What was lacking, however, was a vision of emergency medicine as an academic specialty with a core fund of knowledge, a biology, and an organizational structure like the traditional specialties had.
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ACEP Now: Vol 38 – No 12 – December 2019Peter Rosen had become a visionary advocate for the specialty of emergency medicine at the perfect time.
Transforming Emergency Care
From his position, he began his lifelong mission of transforming emergency care in this country. He started a residency in Chicago and then another one in Denver, when he moved there in 1977 to become director of the department at what was then Denver General Hospital (today Denver Health Medical Center).
Sensing the need for a formalized curriculum, he spearheaded the first textbook written by and for emergency physicians, Rosen’s Emergency Medicine: Concepts and Clinical Practice. At the helm of this large undertaking, Peter in essence defined the parameters and the body of knowledge of our specialty. The book is now in its ninth edition, and the 10th is well under way.
After Denver, he built the residency in San Diego and guided the development of the academic departments at the Harvard-affiliated hospitals. He also served as faculty at the University of Arizona in Tucson, completing his career as the senior mentor for three vibrant academic departments.
In 1979, he wrote an influential paper published in the Journal of the American College of Emergency Physicians (today known as the Annals of Emergency Medicine) outlining “the biology” of emergency medicine and defining ownership of an area of basic science that would define emergency medicine. He founded the Journal of Emergency Medicine to further enrich and support academic work in the new specialty.
Despite his academic and educational achievements, however, Peter’s first loyalty was always to the patient.
Peter was also interested in some of the legal implications of practicing emergency medicine and believed that our legal tort system had, in part, triggered the creation of our specialty by compelling hospitals to staff emergency departments with trained providers. In 1990, he wrote about the importance of being a plaintiff expert witness, saying that “physicians who work as an expert for just the defense may appear to a jury to be less objective than physicians who are willing to testify that another physician was negligent.” He believed that impartial experts evaluating cases for plaintiffs’ attorneys would invisibly stop many lawsuits before they were ever filed. But he also felt that validating legitimate claims by injured patients was important as well. “The last guarantee of fairness in the system is to have available the testimony of honest physicians,” he said. “In the long run, this will prove the strongest defense against nonobjective partisan testimony proffered only to further the financial gain of the dishonest expert.” In pursuit of this, he testified for patients and physicians for 40 years and earned a reputation of uncompromising honesty. However, Peter’s testimony against another physician in a case several years ago was criticized, turning his long-held beliefs into a surprisingly public issue. While he was officially censured by ACEP, Peter always maintained that his testimony had been medically justified and that he was simply acting upon the beliefs that he had voiced and practiced for years.
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9 Responses to “In Memory of Dr. Peter Rosen, a Founder of Emergency Medicine”
December 14, 2019
R HouleI still remember Dr Rosen’s famous “Pretzel Hold Story”.
December 15, 2019
Paul Orcutt MD, FACEPDr. Rosen was the one person I have always respected and admired. My only meeting with him was many decades ago when he administered my oral board exam.
Thank God I chose to study chose textbook for my oral exam.
Paul Orcutt MD FACEP
December 15, 2019
John C JohnsonThanks for the wonderful biography of a legend in EM. Peter was on the ABEM Board and as such could not take the exam until he had been off for I believe 5 or 10 years. When he got around to taking the oral, as was the practice – all oral examiners had the ability to cross off candidates that they felt they had a conflict of interest. With Peter’s cantankerous reputation, NO ONE, wanted to be his examiner. I knew him, of course. Ben Munger CEO of ABEM, came to me the first day of the exam and told me I HAD to test Peter in the double scenario. I reluctantly agreed. When Peter came into my room, I felt like standing and saluting. (think George Patton to imagine the moment) One of the scenarios involved a pancreatitis and one of the critical points was to order an amylase. He did a perfect exam and ordered his KUB and lab, but did not mention amylase. Now what do I do. “Is there anything else you would like, Dr. Rosen” No thanks was the answer. When it later came time to reveal his x-ray and lab results, the amylase was on a separate page which I withheld. He asked – “where’s my amylase” – you didn’t order one my answer – “you caught that, eh ? I would like to order one now” – shortly he got his result. Catastrophe avoided – I would have had to fail Peter Rosen.
December 29, 2019
Donna HelgrenI was fortunate that a large portion of my nursing career was practiced in the ER of DGH. Dr. Rosen was a striking influence during those years. He promoted a team approach to provide the best care possible to all of the patients at every level of need.
February 6, 2020
Frank A MooreRIP.
We will carry on the fight in your honor.
February 8, 2020
Chris Hinson MDI had the chance to meet Dr. Rosen as a resident while at Cook County Hospital in Chicago while working with another Giant in medicine Dr. Quentin Young. He was indeed an impressive Humanitarian and dedicated to the proposition that Emergency physicians must be the best specialist outside of every other specialty and know every other specialty to a degree sufficient to do their job if necessary.
October 5, 2020
Marzieh Fathi“AS A WOMAN EMERGENCY PHYSICIAN IN A DEVELOPING COUNTRY, YOU SHOULD BE STUBBORN”.
I will never fotget your advice…dear Peter.
March 29, 2022
Terrence L. Jones MDAloha ‘Oe Peter,
Your guidance and influence have spread your mindset across the Emergency Medicine landscape, and it has been well appreciated. Mahalo my friend and mentor. You will be sorely missed, as well as Chinese food after the evening shift!
November 2, 2022
Rick PostOne of my life’s profound moments was when Dr Rosen pronounced an individual dead.
My dance studio was having a party at the Brown Palace hotel and when I walked into the hotel all my students were not in the restaurant they were in the hotel lobby. I was told an elderly man collapsed while dancing. Thinking it was one of my students I rushed to find it wasn’t one of my students, but this unknown woman grieving over her husband being worked on by EMTs. I volunteered to assist by driving her to the Denver General Hospital Emergency room, she was not in a condition to drive.
After 2 or 3 hrs Dr Rosen told this lady he did everything he could to save her husband’s life, but was unable to succeed.
I never experienced anything like this before. Speaking to this woman the way he did was so full of compassion and honesty that I will never forget this short conversation.
Dr Rosen left a memory with me that I’ll never forget.