Emergency
medicine vice chair is pioneer in field
by Toni Baker
Training physicians for emergency medicine was mostly just talk when Bruce Janiak decided it was time for action.
It was the late 1960s. He was attending the University of Cincinnati College of Medicine, hoping to work in an emergency room. At a time when academic center ERs were often places where interns and residents worked in isolation to meet after-hour patient needs, it seemed an odd desire.
“I asked around, ‘Who is training in this?’ and the answer was, ‘Nobody,’” says the new vice chair of emergency medicine at MCG. But the young student, attracted to the variety that comes with an evening in the emergency room, didn’t let that stop him.
He teamed up with like minds at Cincinnati General Hospital (now University Hospital) who were having lunchtime discussions about starting an ER program. With funding from the medical school for one slot, the country’s first emergency medicine residency program was born and he became its first resident.
That first year was hard. Academic medicine hallmarks were distinctly missing: no textbooks, no grand rounds with doctors sharing knowledge, no fellow emergency medicine residents to learn with. Dr. Janiak did a lot of self-teaching. He analyzed, for example, that lacerations outnumbered heart attacks and so opted for a plastic surgery rotation.
“In the first year, I had interaction with a faculty member on one patient,” he recalls. “You just kept looking in books and asking senior residents (in other specialties).” But the isolation made him an advocate for his patients.
As time passed, others joined him in the specialty, but even then met with disdain from some faculty. “Every one of us, as we went through, was taken aside by members of traditional specialties and advised what a stupid thing we were doing,” says Dr. Janiak. But when he talked with patients, he knew he was on the right track. “I said if I were stock, I would buy myself because this is going to work.”
By 1982, when he became president of the American College of Emergency Physicians, the organization had grown to 15,000 members with a $4 million budget. Today, membership stands at 20,000 and the budget is $10 million. The country has 50,000 emergency medicine physician positions, but only 25,000 trained physicians to handle more than 120 million annual emergency visits. Even with 100 residency programs, the shortage lingers. “There is no mechanism for controlling supply and demand, but we are getting there,” Dr. Janiak says.
Dr. Janiak, who directed the Department of Emergency Medicine at The Toledo Hospital in Ohio for 28 years before joining MCG, has also been president of the American Board of Emergency Medicine, which certifies emergency medicine physicians.
Dr. Janiak has chaired the Emergency Department Benchmarking Alliance, which fosters best practice in management and service; served on the Accreditation Council for Graduate Medical Education’s Board of Appeals Panel for Emergency Medicine; and is a member of the Advisory Committee of the American Medical Foundation for Peer Review and Education.
He is president of Janiak Consulting, Inc., which provides leadership, clinical and financial management consulting for hospitals and physicians. Dr. Janiak has served as president and chair of the Board of Directors of EMG Professionals, Inc., a medical billing company; as medical director of Heartland Information Services, an international medical transcription company; and president of Professional Emergency Services, Inc., which supplies hospitals with emergency medicine physicians.
Serving as vice chair of emergency medicine at MCG is icing on the cake.
“I always had a fantasy it would end this way and here it is coming true,” he says. “I like doing this work.”
He’s also been busy in his personal life: he and wife Michele have 14 children, including eight under age 18. Mrs. Janiak, whose first husband was killed in Vietnam, had two children when they met. The couple has one biological child together and adopted the others from Ohio, Chile, Paraguay and Brazil.
Like his work, it’s a challenge, but one he would not have missed.
And, believe it or not, he says he does have time for sleep.
| Dr. Janiak’s innovating adventures as an emergency room resident pioneer are shared extensively in “Anyone, Anything, Anytime – A History of Emergency Medicine,” by Dr. Brian J. Zink, associate professor of emergency medicine at the University of Michigan (Elsevier-Mosby, 2006). |