When I was in Residency, the hospital administration wanted to insure that there was readiness on the part of all staff for emergencies – the campus was sprawling, so establishing readiness in the outlying areas of campus seemed reasonable.  At the time of this dictum, I was doing a dermatology rotation.  The chief of staff of the department, a wise and gifted dermatologist of probably 30 years, quipped, “Sure, we’re prepared…If we see an emergent case will slather them with Lidex (the most potent steroidal cream for topical administration), wrap ’em in Saran wrap (a method, called occlusion, which increases the therapeutic effect thus describing the most urgent and aggressive treatment a dermatologist might prescribe), and send ’em to the ER!”


I’ve thought a lot about that funny occurrence while thinking about integration.  True, the wise old dermatologist described what, from his perspective, was the penultimate of his therapeutic intervention, BUT, if the guy needed a pulmonologist or cardiologist, say, he’d be up the proverbial creek with no paddle.  The dermatologist saw no need to integrate…he left that up to the ER doc.  It’s that type of integration that appeals so much to me, coming from that area of emphasis…seems like we’ve discounted that it takes all kinds to make a world…rote administration of any one modality is probably a flawed way of looking at that world?