My Year in the ER: Physician Responsibility and Urban Medicine

Project Overview

A presentation on the power dynamics of medicine and health care.

Identifying the Problem

Through his work in several urban Emergency Rooms (ERs), Ben learned that physicians in complex and chaotic urban practice settings are often disconnected from the needs and realities of their most difficult and vulnerable patients. He wanted to find a way to encourage those who would later come into contact with such patients to be prepared for the challenges ahead and to better understand ways in which they can protect vulnerable patients in the medical system. While Ben wanted to share advice with those seeking to enter the medical profession, he also wanted to present the information in such a way that would encourage young adults already interested in issues of equity to pursue a medical profession.

Creating A Solution

Ben’s project aimed to educate and empower future physicians. He wanted to show them how socially complex the medical landscape can be, and how they as physicians could set the tone in the care of vulnerable groups. He also wanted to stress that there is room to think critically about power and social structure in medicine, and that the subjects covered in liberal arts classes can be applied to any field.

Instead of carrying out research, Ben analyzed his own experiences working in ERs. During his year-long work as an emergency department scribe, he took extensive notes relating to the interactions between physicians and vulnerable clients, collecting cases to illustrate points about physician power and advocacy for vulnerable patients inside the medical system.

Wanting to empower future physicians, Ben contacted his alma matter, Malacaster College, and let the administration know he was interested in giving a talk to college students who had an interest in becoming involved in medicine. The College agreed, and the Biology Department and the Health Professions Advising Committee helped advertise the event and hosted Ben’s presentation. About 40 pre-med students attended the 45-minute talk. After the talk, Ben opened the floor to questions, which allowed the students to ask for more information about Ben’s job as an emergency department scribe.

“What I tried to drive home for the whole lecture was that doctors have a huge amount of power to influence how well the system treats people, especially the most vulnerable,” says Ben. “Nurses and other patient care staff will often advocate harder for patients when doctors set the tone that compassion and advocacy are baseline expectations.” The students left Ben’s talk feeling excited. They were excited to have a look at what their lives could be like years down the road if they chose medicine as a path, and excited to know how much influence they could have as a doctor in terms of advocating for vulnerable patients.

Lessons Learned

Ben stresses that it is always difficult to paint a picture of clinical medicine for those who have not yet participated in the system. “Negative examples—that is, cases where physicians failed to leverage their institutional power on behalf of vulnerable patients—made up more of my presentation than they do in reality,” he says. Ben acknowledges that when giving a presentation of this nature, it is likely to be a challenge to use these cases as examples while also reinforcing the point that the majority of physician-patient interactions are positive and doctors are usually excellent advocates for their patients.


Ben did not have to raise any money for this project, as Mancalaster College generously allowed him to use one of the College's lecture halls free of charge.

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About This Project

HIA Program:

Poland Poland 2008

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