In the same way, social emergency medicine is distinct from public health. Public health is very disease focused. They want to prevent waterborne illness. They want to vaccinate against a specific disease. Some of Doug White’s work is very public health oriented. I view social emergency medicine as more grounded in the patient experience: “I’m experiencing violence in my community. What does that mean to me? I’m experiencing a lack of ability to exercise my free will. What does that mean?” Social emergency medicine will help the patient translate that into a diagnosis and care plan.

KK: With population health management, chronic diseases are managed for a large population. With social emergency medicine, you’re looking at the lifestyle choices and social implications of the environment of the EM patient. Whether it’s gun violence or perhaps motor vehicle safety, it’s much, much more patient safety focused about their environment than it is disease management as in public health.

HA: I think that’s true; that’s a great way of looking at it. We do have a program evaluating the use of health coaches in the emergency department. We assign a young person from our community who has received considerable training in community health outreach work to a patient with diabetes or hypertension. They develop a six-month longitudinal relationship around managing the patient’s disease. Even when we do take on a chronic disease, we do it from the patient, environmental, and ecological perspective.

KK: This is the societal impact that emergency medicine can have on a population, how they’re navigating through their lives, but not necessarily how their family doctor is taking care of their diabetes.
HA: I think that’s exactly right.

KK: I’m getting there. My level of understanding is improving as we talk; you’re making progress.
HA: I lack an elevator pitch. It’s a personal failing, and one I’ve been working on.

KK: I don’t think you need one. It probably requires, perhaps, a cup-of-coffee conversation like this one. It’s not so easily described. I think a good conversation really clears that up.
HA: I was fortunate to have an atypical education in public health at Berkeley, where I got a master’s of science, rather than a master’s of public health (MPH). That encouraged me to dig deeply into a specific topic of interest as opposed to the more broad-brushed MPH.

KK: Are there specific programs now in social emergency medicine or for the emergency physician who’s interested in getting more education?
HA: We had about two and a half hours of abstracts at the SAEM [Society for Academic Emergency Medicine] annual meeting last year. ACEP doesn’t yet have anything going, but I’m looking at trying to initiate an interest group.