An excerpt from The Healing Connection: A Partnership for Your Health.
The blood spurt was alarming though because it therefore indicated that the pressure in the venous system had to be sky high in order to shoot a column of blood in such a continuous arc over my right shoulder.
So, I …
Pericardiocentesis saves a life
During my five-year journey as an emergency medicine physician, I have experienced the adrenaline rush and ever-changing dynamics of the emergency department. Each shift offers a chance to make a meaningful impact on those around me. However, the demanding nature of this work can sometimes challenge my motivation, making it difficult to ensure that every shift is a great one.
Throughout the years, I’ve learned some essential rules that help me …
From burnout to brilliance: How one doctor found balance
The applicability of add-on payment/reimbursement qualifiers/modifiers for emergency procedures should not be limited to patients’ emergency conditions alone. They should also be applicable to situations where arrangements are made for procedures outside regular office hours or on weekends. This includes cases where proceduralists choose to schedule procedures during after-hours or patients choose to have procedures during these times. Additionally, these qualifiers/modifiers should apply to proceduralists who work during after-hours or …
Ensuring fair reimbursement for emergency procedures
The old adage of “do what you love, and you’ll never work a day in your life” may have misled an entire generation.
While researching individuals with high career satisfaction, psychologists Ryan and Deci found that the introspective “follow your passion” approach was rarely a major factor. Instead of relying on some intrinsic passion, people who loved their jobs were found to have work that fulfilled three specific psychological needs: autonomy, …
The 3 things that make people love their work (and why medicine falls short)
Congratulations! Maybe you matched, maybe you scrambled. Either way, you’re here, and after four years of reading and watching, you are about to finally start doing. Get all those practical skills: Intubate! Drop central lines! Insert chest tubes! Sign verbal orders within 24 hours! Write medicolegally bulletproof notes that also capture all the RVUs necessary to maximize billing.
As you embark on your journey to becoming an EM doc, let me …
The rewards and challenges of emergency medicine
I graduated from medical school in 1995. I completed an internal medicine and pediatrics residency in 1999, after which I spent three years in private practice, then moved on to a hospitalist practice for the next four years. From there, I transitioned to an ER job, where I have been for the last seventeen years.
In the ER, my role initially involved expeditiously seeing patients and only performing what was absolutely …
Modern medicine is disappointing to many of us at the later end of our careers
Jason had always cherished the Fourth of July—it was his moment to shine. At 19 years old, he saw himself as a real man, a car mechanic who garnered the attention and admiration of the ladies. With a fit and muscular physique, he relished his workouts and delighted in showcasing his daredevil spirit.
The day was marked by a grand cookout, where Jason reunited with his high school friends. The smoky …
Fourth of July daredevil fireworks mishap: a tragic tale of loss and redemption
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In this thought-provoking podcast episode, we invite guest Casey Grover, an emergency physician, to explore the ethical dilemmas surrounding the treatment of substance use disorders in the criminal justice system. Join us as we examine two compelling …
Treating substance use disorders in the criminal justice system [PODCAST]
As an emergency physician, I’m a strong proponent of living wills, POLST forms, and discussing uncomfortable topics with your loved ones. Even making decisions about your child being an organ donor, if, Heaven forbid, something happened. You never know when the “last time” might be.
A recent case I had served as a reminder of this. The patient and their spouse came to the hospital for what was supposed to be …
Powerful lessons from a tragic hospital incident: the importance of living wills and last goodbyes
I think that from time to time, everyone has had the feeling that they weren’t doing their best. Maybe something we did wasn’t the right thing at the time. Perhaps we should have thought about it longer or acted sooner. We often second-guess the decisions we make, whether they involve matters of love, career, finances, child-rearing, or even where to meet the in-laws for dinner.
While I can do that in …
How an emergency physician’s knowledge and confidence save lives in high-stakes situations
Health care is a dynamic, evolving field that demands a high degree of adaptability and a commitment to lifelong learning from its practitioners. For physicians, improving patient care is often about the challenge of moving from a comfort zone – a place of established practices and familiar routines – to a growth zone, where they are constantly learning, adapting, and expanding their skill sets. This shift is about staying up-to-date …
Subscribe to The Podcast by KevinMD. Catch up on old episodes!
Join us for an enlightening podcast episode as we delve into the challenges facing emergency medicine residency programs and applicants. With 555 unfilled first-year residency spots in the Match, we explore the factors that have contributed to …
Unfilled residency spots and the future of emergency medicine [PODCAST]
The interplay between the brain’s fast and deliberative decision-making systems is complex yet fascinating, shedding light on the cognitive underpinnings of different medical professions, such as emergency room (ER) doctors and radiologists.
Let’s illustrate this with an example. Consider an ER doctor faced with a patient exhibiting symptoms of a heart attack—chest pain, shortness of breath, and cold sweat. The physician must rapidly recognize these symptoms, immediately initiate protocols, administer clot-dissolving …
Decoding the brain’s decision-making: insights for medical professions and strategies for success
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Doctors come from different backgrounds, and we all start medical school with various life experiences. Few people know that I actually started off life as a journalism major. I wanted to write about other people and their life stories. I wanted to travel and photograph what the world had to offer. Then, having lost my journalism job and getting hired at a nursing home as a receptionist, I ended up …
From journalism to medicine: Unveiling the untold stories of patients’ medical conditions
My previous post on this topic described long-term cultural and organizational challenges facing emergency medicine (EM) that pose greater threats to the specialty than temporal challenges (e.g., overproduction of emergency physicians (EPs)). Some challenges are not remediable; they are inherent to the specialty:
However, many detrimental aspects of EM can be substantially …
Where should I begin when describing a period that seemed to have no end in sight? When we, as pediatric emergency department (ED) providers, felt like we were drowning in a tsunami of pediatric patients coming from every direction – from adult EDs needing to transfer seizing children for a higher level of care, from EMS coming in with apneic neonates, and from the endless supply of those from the …
As an ER doctor for many years, I recently retired from medicine to write and explore the world. My husband and I sold our lovely lake home and downsized to a three-season cabin in the woods, smaller than a school bus, and got a tiny RV and a place in Thailand. COVID be damned, we froze our assets camping on the Rio Grande, wintered in Corsica, hiked in the Atacama, …
Discover the surprising lessons of being a terrible patient: How it made me a better doctor
There has been much hand-wringing about the 555 (18.4 percent) unfilled match spots in this year’s emergency medicine (EM) residency match. Several long-standing, excellent programs with outstanding patient pathology and well-known faculty in major metropolitan areas did not fill.
Most hand-wringing has focused not on inherent attributes of the specialty, but temporal issues likely to fluctuate over time, including:
1. An overproduction of 8,000 emergency physicians (EPs)
The inherent problems with emergency medicine that make it contradict new values and behaviors
Towards the end of a busy clinic afternoon, I felt my phone buzz with a page in my jacket pocket. It is rare to receive pages on our phones in the middle of the day because we usually get messages through the EMR or direct calls to the office. I called back the number to the sound of an exasperated ER doctor who had been trying to reach the PCP …
The powerful bond that overcomes the toughest challenges
I moved to Ontario, Canada, a little less than a year ago, with a sense of adventure and a spring in my step. I was excited at the thought of being reunited with family, apprehensive about the hurdles in my path to becoming a practicing physician, but hopeful that there would be light at the end of the tunnel. There had to be.
I had been chief resident at an ACGME-accredited …
The struggle of internationally trained physicians in Canada
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