Catching up with Dr Myers
I appreciate Dr. Myers taking time out of his busy schedule to sit down and chat with me. Dr. Myers was the system medical director when I started at Wake County and appreciate his guidance, expertise and friendship over the years.
· What is your current role?
o I have a unique role as Chief Medical Officer of ESO. Through data acquisition I get a national lens on the strengths of EMS, and areas that may need improvement. The challenge is to gather enough data to be meaningful, while balancing keeping the number of data points reasonable. Processing this data helps us to identify best practices that may be taking place in one area, and passing that on nationally.
· Tell me how you got started, where did your interest in EMS come from?
o At 16 years old I needed money to buy car. I saw an opportunity for a job at the local hospital that participated in the Baylor program. In the Baylor program, you work 24 hours on Saturday and Sunday and get paid for 40 hours. I worked as an orderly, changing linens and bedpans. Geraldine, an ER nurse with more than 30 years on the job, took me under her wing. She told me “If you stay for a month, you’ll never want to do anything else.” She helped me to get enrolled in my first EMT class, and from there was medical school and a career in emergency medicine.
· How do you think your time in emergency medicine has changed your view of the world?
o Emergency medicine teaches you that everyone responds to incentives. We all know that the system is broken; as a patient, given the difficulties in navigating the health care system, why would I access the system in any manner other than via 911? I get help right here, right now. When you’re frustrated remember that people are responding to the incentives they were provided. We have an ethical, moral, legal responsibility to take care of the people that call upon us and they all deserve compassion and care, we have not walked in their shoes and don’t know their stories. It is a daunting thing to be the safety net for the entire population. Our EMS system is strained in very large part because we are attempting to serve each 9-1-1 request as if it is a time-sensitive urgency, if not an outright emergency – while 9 to 10% of the population is calling 9-1-1 and asking for an ambulance each year. We are going to have align incentives and expectations or the system will collapse.
· What do you wish you knew on your first day? What advice would you have for a new provider?
o To keep in mind that as you move up and change roles, you move away from the bedside and move away from the “results” and build delayed gratification. Some people need the immediacy of bedside care, and miss that when they move away from it.
· What advice would you have for someone interested in taking a leadership position?
o First, you must have a moral and ethical guiding compass. There is not a manual for everything and thus you need strong values and morals to guide you. As a leader, you must do and say things that are not comfortable. In a leadership or management position you need to balance allegiance to organization or system vs. the needs of your individual employees. Second, you must find a way to define measurable success for yourself, ask why did you want this position? If it is for a higher salary or just the title, that is the wrong reason. You need to be able to look back and measure success and what that is for you. Never take a job for a salary.
· Where do you see EMS in 10 years?
o In the next 10 years, I think that we will have sorted out decision support such as a more universal standard and medical direction to support telehealth and dispositions other than the ED. Also, I foresee an increase in payer support for quality metrics based on system performance. We will also turn lights and sirens off on most responses and move to a response more like the police department (who are comfortable holding non-emergent calls for a period of time, use less lights and sirens, etc).