Emergency Medicine in Norway

- Hi. So I'm a professor of emergency medicine at UMass in Western Massachusetts in the United States, and I'm also on the board of directors and treasurer for the Norwegian Society for Emergency Medicine. And I'm going to give you a brief history of emergency medicine in Norway. And just a little brief background, Norway has a population of 5.4 million, and it's one of the wealthiest countries in the world with a very high GDP. And they do have universal healthcare for everyone. But until recently, emergency medicine was not a specialty. So I'm going to give you a little bit of talk about the development of emergency medicine in Norway. And this background photo is from my recent summer trip to the Lofoton Islands up in Northern Norway. Next slide please. So in 2008, there was a health supervision committee that mentioned that patients were getting bad treatment in the receiving areas, what we would think of as the emergency departments in hospitals. Again, emergency medicine was not a specialty. The or receiving area is where patients kind of presented as a receiving area to be admitted to the hospital. And there was no supervision in these emergency departments or receiving areas. So this was a report that was established in 2008. Next slide. In 2010, there was a Norwegian physician, but he happened to go to medical school, and train at the United States. And he took this report seriously, and he decided to start the Norwegian Society for Emergency Medicine, or NORSEM. And that was started in 2010. And that was to improve, improve emergency medicine in Norway, or establish emergency medicine in Norway. Next slide. In 2013, one of the national TV stations did a report on the emergency departments in Norway, and they found out that interns were alone in the emergency departments in the vast majority and over 70%. And these new interns had on average of five months experience after medical school. And this is how it was in the United States many, many years ago, before the 1960s where medical students and interns just kind of went to learn, and practice on their own without having any supervision. And that report came out in 2013. Next slide. Also, in 2013, I happened very fortuitously to be living in Norway. I had moved there with my Norwegian husband and our three children. I had taken a leave of absence from my job in the US, and couldn't work because there's no reciprocity between the United States and European countries. So I was living on a potato farm teaching swimming lessons, and they found out, Lars Petter Bjørnssen, who started NORSEM, heard that there was an American emergency physician living on a potato farm teaching swimming lessons.

- So they put me in touch with the right people, and I was recruited to help start a pilot project for the largest emergency department in Norway. And this is kind of simultaneously in 2013 when that report came out. And this hospital was called Ahus, and it had the worst reputation among the hospitals in Norway for having the worst patient care, and patients dying in the waiting room without any attending supervision. So they hired myself and a few other physicians to staff the emergency department 24-7, and give supervision to the interns. So this my very first day on my very first shift speaking in Norwegian, which is not my, my native language. I had a TV crew following me around, because the hospital was trying to improve their reputation. And this big title basically says that Ahus has to had to import help from foreign lands to help staff their emergency departments. Next slide. So we had brought politicians and media in to see what we were doing, as you can see in the previous slide. And after a lot of work and a lot of headaches, the health minister in Norway actually approved emergency medicine as a primary specialty in 2017. Next slide. They started grandfathering in physicians. And in July of 2019, the very first physician was grandfathered in as an emergency medicine attending physician, and he is currently the president of our Physicians Emergency Medicine Physicians Union in Norway. Next slide. So the following year in 2020, Akutt Mottaksmedisn which is emergency medicine, became, had their own doctor's union. So in Norway, all, almost all physicians belong to a doctor's union, and each specialty has their own union. So just four years ago, emergency medicine got its own official doctor's union. Next slide. I did write about the experience and the history of emergency medicine in Norway in great detail, and it was published in "JACEPOPEN" in 2020. Sorry, I don't have a QR code, but if anyone wants to read that, just Google my last name, and "in Norway," and that'll come up. Next slide. In 2022, Norway graduated its first attending physician from residency, that was completely trained in, in Norway. And that was two years ago. Next slide. And this past year in 2023, the Norwegian Doctors Union started publishing its own magazine, and there have been about four copies now that have come out in print. And there are currently about a hundred, over a hundred emergency physicians at attending level now in Norway. Next slide. Oops. And that was it. Sorry, I think you missed the "thank you" slide. I had my contact information with my email on a summary slide, but it's in the chat if anyone needs to contact me. Thank you.

- Okay.