Wound care is a field that many of us never learn about in Medical School. We have all seen wounds, treated burns, road rash, lacerations etc but most of us were not directly exposed to the field of wound care. I did not learn about Wound Care until my first year out of residency. I would work shifts with a physician who was Board Certified in Emergency Medicine and Hyperbaric Medicine. He would often talk about his work in the “Wound Care Clinic” with great passion and would try to get the physicians in our group to come practice at the clinic.
I had just completed my residency in Emergency Medicine and that was the only medicine that interested me…. However, this physician was persistent and did not give up on me. After about a year of “wound care stories” I agreed to visit the clinic and see what it was all about….
I remember the day like it was yesterday. I had finished my night shift and was taking care of my 4-month-old daughter. Lauren was at the hospital so I brought my daughter to my first day at the clinic. She stayed and visited with the nurses in the breakroom and I went to the clinic. I was immediately hooked. My new wound care Mentor had a great relationship with his patients and staff. The clinic ran smoothly and you could see that the care he was providing was improving the lives of his patients.
Some of his patients had wounds that I would have called for an admission if they were in the Emergency Department but he was treating them in the clinic. In fact, he would do his best to keep them out of the Emergency Department to avoid admission and decrease their risk of amputation. He had a few patients that day that were healed and they shared their stories and pictures of their wounds. I was amazed at what they were able to accomplish for these patients outside of the hospital.
He cared for his patients and received as much as he gave in return. There were thank you cards lined up on the desk and his patients were happy to see him. He would talk with his patients about all types of topics while debriding and caring for their wounds and had developed relationships with patients during the course of their treatment. His practice was almost a counterbalance to life in the Emergency Department. I was intrigued and surprised that a field of medicine that was nearly the opposite of Emergency Medicine had inspired me.
After that visit I committed to working Friday mornings at the Wound Care clinic. My initial plan was to practice Wound Care one half day a week. I was just starting out in the field so my clinic day was very light. To make the finances work I would follow my Wound Care shift with a Friday night, Emergency Medicine shift, 7p-7a. Those were some long days but I liked working the night shifts because I could see my daughter before and after my shift. When I worked the day shift 7a-7p I would not get to see her. She would be sleep when I left and when I got home.
I worked this way for years learning wound care gradually and as my knowledge and skills improved I increased my days and eventually stopped working the night shift after my clinic days…. I went from working a 24-hour day to a 6-hour day on Fridays, which was amazing.
Wound Care allowed me to experience a different aspect of Medicine, one with follow up, continuity of care and the professional gratification of healing a patient. Both Emergency Medicine and Wound Care have very unique aspects to their fields and are rewarding in their own way. My practice in Wound Care allowed me to decrease some of my Emergency Medicine hours which improved my experience in Emergency Medicine. I felt less tired when working my shifts and enjoyed my shifts.
My long-term plan at the time was to work a mix of Wound Care and Emergency Medicine until I retired. However, life had different plans. I experienced a tough injury that changed my life (see The Fall) and my professional plan. Overtime, I increased my Wound Care practice and now practice Wound Care and Hyperbaric Medicine full time. I still feel that Emergency Medicine is a great field of Medicine but I do not regret my decision.
I think Wound Care and Hyperbaric Medicine is a great field for Emergency Medicine physicians. We are used to treating wounds in the Emergency Department and often perform procedures on awake patients. In the field of Wound Care, the patients are awake and the procedures are all performed with local anesthesia. Being comfortable with working with your hands, laceration repairs, abscess drainage, debridement, controlling bleeding and the ability to handle unique situations are all skills that you have as an Emergency Physician and are perfect for Wound Care. In addition, we all receive a cursory training in Hyperbaric Medicine and know how to treat the rare emergent conditions of this treatment, seizures, pneumothorax, and barotrauma.
The field of Wound Care is still developing and consists of Surgeons, Family Practice physicians, Podiatrists and Emergency Physicians. It is a great field and Emergency Physicians are a natural fit for Wound Care and Hyperbaric Medicine. A great way to start in Wound Care is to practice Wound Care while continuing to practice in your primary specialty. I think you will find this field of Medicine very rewarding and would be happy to share my experience with you.