Day 5, Final Day of Emergency Medicine - Sean

For the last day in the Emergency Medicine Department, Dr. Lee arranged for us to accompany him to see the Hyperbaric Oxygen Center (HBO Center). I never would have imagined the facility would have looked like it did. It pretty much looked like a smaller-scale submarine.

A mini-lecture was presented to us by two Canadian students on the indications, contraindications, and other important information you would want to know about HBO. While in the facility, we were able to see patients already in the compartment receiving treatment, so we had little patient interaction that day. Dr. Lee let us take more pictures around the facility, and afterwards let us off for the rest of the day.
Rotating in the Emergency Department has taught me about the similarities and differences between the health insurance programs in the U.S. versus in Taiwan. In both, the patient's disposition (or chief complaint) is always the key factor that treatment focuses on. The major difference is the amount of power the patients have over their physicians in Taiwan. I found out that even though a physician may decide a the patient is healthy and should be discharged, if the patient believes they still are sick they can refuse to leave. Even if they are not sick and they just "want to be sure", they have the choice of staying.

In my opinion, this causes lots of problems, such as the obvious unnecessary overcrowding in the hospital. However, the insurance policy allows this, leaving physicians with no choice but to comply. Interestingly enough, the physicians I have followed all seem to have their own ways in circumventing this issue. It ranges from simply reasoning with the patient to even ordering "radiotherapy". (An example of "radiotherapy" is ordering a chest x-ray for a patient, even though symptoms and signs do not provide enough indication for it. However, it serves as proof to the patient that nothing is wrong.) It becomes a type of "psychological therapy" that persuades the patient he or she is fine, when they truly are.

The fast paced world of Emergency medicine definitely was exciting and had lots of variety. I can understand reasons for it being a popular field. But I also understand the requirement of a solid, broad, and thorough knowledge of medicine to be successful in the specialty. To be an ER doc, you definitely have to be on the top of your game, at all times.