P = .001). There was no difference in satisfaction with the quality of emergency medicine residency training (P = .183). CONCLUSION:Career longevity of residency-trained emergency physicians has been greater than early predictions. Interactions with residents, higher income, satisfaction with training decision, and board certification in emergency medicine are variables associated with a higher retention rate.

journal_name

Ann Emerg Med

authors

Hall KN,Wakeman MA,Levy RC,Khoury J

doi

10.1016/s0196-0644(05)80890-x

subject

Has Abstract

pub_date

1992-03-01 00:00:00

pages

291-7

issue

3

eissn

0196-0644

issn

1097-6760

pii

S0196-0644(05)80890-X

journal_volume

21

pub_type

杂志文章
  • Determination of cerebral cortical blood flow: a thermal technique.

    abstract::A mathematical model for tissue thermodilution was developed to study cerebral cortical perfusion before and after controlled perfusion arrest. Cerebral cortical perfusion rates are readily determined by this method. A thermistor was introduced into the subdural space and secured in direct contact with the frontal cor...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(83)80123-1

    authors: Hoehner PJ,Krause GS,White BC,Gadzinski DS

    更新日期:1983-01-01 00:00:00

  • Prospective, randomized trial of epinephrine, metaproterenol, and both in the prehospital treatment of asthma in the adult patient.

    abstract:STUDY OBJECTIVE:To compare the effectiveness and incidence of adverse reactions with three treatment regimens for asthma in adults in the prehospital setting. DESIGN:Prospective, randomized clinical study. SETTING:Inner-city emergency medical service system providing basic and advanced life support and transport to 1...

    journal_title:Annals of emergency medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/s0196-0644(95)70116-8

    authors: Quadrel M,Lavery RF,Jaker M,Atkin S,Tortella BJ,Cody RP

    更新日期:1995-10-01 00:00:00

  • Worst headache and subarachnoid hemorrhage: prospective, modern computed tomography and spinal fluid analysis.

    abstract:STUDY OBJECTIVE:This study investigated the hypothesis that modern computed tomographic (CT) imaging is sufficient to exclude subarachnoid hemorrhage (SAH) in patients with severe headache. METHODS:All 38,730 adult patients who presented to Hermann Hospital in Houston, Texas, during a 16-month period were prospectivel...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:

    authors: Morgenstern LB,Luna-Gonzales H,Huber JC Jr,Wong SS,Uthman MO,Gurian JH,Castillo PR,Shaw SG,Frankowski RF,Grotta JC

    更新日期:1998-09-01 00:00:00

  • Intravenous adenosine in the prehospital treatment of paroxysmal supraventricular tachycardia.

    abstract:STUDY OBJECTIVE:To determine the clinical efficacy and safety of IV adenosine administration in the field for the treatment of paroxysmal supraventricular tachycardia (PSVT). DESIGN:Prospective, consecutive case series. SETTING:An urban emergency medical services system. PARTICIPANTS:Thirty-seven adult patients in w...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(05)82650-2

    authors: McCabe JL,Adhar GC,Menegazzi JJ,Paris PM

    更新日期:1992-04-01 00:00:00

  • Randomized Trial of Intravenous Lidocaine Versus Hydromorphone for Acute Abdominal Pain in the Emergency Department.

    abstract:STUDY OBJECTIVE:We compare the efficacy and safety of intravenous lidocaine with that of hydromorphone for the treatment of acute abdominal pain in the emergency department (ED). METHODS:This was a randomized, double-blind, clinical trial conducted in 2 EDs in the Bronx, NY. Adults weighing 60 to 120 kg were randomize...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.annemergmed.2019.01.021

    authors: Chinn E,Friedman BW,Naeem F,Irizarry E,Afrifa F,Zias E,Jones MP,Pearlman S,Chertoff A,Wollowitz A,Gallagher EJ

    更新日期:2019-08-01 00:00:00

  • Probabilistic linkage of computerized ambulance and inpatient hospital discharge records: a potential tool for evaluation of emergency medical services.

    abstract:STUDY OBJECTIVES:Emergency medical services (EMS) is an important part of the health care system. The effect of EMS on morbidity, mortality, and costs of illness is difficult to evaluate because hospital information is not available in out-of-hospital databases. We used probabilistic linkage to create such a database f...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1067/mem.2001.115214

    authors: Dean JM,Vernon DD,Cook L,Nechodom P,Reading J,Suruda A

    更新日期:2001-06-01 00:00:00

  • Wound care of spider and snake envenomations.

    abstract::Venomous bites and stings are numerous but severe local tissue damage is uncommon. Venoms may be simple substances or complex mixtures of many poorly characterized components whose interactions are still not fully understood. The best studied example of a dermonecrotic venom is that produced by the brown recluse spide...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,评审

    doi:10.1016/s0196-0644(88)80360-3

    authors: Wasserman GS

    更新日期:1988-12-01 00:00:00

  • Acute HIV Discovered During Routine HIV Screening With HIV Antigen-Antibody Combination Tests in 9 US Emergency Departments.

    abstract:STUDY OBJECTIVE:Newer combination HIV antigen-antibody tests allow detection of HIV sooner after infection than previous antibody-only immunoassays because, in addition to HIV-1 and -2 antibodies, they detect the HIV-1 p24 antigen, which appears before antibodies develop. We determine the yield of screening with HIV an...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.annemergmed.2017.11.027

    authors: White DAE,Giordano TP,Pasalar S,Jacobson KR,Glick NR,Sha BE,Mammen PE,Hunt BR,Todorovic T,Moreno-Walton L,Adomolga V,Feaster DJ,Branson BM

    更新日期:2018-07-01 00:00:00

  • Pyrimidifen intoxication.

    abstract::We present a case of lethal ingestion of pyrimidifen, a new insecticide with an unclear mode of action. The primary manifestations were coma and circulatory shock, leading to irreversible multiorgan failure. Pyrimidifen was detected in the patient's blood, urine, brain tissue, and gastric content samples. Minimal stru...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1067/mem.2003.260

    authors: Eisinger M,Almog Y

    更新日期:2003-08-01 00:00:00

  • Variation in communication loads on clinical staff in the emergency department.

    abstract:STUDY OBJECTIVE:We determine whether there are differences in role-related communication patterns in the emergency department (ED). METHODS:This was an observational study of a metropolitan ED. Four medical officers and 4 nurses were observed for 19 hours and 52 minutes. Communication load was measured by proportion o...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2004.04.006

    authors: Spencer R,Coiera E,Logan P

    更新日期:2004-09-01 00:00:00

  • A model of cost-effectiveness of tissue plasminogen activator in patient subgroups 3 to 4.5 hours after onset of acute ischemic stroke.

    abstract:STUDY OBJECTIVE:The European Cooperative Acute Stroke Study III (ECASS III) showed that recombinant tissue plasminogen activator (rtPA) administered 3 to 4.5 hours after acute ischemic stroke led to improvement in patient disability versus placebo. We evaluate the long-term incremental cost-effectiveness of rtPA admini...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2012.04.020

    authors: Boudreau DM,Guzauskas G,Villa KF,Fagan SC,Veenstra DL

    更新日期:2013-01-01 00:00:00

  • The "fallen lung with absent hilum" signs of complete bronchial transection.

    abstract::A 19-year-old pedestrian who was the victim of a motor vehicle accident had a left pneumothorax with a large air leak. Despite a well-placed chest tube, a chest radiograph showed that the left lung had fallen down and away from the mediastinum and that no hilar structures were visible. This "fallen lung with an absent...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:

    authors: Endress C,Guyot DR,Engels JA

    更新日期:1991-03-01 00:00:00

  • Use of a Supraglottic Airway to Relieve Ventilation-Impeding Gastric Insufflation During Emergency Airway Management in an Infant.

    abstract::Positive-pressure bag-valve-mask ventilation during emergency airway management often results in significant gastric insufflation, which may impede adequate ventilation and oxygenation. Current-generation supraglottic airways have beneficial features, such as channels for gastric decompression while ventilation is ong...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2016.03.016

    authors: Dodd KW,Strobel AM,Driver BE,Reardon RF

    更新日期:2016-10-01 00:00:00

  • Informed consent in emergency care: illusion and reform.

    abstract::Many patients seeking care in the modern emergency center are capable of participating in treatment decision making. In the traditional emergency center consent process, the patient or a surrogate is asked to sign a general consent form purporting to authorize any treatment the emergency physician deems necessary. We ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(87)80289-5

    authors: Boisaubin EV,Dresser R

    更新日期:1987-01-01 00:00:00

  • Temporary cardiac pacing in traumatic arrest victims.

    abstract::Temporary ventricular pacing was successfully employed in two patients suffering refractory bradycardia following traumatic cardiac arrest. The hemodynamic response to pacing was dramatic and both patients eventually recovered fully from an apparent moribund state. Cardiac pacing may be an effective adjuvant in the ea...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(80)80233-2

    authors: Millikan JS,Moore EE,Dunn EL,Van Way CW 3rd,Hopeman AR

    更新日期:1980-11-01 00:00:00

  • Geriatric-specific triage criteria are more sensitive than standard adult criteria in identifying need for trauma center care in injured older adults.

    abstract:STUDY OBJECTIVE:We evaluate the sensitivity of Ohio's 2009 emergency medical services (EMS) geriatric trauma triage criteria compared with the previous adult triage criteria in identifying need for trauma center care among older adults. METHODS:We studied a retrospective cohort of injured patients aged 16 years or old...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2014.04.019

    authors: Ichwan B,Darbha S,Shah MN,Thompson L,Evans DC,Boulger CT,Caterino JM

    更新日期:2015-01-01 00:00:00

  • The emergency department utility of Simplify D-dimer to exclude pulmonary embolism in patients with pleuritic chest pain.

    abstract:STUDY OBJECTIVE:Pleuritic chest pain is a common presenting complaint in the emergency department (ED) and a symptom of pulmonary embolism. Patients with pleuritic chest pain would benefit from a simple and rapid way of screening for pulmonary embolism. The aim of this study is to assess the utility of Simplify D-dimer...

    journal_title:Annals of emergency medicine

    pub_type: 临床试验,杂志文章

    doi:10.1016/j.annemergmed.2005.03.018

    authors: Hogg K,Dawson D,Mackway-Jones K

    更新日期:2005-10-01 00:00:00

  • Delayed treatment of serious decompression sickness.

    abstract::We report the cases of three patients with residual symptoms from diving decompression sickness, each of whom presented to a recompression chamber three to seven days following original exposure. All three had complete resolution of symptomatology despite the delayed treatment. The late resolution of symptoms is evide...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(85)80450-9

    authors: Myers RA,Bray P

    更新日期:1985-03-01 00:00:00

  • The time dependence of antithrombin initiation in patients with non-ST-segment elevation acute coronary syndromes: subgroup analysis from the ACUITY trial.

    abstract:STUDY OBJECTIVE:Antithrombins are among standard treatment agents for patients with non-ST-segment elevation acute coronary syndromes. We aimed to determine the association between time from emergency department (ED) presentation to treatment with an antithrombin and adverse cardiac events. METHODS:The study cohort wa...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.annemergmed.2010.06.567

    authors: Diercks DB,Pollack CV Jr,Hollander JE,Blomkalns AL,Emerman CL,Rokos IC,Larson DM,Hoekstra JW,Mehran R,Stone GW

    更新日期:2011-03-01 00:00:00

  • An introduction to the Bayesian analysis of clinical trials.

    abstract::Although most clinical trials comparing therapies are analyzed using classical hypothesis testing and P values, such methods do not yield the information most useful to the clinician, that is, the probability that one treatment is more efficacious than another. Bayesian inference can yield this probability but only if...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(05)80119-2

    authors: Lewis RJ,Wears RL

    更新日期:1993-08-01 00:00:00

  • Crisis intervention in an emergency setting.

    abstract::The situational crisis is a period of acute disorganization of affective cognitive and behavioral function precipitated by a traumatic life experience. We review the clinical features of a situational crisis and the four phases of the crisis sequence. Special emphasis is placed on the practical principles of treatment...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(83)80513-7

    authors: Rabin PL,Hussain G

    更新日期:1983-05-01 00:00:00

  • Carbon monoxide controversies: neuropsychologic testing, mechanism of toxicity, and hyperbaric oxygen.

    abstract::Recent animal and clinical data require a reevaluation of the traditional approach to the patient exposed to carbon monoxide. Unfortunately, these new data are inconclusive and generate controversies regarding the indications and value of neuropsychologic testing, cause of carbon monoxide toxicity, and indications (if...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,评审

    doi:10.1016/s0196-0644(94)70136-9

    authors: Seger D,Welch L

    更新日期:1994-08-01 00:00:00

  • Training with video imaging improves the initial intubation success rates of paramedic trainees in an operating room setting.

    abstract:STUDY OBJECTIVE:Video imaging of intubation as seen by the laryngoscopist has not been a part of traditional instruction methods, and its potential impact on novice intubation success rates has not been evaluated. METHODS:We prospectively tracked the success rates of novice intubators in paramedic classes who were req...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1067/mem.2001.111516

    authors: Levitan RM,Goldman TS,Bryan DA,Shofer F,Herlich A

    更新日期:2001-01-01 00:00:00

  • Adverse Effects of Immune Checkpoint Therapy in Cancer Patients Visiting the Emergency Department of a Comprehensive Cancer Center.

    abstract:STUDY OBJECTIVE:Cancer immunotherapy is evolving rapidly and is transforming cancer care. During the last decade, immune checkpoint therapies have been developed to enhance the immune response; however, specific adverse effects related to autoimmunity are increasingly apparent. This study aims to fill the knowledge gap...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2018.04.019

    authors: El Majzoub I,Qdaisat A,Thein KZ,Win MA,Han MM,Jacobson K,Chaftari PS,Prejean M,Reyes-Gibby C,Yeung SJ

    更新日期:2019-01-01 00:00:00

  • The Effect of Opioid Prescribing Guidelines on Prescriptions by Emergency Physicians in Ohio.

    abstract:STUDY OBJECTIVE:The objective of our study is to evaluate the association between Ohio's April 2012 emergency physician guidelines aimed at reducing inappropriate opioid prescribing and the number and type of opioid prescriptions dispensed by emergency physicians. METHODS:We used Ohio's prescription drug monitoring pr...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2017.03.057

    authors: Weiner SG,Baker O,Poon SJ,Rodgers AF,Garner C,Nelson LS,Schuur JD

    更新日期:2017-12-01 00:00:00

  • Incidence of clinically important biphasic reactions in emergency department patients with allergic reactions or anaphylaxis.

    abstract:STUDY OBJECTIVE:Allergic reactions are common presentations to the emergency department (ED). An unknown proportion of patients will develop biphasic reactions, and patients are often monitored for prolonged periods to manage potential reactions. We seek to determine the incidence of clinically important biphasic react...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2013.10.017

    authors: Grunau BE,Li J,Yi TW,Stenstrom R,Grafstein E,Wiens MO,Schellenberg RR,Scheuermeyer FX

    更新日期:2014-06-01 00:00:00

  • Cardiac arrest witnessed by emergency medical services personnel: descriptive epidemiology, prodromal symptoms, and predictors of survival.

    abstract:STUDY OBJECTIVE:The Utstein guidelines recommend that emergency medical services (EMS)-witnessed cardiac arrests be considered separately from other out-of-hospital cardiac arrest cases. The objective of this study was to assess EMS-witnessed cardiac arrest and to determine predictors of survival in this group. METHOD...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/S0196-0644(00)70133-8

    authors: De Maio VJ,Stiell IG,Wells GA,Spaite DW,OPALS Study Group.

    更新日期:2000-02-01 00:00:00

  • Evaluation of a rapid theophylline test strip assay in the emergency department setting.

    abstract::Test strips recently have become available to measure theophylline levels. One such test strip (AccuLevel) had not been tested in an actual clinical situation with nontechnician personnel. We prospectively evaluated the test strip on consecutive emergency department patients, comparing it with the agglutination inhibi...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(88)80440-2

    authors: Hurley WT,Saglio SD,Henley CE,Gatrell CB

    更新日期:1988-10-01 00:00:00

  • Tourniquet syndrome caused by metallic bands: a new tool for removal.

    abstract::Reported are two cases of metallic constricting devices presenting to our emergency department. A 40-year-old man was unable to remove a steel ring from his engorged penile shaft after autostimulation, and a 22-year-old man riveted a metallic nut onto his right index finger proximal to his distal interphalangeal joint...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(82)80368-5

    authors: Greenspan L

    更新日期:1982-07-01 00:00:00

  • Effects of sodium dichloroacetate dose. Brain metabolites associated with cerebral ischemia.

    abstract::Excessive brain lactate, as may develop in cerebral ischemia, has been implicated as a major cause of irreversible cell damage. With an experimental model that produces cerebral ischemia by bilateral carotid ligation combined with systemic hypotension, previous studies have shown that treatment with 25 mg/kg sodium di...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(89)80054-x

    authors: Dimlich RV,Timerding BL,Kaplan J,Cammenga R,Van Ligten PF

    更新日期:1989-11-01 00:00:00