急诊医生在不同临床环境中的多样化执业.pdf

1、Ugo A.Ezenkwele,MD,MPH,FACEPAndrea Green,MD,FACEPChadd Kraus,DO,DrPH,CPE,FACEPJuly 9,2025THE DIVERSE PRACTICE OF EMERGENCY PHYSICIANS ACROSS VARIED CLINICAL SETTINGSEmergency Medicine Practice SettingsAcademic Emergency DepartmentsCommunity HospitalsCritical Access Hospitals(CAHs)Freestanding Emerge

2、ncy Departments(FSEDs)Urgent Care CentersSpecialty and Hybrid Models(e.g.,tele-EM,event medicine)Academic Emergency DepartmentsHigh patient acuity and complexityAccess to subspecialists,advanced diagnostics,and researchInvolvement in medical education and academic outputPathology:STEMI,stroke,sepsis

3、,trauma,rare casesResources:24/7 consultants,ICU access,advanced imagingCommunity Emergency DepartmentsBread-and-butter emergency medicineEmphasis on efficiency and throughputBalanced acuity with high volumeLimited subspecialty backupPathology:abdominal pain,chest pain,minor trauma,CHF,COPDResource

4、constraints require pragmatic decision-makingCritical Access Hospitals(CAHs)Rural setting with limited inpatient bedsEmergency physician may also serve other rolesHigh need for transfer coordinationPathology:farming injuries,delayed chronic illness,peds emergenciesLimited imaging/labs,reliance on te

5、lemedicineFreestanding Emergency Departments(FSEDs)Often community-based or affiliated with larger systemsManage low to moderate acuityNo inpatient beds,require streamlined transfersPathology:lacerations,pain,minor trauma,stroke,cardiac disease and orthopedicsResources:basic imaging/labs,no surgical

6、/ICU backupUrgent Care CentersLower acuity care,usually no EMS arrivalsFocus on rapid evaluation and dischargeEM-trained physicians bring expertise to low-risk patientsPathology:viral syndromes,minor injuries,UTI,rashesMinimal resources:no CT,limited labs,shor