Five Questions With: Dr. Brian Zink

"The single most important technological advance that has reduced death and injuries in my career is safety restraints and airbags in vehicles."

Dr. Brian Zink is chief of emergency medicine for Rhode Island, The Miriam and Newport hospitals, and is the author of “Anyone, Anything, Anytime: A History of Emergency Medicine.” He was recently featured in a Rhode Island PBS documentary about the history of emergency medicine.

PBN: How long has emergency medicine existed as a medical specialty, and how is it defined?
ZINK:
Emergency medicine became a certified board within the American Board of Medical Specialties in 1979 and then gained status as a primary board – the American Board of Emergency Medicine – in 1989. Emergency medicine is a specialty that focuses on the acute care of illness and injury. It provides round-the-clock care to people of all ages and with all types of medical and psychiatric problems that require immediate attention.

PBN: Before the creation of emergency medicine as a specialty, was it an “unofficial” specialty that built its knowledge base in-situ?
ZINK:
Emergency medicine as a medical field grew out of a public demand for emergency care, with emergency department visits increasing dramatically from post-WWII to the 1980s, and still increasing today to more than 130 million visits per year. The first full-time practitioners of emergency medicine, who came from other fields, started in 1960. The first specialty organization of emergency medicine, the American College of Emergency Physicians, started in 1968, and residency training programs started in 1970. So, a lot of things were developed outside the medical establishment before official approval as a board.

PBN: Have emergency rooms been influenced by military hospitals during wartime and/or disaster site triage centers?
ZINK:
The Korean War (think of “M*A*S*H”) first showed that coordinated emergency medical services combined with rapid transport to qualified medical care teams (Army field hospitals) could greatly improve survival in people with traumatic injuries and shock. This was reinforced by the Viet Nam war medical team experiences. The medics and physicians who came out of these wars were appalled to see the poor state of EMS and emergency care in the U.S. civilian world. It was said at the time that you had a better chance of surviving a gunshot wound if you were wounded in a jungle in Viet Nam than if you were shot on the street of a major U.S. city. This drove a lot of attention at a national and local level to improving pre-hospital care, EMS, and stimulated the fields of emergency medicine and trauma surgery.

- Advertisement -

PBN: What single technological advancement during your career in emergency medicine has saved the most lives?
ZINK:
This may be surprising to most people, but for all the advances we have made in medical technology to improve diagnosis and enhance emergency treatment, the single most important technological advance that has reduced death and injuries in my career is safety restraints and airbags in vehicles. When I was in training, I would routinely see people killed and maimed in motor vehicle crashes as they hit the steering wheel or were ejected from vehicles. Now, people have no injuries or minor injuries even from higher energy crashes if they wear their seat belts and their airbags deploy. So, preventing injury is just as important as treating it.

PBN: What protocols, if any, exist for emergency medicine doctors to avoid burnout, and is the perception that it is a field with a high level of burnout accurate?
ZINK:
In the group of 100 emergency physicians that I lead, we have not had one physician leave the field due to burnout in the past eight years. Certainly, the intensity of the work, the irregularity of the schedule – having to cover all hours of the day, 365 days a year – can cause stress. On the other hand, the incredible variety of cases, the fact that you are directly in touch with your community as an emergency physician, making crucial diagnostic and treatment decisions, and the responsibility of having to rapidly create trust with patients and families all makes the work incredibly fulfilling and rewarding. In our group, we offer a number of sessions each year on wellness and avoiding burnout, and this is increasingly common for emergency physician groups.

No posts to display