Enjoy the next Thomas Jefferson Point-of-Care Ultrasound Educator of the Month Series!  This post is brought to you by Resa E. Lewiss MD Point-of-Care Ultrasound Director at Thomas Jefferson University Hospital in Philadelphia, PA. 

Community Emergency Medicine: Lessons in Just Asking as a Point-of-Care Ultrasound Director

Dr. Mulflur is the Director of Point-of-Care Ultrasound (POCUS) at Jefferson Northeast in Philadelphia. Jefferson Northeast consists of three community hospitals, Jefferson Frankford, Jefferson Torresdale, and Jefferson Bucks. She runs the division with one other fellowship trained faculty member.  They oversee POCUS training for 60 residents. There are three residencies in one: Emergency Medicine, Emergency Medicine/Internal Medicine, and Emergency Medicine/Family Medicine

Dr. Mulflur joined the Jefferson POCUS Division as the August educator of the month. Molly trained at the University of Maryland School of Medicine, Temple University Emergency Medicine Residency and Temple University Ultrasound Fellowship.  She is among a large number of emergency physicians, who complete an ultrasound fellowship and then take a leadership position in a community setting.   

Overall, Dr. Mulflur feels she has been set up for success for her leadership position. From the start, her department demonstrated its commitment to the POCUS program.  The department purchased an adequate number of ultrasound machines to run a program, to provide patient care, and to train learners. Moreover, she was given additional academic protected time, which she felt allowed her to fulfill her roles and responsibilities. 

When Molly took the POCUS director position, she had additional time protected to be the director, to run a resident rotation, and to run a medical student rotation.  Additionally, her division teaches critical care fellows, internal medicine residents and performs quality assessment for the emergency department. 

Molly has found that being regimented in her education of residents for POCUS has been fruitful. Only in this way have residents learned to perform structured ultrasound examinations. Over time this has created an environment of senior residents teaching junior residents. Currently she and her team are actively restructuring the resident curriculum to enable an objective assessment and to prevent the degradation of skills over time.

Over her four years at Jefferson Northeast, she has collected compelling data, which supports the success of her program. She has demonstrated that emergency physician performed ultrasound decreases the instances of calling in an off-site radiology ultrasound technologist overnight.  This can prove the cost effectiveness of POCUS. Her data also shows that when the technologist is called in, the patient commonly has true pathology identified by the ultrasound examination.  This suggests that emergency physicians are utilizing POCUS first to make the next best step diagnostic decision for patient centered care.

Dr. Molly Mulflur has built a POCUS program and is using data to prove the clinical effectiveness of POCUS. She can be contacted by email Molly.Mulflur@jefferson.edu.