DR. STEVEN MARC FRIEDMAN
EMERGENCY MEDICINE BIOGRAPHY
Dr. Steven Marc Friedman is Assistant Director (Research) at UHN Emergency Medicine, and Associate Professor, DFCM, Faculty of Medicine, University of Toronto. He completed his medical training at the University of Toronto and McMaster University, and an MPH at Harvard University, where he focused on health care management and research methods.
Dr. Friedman's core research interests and scholarly publications relate to clinical practice, barriers to care in the emergency department (ED), and cycling safety and injury prevention. The overarching operational aim of his work has been to develop an emergency medicine program that mentors young physician researchers in emergency medicine.
Typical projects focusing on physician-related barriers to care have included a Canada-wide study of physician practice variability and deviation from best practice in subcutaneous abscess management; a Canada-wide study of physician compliance with notifiable disease reporting requirements; a Canada-wide study of resident perceptions regarding personal on-call and procedural competence, adverse events and reporting these to supervisors; a study of interruptions and communication barriers in the ED; the design and trial of a novel translation aid to enhance emergency physician communication with non-English speaking speaking patients; and, the clinical impact of discrepant diagnostic imaging reporting and reinterpretation. Patient-focused studies have explored patients who leave the ED without being seen; health-consumer perceptions regarding queue-jumping and preferential access; barriers to patient follow-up with specialty clinics after discharge from the ED; patient dignity and privacy in the ED; and patient comprehension and compliance with ED discharge instructions in a multicultural health setting.
Projects relating to cycling safety and injury prevention have included a control-matched survey of Toronto bike-share users exploring cycling safety practices, barriers to helmet use, and impressions regarding proposed remedies to increase helmet use; a multi-centered collaboration exploration cycling injuries and the built environment; and an evidence-based review of Canadian cycling injuries and safety policy, leading to co-authorship of the Canadian Association of Emergency Physicians Position Paper on Cycling Safety.
Dr. Friedman is Co-I and Emergency Medicine Lead on Seamless Care Optimizing the Patient Experience (SCOPE) – A multidisciplinary, primary care practice-based Intervention to reduce ED visits and hospitalization for complex patients. He is also Co-I ad Emergency Medicine Lead on an evaluation of a birth cohort hepatitis C screening program in an academic emergency department and different community settings in Toronto.
Dr. Friedman is Director of STAR-EM, the UHN Summer Teaching and Research in Emergency Medicine Program at University Health Network, Toronto.
Barriers to Care
Quality Improvement & Patient Safety
Chartier LB, Masood S, Choi J, McGovern B, Casey S, Friedman SM, Porplycia D, Tosoni S, Sabbah S. (2022). A blueprint for building an emergency department quality improvement and patient safety committee. Can J Emerg Med. doi: 10.1007/s43678-021-00252-2
Kirubarajan A, Khan S, Got T, Yau M, Bryan JM, Friedman SM. Mask shortage during epidemics and pandemics: a scoping review of interventions to overcome limited supply. BMJ Open, 2020; 10(11): 1-25. doi: 10.1136/bmjopen-2020-040547
Friedman SM, Porplycia D. STAR-EM: An innovative summer research program for medical students. CJEM, 2020; 1-4. doi:10.1017/cem.2020.366
Wiercigroch D, Ben-Yakov M, Friedman SM. Regional anesthesia in Canadian emergency departments: emergency physician practices, perspectives and barriers to use. CJEM, 2020; 1-5. doi:10.1017/cem.2020.51
Friedman SM, Capraru C, Bates K, Porplycia D, Mazzulli T, Vanderhoff A, Hansen B, Shah H, Janssen H,
Feld J. Birth cohort hepatitis C screening in an academic emergency department in Canada: Preliminary
results. CJEM, 2020; 22(S1), S23-S23. doi:10.1017/cem.2020.99
Friedman SM, Porplycia D, Varriano B. Unhelmeted injured cyclists in the emergency department:
Demographics, cycling behaviour, and attitudes towards helmet use. CJEM, 2020; 22(S1), S38-S38. doi:10.1017/cem.2020.139
Friedman SM, Porplycia D, Lexchin J, Hayman K, Masood S, O'Connor E, Xie E, Bryan J, Smith-Gorvie
T, Lim D, Leung J, Sheikh H. STAR-EM: An innovative summer research program for medical students
in an urban Canadian academic emergency department. CJEM, 2020; 22(S1): S10-S11. doi:10.1017/cem.2020.67
Javidan A, Kirubarajan A, Lee D, Porplycia D, Friedman SM. Non-legislative interventions to promote
helmet use in adult cyclists: A scoping review. CJEM, 2020; 22(S1): S99-S99. doi:10.1017/cem.2020.302
Wiercigroch D, Friedman SM, Porplycia D, Ben-Yakov M. Regional anesthesia in Canadian emergency
departments: Emergency physician practices and impressions. CJEM, 2020; 22(S1): S66-S66. doi:10.1017/cem.2020.213
Capraru C, Friedman SM, Bates K, Mazzulli T, Porplycia D, McCormack B, Vanderhoff A, Shah H, Janssen
H, Feld J. Results of a birth cohort hepatitis C screening program in an academic emergency department in
Canada. Journal of Hepatology, 2019; 70: E326- E327. doi:10.1016/S0618-8278(19)30638-3
Capraru C, Hansen B, Vanderhoff A, Friedman SM, Bates K, Mazzulli T, Porplycia D, McCormack B, Juan J,
Jung H, Shah H, Feld J, Janssen H. Assessment of hepatitis C screening strategies in different community
settings in a Canadian metropolitan area. Journal of Hepatology, 2019; 70: E326-E326. doi:10.1016/S0618-8278(19)30637-1
Hosford K, Winters M, Gauvin L, Camden A, Dubé AS, Friedman SM, Fuller D. Evaluating the impact of implementing public bicycle share programs on cycling: the International Bikeshare Impacts on Cycling and Collisions Study (IBICCS). International Journal of Behavioural Nutrition and Physical Activity. 2019; 16:107.
O’Brien T, Ivers N, Bhattacharyya O, Calzavara A, Pus L, Mukerji G, Friedman SM, Abrams H, Stanaitis I, Hawker GA, Pariser P. A multifaceted primary care practice-based intervention to reduce ED visits and hospitalization for complex medical patients: A mixed methods study. PLoS ONE. 2019; 14(1): e0209241. doi.org/10.1371/journal.pone.0209241
Friedman SM, Al-Den A, & Porplycia D. (2018). P051: Management of subcutaneous abscesses in the emergency department. CJEM, 20(S1), S74-S75. doi:10.1017/cem.2018.249
CI Capraru, SM Friedman, K Bates, T Mazzulli, D Porplycia, B McCormack, AM Vanderhoff, BE Hansen, H Shah, HL Janssen, JJ Feld. Evaluation of birth cohort hepatitis C screening program in an academic emergency department. J Viral Hepat, 25: 162-162. doi:10.1111/jvh.226_12923
CI Capraru, BE Hansen, AM Vanderhoff, SM Friedman, K Bates, T Mazzulli, D Porplycia, B McCormack, JV Jua, H‐M Jung, H Shah, JJ Feld, HL Janssen. Evaluation of hepatitis C screening strategies in different community settings in a Canadian metropolitan area. J Viral Hepat, 25: 166-167. doi:10.1111/jvh.234_12923
Tara O’Brien*, Ian Stanaitis, Noah Ivers, Pauline Pariser, SM Friedman, Howard Abrams, Geetha Mukerji, Laura Pus, Gillian Hawker. A Multifaceted Primary Care Practice-Based Intervention to Reduce ED Visits and Hospitalization for Complex Patients. Abstracts from the 38th Annual Meeting of the Society of General Internal Medicine. Journal of General Internal Medicine. 2015;30(Suppl 2):45-551. doi:10.1007/s11606-015-3271-0.
Friedman SM, Adamson M, Cleiman P, et al. Helmet-Wearing Practices and Barriers in Toronto Bike-Share Users: a Case-Control Study. CJEM. 2015:1-9.
Cripton PA, Shen H, Brubacher JR, Chipman M, Friedman SM, Harris MA, Winters M, Reynolds CCO, Cusimano MD, Babul S, Teschke K. Severity of urban cycling injuries and the relationship with personal, trip, route and crash characteristics: Analyses using four severity metrics. BMJ Open 2015; 5:e006654
Teschke K, Frendo T, Shen H, Harris MA, Reynolds CC, Cripton PA, Brubacher J, Cusimano MD, Friedman SM, Hunte G, Monro M, Vernich L, Babul S, Chipman M, Winters M. Bicycling crash circumstances vary by route type: a cross-sectional analysis.BMC Public Health. 2014 Nov 22;14:1205.
Fuller D, Gauvin L, Dubé AS, Winters M, Teschke K, Russo ET, Camden A, Mee C, Friedman SM. Evaluating the impact of environmental interventions across 2 countries: the International Bikeshare Impacts on Cycling and Collisions Study (IBICCS) Study protocol. BMC Public Health. 2014 Oct 25;14(1):1103. [Epub ahead of print]
Letovsky E, Rowe BH, Friedman SM, Snider C, Sullivan E. CAEP Position Statement: Improving bicycle safety in Canada. CJEM. 2014 June; 16.
Friedman SM, Vallipuram J, Baswick B. Incidental findings of elevated random plasma glucose in the ED as a prompt for outpatient diabetes screening: a retrospective study. BMJ Open. 2013 Dec 18;3(12):e003486. PubMed PMID: 24353254; PubMed Central PMCID: PMC3884805.
Harris MA, Reynolds CC, Winters M, Cripton PA, Shen H, Chipman ML, Cusimano MD, Babul S, Brubacher JR, Friedman SM, Hunte G, Monro M, Vernich L, Teschke K. Comparing the effects of infrastructure on bicycling injury at intersections and non-intersections using a case-crossover design. Inj Prev. 2013 Oct;19(5):303-10. PubMed PMID: 23411678; PubMed Central PMCID: PMC3786647.
Friedman SM, Merman E, Chopra A. Clinical impact of diagnostic imaging discrepancy by radiology trainees in an urban teaching hospital emergency department. Int J Emerg Med. 2013 Jul 16;6(1):24. PubMed PMID: 23866048; PubMed Central PMCID: PMC3716958.
Teschke K, Harris MA, Reynolds CC, Winters M, Babul S, Chipman M, Cusimano MD, Brubacher JR, Hunte G, Friedman SM, Monro M, Shen H, Vernich L, Cripton PA. Route infrastructure and the risk of injuries to bicyclists: a case-crossover study. Am J Public Health. 2012 Dec;102(12):2336-43. PubMed PMID: 23078480; PubMed Central PMCID: PMC3519333.
Teschke K, Brubacher JR, Friedman SM, Cripton PA, Harris MA, Reynolds CC, Shen H, Monro M, Hunte G, Chipman M, Cusimano MD, Lea NS, Babul S, Winters M. Personal and trip characteristics associated with safety equipment use by injured adult bicyclists: a cross-sectional study. BMC Public Health. 2012 Sep 11;12:765. PubMed PMID: 22966752; PubMed Central PMCID: PMC3490930.
Winters M, Babul S, Becker HJ, Brubacher JR, Chipman M, Cripton P, Cusimano MD, Friedman SM, Harris MA, Hunte G, Monro M, Reynolds CC, Shen H, Teschke K. Safe cycling: how do risk perceptions compare with observed risk?. Can J Public Health. 2012 Jul 10;103(9 Suppl 3):eS42-7. PubMed PMID: 23618088.
Friedman S, Guo R. In support of a journey of metacognition. Acad Emerg Med. 2011 May;18(5):549-50. PubMed PMID: 21569173.
Friedman SM, Sowerby RJ, Guo R, Bandiera G. Perceptions of emergency medicine residents and fellows regarding competence, adverse events and reporting to supervisors: a national survey. CJEM. 2010 Nov;12(6):491-9. PubMed PMID: 21073775.
Friedman SM, Vergel de Dios J, Hanneman K. Noncompletion of referrals to outpatient specialty clinics among patients discharged from the emergency department: a prospective cohort study. CJEM. 2010 Jul;12(4):325-30. PubMed PMID: 20650025.
Han A, Laranjo H, Friedman SM. The design and pilot of a translation aid to help ED clinicians enhance communication with the Portuguese-speaking patient. Int J Emerg Med. 2009 Apr;2(1):41-6. PubMed PMID: 19390916; PubMed Central PMCID: PMC2672976.
Friedman SM, Provan D, Moore S, Hanneman K. Errors, near misses and adverse events in the emergency department: what can patients tell us? CJEM. 2008 Sep;10(5):421-7. PubMed PMID: 18826729.
Friedman SM, Schofield L, Tirkos S. Do as I say, not as I do: a survey of public impressions of queue-jumping and preferential access. Eur J Emerg Med. 2007 Oct;14(5):260-4. PubMed PMID: 17823560.
Friedman SM, Sommersall LA, Gardam M, Arenovich T. Suboptimal reporting of notifiable diseases in Canadian emergency departments: a survey of emergency physician knowledge, practices, and perceived barriers. Can Commun Dis Rep. 2006 Sep 1;32(17):187-98. PubMed PMID: 16989044.
Monzon J, Friedman SM, Clarke C, Arenovich T. Patients who leave the emergency department without being seen by a physician: a control-matched study. CJEM. 2005 Mar;7(2):107-13. PubMed PMID: 17355660.
Clarke C, Friedman SM, Shi K, Arenovich T, Monzon J, Culligan C. Emergency department discharge instructions comprehension and compliance study. Can J Emerg Med. 2005 Jan;7(1):5-11. PubMed PMID: 17355647.
Read more about Dr. Friedman’s research here:
Connect with Dr. Friedman