🩺 ER Director & Family Medicine Doctor Interview
📧 🎙 With Dr. Quayle
Date : July 19th 2025 @ 4:30 pm
INTRODUCTION SECTION
Q: What’s your name, title, and what department do you work for, and what hospital, clinic, or organization are you currently employed at?
Dr. Quayle: My name is Dr. Carter Quayle, and I am a physician. I work in the ER. I'm actually board certified in Family Medicine, and I work at a rural access hospital in central Louisiana.
BACKGROUND
What inspired you to pursue medicine or healthcare?
Well, there were physicians in my family. I had an uncle who was a radiologist, another uncle who practiced ophthalmology, and my father is an ophthalmologist. So I had role models. I think probably the strongest role model was my father, just being exposed to seeing how he interacted with his patients and kind of was a strong motivator for me to to kind of do something like that where you could help people and interact with people.
What was your path like — undergrad major, medical school, residency, any detours or defining moments that shaped your career in emergency medicine?
I took somewhat of a less-than-traditional pathway to becoming a physician. I went to a liberal arts college in Virginia and graduated with a degree in Sociology and Anthropology. I went to medical school outside the country in Mexico, in Guadalajara, which is a large city in the western part of Mexico. Then I did what is called the Fifth Pathway—one year at a New York Medical College–affiliated hospital in Connecticut. Then I did my residency in Family Medicine in Louisiana.
THE JOB ITSELF
What does a typical day look like for you as an ER Director?
A typical day in the emergency room can vary greatly. There's no real control that we have about what shows up, when they show up, or what kind of problems they have. So we kind of have to read and react to what comes in the door. It could be anything from a heart attack to a manic episode to a limb injury. You never really know what you're going to get, which is kind of fun.
What’s the hardest or most surprising part of working as a resident?
I'm a little older, so I was in residency when they transitioned to having some type of regulation regarding resident hours. When I started, there was really no limit on the number of hours we could work. At one point during my residency, they did limit the hours residents could work continuously. It depends on the specialty and the program, but I think residencies work best when the residents get along and unify around the central mission of taking care of patients.
REFLECTIONS
Most memorable patient or case experience in the ER?
There was a young adult female who arrived on a backboard and a collar. I was working at a trauma center and saw them wheeling her in. She had freckles. I asked her name to assess her GCS and make a rapid assessment, but she couldn’t really speak. She was very pale and had a condition called tension pneumothorax. She was riding her bike across the country and had been struck by a vehicle. A majority of the injury was blunt force trauma to her torso and her lung collapsed, but the air was squeezing, squeezing her heart. So what you have to do is create a hole in the chest, going between the ribs, to release the built-up air pressure. The reason is that the heart chambers are under so much pressure they get squeezed and can't expand properly to pump blood. So in her case, we were able to do the most important initial step, which is relieving that pressure. After that, we had the trauma surgeon come in, and later on, a thoracic surgeon got involved in her care, along with an orthopedic surgeon since she also had a lower extremity injury. It was definitely a memorable save. And it wasn’t just me. There were great nurses, but being able to help her in that moment was incredibly satisfying and unforgettable.
How do you stay calm and focused during high-risk, high-pressure emergencies?
I think preparation starts when you're not the one in charge. In medical school, you get exposure and see how professors deal with problems. As you progress, you become more and more involved. By the time you're out and practicing, you can read and recognize what's going on. But even when you're done with residency, you still don't know everything. I’ve learned a lot from peers. The ER is a bit like mixed martial arts, you might be good at central lines while someone else is good at reducing dislocations. You compare notes and pick up tips when you can. It’s always a learning process.
Why did you choose Family Medicine and become an ER Director over other specialties?
One element of my background was a liberal arts education, so I had a lot of exposure to different disciplines. I gravitated toward broader areas. I frequently tell patients we’re a jack of all trades, master of none, and they kind of get it. So we're able to make an assessment and then try to get patients to the experts. So whether it's us trying to get a telepsychiatry consultation for a patient or telestroke or referring them to the cardiology cardiologist, we're trying to make an assessment and make an appropriate disposition on these patients.
So you guys are the first people to meet the patients and assess their situations?
Yeah. I mean, hopefully they'll have some primary care provider that's also looking out for them. But if they're in an emergency or an emerging condition, we really try to get them to the appropriate hospital with the appropriate staff to take care of their specific issue.
Since you are an ER director, what does effective teamwork look like in the ER — and how has that influenced your leadership?
We're a rural access hospital, so we have single physician coverage. No mid-level providers like PAs or nurse practitioners. It's really important for doctors and nurses to have camaraderie and a good team approach. I think we've got that. We usually have one or two RNs and one LPN on each shift. When we're supporting each other and at more stressful times, I think that that's appreciated by your teammates. When everybody gets along, the time goes by really well.
Yes, I often see videos online where nurses talk about feeling disrespected by doctors. I think a lot of that stems from poor communication and a work environment that isn’t as collaborative or supportive as it should be.
Absolutely. Nurses truly are the backbone of patient care, and they can make or break the experience, for both the physician and the patient. It’s essential to show them the respect they deserve because their job is incredibly demanding. Physicians have challenging roles as well, and so do licensed practical nurses. When everyone acknowledges that we're all working through difficult tasks toward a shared goal, and we support each other as a team, the entire environment becomes more positive and effective.
What’s the most underrated skill in emergency medicine — something people rarely talk about, but that really matters?
I think the most underappreciated skill is probably communication. You have to communicate with patients and make them feel heard. They need to know you're focused and understand their complaint. I think it's important to validate their being in the emergency room, even if the complaint is, you know, even if they don't have a true emergency, I think it's important to validate their concerns. It’s appropriate to reassure them and put them at ease when something's not life threatening or, or serious and that they're going to be okay. I think that's important. I think communication also is very important when you need to get that patient and you may have a peer-to-peer conversation and you need to make it concise, succinct. It's important to communicate clearly with your peers effectively too for the benefit of the patients. That helps everyone.
ADVICE SECTION
What advice would you give to high school or college students interested in medicine — or emergency care specifically?
Enjoy the moment. You know, you may not be able to have that time with, you know, your friends doing cross country or your swim meets and, and make sure that you enjoy that. And then also, you know, take those courses that, you know, I took a 20th century modern American art class in college that had absolutely nothing to do with, you know, pre-med or anything. It was a great teacher. In college, pursue really good teachers, even if it’s outside your major. You’ll appreciate that later when you're knee-deep in biology or genetics.
What do you wish you had known earlier in your path — maybe during undergrad, med school, or early residency?
It can be stressful. It’s a long road. You want to build good habits and work on developing them early, because they’ll make your life easier in the long run. So, that means not waiting until the last second or procrastinating. I used to be a terrible procrastinator, but I’ve learned to manage my time better, now that I have all this gray hair. I think the main takeaway is to maintain a balanced approach, relax, avoid stressing too much, and just trust that you’ll get there. It’s a very long journey. It’s a marathon.
How do you manage stress, avoid burnout, and stay resilient — especially in such a demanding specialty?
Recognizing your workload and maybe understanding some elements of the volume that the facility has, the volume, the acuity, you know, how many nights are you working? At what stage in your career are you? Build resilience. Know when to ask for help, when to take a break. Family and healthy outlets matter too. Family vacations, making sure that you're getting enough sleep, self-care in that regard. Those things are important to kind of keep yourself fresh so that when you go in, you can give your best to the patients.
PERSONAL
Has there been a case or experience that changed the way you think about medicine or life in general?
I can't think of one specific case that has changed the way I look at life in general. But you see people that have adversity, some people that really have tough medical conditions, and it really puts things in perspective. So if you think that you're having a bad day and you see someone who's dealing with a really bad diagnosis, maybe some metastatic cancer, it puts things in perspective of how fortunate you are. One is when they're in good health, and the difficulties that other people are facing help you say, look, I've got a lot to be grateful for. So that's another thing that helps put things in perspective.
What non-medical skill has surprisingly helped you most in your career?
It's really how well am I doing listening, and how often do I remind myself, okay, let's go, let's really be a good listener, let's try to communicate effectively. Those kinds of things are important, and it's also important to understand other people's perspectives. And that can be—you can take that anthropology course or sociology course and understand people that have a different experience than you do, so that you can be more empathetic and communicate better with them. I think that's important, because you may have gone to school for a long time, and you might see somebody in the emergency room who's never really gone to school, or you might end up speaking to them in their native language. Being empathetic helps you connect and communicate better.
If you could change one thing about the healthcare system, what would it be and why?
Well, that's a tough question. You know, I think maybe the complexity of it all, you know, I think a lot of physicians, and myself included, they don't really have a clear grasp of all the economic influences, the complexity of payers and payer sources, and those types of things. But I think, by and large, though, I think the system works. Is it perfect? No. But, you know, I think being able to reduce the economic expense that one has to pay for healthcare, if we could reduce that and get people focused on making healthier decisions, I think that would benefit all of us. There's a lot of substance abuse and mental health issues that we see in the emergency room. And if we could address some of those things to help everybody be able to be healthy and participate in lowering the costs, I think it would be beneficial.
Yeah, like making medicine and healthy choices more accessible to people in rural or underdeveloped locations is a big thing that I think we all need to come together and slowly change.
Yeah, even in some of the bigger cities, you see a lot of homelessness and a lot of substance use, and it's a challenge to the healthcare system.
