I refer you to:
Davidson SJ, Koenig KL and Cone DC: Daily Patient Flow Is Not Surge: “Management Is Prediction” Academic Emergency Medicine. 13(11)1095-6. November 2006. http://onlinelibrary.wiley.com/doi/10.1197/j.aem.2006.07.021/epdf
It is incumbent on every one of us as physicians to do our best to serve our patients and I appreciate your post and the discussion it has provoked among colleagues locally pointing to the behaviors central to fulfilling that responsibility. It’s my view that personal responsibility is both necessary, but insufficient to the challenge emergency medicine practice currently confronts.
As has been noted by many others before me, the distinguishing technology of the specialty of emergency medicine is the system of care. The system of care is a responsibility of all of us, but particularly is a responsibility for those who lead we (in W. Edwards Demings’ words) “willing workers.” All of you, the nurses, technical and support staff who labor alongside you are surely “willing workers.” Our department has been fortunate for leadership cognizant of and driven by system principles as has yours.
Still, though personal responsibility is essential and the advice from your blog post is central to fulfilling that responsibility well, perhaps you will reflect on how we in emergency medicine deliver health care and how that system might change.