“We have the best job in medicine. Do it with heart.”
Since he was a kid, Dr. Joshua Gauger dreamed of being a doctor. He was inspired by his small-town primary care physician, who he saw as a “jack of all trades” who cared for a wide variety of patients and medical conditions.
Years later, Gauger enrolled in medical school with a goal to enter family medical practice. A rotation in the emergency department (ED) during his first year quickly shifted the course of his career.
“Emergency medicine is the field where you can truly take care of every patient,” Gauger says. “We treat anyone, at any time of day or night, no matter their health concern or ability to pay for care. And we get to do really cool things to help those patients.”
Inspired by his experience, Gauger matched into emergency medicine and completed residency at the University of Cincinnati Medical Center. During his final year, he served as Resident Assistant Medical Director for the Center for Emergency Care at UC Hospital, where he cultivated his interest in improving ED operations to better serve patients and support health care teams.
According to Gauger, an assistant professor of emergency medicine, one of the specialty’s greatest strengths is its practitioners’ ability to make critical decisions quickly — often without a complete diagnosis. On any given day, Gauger might employ the full breadth of his medical training and professional experience to care for patients while managing the busy, multifaceted ecosystem of the emergency department.
Adaptability and equanimity are two important characteristics that every emergency medicine physician must possess.
“These vital skills extend beyond patient care,” Gauger says. As medicine — and seemingly all aspects of life — advance at a blistering pace, he believes this differentiation makes emergency medicine physicians especially suited to lead the future of health care.
“We are a specialty that runs towards the fire and remains calm under immense pressure,” Gauger says.
The COVID-19 pandemic tested these skills in unprecedented ways. For Gauger, the experience underscored both the challenges and strengths of his specialty.
“When the world was closing down, we stepped up,” he recalls. “We shifted our entire focus to caring for the sickest patients with limited resources, all while knowing we were putting ourselves in harm’s way.” This commitment to resilience and courage reflects the values that first drew him to emergency medicine.
Guided by the mantra “Do it with heart,” Gauger’s approach to patient care centers on empathy and compassion. The phrase is inspired by an essay written by a former mentor. It reminds him of the privilege and responsibility that emergency medicine physicians have to their patients and communities. For Gauger, it’s a call to care deeply for all patients, especially the most vulnerable.
Gauger’s dedication extends beyond the bedside to his administrative and operational work. He focuses on quality improvement and patient safety, leading initiatives on sepsis, stroke and trauma care. He also serves as medical director for the BerbeeWalsh Emergency Department at University Hospital.
Gauger is particularly proud of a recent achievement, helping UW Health’s East Madison Hospital earn Level IV Trauma Center designation from the Wisconsin Department of Health Services. He serves as medical director for trauma at the hospital.
According to Gauger, the new designation recognizes the hospital’s ability to evaluate, stabilize and provide advanced care to patients with traumatic injuries before being transferred to a higher level of care, if needed, such as the Level I Trauma Center at University Hospital.
“To make this designation a reality, it took everyone who supports the patients in our care,” he says. “It was a collective effort, and we couldn’t be prouder of our nurses, physicians, support staff, and everyone else involved.”
Outside of work, Gauger values time with his wife, Catherine, and their three-year-old daughter, Lola. When he’s not with his family, he enjoys competitive kayak bass fishing and relaxing on the water.
Asked why students should consider a career in emergency medicine, Gauger’s response is simple: “We have the best job in medicine.”
From adrenaline-filled moments during critical care situations to the continuous challenge of improving health care operations, Gauger’s career highlights the field’s extraordinarily dynamic and impactful nature. He ends on a message to all of the aspiring physicians out there, whether young or looking to change careers later in life: “Wherever your journey in medicine takes you — and despite its ups and downs — always do it with heart.”