Speaker 1: 0:01

Welcome to the Healthy Matters podcast with Dr. David Hilden , primary care physician and acute care hospitalist at Hennepin Healthcare in downtown Minneapolis, where we cover the latest in health, healthcare and what matters to you. And now here's our host, Dr. David Hilden.

Speaker 2: 0:18

Hey everybody, it's Dr. David Hilden, your host, and welcome to the podcast. Today we are gonna talk about the emergency department. You've all likely heard about it or you've been to your local emergency department, but do you really know how an emergency department operates today? I am joined by my friend and colleague, Dr. Tom Wyatt . He is the chair of the Department of Emergency Medicine at Hennepin Healthcare, and somebody I've known for a good 20 years or more. Tom, welcome to the show. Thank you, Dave . So you're the chairperson, you're the chair of the Department of Emergency Medicine. You're a unique chair of emergency medicine. We're an academic medical center. We're a large level one trauma center in downtown Minneapolis. And you're a Native American man. That's true. You , you're one of the very few people who I could say that about. So I wanna talk to you, if you could, about first of all, our emergency department, second of all, about your path to it, and then after the break a little bit later, we're gonna talk about some of the challenges and what people can expect in an emergency environment. So you and I did our internship together right here at Hennepin Healthcare. It was HCMC, Hennepin County Medical Center some 20 years ago. Tell me about your career path, if you could .

Speaker 3: 1:21

Yeah, so I remember back in those days, Dave, you're a lot smarter than me , that's for sure. Um,

Speaker 2: 1:26

Oh, that is not a true statement. <laugh> .

Speaker 3: 1:29

Um, yeah, I , I remember those , uh, training days very fondly. And I , I feel like I was trained at the best , uh, emergency department in the world, if I may say so. And then, you know, after my three years of training, I went out into the community. Um , I left Hennepin for 13 years, and I worked for , uh, Allina at , at Mercy Medical Center up in Rapids in Minnesota, and had a , a really great time there. Uh , really trying to learn from , uh, some of my mentors at that, at that shop, and kind of tried to hone my skills as an emergency physician , um, as a clinician, and really enjoyed that work.

Speaker 2: 1:59

And now you came back to us, you even met your wife in tra did you, can I even say that?

Speaker 3: 2:04

You can, yeah. Yeah. My wife Karen, she's an emergency physician as well. She was in my residency class, and she's been at North Memorial now for 21 plus years.

Speaker 2: 2:11

So you're back in Hennepin now, and you're running what I still consider to be the nation's Premier Emergency Department. Tell us about your department. Yeah,

Speaker 3: 2:19

I would agree , agree with your assessment there. I think that , um, HCMC has a very long kind of storied history in terms of emergency medicine. If you look at our training program, we're accredited as , as being the second oldest in the , in the country. There's only one that's older than us only by six months. And since 1972, we've been training the, the best emergency medicine residents in the world, in my opinion. And it's really been o obviously the people that came before me, but a lot of those people that have kind of paved that path for us in emergency medicine started , uh, right here at Hennepin. If you think about emergency ultrasound, if you think about the management of emergent airways, those are just two examples. A lot of the research that we've done as a department, it's just an incredible training program. And , uh, it's an asset to the organization. And the organization. He , and healthcare is definitely an asset to our community.

Speaker 2: 3:07

I was one time visiting a friend of mine who's an emergency doctor at Brigham and Women's in Boston, one of the nation's premier hospitals, a big hospital, everybody knows about Brigham and Women's. And she was a friend of mine, and I was getting a tour of the place, and she took me into their emergency department, which is not ours, but she took me in there. And all she had to say to her emergency colleagues in Boston was, well, this is my friend David. He's from Hennepin in Minneapolis, and that's all they had to know about me. It was because of our emergency department. They say , oh, we know all about you out there in the Midwest. Emergency doctors around the country know about this place. So you run a level one trauma center. What is that? Yeah,

Speaker 3: 3:46

A level one trauma center is a emergency department, a hospital system that can handle any traumatic injury. And that takes a really t tremendous amount of resources , uh, that are, you know, put toward that. And basically you get verified by the American College of Surgeons who verifies trauma centers, and then you get designated by your state to become a level one trauma center. And so we're the biggest , um, busiest emergency department and level one trauma center in , in the state. And we've been that way for, for many years now. I

Speaker 2: 4:12

Would imagine we're the biggest one from Chicago to Seattle across the whole northern Yes. Uh , part of the country. I believe

Speaker 3: 4:18

You're true. One , we're definitely one of the biggest in the , in the upper Midwest. And I think we are the biggest between Chicago and

Speaker 2: 4:23

Seattle. And that means that 24 7, 365 days a year, it's your team of doctors, advanced practice providers, nurses, everybody in the emergency department. And then you have a whole other support team of surgeons and other consultants that are at the ready, doesn't it? Yeah.

Speaker 3: 4:38

I mean, that , that level of readiness , uh, does come with , with a cost, you know, with all those resources. But I think you can also attest to this, Dave , and that it is very much a team effort whenever somebody that comes in acutely injured or ill, and you go into our resuscitation area, which we call the stabilization room or the state room, and to people who aren't really familiar with that room, if they open the , the doors and they look inside, you know, when we have all four bays full of patients, it can look pretty chaotic in there. You know, there , there could be 75 people in that room, but everyone knows their role. Everybody is, is so well trained , and the communication in there is so tight that it just works.

Speaker 2: 5:14

I wish the public could see that in action. 'cause I have, and you might say it looks chaotic, but it doesn't look like the old show er, where there's like shrapnel flying across the room and people yelling and screaming at each other. I do see everybody has their role, and I look at the doctors and the nurses, and they're, they're on alert. They're obviously very focused and engaged at a high level of reactivity, but they're calm at the same time. Your team kind of knows what they're doing.

Speaker 3: 5:41

I agree. And I think that collaboration is the key word there. Yeah.

Speaker 2: 5:44

So I'm gonna shift a little bit and talk about you. If, if we could, I said at the top of the hour that you're an American Indian man, you are in an academic medical center and you run one of the largest and most premier emergency departments in the country. How did you get to this place? And how does your role as a member of an enrolled tribe in this state, how does that inform your work?

Speaker 3: 6:06

Yeah, I think , um, it's a great question. I could really take you on a, a long kind of winding answer, but I think in, in general, for me, it's , uh, having people that supported me. Um, even early on in my career, I was the first person in my family to go to college. So I didn't really have people that actually knew how to navigate that world. And I grew up in , in Oklahoma, I grew up kind of , uh, with my , a foot in both worlds, both the traditional world, while my mother's full blood American Indian, she's a tribal enrolled member of the Oppa and the Shawnee Tribes, as am I. And then my father was white. He was the first white man that actually ever married into my mom's family. And so I was kind of in , in both those worlds. And learning how to navigate both those worlds was pretty important for me. I went to college, university of Oklahoma, and then I took about a year and a half off, and I , it was that time that I worked, started working as a first in EMT and then a full paramedic, and really got to love taking care of patients in that pre-hospital setting. And then from there, I got accepted into the University of North Dakota School of Medicine into a program called Inmed or Indians into Medicine. And that program still has , uh, the highest number of American Indian medical students of any medical school in the country. Shout

Speaker 2: 7:13

Out to UND for that. Yeah,

Speaker 3: 7:15

UND is great in that , in , uh, I'll , I'll also add that the University of Minnesota and Duluth, the Center for American Indian Minority Health is very close to , to UND. They're doing some great work and in , in Duluth. But UND was great for me. You know, I , I was a little bit of a non-traditional student, and it took me a little while for my first two years to really, you know, learn how to study again in Excel. Um , but then it was something when I was there and , you know, I , I thought about emergency medicine and given my career as a paramedic, and there were two emergency physicians in Bismarck, North Dakota that had trained at Hennepin. And I, I started talking to them about, you know, going into emergency medicine, and they, they said, have you ever heard about HCMC? And I , I hadn't. So they helped me set up a rotation and the rest is history.

Speaker 2: 7:57

And now you're running the department

Speaker 3: 7:59

<laugh> . Yeah, now I'm running the

Speaker 2: 8:00

Department, yes . Yeah. Yeah . I bet you probably didn't consider that when you were grown up in Oklahoma.

Speaker 3: 8:04

Did not. Absolutely

Speaker 2: 8:05

Not many of our patients are , uh, largely of the Dakota, Lakota , uh, Anishinaabe , um, Ojibwe tribes and , and other tribes in this state. And I'm gonna be laying my cards right out on the table. We haven't always, as a medical system done right by those communities. What are your thoughts about how we can care for all of our communities, but even particularly for Native American populations?

Speaker 3: 8:31

Yeah, I mean, I think both as a , not just as a , as a medical institution, have we not done right by American Indians as , as a society, right? And that just goes all the way back to history. And we , again, we could talk

Speaker 2: 8:41

Hundreds of years,

Speaker 3: 8:42

Hundreds of years, we're talking about centuries, and we could talk about that all day. I think, you know, Hennepin Healthcare is very unique in that we serve a very large proportion of American Indians. Um , you know, as our patient population , uh, we see about 4% of our overall patient population as American Indian. When you compare that to the , the population of Hennepin County for American Indian, it's only about one to 2%. But I think that, you know, having programming as, as Hennepin Healthcare has committed to, like having American Indian cultural navigators that are present and that can help do exactly what it says, help American Indian patients navigate the system, which are , you know, medical, our medical system is very complicated even for people who are, are used to it and know about , uh, how to navigate it. So having those people present in our institution, very, very important. If you look at programming like the Talent garden and our health equity department is really, what's that? Uh , the Talent Garden is , uh, a program that was developed by our health equity department, and one, and one individual in particular that I'll , um, call out is Jim Peters to really engage underrepresented minorities who have not had a lot of the op same opportunities that white people have had, to be blunt, and to bring them into Hennepin Healthcare for a day and allow them to experience what it's like to interact with healthcare professionals, physicians, nurses, pharmacists across the gamut of healthcare providers, of people who look like them, that are maybe even from their same communities and from the same culture and from the same ethnicity and race. And so it's been a really an amazing program. And American Indians, and we've had two American Indian youth with stethoscopes events where we bring these young, you know, kids in teenagers, right ? Teenagers, yeah. Um, that come in with their, sometimes their family members, sometimes their school counselors, and they get to spend a day with us. We have panel interviews, we actually have them go through stations, you know, they're in the sim center, they're doing all these really cool things and just, you know, seeing people that look like them , uh, giving them that , uh, inspiration, you know, in many cases is something that's really important. And really it's, for us, it's really just showing them that we, we care about them and that we believe in them. And they can certainly accomplish a career in healthcare if they , they choose.

Speaker 2: 10:42

I've heard somebody , um, say to me, who's a lot smarter than I am? You can't be it if you can't see it. And so to have all of these American Indian kids see a doctor, not only a doctor, but the leader of this cool department, you know, where you're making a difference and you're doing all these things at an academic center and being the one in charge that's an American Indian guy who's in charge. And you could be that too. I think that is really, really exciting. That being said, you told me earlier that Aaron Robinson , another doctor that I happen to know is another American Indian man in your department, and that you two represent not how it is everywhere else.

Speaker 3: 11:20

Yeah, it's true. If , um, from our knowledge , um, when we inquired last year to the national database, there's only two academic emergency medicine physicians who identify as American Indian, and it's Dr. Robinson and myself. And we're both at Hennepin. You're

Speaker 2: 11:34

Both here. Both here in downtown Minneapolis.

Speaker 3: 11:36

Yeah. And so I think obviously that's not necessarily , um, a way to pat ourselves on the back, Dr. Robinson and I, but it's almost like an indictment on the system, right?

Speaker 2: 11:45

That's what it is . It is . It's like, where is everybody else? And we need to correct that.

Speaker 3: 11:49

Yeah, agree. But I think if you look at some of the efforts that Hennepin Healthcare has put into really recruiting American Indians, you know, I just heard a number that , um, is a little over a year and a half ago. We were around 26 American Indian employees out of the 7,000 here. And now we've more than doubled that from my, from my understanding. So that's, that's pretty good progress. If you look at our emergency medicine , uh, residency, we've, we have our first American Indian resident that we recruited, and we had a number of American Indian , uh, medical students rotating in the emergency department , um, this past

Speaker 2: 12:18

Summer. That needs to be a goal of all of us. Um, we need to have our medical staff, our doctors, our nurses, our everybodys represent the communities, not just that look like me. And historically that's what medicine has been. So you're an American Indian man, but our patients are from all kinds of cultures. How can we increase representation on our medical staffs , um, in general , um, whether it be in native communities or elsewhere?

Speaker 3: 12:47

Yeah, I think that's the , uh, the really important question a lot of people are trying to answer. And I think a lot of it is , uh, people have to recognize that there aren't just these huge pools of people to, to, you know, draw from that this is gonna take, it's a long game. And so a lot of the work, you know, you hear terms like a middle school to medical school starting early, as early as you can in the schooling of, you know, young children coming up. And this really introducing them to , uh, healthcare is really important. And I think, again, just, you know, practicing cultural humility. Obviously, you know, hand up in healthcare has the Compass program , um, which is being rolled out to all of our employees, which is really important. Um , could

Speaker 2: 13:22

You explain that to our listeners? Yeah.

Speaker 3: 13:23

It's really a, a program that initially was targeted , um, kind of of leadership and now it's kind of been rolled out to every employee in the organization to really teach this idea of cultural humility and learn about , uh, different cultures, especially the, the , the patients, you know , um, that we see coming to us for help for their healthcare. It's a first step. It's been rolled out, and I think it's been , uh, well received by, by our , our organization. It definitely is something that takes a lot of work and a lot of , uh, thoughtful reflection , uh, for everyone.

Speaker 2: 13:53

I like the term cultural humility, which is one I wasn't all that familiar with until recently through some of the stuff we've been doing in the Compass program here at Hennepin. We used to use this word cultural competence. That's a joke. I agree. I can't be competent in <laugh> in the culture that you grow up in, in Oklahoma. I can never be competent in anything about that, but I can be humble and learn about other cultures. So before I get to the break, what do you like to do outside of this work?

Speaker 3: 14:20

Try to stay healthy. You know, I'm a a trail runner, so I try to do that just to , it kind of clears my mind, but I also know you

Speaker 2: 14:26

Gotta twist your ankle

Speaker 3: 14:27

<laugh>. Yeah, yeah . I've had my , i , I have my list of injuries. Yes. <laugh> , um, you know , I have , uh, three , um, high school , uh, children, my wife and I, and so they keep us really busy with other activities too. So it's really good to be a family man or try to be, and kind of stick grounded.

Speaker 2: 14:40

So do you still stay in touch with your old friends in Oklahoma? Of course. Yeah . Absolutely . Do you have family down

Speaker 3: 14:45

There still? Yeah, my mother still is there. She's 89 years old. She's , uh, one of the tribal elders. Uh , and I have a sister and her family there too.

Speaker 2: 14:51

Oh, that's cool. Yeah. Big respect to her. Yeah , that's , that's lovely. Thank you. We're talking with Tom White . He's the chair of the Department of Emergency Medicine at Hennepin Healthcare here in downtown Minneapolis. And a long time colleague of mine. When we come back, we're gonna talk more specifically about running a big, huge emergency department. Stay with us. We'll be right back

Speaker 4: 15:14

When Hennepin Healthcare says, we are here for life. They mean here for you, your life and all that it brings. Hennepin Healthcare has a hospital, HCMC and a network of clinics both downtown and across the West Metro. They provide all the primary care and specialty care you would expect to find, but did you know they also have services like acupuncture and chiropractic care available at many of their primary care clinics and at their integrative health clinic in downtown Minneapolis. Learn more@hennepinhealthcare.org. Hennepin Healthcare is here for you and here for life.

Speaker 2: 15:51

So it's no surprise to anyone, Tom, that , that this job can be hard. Start us off by talking about just kind of the range of things you might see in a given day. It's not all people who are critically ill. That's

Speaker 3: 16:03

True. No , that's true. And I think that's part of the, the stress of it is that, you know, as an emergency physician, you're never gonna have the same day , uh, ever at

Speaker 2: 16:10

Work. Did that draw you to it? Did you like that? Did

Speaker 3: 16:13

You like that part of it? It did . Yeah, it did. I think it draws most of us , uh, to it because there's a lot of people that, that don't like that. Like a lot of people like to, you know, expectations and kind of routine things. And that's definitely not the emergency department. That feeling of pressure and stress that you don't know what's gonna be coming through the door is something that you can get used to. But sometimes it does catch you all off guard.

Speaker 2: 16:31

It does, I bet. 'cause So we're gonna get a little bit more into some of the really serious things you see, but you might in one day see a kid with an earache and a baby that's swallowed a tablet and a with a terrified parent, and then a gunshot wound and then somebody having a heart attack.

Speaker 3: 16:46

No, that's true . I think not , it's not just major trauma, but we see a lot of the time sensitive conditions, you know, heart attack and stroke are the two that come to mind along with trauma. But we see primary care complaints as well. We see urgent care complaints, we see some complaints that aren't necessarily even medical, sometimes they're social related . So there is a , a wide range of things that , that we have to

Speaker 2: 17:06

Deal with. Mental health issues, substance use issues. Could you comment on those? Yeah,

Speaker 3: 17:09

Unfortunately, too many. In fact, if you look at the trajectory over the last decade or so, I mean both substance use disorders, opiate use disorder in particular as well as, you know, mental illness, those, those visits have gone way

Speaker 2: 17:21

Higher. Any idea why that is? So you're, you've got patients in the emergency department, I will just tell listeners, every single solitary day with a mental health , uh, crisis of some kind or not a crisis, just a mental health issue that needs addressing or a substance issue that needs addressing either a crisis or just they don't know where else to turn. Why do you think that is? Is there , is our community mental health and substance use system broken? Yeah,

Speaker 3: 17:46

I don't know that it was ever , um, to be honest, really robust enough to be broken. I think it's just been underdeveloped, you know, that's part of the problem. Um, I think that our county is doing the best that it can do. I think that it could do more probably, but I think that that's not exclusive to our county. It's definitely not exclusive to our state or, or our healthcare organization. But I think that if you look at an true emergency department, you know, in a , in a perfect world, would see emergencies and we see more non-emergencies than we do emergencies. Then if you add on the substance abuse and the mental illness and those types of patients that come in and a lot of the social problems, seeing patients that are unsheltered and that have food insecurity, those are all pretty common complaints in the , in the emergency department. And, you know , we don't have the resources all the time to take care of all those things. So we would count on external resources, you know , from the county, et cetera, and other community partners. And sometimes those resources just aren't there.

Speaker 2: 18:38

Yeah, I would second that. We don't really have a system that is robust in the community that meets communities where they are and with what they need. And so they get great care in your emergency department, but sometimes that's the only place they know where to go. And the needs are not being met by a healthcare system that is not functioning as well as it should be. I think that's what I would say on that. That's right.

Speaker 3: 18:58

That's right.

Speaker 2: 18:58

So we talked about this breadth of things you see, how do you get through that day? How do you support your staff and what's it like to bounce around on that rollercoaster?

Speaker 3: 19:10

Yeah, sometimes it can be tough. I think , um, learning to handle the transitions is the hardest part. And that's something that we, we try to focus on in training. How do you go from a really high stress, emotional case many times, say for instance, a , a child is involved to where you're doing invasive procedures and making some very quick decisions about trying to stabilize someone or save their life

Speaker 2: 19:32

When you only have seconds or minutes Exactly . At most , right ? Yeah .

Speaker 3: 19:35

And you're working together as a team and it's, it's a very high stakes and high stress environment. How do you go from that to walking to a different area of the emergency department, which you do , um, and seeing an earache or a sore throat or something of that nature. So you have to be able to manage those transitions. And for me, over the years, I guess the best advice I would give and I try to give to our residents is you have to really only focus on the things you could control. 'cause if you let those other things you can't control kind of creep in during a shift, then that's when it can really catch you off guard and kind of , uh, uh, cause you to lose focus. You , you can sit there and pause and think about why do I have so many guns in this country? Or how come there's so much domestic violence and how come there's so much substance abuse? But you can't control any of that. All you can control is what's in front of you. And so if you can do that and you still connect to that purpose and how you're making a difference, then I think that's the way to get get through it.

Speaker 2: 20:26

There's probably very, very few other professions in the world where , where you come home at the end of the day and you maybe had your hands inside somebody's body , and then you had about two minutes to deal with that and process that because there's another person, always another person waiting for your care next. I don't know if there's any other job like that where that would actually happen. And, and so I imagine that when you're leading a very large department, and it's not just doctors,

Speaker 3: 20:56

I wouldn't be able to forgive myself if I didn't say how amazing our nurses are in our emergency department. I'm in continuous awe of them at times when I see the multitasking, especially with the critical patients that we see and the duties they perform and they're really the backbone of our emergency department.

Speaker 2: 21:11

There are a team of incredible nurses. Some of the best nurses I've ever seen in my life are the emergency nurses at Hennepin. There's nurses, there's physician assistants, nurse practitioners, there's chaplains, there's the people that clean the department. There are environmental service workers who come and make sure that that place is ready for the next person. So I can't imagine what it's like to support all those people who see this every hour of their day and then have to move on. And I like that about what you can control. But in the end, how do you, when you go home at the end of the day, do you leave it at work? How do you, how do you separate and how do you care for your own wellbeing?

Speaker 3: 21:48

Yeah, it's sometimes it's not easy. Um, I think that just really trying to connect back to the purpose and that you are doing good. You are in a position to help people is really important. So really connecting back to that purpose, I think that's why a lot of us work at , uh, Hennepin Healthcare, just because that there is so much, it's such a mission-driven organization and there is so much purpose in what we do. So I really think that's the key.

Speaker 2: 22:11

So you might self-select kind of people who run on adrenaline a little bit.

Speaker 3: 22:14

Yeah. I think you have to people that maybe run on adrenaline, but also people that are comfortable making decisions without a lot of information. Mm-Hmm . <affirmative> because that happens to us sometimes when people come through the door and , and they're unidentified and we have no idea, you know, what their medical history might be. They're on any medications, for instance, you know, it's all done. And so that can be stressful as well. So again, we have to train to take in the information we're getting diagnostically and also from, you know, people that might know what happened pre-Hospital when those patients came in to really make some quick decisions. And sometimes the decisions aren't always the correct ones, but we have to be able to really , uh, adapt and pivot right away. And once we figure that out,

Speaker 2: 22:52

I wanna dig into that a little bit more. 'cause you do hear people say, I went to the emergency department. The doctors got it all wrong. You know, they, they did this, they didn't do that. I left there, I still had my problem and they didn't get it. Right. Right. You and I both know that you are making decisions on very limited information in a very short period of time and you have the best diagnostics in the world, which you have access to. What are your thoughts on that when you hear that? Yeah, the doctors didn't know what they were doing. The ed, they got it wrong.

Speaker 3: 23:20

Yeah. Sometimes I , I do hear that and I can understand the frustration of people maybe, you know , there's long waits these days. Mm-Hmm . <affirmative> because the system is really clogged up. And we can certainly talk more about that, but I think you , you have to listen to people because a lot of times you can learn from what they're, they're saying with their frustrations. But I always like to approach a patient when they come in. I always like to ask 'em right up front , you know, what are your expectations from this visit? 'cause we're an emergency department. I'm not a primary care physician. I'll likely never see you again as a physician. Tell me what you're here for, what brought you in? And I'll tell you that, you know, my job is to rule out life-threatening conditions, emergent conditions, and to try to identify what the cause of your symptoms are and then try to devote resources to either helping you during that visit or if you can be followed up safely as an outpatient, how do I get you connected with that care?

Speaker 2: 24:06

Yeah. 'cause sometimes you're dealing with like a lifetime of medical problems or a year's worth of medical problems in that hour that you have with them and you know, maybe haven't been in a healthcare system and like you have an hour <laugh> , you know ? I like that expectation setting. In our last section, I wanna talk to you about your administrative role a little bit. Um, 'cause you run this big department, it's more than just caring for the patient in front of you. Do you have resources to deal with? You have to keep your people safe , um, you have to deal with space and overcrowding and funding and all that. What things are most on your mind when you go to sleep at night on an administrative level? What are the challenges that you are , that you're thinking about?

Speaker 3: 24:45

Yeah, there, there's a lot of 'em . And coming into this role, just this recently, I'm , I'm, you know, every day there's, there seems like a new one that kind of takes the priority, but for me it's the wellness of our providers and our, our nurses and the support staff. Everyone that works in the emergency department is, is top of mind for me and their safety while they're working. Are they staying mentally healthy? You know, all those things and all the different supports that we have in place to, to help people that are maybe struggling. That's really important to me. I think also , um, the flow, I touched on that a little bit earlier. We need more space to see more patients. If I had a , a magic wand to wave , um, it would be to create more space in the hospital so we could get our patients flowing. You know, the analogy is the, the faucet, you know, the inflow is completely on all the time. And we don't have control over that because we're an emergency department. We have to see everyone that walks through the door. It's

Speaker 2: 25:34

Not like , can close the doors and turn off the lights Yeah . And say close see you tomorrow.

Speaker 3: 25:38

No , it's a, it's , it's a government mandate, which we kind of look at that as a badge of honor. Yeah . We're happy to see anyone that walks through the door at any time . Doesn't matter who you are. But the outflow is the thing that's really kind of backing up. Now we're not able to get patients moved through and into the hospital. 'cause the hospital has struggles discharging people out into the community to those resources. So it's a big problem. Again, it's not unique to our hospital or to Minnesota. It's a , it's a national problem.

Speaker 2: 26:03

It is, I think something that listeners ought to know about the things that you might see when you go to your doctor or your emergency department are due to a system that, that is got a lot of backlog right now. It's hard to get somebody out of the hospital because there's not enough community resources to support them. And if the hospital's full, the people are sitting in your emergency department waiting for a bed, and if they're waiting for a bed, they're taking up a spot in your emergency room. That means the waiting room's getting really crowded. So it's not for lack of wanting to get you through quickly. It's that there are some realities that are really challenging in our healthcare system. That's

Speaker 3: 26:39

A hundred percent correct. And I think that because of that, different hospitals systems are looking at how do you try to move care out to triage out in

Speaker 2: 26:46

The waiting even

Speaker 3: 26:47

Practically. Seriously . Yeah. Yeah. How do you do that? Um, so we've obviously been looking , uh, and trying to adjust and adapt in that regard, but it's hard to do when you, you have, you know, the space isn't there and so that's another issue. So

Speaker 2: 26:58

You're, you're in the first year of your job running this. What would you leave us with? What brings you hope about your job?

Speaker 3: 27:05

Well, I'm really excited about coming into this new role because again, I work with a fantastic , uh, number of emergency medicine faculty. We have 52 of us now, which we've grown tremendously in the last decade. And the opportunities are very plentiful for us to , uh, not only to maintain some of our excellence as a department, but also to improve upon things and innovate and conduct more research and to continue to train the best emergency medicine residents in the world while we serve our community.

Speaker 2: 27:33

I, for one, am glad you're in this role because I, I'm proud of our hospital and our front door to the world is indeed the department you run. And thank you for taking on this job as leading that department and thank you to your whole department. Thank you. We've been talking with Dr. Tom White about what it's like to lead a large level one emergency department and his unique role as one of the only American Indian healthcare leaders in the country in emergency medicine listeners, thanks for tuning in and I hope you'll join us for our next episode in two weeks time. In the meantime, be healthy and be well.

Speaker 1: 28:09

Thanks for listening to the Healthy Matters podcast with Dr. David Hilden. To find out more about the Healthy Matters podcast or browse the archive, visit healthy matters.org. Got a question or a comment for the show, email us at Healthy matters@hcme.org or call 6 1 2 8 7 3 talk. There's also a link in the show notes. The Healthy Matters Podcast is made possible by Hennepin Healthcare in Minneapolis, Minnesota, and engineered and produced by John Lucas At highball Executive producers are Jonathan , CTO and Christine Hill . Please remember, we can only give general medical advice during this program, and every case is unique. We urge you to consult with your physician if you have a more serious or pressing health concern. Until next time, be healthy and be well.