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Focus on David K. Tan, MD

David K. Tan, MD, EMT-T, FAAEM, is assistant professor in the division of emergency medicine and director of Washington University EMS. His areas of interest include pre-hospital emergency care (EMS), tactical medicine, disaster medicine, EMT and paramedic education and training.

Dr. Tan sees patients at Barnes-Jewish Hospital, emergency department, 400 South Kingshighway, St. Louis, MO 63110.

What happened in the course of schooling to make you choose your specialty?

I’ve always loved the challenge of managing different patients who are ill or injured -- it keeps the day very interesting. It forces me to use all the skills learned, in medical school and residency, on patients who are often critical and near death. I chose the specialty of pre-hospital medicine because in addition to dealing with the medical issue at hand, you must take into account the complexities of your surroundings. Dangers such as hazardous materials, structural collapse, fire, or ballistic threats to yourself and the patient must all be considered.
Dr. Tan and family

What brought you to Washington University?

I was born and raised in the St. Louis area and have always respected Washington University’s reputation for having the finest medical care and being a national leader in medicine -- even before that tag line was created. I’m surrounded by colleagues from every discipline who are equally committed to the most advanced and compassionate care that modern science has to offer.

Which aspect of your practice is most interesting?

The pre-hospital factor of the unknown that occurs when responding to a medical emergency in the field is definitely the most interesting. Even the most innocent sounding call can become complex, with a challenging evaluation and treatment -- depending on what else is going on and where the patient is located.

The other day I happened to be working a shift with one our fire protection districts that contracts with Washington University for medical oversight. I went with them after they received a call to a traffic accident where the driver crossed four lanes of traffic and landed at the bottom of a 100-foot embankment. Most emergency physicians don’t ever see the absolute turmoil and chaos of the initial scene – they are used to seeing the patient brought into the ER on a stretcher, after he or she has been “tidied up”.

We were standing ankle deep in mud as we hauled the driver up out of the embankment with a rope and pulley system. It took us 30 minutes to get him out of the car. I was able to talk to the emergency department physician at Barnes-Jewish Hospital to let him know what to expect when the patient arrived there. I was also able to make suggestions to the paramedics and they were able to ask me questions. It was a great example of how direct medical oversight can affect and improve patient care.

The other interesting aspect is being involved in the education of our pre-hospital colleagues who bring patients to the hospital every day – the firefighters, EMT’s and paramedics who act as physician surrogates answering the call for help 24/7. Washington University EMS Physicians are very involved in various educational programs that help these first responders become better medical practitioners as well.

Dr. Tan demonstrating a vehicle extrication

What new developments in your field are you most excited about?

Pre-hospital medicine is closer than it’s ever been to obtaining board-certification status. The American Board of Emergency Medicine has been cautiously optimistic about the latest revision to the proposal for official specialty status for EMS. If approved, EMS would become the sixth sub-specialty under the parent board of ABEM joining Medical Toxicology, Undersea and Hyperbaric Medicine, Pediatric Emergency Medicine, Sports Medicine, and Hospice/Palliative Care Medicine.

Can you explain the importance of your EMS Fellowship program?

You can’t take just any physician, put him or her at the site of a car accident in the bottom of a ravine, and expect them to know what to do. They wouldn’t know how to function in that environment – it’s not a criticism of their medical training, but doctors aren’t trained to function under those conditions. The EMS fellowship teaches them how to practice medicine in a hostile environment – in a collapsed building in an earthquake, a flattened house in a tornado or a traffic accident in a hard-to-reach place. Our EMS fellows obtain training in basic fire fighting, law enforcement, SWAT, search and rescue, and hazardous materials. They all have incident command training called NIMS (National Incident Management System).

I’m proud to provide world-class training to our fellows here at Washington University. They leave here with the ability to provide patient care -- as safely as possible -- in all situations.

Which particular award or achievement is the most gratifying to you?

I received a Distinguished Service Award from my colleagues at Abbott Ambulance, Inc. which is extremely meaningful to me because it comes from the pre-hospital colleagues I work with every day.

What is the best advice you have ever received?

My cousin, Dr. Aaron Jonan, was a physician who served as a role model for me as I was working through pre-medical studies in college. He told me one of the keys to success in life was being tenacious – never give up on your dreams, no matter what. I needed that philosophy through many a night -- not only in college but through medical school and residency. It is advice I pass along to other students who ask me what it takes to succeed. Keep your eye on the prize and never give up.

If you weren’t a doctor, what would you like to be doing?

I absolutely enjoy being out in the field and feeling like I’m making a difference. If I weren’t a doctor, I’d be doing something in Public Safety – paramedic, firefighter, or law enforcement. The nice part about my specialty is that it allows me to do just that – working as an EMS Physician with EMS, police, and fire departments.

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Copyright 2015 Washington University School of Medicine