Emergency department administration and management

The practice of clinical emergency medicine is difficult in the modern health care environment. We can be proud of the fact that emergency physicians are there 24 hours every day to assist with medical emergencies while satisfying crucial needs that society has otherwise neglected. The emergency department is often the first and last resort for approximately 110 million patients annually. Increasingly emergency physicians are challenged not only with clinical work but also with administrative and management responsibilities. Without effective management and administration skills or resources, clinical emergency medical practices can fail and patient care will suffer. But how does an emergency physician learn about administration and management? Emergency medicine physicians traditionally learn how to manage through experience. This experience may be easier for some who can use natural skills to be successful. Others have learned from mentoring with more experienced physicians. For the future it is important that emergency medicine residents learn and master administrative portions of the core curriculum. Traditionally such administrative and management topics during training were given little attention. Some program directors and some residents considered them only a necessary “filler,” certain that clinical medicine was the real challenge. Several texts more recently have addressed administration and management in emergency medicine and are an additional source of information for those interested in developing administrative skills. Some emergency medicine management companies provide specific training for those with skills and interest in learning more about emergency medicine management. The good news for emergency medicine physicians is that more information is becoming available to learn about emergency medicine management. Sharing this management knowledge and experience is critical for our specialty's success. I am proud to work with the contributors in this Clinics edition whose work will make emergency medicine management information more accessible and thus better. It is one more step toward ending divisiveness in emergency medicine by focusing on learning and resolving challenges that affect our patients, our hospitals, and us as providers.

Many thanks to the contributors who took time from incredibly busy schedules to share information with the readers. Thanks to the office staff at Northwest Emergency Physicians and Team Health who allowed me the time and resources to help with this edition. Thanks to the staff at Emergency Medicine Clinics who made this publication possible, especially Karen Sorensen. And special thanks to all the emergency medicine physicians who are out there 24 hours each day making a real practical difference in individuals' lives and in assisting in societies needs.