Leonardo Huertas, MD: Managing in an Emergency Setting

On drug regulation during the opioid epidemic:

Curbing opioid epidemics is an issue that probably involves many different factors. Part of it actually comes back to us as physicians. Years ago, the AMA was pushing the fact that we needed to treat pain. Pain is perception for most patients, and we aggressively treated the pain these patients were having. And as such, we basically introduced more opioids into our society and our civilization.

When compared to other industrialized countries, we use opioids significantly higher than any other country in this world. Any regulation that allows us to curtail the uses and abuses of opioids, I think is welcome. There's certain drugs that are not needed right now. I don't have an issue with the FDA imposing some restrictions on medications that may or may not be that helpful.

What do emergency medicine physicians talk about?

We talk about how difficult it is on certain days. The volume can be significant, the acuity could be significant. And how to best deal with that on a typical day — people deal with different types of stress differently — and trying to sometimes get to the end of your shift is difficult for some. It's a daily task that we have to best figure out.

What are your remedies?

We basically try to be supportive of each other. And when there's issues, I have a great team, and the team is excellent at being supportive and working out issues we've developed throughout the day. Between my 2 associates, the nursing director, the nursing manager, and the administrative personnel, we tend to be able to deal with most issues on any given day.

The next issue that tends to crop up most days is anything with computers — IT issues. And those are difficult to deal with because they're out of our scope, and we still have to deliver our care. Between the personnel, the IT, and the patient load, it makes for an interesting day in the emergency department.