Emergency departments are becoming a frontline for addiction treatment. In this episode of the Stanford Emergency Medicine podcast, treatment pioneer Dr. Gail D’Onofrio of Yale University talks with guest host Dr. Manish Shah about how ED-initiated buprenorphine is transforming care, challenging stigma, and redefining the role of emergency medicine in addressing substance use disorders.
Emergency departments are becoming a frontline for addiction treatment. In this episode of the Stanford Emergency Medicine podcast, treatment pioneer Dr. Gail D’Onofrio of Yale University talks with guest host Dr. Manish Shah about how ED-initiated buprenorphine is transforming care, challenging stigma, and redefining the role of emergency medicine in addressing substance use disorders.
Dr. Shah:
Hello everyone, and welcome back to the Stanford Emergency Medicine Podcast. I'm Dr. Manish Shah, Professor of Emergency Medicine and Pediatrics at Stanford, and I am excited to be your guest host today for this very important topic. Emergency departments see the consequences of substance use disorders every single day.
For a long time, though, the job of the emergency physician was mostly to stabilize the immediate crisis and then move patients along without really addressing the underlying addiction. Over the past decade, that paradigm has begun to change. Increasingly, emergency physicians are helping start patients on real treatment for addiction.
Few people have done more to shape that shift than today's guest. Dr. Gail D’Onofrio is the Albert E. Kent Professor of Emergency Medicine at Yale and the founding chair of Yale's Department of Emergency Medicine in 2015. Her landmark study demonstrated that starting buprenorphine in the emergency department helps far more patients get into addiction treatment.
That work helped change practice across the country. In 2023, she was elected to the National Academy of Medicine for her contributions to improving care for people with substance use disorders. Today, we explore how emergency medicine became a critical entry point for addiction treatment and what that means for the future of our field.
Dr. D’Onofrio, welcome to the podcast.
Dr. D’Onofrio: Thank you. I'm happy to be here.
Dr. Shah: So, you had a career before medicine—nursing, running your own firm consulting at Hewlett Packard. What pulled you back toward clinical work, and what was it like walking into the emergency department at Boston City Hospital, now known as Boston Medical Center, in the middle of the crack epidemic?
Dr. D’Onofrio: So it was a long, circuitous route, but actually I’ve always wanted to be a doctor. I was going to be a doctor, and somehow I got a little bit swayed early on. It was a long time ago—there were very few women in medicine then. And I went to Duke thinking I would do nursing.
Then I realized, no, I really wanted to go to medical school. So I was a dual major, and that worked out well. For other life circumstances, I ended up holding off going to medical school and went to Boston instead, where I became a nurse—a critical care nurse. The Nurse Training Act sent me to graduate school for free, where I learned about education and health policy, which I think has helped frame my work throughout the rest of my career.
So I learned a lot and developed many skills along the way. But the focus—I always wanted to be a doctor since I was very young. I had bad asthma and went to a doctor who happened to be a woman, which was unheard of in the fifties, and it was really amazing. I think I must have connected with her in a way that made me want to do this.
That brings me to Boston City Hospital. I loved my time there, but it was really a zoo. It was chaotic. It was the first real year where we went through a match in emergency medicine. The faculty were not emergency medicine–trained, most of them, although Dr. Peter Moyer, our chair from New York, was phenomenal.
We had many physicians from infectious disease, internal medicine, and other specialties. They did not know how to do everything we needed, and we were the trauma center of the city, seeing enormous amounts of trauma. It is hard to imagine now how we would get four or five gunshot or stab wound patients in an hour.
So it was relatively scary, but a small group of us learned as much as we could—sometimes in labs with animals—and then came back and did it. We just had to move forward. We knew we had to, because no one else was going to do it. That really set the tone.
I initially wanted to be a trauma surgeon. At first, I thought that was what I would do. But a lot of trauma surgeons talked me out of it, because at the time you had to live in the hospital—you could not go home. We were up all night operating when I was a student, and they said it was not compatible with life.
But I loved it. And they said, “This thing is coming—it is called emergency medicine. You are going to be great at it.” I said, “What is that?” And they said, “You can do all the procedures, but you will have a better life, and it is something you will enjoy.”
So really, on a wing and a prayer, I did it. I had no idea. There was nowhere I could go to understand what emergency medicine was like. These surgeons—who had operated in Vietnam and other wars—told me, “This is where you need to be. Go there. It will be perfect.” So I did.
And I learned a lot. I liked trauma and did as much of it as I could. But honestly, I learned how to be very good at saving people’s lives.
But then patients would say, “Doc, don’t you remember me? I was here last month,” coming in again with a stab wound. It was one patient after another. And all it was was substance use.
I did not go into this thinking I wanted to work in addiction. I went into it wanting to do procedures and help people with injuries. But I realized that was not really helping them.
It is like the old public health paradigm where people are upstream throwing others into the water, and you are downstream pulling them out. Eventually, you realize you have to go upstream and figure out why they are being thrown in.
So that is where it started.
Dr. Shah: Wow. It is really inspiring to hear how that variety of experiences shaped your interest in what you are doing now, and also to hear how you were at the forefront of emergency medicine and a pioneer in research.
You know, relevant research questions often emerge from observations at the bedside. You started to touch on this a moment ago, and I am curious—was there a specific patient or pattern that made you think this is a research question worth answering, and not just a clinical frustration?
Dr. D’Onofrio: So my first real project was around alcohol use disorder and seizures related to withdrawal. I was told that you had to give five days of Dilantin, and I said, that makes no sense—why?
When you think about Dilantin as an antiepileptic, you can actually hurt people—it lowers their seizure threshold. So our patients, when we discharged them, would go to the shelter, take their five days, and I would see the same person back the next week. And I am giving them five days to die. I said, this has got to stop. There cannot be a real medical reason that I am doing this.
So my first trial was with another faculty member. I was a resident, and we did placebo versus Dilantin and realized that neither worked, as we suspected. So Dilantin was worthless.
Then, when I was a new attending, lorazepam came out, which is known as Ativan. It was a great medication because it could be given IV and was absorbed very well, whereas Dilantin or Valium is not absorbed well parenterally. So it was a great choice—it could help withdrawal and potentially prevent seizures.
The reason is that when people have an alcohol withdrawal seizure, they tend to have multiple seizures afterward. Once they have more than one, you do not want to release them from the ED or send them to detox, because they may have more and could die.
So we did this study. In the old days, you did everything yourself. We only had $5,000—it was my statistician, someone to randomize patients, another resident, and a new faculty member. We did everything together. We prepared the vials in the pharmacy, had them available, and administered them to patients with alcohol withdrawal seizures.
We were shocked to find that hardly anyone had a recurrent seizure—and if they did not get the medication, almost everyone did. It was amazing. The study was published in the New England Journal of Medicine.
It changed practice, and even today it is still a board question—give two milligrams of Ativan and see what happens.
I was not doing this because I wanted to go into addiction medicine. I did it out of curiosity—why are we doing this? It makes no sense. Someone needs to explain why we are giving these medications and how we can better help people. That was it.
Dr. Shah: Wow—New England Journal of Medicine as your first publication. That is quite inspiring. Quite a high bar.
I am curious, before the buprenorphine trial, what made you believe that the emergency department could be something more than a revolving door for patients with addiction?
Dr. D’Onofrio: Well, I was very interested in a lot of different things around addiction, and I focused a lot on alcohol use disorder, or really just drinking too much—not even necessarily moderate to severe disorder.
I was learning how to do interventions and just talking to people, and doing different types of interventions related to alcohol. And honestly, it was really circumstance—the RFA came out from NIDA looking at drugs that could be used to screen and intervene for substance use.
I remember calling the project officer and saying, “You do not really think that the same intervention would apply to someone using cannabis or marijuana and someone using heroin or Percocet, right?”
And he said, “Well, people can do whatever they want.” So I said, “Would you mind if I focused on patients with opioid use disorder and thought about using this drug, buprenorphine?”
Buprenorphine had been around for quite a while. It had been used in France, and Dr. Swartz in Baltimore was starting to use it. In our Yale system, Dr. O’Connor was using it in the primary care setting.
So I learned about it and worked with him and Dr. Fiellin from internal medicine. I said, “Let’s try it in the hospital. Do you think we could do that in the emergency department?” I thought, why not?
So I went to their clinic, learned how to give it with a nurse who was administering it most of the time, talked to patients about what they liked and did not like, and then said, okay, we are going to do it. I submitted the grant, was fortunate to receive it, and I essentially administered it myself.
The other faculty did not even know what I was doing. I told them, “I have this medication. I will be here and handle it—you do not have to do anything.” I had research assistants identifying patients with substance use disorder.
There were three pathways patients could be randomized into. The first was referral only. But I made sure they were given a real referral—aligned with their insurance and preferences—not just a piece of paper.
The second was Project ASSERT, which involved substance use navigators providing an intervention to motivate change and a facilitated referral. They would call the site and notify them that a patient was coming. I thought that would be the most effective.
The third group received that intervention plus buprenorphine. It was an efficacy study, so they received the medication and follow-up care through Dr. Fiellin’s office.
I was really surprised when we analyzed the data—almost 80% of patients were in treatment at 30 days. It was remarkable.
I did not expect it to be that effective, but having seen these patients improve so quickly, it was an incredible experience. Being able to relieve symptoms rapidly and then motivate patients to continue treatment—it was truly transformative.
It was a really mind-blowing experience to change something that had never been done before.
Dr. Shah: You know, in emergency medicine, we have long defined ourselves around the acute—stabilizing our patients and then handing them off, either to the inpatient setting or back into the community. Addiction care typically gets framed as referral, harm reduction, and then someone else’s responsibility.
How does your work challenge what our field thinks addiction care is and who is responsible for managing it?
Dr. D’Onofrio: Unfortunately, a lot of people think that is what we do—that we stabilize people and send them on. But actually, if we only treated truly acute issues, we would need about 10% of our current workforce. That is not all we do.
Now more than anything, the ED is really the number one place people go for unscheduled care. And I do not care what your socioeconomic status is—you end up in an emergency department. The minute something is wrong, even if you have a doctor to call, the answer is, “Go to the ED.” For everything.
So we have a real opportunity not only to provide that initial stabilization, but also to make sure people are on their way to getting better. As you can see, we already do many things—we provide immunizations in the emergency department. We can give a flu shot or a COVID shot anytime. And as a pediatrician, you know there are other vaccinations we can provide as well.
So when you think about emergency medicine, what I believe—and what I hope others believe—is that we are there to improve the health of the public. If you keep that in mind, it becomes much easier to decide what to do next.
I want to make it as easy as possible for people to have the opportunity to do well.
Dr. Shah: Improving the health of the public—such an important part of what we do in emergency medicine. So I am curious, what has to change in training, in pharmacy, and in how systems are organized to make that happen? And specifically, with what you have done—ED-initiated buprenorphine—but also beyond that.
Dr. D’Onofrio: Well, the sad thing about buprenorphine is that I published that article a decade ago, and even now there are not as many places as there should be that are offering that treatment.
And overall—not just in EDs—less than 20% of people with an opioid use disorder are on medications that are incredibly effective, like methadone or buprenorphine.
So why people are not doing it is an interesting question. I have not fully figured it out, but it is mostly stigma. First, I want to make it easy for them.
We have pathways in Epic where you just press a button, and it does everything for you. It can even write your note and tell you where to refer someone. There are a few options based on patient preference or insurance, and once you select one, everything is generated. So it is really quite easy. That is one thing we can do.
Another is monitoring and feedback. In Boston, there was an incredible woman focused on interpersonal and domestic violence. Back then, we used paper charts. She reviewed every chart involving an injured woman, and if you did not document that you asked about domestic violence, the chart was returned to you. Every time.
So you learned very quickly not only to ask, but to document it. Every chart I had, I made sure it was addressed—either noting that I asked and it was not an issue, or that it was and I followed the appropriate pathway. She enforced that standard consistently.
I think we need something similar. People need immediate feedback—why did you not offer it? Why did you not prescribe it? What was the reason? And really, there are no good reasons not to offer it. Patients can decline, of course, and you simply document that you offered it, they declined, you provided naloxone, and gave them follow-up options. That takes only a few minutes.
But not offering it—especially when overdose is the leading cause of death for people under 45—is a serious issue. Most of these are young people. Why are we not offering a life-saving treatment?
We would never send someone home with a myocardial infarction. We know their risk of death is significant. The same is true for patients presenting after a non-fatal overdose.
Yet we often send them out with instructions to “go talk to someone,” without offering treatment. Think about ST-elevation MI—hospitals invest enormous resources to ensure rapid EKGs and cath lab access within strict timeframes.
They do that because there are financial consequences tied to performance. I wish we could create similar accountability here, but this falls more under Medicaid, which is state-run, so it is more difficult to standardize.
Still, I wish this were a defined quality measure. Otherwise, it depends on individual hospitals.
And people need to understand that if a patient leaves without being offered treatment and dies, there is significant liability—for both the hospital and the physician. So clinicians should think very carefully before discharging someone without offering treatment.
Dr. Shah: So I heard a few things in what you just shared. One is that, in medicine, as investigators, we can generate evidence, but there can be a lag in adopting that evidence—the knowledge translation piece. And you mentioned one barrier for this condition specifically: stigma.
However, you also noted some things that help facilitate that. You talked about feedback loops and clinical decision support in the electronic record. What are the barriers and facilitators to truly implementing the evidence you have generated? What have you seen?
Because there are hospitals in this country that are adopting this evidence and implementing it into practice, and others that are struggling—what have you seen works, and where do people struggle?
Dr. D’Onofrio: Well, honestly, they just do not get started. So what they need is one champion—they need one person in the ED, whoever it is: a nurse, a secretary, it could be anybody—who wants to initiate a process.
And then it takes someone to start that process. The thing I hear most often is, “We do not have any place to send anybody.” Right. Well, the government sent me to four large cities with one grant that said they did not have anything. Believe it or not, I went there—it is remarkable. I could tell you the story.
So I am in Baltimore, which has lots of treatment centers. They tell me they have nothing. They say they send people to one place, and that place never takes them. So I go there and do focus groups with the staff, and they say, “I do not know why that ED keeps sending us patients—we do not take people off the street. We tell them over and over.”
People have to stay there for about five days, go through therapy without medications, sit there withdrawing, and then maybe they are accepted. But once they are, it is a great resource—job training, medications, housing—it is a really big deal.
So we worked with them and said, “Okay, we will give patients five days of medication, then have them come to your outpatient setting, and then you can take them.” I also found many other places that were willing to take patients.
Then I went back and explained, “Here are the places they can go—refer them there.” I did the same thing in Cincinnati and in New York City, in an ED across the street from the first methadone clinic. They did not know how to refer patients there or what would happen when they arrived.
Again, you could not just walk in. But they had a clinic on the third floor that provided buprenorphine and was very willing to take these patients. They said, “Just send them—they can show up any day before noon, and we will see them.”
So mostly, I need a champion at each site. I need someone to identify those resources so that people feel comfortable.
But honestly, we send out many patients who do not have primary care. Do you ever say, “I am not going to give them antibiotics because I do not know if they will follow up?” No—you do not do that. Right?
Dr. Shah: Right.
Dr. D’Onofrio: You give the antibiotic anyway. So really, who cares? Start it and then get them somewhere. But if there is nowhere to go, they will find someplace to go. Or they will come back, and then you will find it. But those are the issues people want to know: where can they go?
I do not think there is a place in this world I cannot get somebody to, and people have called me sometimes. It is far. It is far, and it is complicated. Someone told me—in the middle of, I think it was Nebraska, I do not want to be wrong—but I found them a place fairly close that the person could go to and was willing to go to. He said, “You tell me where, I will find you a place.”
There is a dearth of methadone clinics. Those are run by opioid treatment programs—SAMHSA and others. There are really difficult places in the country where there are deserts of those. But they do have a lot of doctors and APRNs who can now prescribe buprenorphine. In the past, you had to do extra training, and that was a big barrier. But we did away with that, and it still has not increased the use of buprenorphine. So that was really just an excuse, honestly.
At Yale, I made every single doctor do it. I gave classes, and they passed and obtained the waiver. I am not sure that alone made them do it, until I implemented things like the pathway or followed up on every patient who did not receive it. So that feedback is incredibly important. You have to get the directors involved.
I learned early on that, just like individuals with substance use disorder, you cannot necessarily change everything about people. I cannot make a doctor change their thoughts about stigma. But I can change behavior. I can create consequences for not doing it through quality measures and feedback. So people do not have to like it or even change their beliefs—I just need them to change the behavior and follow the process, because they are going to get patients in and out, and that is what matters to them.
I did a study once with residents at two different institutions around alcohol. In one, I gave them a lot of training, and in the other, I did not. I looked at what they did for patients through chart review, and I also gave all of them brief attitudinal skills. What I learned was that I did not change people’s attitudes, but I did change behavior in one setting—because they knew I was looking. I told them what to do, gave them the skills, and they could do it. So they did it.
I did not necessarily change their attitudes, but I achieved the behavioral change, and I know it works. I use this example often: one of our medical directors, who sees a lot of patients, called me once and said, “What is the dose?” I said, “Why are you asking me? You do this all the time.” He said, “Epic is down. I do not know—just tell me the dose.”
So I know he is doing it through the pathway all the time, even if he does not remember the details. But it helps him get people out, and that is his priority—getting patients in and out as fast as possible and keeping beds open. And I am fine with that.
Dr. Shah: And that is a great example of how we rely on clinical decision support for something that is so core to processes of care.
Dr. D’Onofrio: Right, right.
Dr. Shah: I wanted to go back to something you mentioned earlier. You talked about how, when things started, it was really the crack cocaine epidemic that was going on when your interest in this began, and how things have evolved since then.
Now, with fentanyl and other synthetics being more of what we are seeing, how has that changed the pharmacology and the street reality of opioid use disorder? And what is the next hard question the field has not fully confronted yet regarding that?
Dr. D’Onofrio: Right. Well, even though we have seen somewhat of a decline, it is not over with opioids. And unfortunately, I think we are kind of ticking upward. So we cannot take our eyes off that. We still have it, but now we have other things—adulterants—that make things more difficult. Some of these are sedatives, often veterinary sedatives.
We are also seeing something now that is a much stronger sedative, which people can develop withdrawal from. So it is more difficult to know whether they are withdrawing from that or from fentanyl or something else. This is never going to end.
There is always going to be something, so we cannot take our eyes off the opioid problem. But what is also happening now is that stimulants, primarily methamphetamine and cocaine, are really rising. In mid last year, for the first time, overdoses related to those drugs exceeded those from heroin or fentanyl. So it is increasing.
We unfortunately have no FDA-approved medications for stimulant use disorder, so we need to start thinking about that.
Cannabis is also a very difficult drug. It is a drug, and it has mind-altering properties. It is not good for brain health.
If you think about what happened with the opioid epidemic, it started when kids got access to Percocet. That is how it began—a lot of people got ahold of it and thought it was safe. I talked to many of them, including college athletes who had injuries.
They thought that if it came from a medicine cabinet—your mom’s or your grandmother’s—it could not kill you. A doctor prescribed it, so it must be safe. They were not getting something off the street. That is how it started, and then everything went downhill from there.
Cannabis is similar now. It is legal in many states, so people assume it is safe. But it is not. There is nothing good about cannabis, especially for younger people whose brains are still developing, and also for older individuals who may have used it before when it was less potent. Now it is much stronger.
It also comes in many different forms, and people often do not know what they are taking. There was a recent article describing how schools cannot stop high school students from using it. Teachers report that many students are high, and they do not know how to address it. They are checking backpacks, bathrooms, and finding cartridges in all kinds of places.
So it is—it's horrible. Just to give you a sense of cannabis, there are about 60 million people who use cannabis, but I think about 20 million have a cannabis use disorder. That is not possible when you think about opioids—five to six million—and stimulants—around four million. But we are talking about a use disorder, right? That means you have gotten into some kind of trouble with it. It is not that you just used it and never had any difficulties. It is a use disorder.
So that is scary. That really is scary. And we are headed toward a really bad time because we are saying it is okay, and I cannot tell people what is okay. People ask me about alcohol all the time. With alcohol, there is a standard amount—one ounce of distilled spirits, a normal 12-ounce can of beer, or five ounces of wine. There is a standard. I can tell you what I consider low-risk limits. I can tell kids you are really not supposed to drink, but if you do, keep it under a certain amount.
Right—I cannot tell you that about cannabis, because I do not know what you are taking. I do not know how much you are inhaling. I do not know what that is. I do not even know—if you go to a store and it tells you how many grams, I do not know what that means.
So we do not even have a way of messaging this. What does it do to your brain? How do you know that you should not get in a car, or that you should not be on the street where you might step off the sidewalk and get hit by a car? I do not even know how to approach that.
And so we are going into uncharted waters for both young people and older people. The horse is out of the barn—I do not know how to stop it. People will think that I am being alarmist, but I am not. We are going to see horrible morbidity and mortality associated with it.
Dr. Shah: That is very sobering to hear—your perspective on cannabis and on substance use in general. I am paraphrasing a bit, but I think you said we are never going to completely fix it.
And that can be something that causes us to lose hope. However, at the same time, I think we have an opportunity as investigators. Knowing there will always be a problem we need to address, we can do that through the evidence we generate.
So I wanted to shift a bit to thinking about the early-stage investigator who is just starting out in academic emergency medicine. For them, there is often a tension between following the money—where funding exists—and following the question they really care about. You built a landmark research program by doing the latter. What would you tell an emerging physician-scientist who is trying to be strategic while also studying what they are passionate about?
Dr. D’Onofrio: So again, the conversation is always about: tell me some things you are passionate about, and then find a place that is actually fundable, because you need money to do it.
More and more now, with the way things are going at the NIH, we have to be sure that we are in their priority lane. Do not submit something that is innovative but not in their priority lane, because it is not going to go anywhere. There will be fewer general program announcements; there are going to be more directed RFAs.
I was remiss in not mentioning this about substance use. Half of people use it to feel better, and half use it to feel good, so there is a significant mental health component in those who use substances, as well as co-occurring conditions like ADHD. We need to make sure we have people studying the mental health aspects, because our EDs are overwhelmingly filled with these patients.
That would be one area. If people came to me and said, “I want to do something around depression, anxiety,” or similar topics—that is great. Anything in the areas we have discussed related to substance use disorder is also important.
There are also many opportunities in fields like pediatrics—people are interested in adolescent brain development and what is happening there, across a range of issues from injury to substance use.
Another question will likely be what happens as vaccination rates change. I am not sure we will find funding for that, but we are likely in for a long period dealing with diseases we have not seen before. So what are we going to do about that?
There are many questions, but they need to align both with your passion and with areas where funding agencies have interest.
Dr. Shah: That is wise advice. You have had an impressive career—you have accomplished so much. Looking back at your own arc—nurse, consultant, physician, researcher, department chair, National Academy of Medicine member—what do you now understand about how careers like yours are actually built that you wish someone had told you earlier?
Dr. D’Onofrio: I think one of the first things is the importance of preparation, which we did not always recognize. People need real coursework in the research process. Whether that is a PhD, a master’s in health sciences, or something similar, you cannot just go out there and wing it. You have to have that preparation.
And then we need perseverance, because there are a lot of trials and tribulations in doing this work, and you need a lot of people to help you. Lastly, you need to withstand a lot of difficulty, because that is going to happen.
But mostly, I think people need to start early, get the right preparation, and find mentors who will help them. Those mentors do not have to be at your own institution—they can be elsewhere—but you need someone who will look out for you and give you good advice.
Seek out experts. I still do that now—when I am thinking about a project, I call someone who is an expert in that area before I start reading the literature. I need to know where to start. So you have to reach out and build a group of experts before deciding what area you want to pursue. You need to understand what has already been done, what the gaps are, and where you can contribute.
It is very doable, and it is rewarding. It can feel overwhelming, but it is also a wonderful thing to be able to say that you have taken a problem and helped move it toward a better place, improving people’s health.
We need people in emergency medicine who are curious and willing to ask these questions. We need pipelines of individuals who want to study these problems. And almost always, those interests can be aligned with areas that are fundable.
Dr. Shah: Something I appreciated about what you said is that, yes, it begins with curiosity and passion, but research is also a team sport. It requires mentorship, collaborators, and engagement with the community.
We spoke a lot today about things that can bring us down. I would like to end on a positive note. What is it that keeps you inspired, and what gives you hope?
Dr. D’Onofrio: Well, what keeps me going, honestly, is that there is always something else I feel like I could do. Right now, I am really looking forward to trying to use GLP-1s in stimulant and cannabis use—areas where we do not have FDA-approved treatments. I also think they may be helpful for alcohol, and we are testing that. People are also testing them now with opioids—whether you could use buprenorphine with a GLP-1—because we know that people are not retained on these medications as long as they should be. Why do they stop? What are the other reasons?
These new medications seem to affect the dopamine and reward circuits, as well as cues and craving. It is a track that applies across different types of substance use—it is transdiagnostic, I guess is the best way to describe it. That could help people we have not been able to help before, where we do not currently have medications.
What keeps me going is that I keep thinking of another idea. I also have great young faculty around me—they have important questions and want to move forward. Watching them and helping them develop is exciting, because they are the next generation who will improve the health of the public in many different ways.
I am never discouraged about the possibilities. I just think we need departments that are willing to invest effort and provide the necessary resources.
Dr. Shah: That is exciting—new ideas and great questions on the horizon. The field of medicine is constantly evolving, and emergency medicine is as well.
Well, that is a wrap for today’s episode. Many thanks to Dr. Gail D’Onofrio for sharing her insight, experience, and perspective with us. Thanks as well to all of you for listening to the Stanford Emergency Medicine Podcast.
We appreciate you tuning in, and we look forward to bringing you more conversations with leaders across emergency medicine. And as our regular host, Dr. Matt Strehlow usually closes the podcast: keep taking care of anyone, anything, at any time.