In conversation with Dr Yusuke Ueno-Dewhirst

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In Conversation provides a glimpse into the life of a healthcare professional with a passion for their field of medicine.

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IN THIS ISSUE WE TALK TO Dr Yusuke Ueno-Dewhirst
What prompted your decision to work in the area of emergency medicine (EM)?
I realised late in my career that EM ticked all the boxes for me. EM allows me to manage the acute clinical aspects of a patient’s presentation without being in a clinic or ward round. I think it really appeals to my interest in being an acute generalist and my desire to be a problem solver. When I started working in EM, the variety, diversity and broad range of exposure was really appealing to me.
How did your career path lead you to your current position?
I don’t think I’ve ever had a specific career path mapped out in front of me. It was a combination of good timing and a desire to learn more about different specialities in my training. Ironically, when I graduated in 1996 in the UK EM wasn’t an appealing career at the time so I started training in surgery.
Little by little I became dissatisfied with some aspects of surgical training and in 2002 I took a career break to come and work in an emergency department in Australia. That was Nambour General Hospital on Queensland’s Sunshine Coast and I never looked back. Here I experienced other specialities such as critical care and medical management. In 2007 I decided to complete my training in EM. For me, the beauty of emergency medicine is that I get to use everything that I’ve learned along the way on a daily basis. All the other EM specialists that I’ve met have diverse backgrounds and this adds to the richness of our speciality.
What inspires and sustains you in this demanding field of medicine?
Well it’s a combination of things. It’s the satisfaction after a busy shift where everyone has worked really hard to achieve the best outcome for all of our patients. Those days can be tiring yet very rewarding. It’s also about being able to contribute to patients and my team; the day that I no longer feel this, will be the day I move on. In terms of making contributions to our department, I have been involved in supporting our EM trainees through a major change to their curriculum last year and I’ve been lucky to be involved in the planning and design of the new hospital in Kawana (Sunshine Coast University Hospital). On a personal level, what sustains me is having a very supportive and understanding family and an ability to switch off on my days off.
What are some of the challenges facing EM physicians?
For the EM physician as an individual, the challenge is to retain job satisfaction and longevity in an increasingly demanding environment. The demands on your time, the emotional involvement and at times the physical and psychological drain can be challenging for an EM clinician. As a young doctor the late nights and disturbed sleep that come with shift work may be manageable but as you get older it becomes more difficult to recover from. The healthcare system needs to ensure that the collective experience of senior emergency physicians is not lost in this environment.
The other challenges for us in EM, mirror what is being felt across the work together - meeting the needs of an ageing population and patients with chronic diseases such as diabetes. EM is in the space between primary care, community health and secondary health so if the overall system is not equipped to cope with rising demands, EM will be expected to fill that widening space. As we are available 24/7 - and don’t close our doors, the Emergency Department is becoming the place that is expected to tackle the deficits in other systems, including social welfare.
There are also opportunities for EM physicians to make a difference to help meet these challenges. At Nambour Hospital for example, the Geriatric Emergency Department Intervention (GEDI) team are making significant contributions to the better management of this group of patients with complex needs.
Do you see any interesting innovations coming into EDs in the near future?
EM is a place where innovation comes with the job. We need to innovate when it comes to patient models of care. GEDI is a perfect example of such innovation.
EM physicians are well placed to drive innovation through research. The Queensland Emergency Medicine Research Foundation, for example, supports research into EM to see what treatments work and how we can innovate to best care for our patients.
Treatments and medications have changed dramatically over the past 20 years and we need to stay up-to-date with progress in other specialities. HIV is a good example of a disease that is now described as a chronic disease that people can live with instead of a death sentence. So these changes drive EM clinicians to maintain linkages with other specialities and work together to ensure that our patients get the best up to date care possible.
As far as technological innovation goes, there are always new devices that build on existing technology but I don’t think we have seen the full potential of what modern technology can offer EM.