Ep. 12 | Clark Connell, MD, Medical Director Emergency Medicine, SGMC Health

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Join us for an insightful episode with Clark Connell, MD, Co-Medical Director of the Emergency Departments at SGMC Health Main and Smith Northview. Discover a day in the life of the ER, learn when to choose the ER vs. Urgent Care, and explore the innovative "express care" system designed to reduce wait times for more minor concerns. Dr. Connell addresses common complaints, emphasizes the importance of a positive organizational culture, and shares the hilarious story behind his signature outfit. Tune in for practical advice, behind-the-scenes stories, and a fresh perspective on emergency medicine!

Transcript

- Welcome to another episode of What Brings You in Today.
 
- I'm Erika Bennett. 
 
- And I'm Taylor Fisher.
 
- And today we are here with Clark Connell, MD with Emergency Medicine. So Dr. Connell, what brings you in today?
 
- Good morning. Today I'm here to talk about emergency medicine services here at SGMC Health and all about the emergency department.
 
- All right. We have a very busy emergency department, don't we?
 
- We have busy emergency departments with an S, right?
 
- That's right. Growing. So we opened up our Smith Northview campus ER beginning of 2022, 2023, and we really thought that was gonna help alleviate some of the volumes here at Maine. And then we found that it was just as busy, so Sure. Tell us a little bit about what a day in the ER is like.
 
- Absolutely. So I think one word that would describe it would be unpredictable, right? So we try to plan for a certain volume of patients to come in within a 24 hour period, but what people don't see sometimes are the spikes. So there may be one hour, we have 20 people check in within one hour. The next hour there may be zero people check in. So obviously we try to, to average that out with our staffing models and wait times, et cetera. But if one word would describe the emergency department, it is absolutely unpredictable. We could have trauma patients coming in, we could have an influx of EMS patients coming in. It could be an influx of patients coming through the front door with, you know, abdominal pain or nausea or shortness of breath. So that's one thing I love about emergency medicine. I think that's what draws emergency physicians to the specialty, is you never know what is going to walk through the door.
 
- They tend to be adrenaline junkies.
 
- They tend to be Is that true? It is absolutely true. The older I get, I think my adrenaline is maybe running out a little bit.
 
- Is that why you have the coffee with
 
- You? I have the coffee for multiple reasons, but that is one of them. So,
 
- Okay. So er, what type of patients come to the er? You said trauma, but what do you really see? What do you see?
 
- Yeah, so I mean, you know, so, so let's start from the most, the highest acuity patients. Let's, let's start with that. So we definitely see our trauma patients, right? So people who are critically injured, whether it be from a motor vehicle collision, maybe a gunshot wound stabbing, those people typically arrive by EMS. We get sort of a heads up. They're on the way here. And we do the entire trauma activation, which involves getting the trauma team together, getting the ER physicians prepped, getting the nurses prepped, making sure that our radiology department with both plain film X-rays and CT scan capability are ready to receive the patient. Having our trauma surgeon, who's our general surgeon, come down and, and sort of get ready. So, so that's kind of the tip of the spear. High acuity behind that. We obviously have our heart attack patients, and again, most of the time with our heart attack patients, we know those people are arriving via EMS. The EMS or ambulance service has the capability to transmit an EKG to the hospital. The nurse takes that. EKG prints it out immediately, brings it to one of the emergency medicine physicians. We can look at the EKG and tell if the patient is having a heart attack or not before the patient even arrives, which is, is really neat. If we think the patient is having a heart attack, we can go ahead and activate the cath lab team. So that team is already preparing to receive that patient 10, 15, maybe 20 minutes before the patient arrives. And all of this is in an effort to expedite that patient's care, right? Time is of the essence. Literally minutes count from there. Stroke patients, we have, you know, patients with congestive heart failure, COPD, shortness of breath, abdominal pain, appendicitis, you know, minor lacerations, fractures, you know, tummy aches, you name it. See a fair number of pediatric patients with fevers, ear infections, maybe flu, maybe covid, a number of things. So that's one thing I, I love about the special. We talked about sort of being a, an adrenaline junkie and, and not really knowing what's going to come through the doors, but also just the wide variety. So I'm always impressed by my colleagues that, you know, we take care of premature infants, we take care of even a step before that. Pregnant patients who have a fetus. Yeah, we take care of people who are 102 years old and we take care of medical problems. We take care of traumatic problems. So we do neurology, we do cardiology, we do ENT, we do pulmonology, we do gastroenterology, we do dermatology, we do it all. We just have to do it within the confines of the emergency department. And we have to take the emergency aspects of those specialties and boil it down into the salient points of our everyday shift. So I like being sort of a jack of all trades. The downside of that is I'll never be an expert in any one thing, right? So the cardiologists are obviously much better at taking care of cardiac conditions than I will be, but I'd like to argue that the ER folks can take care of the first 15 or 20 minutes of any emergency. Yeah. And then we know when to call and who to call. And so here at SGMC Health, we have phenomenal consultants. So if I call the cardiologist in or the neurologist or whoever it may be, boom, immediately I get them on board. They come in, help us manage the patient and get the patient taken care of. So I hope that answers the question. Maybe more answered than you wanted.
 
- Maybe. I think I forgot the question.
 
- So, okay. So we're not taught in school. I always keep going back to this same comment, but we're not taught, taught how to seek out care. Like what is the appropriate care place to receive care when we are not well sure. Or have something happen to us. Absolutely. So let's explain a little bit about utilization of ER versus urgent care. Urgent care being relatively new in the last couple of years has really, you know, gotten more popular. Oh, absolutely. Gain more knowledge, but absolutely. How do you determine if you go, if you should go to an urgent care or an emergency
 
- Room? Sure. No, I think you hit the nail on the head. I mean, so we don't, I mean, there's not a class in school or college, right? So how to pick your emergency or urgent care visit 1 0 1, it's more of English and math. So, you know, unfortunately, or maybe fortunately, a lot of the decision making that people have regarding should I go to urgent care or the emergency department? Which emergency department is mostly based on anecdotal experience, right? So my aunt so and so had this problem and she went here and it worked out really good for her, or it didn't. And so a lot of people based decisions off previous experience. But if you think about it and just kind of take a step back, okay, what is, what is urgent care built for? And it's, you know, when we think about it from a common sense approach, okay, I just, I just kind of feel bad. I, I don't have a life threatening emergency. I'm not, you know, gasping for air. So I, I, I kind of break it down into the ABCs, you know, A for airway, B for breathing, C for circulation. We kind of have an algorithmic algorithmic approach to that in the emergency department. So if I've just got, you know, cold symptoms, sore throat, maybe a minor burn that's probably smaller than the palm of your hand, you know, minor cut, sprained ankle, absolutely urgent care is your place to go. Now that being said, urgent care obviously has hours of operation. So if you have an urgent care type complaint, but it's in the middle of the night or maybe early in the morning before urgent care opens up, you can absolutely come to the emergency department and we'll get into this later in the podcast. But we have an express care feature within our emergency department that is sort of built to take care of those complaints and to try to do it in a rapid fashion to get people in and out. So that's sort of your urgent care subset. Now, if you feel like you're really struggling, you've got a life threatening injury, obviously bad traumas, heart attacks, strokes, shortness of breath, I mean, those are the things for the main department, emergency department, you know, it's hard to say, okay, gosh, I think I have an A problem that's gonna require surgeon to sort of evaluate. But you know, if you're having severe abdominal pain, nausea and vomiting, obviously shortness of breath, chest pain, you know, weakness or numbness on one side of your body or inability to speak, which would be like stroke symptoms, then you know, you need to get to the right place. Having the luxury of working both at main campus and at Smith Northview and working a few shifts at urgent care, I can kind of see all the three locations that we have and how they work with one another. So if you happen to go to urgent care and you're having an emergency that requires the main er, then we're absolutely gonna identify that within a matter of minutes and arrange for transportation to get you to the right place. Vice versa, if you come to the main emergency department and you just have a very minor complaint, we're still gonna see you. We're gonna triage you, we're gonna see you, and we're gonna try to do it as fast as possible. We'll talk about wait times later, but that's our goal. Yeah, I mean, we want to get everybody seen. So even if you don't make the right choice, we're here for you to help correct that and get you to the right place in a very time sensitive fashion.
 
- Yeah, because the one thing that we can't do, and we're just limited based on regulations, is we can't, if you come to the er, we can't say, Hey, this really is better suited for an urgent care. You should leave and go to the urgent care. That is correct. We can't do that as a hospital because we are required once you enter the ER to go ahead and sure. Do a medical evaluation. So that's one reason and we just, we can't offer that. And some people wonder why we, you know, but that's regulation, so we can't do that. Right? Yep. That's, and that I think is brings, so it really is important to make the decision right before you approach a facility. But if you do end up in the ER and it is not a life threatening event, explain a little bit about the express care and this was just recently put into place and kind of how that operates, what types of patients that it sees, and then the benefits it provides to both our patient with their experience, but then with our main er.
 
- Sure. So, you know, the ER is always a sort of a moving target, trying to expedite the flow, trying to do the best thing we can do for our patients. But we did identify a subset of patients and, and when you come into the er, we kind of triage you based on five different levels. Level one being the highest acuity, most life threatening, and level five being the least acute. So we noticed that our level fours and five, so we're talking about people with like a simple strep throat or a cold or maybe maybe even a little small burn, something that really does not require us to use a lot of resources. We identify those people that would come to the ER and they would have longer wait times, right? So obviously we want to get it right, the people who need an immediate intervention for a life-threatening injury, we wanna make sure we get those people seen ASAP. And I think we do a good job with that. Where I think there's room for improvement across the board in every emergency department in the United States are those lower acuity people. So how do we now take those people and, and sort of expedite their care, prevent them from sitting in the waiting room for hours and hours? Because that's what we hear. I mean, let's face it, nobody likes wait times. Our patients do not like wait times. And I'm gonna let tell y'all a little secret. The ER doctors don't like long wait times either, and the nurses don't like long wait times either, right? So we, we want to do it right, we owe it to our patients. That's what we're here to do is provide not only good care, but time sensitive care, timely care. So Express Care was sort of born out of the idea that, hey, what can we do to better serve our lower acuity patients? And so what we did is we tried to carve out times between 7:00 AM and 11:00 PM that we now have some additional dedicated resources and staff and a dedicated physical location within the emergency department to process our lower acuity patients to be able to get them something as simple as a strep test done in a matter of minutes instead of hours. And the goal is to get people in and out, you know, really as fast as possible. I mean, we really would like to do that under an hour, but what's stopping us from doing 30 minutes? So, and now for the first time in a long time, we're tracking that data and trying to make meaningful changes. So from one month to the next, if we see our average time has been, you know, 120 minutes when we start, okay, what can we do to get that down? And, and so for example, some of the things we have done is, is sort of incorporated some, some point of care testing. So before, if you had strep throat and we had to do a strep test on you, we do a little swab in the back of your throat, we'd send that to the lab and, and the process of sending that to the lab and getting it back just added minutes to the process, yeah, it added an extra 30, 40 minutes to us getting that result back. Well why can't we just do that in the emergency department? Why can't we eliminate that step? So it's number one, identifying barriers like that. And number two, addressing those barriers and fixing them. So there's always a rate limiting step, right? There's always rate limiting step, and when you fix the rate limiting step, now there's another rate limiting step. Yeah. So you just continue to process things like that. So we've made some meaningful change, we've improved our throughput times with that. You know, honestly, we could grow the business in that area. Yeah. I mean, we could stand to see more people with strep throat, you know, minor injuries and illnesses. We've got the bandwidth to do it. I walked through yesterday and you know, that little area of our ER was, you know, it it had some empty beds, had some availability, you know, I wanted to go outside and say, Hey, no lines, no waiting, come on in. No.
 
- Well, I mean, it's important to know that because, I mean, let's just face it. Traditionally, if you came to the ER with something that was not a heart attack, stroke or traumatic injury, you know, you run the risk of having to wait a while because you don't know what else is coming through the door, right? If you are just operating under that triage process. So I think that's great that y'all have that in place now.
 
- Sure. Absolutely. And you know, so we want to get it right. We wanna do it as efficiently as possible. The, the flip side of that is we don't wanna miss anything too, right? Right. So it's a double-edged sword. So we don't want to just get people in and out for the sake of timely timeliness in our care, because occasionally somebody may come in with, you know, oh, I got jaw pain and it may be my tooth, but it really is a heart attack. Right. Symptoms or something else. So we, we don't, you know, so there's a trade off there. Yeah. Again, we wanna do the best we can. We know we can do better with our wait times, but we also want the public to know that we don't wanna miss anything either. So if we need to spend an extra five or 10 minutes and get it right, then, then that's more important than anything else. You know, so, so it's, it is always a balancing act. Yeah. Yeah.
 
- I know I've been in the ER with people before and they're like, why are they doing all of these tests? Like, what is taking so long? And I'm like, well, they don't wanna just send you home Sure. Without covering all of their bases. Absolutely. So it's easier for us to think that way since we work here. Yeah. And try to, you know, dispel, but we're just taking our time just 'cause we wanna Right.
 
- Well it's experience. Right? So we talked earlier about when people choose urgent care or the emergency department, it's usually based on an experience or an anecdotal story. So on the flip side, if you look at the way an ER physician is wired, we know about all those stories of man, this person came in, it seemed like a little simple complaint. All you need to do was one test and one x-ray and let 'em go. But then it turned into be something different and nobody wants to miss that. That's something different. Whatever it is.
 
- I am curious if there's times that the ER is busier than others. Is it predictable or it's just completely unpredictable?
 
- Well, it, so it, it is unpredictable. However, if you look at averages, so let's take a month for example. If I took a month's worth of data and looked at it just on a day by day basis and broke it out and looked at volume curves throughout the course of a 24 hour period, it's like anything else. Most people are asleep at night, right? So, so not many people are, you know, twisting their ankle or yeah. Whatever it may be. So our volume starts picking up about 10 or 11:00 AM starts to rise till about two o'clock. It's a little bit of a plateau there. And then it starts rising again about four or five, six o'clock continues to rise till about midnight, then it kind of falls back down. So between midnight and about seven or 8:00 AM is our lowest time and that is the lowest time for people actually signing into the emergency department. Right? So sometimes people may sign in an hour early and they're waiting, but that's the lowest average number of sign-ins per hour that we have. You can then take that data and go not just looking at a 24 hour period, now let's look at a seven day period. Monday, Tuesday, Wednesday, Thursday, Friday, Saturday, and Mondays and Tuesdays are by far our busiest days from a statistical standpoint. I don't know why that is. I don't know if people just wait, try to tough things out over the weekend. Yeah,
 
- They wait - It all around around and let's go to the er. But, but no doubt Mondays and Tuesdays are the busiest days. And from a physician standpoint, we up staff those days, we actually staff more to try to fit the volume. So we're always trying to match up the appropriate coverage with the appropriate patient volume. And then if you now go out even a further step and look at a 12 month average, summertime usually is a little bit lower. That may be, you know, maybe it's the college students at VSU not as many during the summer semester. I don't know if that plays into it
 
- Or people are traveling, they're not here as much.
 
- Yeah. I guess maybe the weather's nice, they'd rather go water ski in as opposed come to the er. They
 
- Get, they go to the ER somewhere else because they get injured.
 
- Yeah, I guess I don't, maybe the ones vacation are coming to us, but that's kind of what you see. So, so during the middle of the day, and then of course Monday's, Tuesdays and then typically more fall, winter are our busier times
 
- As far as ambulance and EMTs go. You mentioned that heart attack, it's good to go ahead and call 9 1 1. Sure. Because they can start to do some of that early intervention. Same with stroke. But do you get in the ER faster if you have a non-emergent emergency and call, so you sprain your ankle hypothetically, right? And you called the ambulance. Does that get you a quick, fast pass through the er?
 
- No. So we still triage everyone based on acuity, regardless. You know, if you come in by ambulance or by private vehicle, there are plenty of people who come in the front door by private vehicle who are having a heart attack or stroke and they immediately get brought back. There are people who call the ambulance who have, you know, maybe a minor injury that may get triaged and have to go sit in the lobby for a brief period of time. We don't want anybody sit in the lobby. That's not what we're here to do. Right. And if you come in by EMS, I mean we, we prefer to try to get you into a room, but there definitely are times when the patient who comes in the front door by private vehicle has a more severe condition than somebody who comes in by EMS. So I think our nursing staff, our triage nurses, our charge nurses do a really good job of kind of playing air traffic controller to kind of balance what's coming in the front door versus the EMS ramp and trying to really delegate who needs to bed next. It's really an amazing, if you've ever been down, there's amazing process to watch. You think about how many people are coming in, it's unpredictable, you know, some are coming by EMS, some coming in the front door. But to watch our nursing staff navigate that Yeah. And to try to, you know, not only get a patient who's admitted upstairs, but then now I've gotta put a new patient somewhere. Where do I put 'em? It's, it really is very similar to air traffic control. Yeah. Trying to get airplanes to land, you know, at the airport or
 
- Something. Well when you work in the healthcare field, you know, we talk about the ER and we realize that the ER is much more than the er. Right. It is just a piece of the puzzle of the overall health system. Yes. And I don't think the general public realizes that because you've gotta think about the patients that are in the ER that are having that life threatening, how they then have to fit in to either a surgery or a specialty or a bed up on the floor. So it's definitely for the ER to be efficient and successful, you know, we have to have our entire operation, you know, running smoothly. Sure. And everyone's got to be working together. But I think that's something you don't really think about. The average person doesn't understand that. Sure.
 
- Absolutely. I, you know, I think day one when I got here, of course they embarrass you at morning huddle and introduce you to everybody and then they expect you to say a few words and kind of deer in the headlights. And I, I think one of the comments I made is like, you know, hey, if the ER runs really well or if the ER does not run really well, probably, probably no credit to me. And probably equally no blame to me because it is dependent on other departments. So it really does take the entire organization working together. I mean, we're,
 
- I made the example you gave with the lab. I mean, just even having a, you know, a specimen Sure. Ran or a test. And when you're in the ER waiting in a room and they run, they come and do an x-ray or something, and then you have to wait how long before that X-ray it's read. Sure. You everyone feels like it should be instant. Yes. Right. You just scan me, the, the tech tell me am I having a heart attack? Right. Right. That'd be awesome.
 
- As a
 
- Patient, that's what you want. Yes. I mean that's what, and that's what people expect that don't under, you know, know what all has to happen. That, that, that then has to go somewhat to another physician that's gotta read it and then you tech is like, I can't tell you anything. Yeah. Yeah.
 
- It, and we ask them too, like, can you help me? Can we, can we get this done faster?
 
- Yeah. It's just definitely a big puzzle.
 
- Yeah, yeah it is. Yeah. And
 
- Even with like blood and having, like when you mentioned the trauma component and then having access to the appropriate blood when they're coming in to be, I mean, you've just got so many different departments working together
 
- And Yeah. It, it is very complicated now. And, and in addition to that, more so than any other industry, the regulation, right. The paperwork, all the different laws and things have to follow. So that adds another layer of complexity, more delays into that. So it is amazing how efficient every piece of the puzzle has to be to make it work. Yeah. Just right. So,
 
- Well, I know that we're constantly looking at it. Your team is constantly looking at the numbers and seeing, so that, I mean, that's just good to know and that, I mean, you care, you right? Absolutely. You care, y'all care about your patients and you wanna do a good job and Yeah.
 
- I mean, my family's been treated here before. I've been a patient in the er and, and that stuff matters, right? So I mean that, that kind of goes to why we do this. If I can have an entire team that cares, then things are probably gonna eventually work themselves out or at least work in that direction. I'd much rather have a team of people who care about wait times, who care about providing good quality service than a team that cares about just meeting a number. Meeting a metric is so much more than that. The metrics, you know, should work themselves out. We should see meaningful change, not for the sake of the change, but because we care and we want it to change. And I, that's always been my philosophy and leadership. That's the way I would want somebody to treat me. That's the way I personally try to practice. And, and I, you know, I think that the more people in the organization that, that have that philosophy that say, you know what, this matters. These people are important. We want to get it right. We wanna do it as fast as possible. That's contagious. Yeah. And, and if we get a little traction with that, we can get a long way. ER's a tough place to work. People are sometimes at their worst Yeah. In their, in the emergency department. And that's because they're having an emergency. I mean, tensions are high, emotions are high, we get it. But at the same time, there's no better opportunity. There's no better place for opportunity to have an impact on someone than the emergency department. So we try to celebrate those things, right. So when there's a great patient outcome, you know, somebody's super, you know, impressed with their care, we celebrate that because I want people to see that matters. People care. Yeah. We get enough negative feedback in different arenas. I'm not a social media guy, don't want any part of it. My wife can do all that stuff, but it's out there. I mean, you know, we're not gonna hide from it. We, we know there are complaints and stuff, but I think there's more good than there is bad. And we're gonna take that and run with it.
 
- Yeah. So I get a report every day of all of our reviews that are left on Google. And primarily, I mean, we get 25 star reviews every day and, and then every other day we might have one negative Sure. And then we, we do look into that and follow up on that because that's opportunities for us to improve. So we're always trying to be better. Right? Absolutely. And trying to be the best for our patients. And talk a little bit real quick about the new er Yes. The, the construction that's happening here at main campus,
 
- Pretty exciting. I went outta the country for nine days and came back and the auditorium's gone. Right. So, but, you know, long overdue I think is is one thing to say about that. So our current emergency department is, you know, we've really outgrown it. It's is dated in its layout that creates some inefficiencies with just the number of steps that a physician or a physician assistant or a nurse or a tech or anybody has to walk to cover ground. So we're really excited about the new emergency department, bigger, more space, more state of the art equipment in there, you know, better ingress, egress, ingress kind of stuff. You know, I think better patient flow. We have set apart places for our express care that we talked about earlier places for our psychiatric patients. I mean, it's gonna be awesome. Yeah. It's gonna be really nice. It's gonna smell nice and new. I think everybody come out and see it for the first few days, whether or not they have an emergency or not. So Yeah,
 
- It's gonna be
 
- Awesome. Yeah. But it's, it's gonna be great. I think as we take that next step and sort of being the leader in this area for medicine, that's gonna be an integral part of that. I think, you know, taking our trauma services to the next level to continue to build on the great work that's already already done with our, our stemi, our heart attack team, our cardiovascular teams, our stroke teams. This is sort of that next step. And I think that the patients, you know, if you've been a patient in the er, I mean, you see it stated, right? So would you rather, you know, if you're going on vacation, would you rather stay in an Airbnb that's built in 2023 or one that's built in 1997 or 1973? Yeah. You know,
 
- Well, just the efficiencies it'll bring Yeah, absolutely. Having it built for what we need and what this community needs. Because obvious that er I think was built in 1990,
 
- Maybe even before that, I'm not sure.
 
- It
 
- Looks like about 1960.
 
- But I mean obviously our population has grown since then. Yes. Right? Yes. The, the needs have grown. So having that larger to be able to help and then being built so that it can be the most sophisticated er, I mean, truly to, to, to compliment what you said about the heart and vascular and the neurosurgery and all the different specialties that we have grown over the past couple of years. You need to think about that when selecting your er Oh, absolutely. Is just that hospital have you know what you need.
 
- Absolutely. And I think, you know, take it a step further, I think that that's gonna play into retention of nurses, right? So if you're a new nurse and I can go work at a new facility, that's just, it's just nice. Yeah.
 
- It's given our workforce the ability to do their job better.
 
- Yes. Absolutely. So I'm excited about it. Cool.
 
- Be fun. We are too. Well I see you have a coffee cup in your hands. I know you eat here, right? And I know you're here all the time. So we always ask people at the end what your favorite meal is, either in the spice or the cafeteria.
 
- Oh wow. Like a trick question. Well, you know, it's always, I so start with this. It's always nice to walk up to the Starbucks and Ms. Selena just says, doc, I got your coffee over here. She's
 
- Kind a creature of
 
- Habit. So, so I appreciate that. And always with smiling face, she always has my coffee ready for me. Favorite meal? Well, I'm sort of, I try to be healthy. So usually it's baked chicken and that
 
- Sounds very
 
- Boring. Whatever, whatever vegetable they have kind of a creature of habit,
 
- I'll say. Well, speaking of creature of habit, we cannot let this episode end without acknowledging the outfit that you have on.
 
- That's right. It's,
 
- Are you at work or are you not working? We don't know. Well,
 
- I think this podcast is somewhere in between, right?
 
- That's right.
 
- It's so, so for, for those watching or listening, I always get picked on for the, the khaki pants and the scrub top. And I will say it, this had its origins back in 2004. Could have left it there in five, right? I could have, but I'm gonna just run with it. You opened a can of worms. I'm just gonna,
 
- 10 years ago. That's like 20 years ago. 20 years ago. My math,
 
- It's a lot of gray hair, a lot of miles here. So, so in residency we would do this lot because we would, back then we didn't have, you know, I hate to date myself. Oh
 
- Gosh. Tell me how big your phone was or pager. Was it a pager? Well,
 
- Well no, it was a bag phone. So just stay in your vehicle. Right. So, you know, your pockets would fill up with different things. So we, we gotta the point where we wear like khaki pants or something with a scrub top and it's easy to interchange. So like if I'm, if I'm gonna go out and have dinner with my wife after work, I gotcha. I can just put on another
 
- Shirt. Can easily remove the scrub top. You don't even have to change your pants. You go to dinner
 
- And you can, or you can have like a t-shirt on. You just take it off and you like
 
- Really? It's day to night transition. Yeah, yeah. You know, I used to read about those in magazines, but don't you guys have lab coats with
 
- Big giant pockets?
 
- We do now I tend to think the lab coats where it slows you down. Right. So it's nice to acknowledge I'm a doctor, but I, I'm totally not an ego guy. I, I'm okay. Like I'm just a normal, obviously
 
- I'm a
 
- Normal guy. So, but it, but it portray, you know, so if you get something on your shirt, it's not your polo shirt or whatever, you know, it's your scrub top shirt. So, and I like it. It's comfy. You never
 
- Know what you're gonna see in the er. That way you don't mess up your
 
- Good clothes. Makes fun of me. Every time I wear it now I do it just almost out of spite
 
- Just to, well I, I almost see it like a mullet. It is like the wardrobe, the mullet version of a wardrobe.
 
- It kind of is. Yeah.
 
- But it's both business. Neither is party. Do you party in your khakis?
 
- I don't even know how to answer that. You, so it's, it's, let's just say it's versatile. It is. Well-rounded, versatile wardrobe. Okay, how about that? So versatile.
 
- I, I just see how you are just efficient. Right? That's like you were talking about the processes that you're gonna improve that. Right. You know, taking steps away from the process that are not necessary. This is the suit. This is this
 
- T-shirt of outfits. Yes. This is a suit, a tuxedo T-shirt.
 
- Now remember you're also talking to a male. So 90% of my wardrobe selection is what does not need to be ironed right now. I
 
- Mean that's mine too because
 
- I'm already steamers now through
 
- It. Those are
 
- Phenomenal. I've heard, I've heard of these things, but I've never seen one. Okay,
 
- Well Kara Hope can get you a link to a steamer. She actually got me one and evers, it's changed my life. I
 
- Got it. I got it. So maybe, so, so today when you post these, do people put like comments?
 
- Yeah,
 
- We can, there will be comments. Vote
 
- You can link your favorite steamer. Yeah, we can vote. Okay. Is it, is it We can vote on the wardrobe. We're gonna do a poll.
 
- Full scrubs or full not scrubs or Yeah. This is deteriorating. We should, that's
 
- Fine. We should stop while we're, we're, we should talk about more
 
- Here to serve you. Alright.
 
- Alright. We gotta have fun, right? Absolutely. I mean we have a very, I mean you, I say we have a very serious job. You have a very serious job. Yeah,
 
- But
 
- I'll, but you gotta have fun too. Oh. So that's what we like, we like to do that
 
- Here. I agree. I think, you know, somebody said it way before I did, but laughter sometimes is the best medicine. Yeah. But I think it goes to show like, hey we enjoy what we do. We have fun and it's okay to have fun. I mean we need to be professional at times. Obviously we should never not be professional. We should never be unprofessional. Right. But I think it's okay to have fun. I think that is sort of part of the culture we try to foster here. You know, between myself, my colleagues working in the emergency department. We wanna enjoy being at work. Right, right. So
 
- You spend most of your life at work. Yes. More time at work than you do with your family.
 
- Absolutely. So if we can enjoy and kind of, you know, joke with one another and do stuff as long as we're doing our job and taking care of people, I think that's great. I think too, I think I'm more likely to walk into the next room with a smile on my face if I've enjoyed the past five minutes Yeah. Of my colleagues. I think that's true for everybody. Yeah. Throughout the entire organization. So have fun. Have fun at work. Right. We're here for a mission street taught us that
 
- To improve the lives of always earth.
 
- That's right. So, you know, it's hard to flip that switch on and off. Right. I should not just flip on my happiness switch when I'm in with a patient and then flip it off and I'm walking through the hallway. Yeah. It should just stay on. Right. Sometimes the light burns a little brighter and other times, but it should just be home all the time. Make it easy. Flip your switch on. Leave it on, let's go.
 
- I like it. I think that's a great way to wrap up today's episode. Absolutely. Be kind, be happy. Love where you work, love what you do. That's right. And I clearly you do. So we do too. Well
 
- I hope I didn't embarrass anybody today, so
 
- Well, we'll see. We'll let the listening audience tell us. Alright, well thank you Dr. Connell. Thank you for everything you've done in the ER and you're welcome. Continue to do just to enhance the level of care that we can give our patients in our growing region.
 
- Absolutely. Thank you for having me.
 
- Yes. And thank you to all of our listeners and continue to like, subscribe and leave us reviews.