Beyond the Emergency Room
Q&A session with UNM's new chair of emergency medicine, Dr. Steve McLaughlin, to learn more about his philosophy on patient care, education, academic hospitals, and his life outside the ER.
In talking to Dr. Steve McLaughlin, newly appointed chair of emergency medicine at the UNM Health Sciences Center, you start to understand why he's in the field of emergency. McLaughlin comes across as a calm, level-headed person who, in an emergency, you would want present to provide organization to a chaotic scene.
I recently sat down with Dr. McLaughlin to learn more about his position as chair and what else he's passionate about beyond the emergency room. He's incredibly intelligent and thoughtful, but also fun spirited when talking about trail running in the Sandias and how his kids think the world of their dad for being in a TV commercial.
LL: What drew you to the field of emergency medicine?
SM: I wanted a specialty that was very practical. Something that you could actually use in dealing with the kinds of emergencies and medical problems you see every day with your family and friends, or when you're outdoors.
LL: What does a chair of emergency medicine do?
SM: The chair is responsible for the overall operations of the department which includes four major mission areas. Our biggest mission area is our clinical activities which includes taking care of the 85,000 patients a year that come through the UNM emergency department. We also have really significant educational missions including working with the medical students and teaching our residents. We have 36 EM residents in the program as well as our fabulous paramedic programs through the EMS Academy. Then we have our research mission which again is very important. We do tremendous research here in a lot of public health issues, health services research, disparities in health care, toxicology, EMS – so a lot of different research themes. The fourth mission I would say is the administrative or service mission. The chair's job is to be responsible for the overall leadership of those four missions. A large part of that is supporting your faculty and staff to make sure they can do the things they need to do.
LL: What do you like about working at an academic medical center/teaching hospital?
SM: The best part about working in a teaching hospital are the conversations that you have about the patients with your learners, ED staff and colleagues and being able to really think about and talk about how do we best approach this particular patient's problem. In a private practice environment you really don't have the opportunity very often to have these conversations.
LL: What is your approach or style when it comes to patient care?
SM: I think different physicians have a different style and a lot of that comes from your personality. In emergency medicine the ability to quickly build a rapport with a patient to help them trust you to take care of them is really important. I think I have the ability to quickly understand the patient's emotional state at the time and then to meet them where they are. So patients who are anxious, patients who are afraid, patients who have a particular concern – it's really being able to find where they're at emotionally and bring them along to where they need to be. The critical piece is how you communicate with the patients.
LL: What are some of the tough trauma cases that you've seen come to the hospital?
SM: There are a lot of patients that you see where the diagnosis or treatment may be either technically challenging or difficult to find a clear answer. We also have the patients that are emotionally challenging whether it's a child who is sick or someone you feel a connection with right away. One patient that stands out to me was several years ago where I took care of a young man who was a bull rider. He was doing riding in a rodeo in town and had a pretty significant injury. I think he was actually stepped on by the bull and ended up coming to the emergency department. He went to the operating room and later ended up dying from his injuries. That one stands out to me because I'm sure I was the last person to actually talk to this young man about what happened to him and how he was doing. You then have this very deep connection of having this last conversation with somebody which you feel when you're talking to his wife and his parents and explaining what happened.
LL: Do you have any advice for students wanting to pursue a career in emergency medicine?
SM: I would say the most important thing is to pursue your passion. Whatever you choose to go into, whether it's emergency medicine or radiology or internal medicine, that should be the thing that when you wake up in the morning that's what you want to get up and do. You think about it at night when you go to bed, you want to read about it. It ought to be your passion. You shouldn't go into it for any other reason; not the money, not the hours. It has to be the thing that you love to do. For me, that's what emergency medicine has been.
LL: Are there any myths or major misconceptions you want to clear up about being an ER doctor?
SM: I think there's a couple. Number one would be that emergency doctors save a lot of people's lives. I think that you occasionally have an encounter with somebody where you can say I think I just saved that person's life, but that's pretty rare to happen individually. I think emergency medicine is really very much a team sport. In the ED we are often the ones that are helping to figure out what's wrong with the person and then gathering the resources needed to take care of them, but the ultimate outcome of the patient depends a lot on the whole team. The other misconception would be that everybody that comes to the emergency department has some dramatic illness. We do see that, illnesses and injuries that are very dramatic, but a lot of the things we take care of every day are folks that have significant social problems or significant economic problems which are playing into their illness. Going into emergency medicine you need to be willing to help people with those financial and social problems because it's a huge part of what brings people to the emergency department.
LL: Where are you from and how did you end up in Albuquerque?
SM: I grew up in Seattle and then moved to Southern California for college. When I finished college, I ended up going to medical school at Mayo Medical School in Rochester, Minn. After living in Minnesota for four years, my wife and I both wanted to come back out to the West. In 1995, I interviewed at the University of New Mexico for its emergency medicine residency program which is one of the best programs now and it was back then as well. I just really liked the program and I had some family connections here.
LL: What do you like about Albuquerque?
SM: I like the mountains. I like the diversity. I like the fact that having lived in Seattle with over 200 days of rain per year that now I live in a place with 300 days of sun per year. That's fantastic. I think the access to the outdoors and the diversity of the people here makes this a great place to live. I also think it's a great place to raise a family.
LL: What do you think about being part of the TV commercial for UNM Hospital?
SM: I'll just say that it's frightening to see yourself on TV, but I really believe in the mission of the Health Sciences Center and I'm happy to embarrass myself to try to help the institution. I'll also say it's been a lot of fun for my kids to have their dad on a TV commercial . They think it's pretty neat.
LL: Did you really do the La Luz trail race?
SM: I've finished the race 13 times since 1997. I missed a couple of years in there because of injury, but this last year was my 13th finish.
LL: Why do you like trail running?
SM: I find that for me it's a great way to get into the outdoors. I feel like it recharges my batteries emotionally and physically. The Sandias are incredibly beautiful mountains, but you have to be in them. To look at them from a distance, they are pretty, but actually being out in them and seeing what's there up close is amazing. I think it's just a spectacular place. And, you can't beat the workout of running up a mountain at 10,000 feet above sea level.
LL: Why is your own health important to you? Do you see that as helping you in your own profession that you are physically active and that you take care of your own health?
SM: I think we often tell our patients to watch what you eat, get your exercise, don't smoke, and I think it's kind of hypocritical to then not actually do those things. For my wife, Wendy, and I this is something that we do 5-7 days a week. We're out exercising or at the gym almost every day. I think it gives you that emotional balance. I think it also gives you the physical endurance to work night shifts and to work long hours in the emergency department. You're on your feet constantly doing procedures and taking care of patients. It really takes emotional and physical stamina to do this job.