Don A. Berkow, M.D.

Don A. Berkow, M.D., chairs the Department of Emergency Medicine at Lancaster General Hospital. We asked Dr. Berkow about the department’s current priorities and challenges, plus how he manages stress.
 
What is your background and current role with LG Health?
I’m from Baltimore, and I went to college at Franklin & Marshall. I joined Lancaster Emergency Associates in 1986, right after residency in Kentucky. I’ve served in leadership roles within our group and for the Medical & Dental Staff for about 26 years. I’ve chaired the Department of Emergency Medicine since 2017. I devote about two-thirds of my time to administrative tasks and the rest to patient care.
 
How has the Emergency Department grown during your career?
Our group has grown from six members to 34 providers. In 1986, we saw 34,500 patients. We’re on track to see 118,000-plus this year. Our ED has expanded twice, and we are looking at future options to handle our growing census.
 
How do you work with other departments at LGH?
Emergency medicine deals with literally every other department at the hospital. Any process or technology changes affect us, and we need to be involved. We make it a priority to work together on process development and performance improvement. We work especially closely with Trauma, Lab, Radiology, Service Lines and EMS. Our combined strength offers many advantages to our patients, such as access to an in-house trauma surgeon 24 hours a day and our acute MI and stroke programs.
 
What are some of your department’s current challenges?
Certainly the ED mirrors society overall, which includes patients who are struggling with addiction, mental illness and even homelessness. We want to provide expedited care for our patients’ immediate problems, while also screening for and addressing issues such as depression or abuse. For example, we are working on “warm handoffs” to connect patients with follow-up treatment for addiction.
 
How are you working to see patients more quickly?
Once any patient enters our doors, we want to treat them as quickly as we can. We recently opened our Rapid Treatment Area, which uses the concept of “vertical beds.” Patients move quickly through, then to a “results waiting area,” so we can continue to bring patients back. Working with our colleagues throughout the health system, we have made major progress in reducing the number of patients who leave without being seen. The growth of our urgent care centers, for example, has decreased the number of patients who come to the ED with less emergent conditions. 
 
We keep a scorecard for every interval of time spent in the ED – such as from the time a patient walks in until they see a provider – and we watch that very carefully. We are above benchmark in many cases. In particular, we are looking at innovations that can make an impact during surges in patient volume, such as exploring the use of telemedicine or rethinking the way we do triage.
 
How do you prepare for a potential mass casualty event?
We are constantly looking at our preparedness and how we can improve. We know that drills are part of being vigilant. When we do drills, we spend a lot of time discussing how it went and what we can do better next time. With the way the world has changed, we also have to be more vigilant about ensuring the safety of our staff, patients and visitors.
 
What do you like most about your job?
Emergency medicine can be physically demanding, as well as using your brain for quick diagnosis and stabilization. I still like taking care of patients. I also enjoy clinical process development – creating a consistent approach that works for both our patients and our providers.
 
What do you like to do when you’re not at work?
Burnout is very prevalent in emergency medicine. We get exposed to all kinds of illnesses, and we can get run down. There’s also physical stress from working different shifts. We have to be very adaptable to change. I find that some type of physical activity, as well as reading material that is not academic, is essential for relieving stress. I also enjoy the occasional double IPA.

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