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Behind the Scenes: A Day in the Life of an Emergency Department Physician

| Date Posted: 3/29/2022

PINEHURST, N.C. - Hospital emergency departments have always been busy, and though visits dropped for a month or two at the beginning of the COVID-19 pandemic, the rest of the last two years have been busier than ever. In the Sandhills each year, thousands of people visit one of four FirstHealth hospitals seeking care for any number of critical ailments.


They encounter staff, nurses and emergency department physicians, a team of professionals working together to assess needs and offer high-quality care. But what is it like to work in this environment? In recognition of Doctors' Day on March 30, FirstHealth spoke with Julie Verchick, M.D., about what it’s like to work in an emergency department.


Tell us a little about yourself: I’m a residency-trained, board-certified emergency physician and I have been working for Sandhills Emergency Physicians since July 2000 after completing medical school at the University of North Carolina at Chapel Hill and an emergency medicine residency at Wake Forest Baptist Medical Center. Our group is contracted by FirstHealth to provide emergency medical care 24 hours a day at FirstHealth Moore Regional Hospital, MRH – Richmond, MRH – Hoke and Montgomery Memorial Hospital.


Our physicians see patients of any age with any problem or concern, and we also work closely with and supervise advanced practice providers (physician assistants and nurse practitioners) who are an essential part of our team. We work in partnership with FirstHealth staff, including nurses, nursing assistants, secretaries, other ancillary staff in the laboratory and radiology, and we also interact frequently with other physicians, PAs and NPs. I have lived in North Carolina since 4th grade and met my husband while attending college at North Carolina State University. We have raised our three children in Pinehurst.


Describe a typical day: Well, there is really no “typical” day in emergency medicine. I work at three of our four hospitals, with shifts during the day, evening and night. Sometimes they are eight-hour shifts, and other times they are 12, depending on location. Holidays and weekend shifts are necessary as well because our hospitals never shut their doors.


Our shifts start with taking sign out from the physician finishing his or her shift. This transfers the care of patients to the oncoming doctor. Either before or after sign out, I will log into our computer systems and open programs we use to document patient charts, communicate with coworkers and consultants. The rest of the shift is spent evaluating new patients as well as continuing to care for patients already being treated by checking to see if they feel better and following up on test results to help determine if patients can be discharged or if they need additional testing, care from a specialist or admission to the hospital.


Priority is given to the sickest patients who are seen and treated first regardless of how long other patients may have been waiting. We also answer phone calls from paramedics about patient care as well as talk to other medical providers who may send patients to the emergency dept for care. When my shift is over, I then check out to the physician starting his or her shift and head home. 


What skills are most important in an emergency setting? An emergency physician is truly a jack of all trades because we treat a wide variety of complaints, diseases and injuries that span general medicine and all specialties. We see patients with chest pain, abdominal pain, shortness of breath, infections, injuries like broken bones and those sustained in car accidents. We also see gunshot wounds, rashes, poisonings, depression, psychosis, colds, sore throats, vomiting, diarrhea, the list goes on. In my career, I’ve cared for patients from 24 weeks (a baby born prematurely in the emergency department) to over 100 years old.


An essential skill for emergency medicine is rapid assessment and decision-making. Effective communication is also essential. We are trained to perform many procedures including managing airway problems, performing CPR and resuscitations, stabilizing broken bones, repairing lacerations (cuts), placing chest tubes, delivering babies, etc. We provide care for patients and their families often during extremely stressful times of injury and/or illness.


The most rewarding part of your work: I enjoy the great variety in emergency medicine, not only many different complaints and problems but also all kinds of different people. I love to identify a problem and “fix it” – provide care to make an illness or injury better. Though we may not always be able to give an exact answer as to why a patient is feeling bad, we strive to make patients feel better and provide information for follow-up. I also enjoy the challenge of “organizing” the chaos that is intrinsic to the practice of emergency medicine. There is constant prioritizing of who needs immediate care with frequent interruptions and rapid transitioning between patients, workflow (such as charting information, receiving results from tests), and communicating with coworkers and consultants.


What led you to medicine? My childhood goal was to be a veterinarian “when I grew up.” However, while in college, I spent time with several veterinarians and spent time in an emergency department in Ohio where my aunt worked at the time. Though I loved animals, I was more fascinated by “people medicine” and decided to pursue a career as a doctor.


Outside of the emergency department, what do you and your family do for fun? Personally, I like spending time with my husband and kids, taking long walks with our dog, stand-up paddleboarding, cooking, reading and traveling. My family and I all enjoy sports and outdoor activities. In the fall, you will find us in Raleigh cheering on the N.C. State Wolfpack football team!

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