Emergency Medicine

Seen but not heard: How does the medical system value its scribes?

Physician
April 12, 2022

As an off-cycle medical student with an extended break between the completion of my M4 rotations and the conferment of my MD, I took a job as a medical scribe to keep myself active in the clinical setting (and, it must be said, provide myself with much-needed income).

I was atypical among most medical scribes, who are generally college students/graduates looking to obtain experience before applying to postgraduate medical programs, so …

Read more…

Are my coping skills a result of my emergency medicine training?

Physician
April 10, 2022

In the wake of a harrowing year, I’m left wondering, is a career in emergency medicine worth it? Like so many of my colleagues, I suffered personal tragedies during the pandemic that exacerbated the incredible stress at work.

My brother died in March of 2021, three weeks after receiving a diagnosis of metastatic colon cancer, and tragically, just six months later, my mother also died unexpectedly.

I have no doubt that emergency …

Read more…

True happiness and fulfillment come in servitude of others

Physician
March 21, 2022

Have you ever really appreciated the silence? The true silence that transports you to the root of it all. Our lives are a perpetual hamster wheel, chasing aspirations with underlying motivations that I often don’t completely understand. Good intentions and acts of kindness, seemingly altruistic, have hidden motivations of affirmation or appreciation. Why do you do what you do? It seems so obvious on the surface, but like an onion …

Read more…

Combat name-based microaggressions with these commitments today

Physician
March 13, 2022

A recent conversation with a colleague took an unfortunate turn when he asked me to teach him how to say my name. I happily obliged. “It’s O-HA-BUN-WA” I said phonetically with a smile on my face. Like many with ethnically distinct names, I get so happy when people attempt to say my name correctly. His response, however, was quite shocking.

“I will never be able to pronounce that,” he said emphatically. …

Read more…

Only patients can save U.S. health care

Physician
March 11, 2022

U.S. health care is going to hell in a handbasket, but only as patients can we alter this. Centers for Medicare & Medicaid Services (CMS), hospital administrators and we patients are all guilty of worshiping at the altar of “patient satisfaction.”

It’s not that patient satisfaction is necessarily a bad thing. As a patient myself, I certainly seek out convenience and satisfaction. A UC Davis study in 2012, …

Read more…

Human nature will help patients better than any algorithm or AI

Tech
March 4, 2022

Tapping into the mindset of one of the most villainous cinematic computers, the HAL 9000 of 2001 A Space Odyssey, may provide introspection to save us from the same paranoid meltdown that led HAL (spoiler alert) to embark on a murderous rampage. Homicidal activity should not be a lurking risk in any of us, but burnout is.

Briefly, in case you are unfamiliar with Stanly Kubrick and Arthur C. Clarke’s sci-fi …

Read more…

Solving the low-acuity emergency department problem

Policy
February 9, 2022

Before I worked as a medical scribe, I didn’t realize how many mildly ill people visited the emergency department (ED). In my first few weeks, though, I learned that patients with minor complaints, such as sprains, cavities, rashes, and common cold symptoms, actually present to the ED quite often – often enough that the hospital where I worked had to dedicate an entire 12-bed wing to them. In most EDs, …

Read more…

A gang member shot by cops and paralyzed just wanted a radio

Physician
February 8, 2022

My patient was trying to kill himself by refusing to treat a bladder infection. I looked down at him. His aura was black, indicating the premeditated murder of a human. Guess they hadn’t caught him for that one. His gang tats were Latin American, and his eyes were black. He didn’t like me much.

I wasn’t phased. He couldn’t do much about it, paralyzed from the neck down.

“It’s not going to …

Read more…

The work of an emergency department nurse through the eyes of a medical student

Education
February 7, 2022

Each time I am in the emergency department (ED) as a medical student, I meet new members of the health care team that make superior patient care possible. I have quickly developed a greater appreciation for the fact that no medical professional works in an isolated bubble. The strengths that each other bring to the table are paramount to the flow of patient progress. Before my time as a medical …

Read more…

A physician’s running list of microaffirmations

Physician
January 30, 2022

Microaffirmations are the antidote to microaggressions. Microaggressions are the little insidious comments or acts of barely perceptible injustice and bias that bite and nip and slowly erode our confidence in our belonging, worth, and power. As I continued the medical training journey, I continually searched for the antidote. Mere protection against the daily barbs and arrows was not enough. I needed more than protection- I needed an offensive strategy as …

Read more…

Is EMTALA really protecting patients during COVID?

Policy
January 28, 2022

I am a physician at a critical access hospital. I manage both the ER and inpatient service and am the only physician in the hospital. This is the reality for many rural hospitals across the country. With no urgent care in town, and with primary care offices few and far between, these hospitals see everything.

We see patients with ailments from a minor finger laceration to those with septic shock from …

Read more…

Setting boundaries and the power of saying no

Physician
January 26, 2022

As a working mom of three kids and an emergency medicine physician, I have had to embrace home workouts since before the pandemic. I am a huge Peloton fan! In December of 2020, Robin Arzón, VP of fitness and an instructor for Peloton, partnered with Shonda Rhimes (creator of Grey’s Anatomy) to do a series about Rhimes’ book Year of Yes.

The power of saying yes. In 2020, just pre-pandemic, I …

Read more…

ADVERTISEMENT

What it’s like to work with International SOS

Physician
January 24, 2022

At the beginning of August 2021, during the early stages of opening my practice, I decided to take an opportunity that I would be forever grateful for. The organization International SOS was looking for physicians and other health care providers to join a massive once-in-a-lifetime operation at Fort Lee military base.

At the time, the country was attempting to end the war in Afghanistan quietly. We were told that there would …

Read more…

The world according to Steinbeck

Physician
January 12, 2022

So I am on the road again — sort of. What I do is work away from home, which isn’t quite the same thing. Where I work as a radiologist is not within commuting distance, so I stay at a nearby hotel. In general, that has worked out fairly well.

Not long ago, however, when I went to start the car after breakfast, I became immediately aware of a roaring sound.

The …

Read more…

The death of empathy

Physician
December 30, 2021

Reflect and earn 1.0 AMA PRA Category 1 CME for this article.

You used to come to us struggling to breathe and begging for our help, and while we stood over you preparing for intubation, we would feel all the feels while looking into eyes that we knew might never open again. We would break down and cry while telling your family that you didn’t make it or …

Read more…

War is really not all it’s cracked up to be

Physician
December 5, 2021

An excerpt from All Bleeding Stops.

42nd Surgical Hospital
Phu Bai
Republic of Vietnam
December 1967

Private Ira Stein has so many wounds, has lost so much blood, that the corpsmen nearly bring him straight to Graves. Steve Benson can’t get a pressure. He shakes his head. “Matthew, there’s no point taking this kid to the OR. He’s too far gone. He has no chance.”

“Bullshit!” …

Read more…

Reflections after the last ER shift

Physician
November 30, 2021

Working in an ER is unlike any other branch of medicine.  Your specialty is unpredictable.  You have no scheduled patients and no set pace.  You could be fighting boredom one hour and running around with your hair on fire the next, or the next 11, for that matter. Your patients are not stratified by age, gender, body part, or severity of injury.  Your next patient could have an infected cuticle, …

Read more…

Every patient is someone’s loved one

Physician
November 13, 2021

It felt like watching a train go by with no control over its destination and no way to stop it. We simply had to watch our loved one as he made his way towards death.

The doctor said he had a traumatic brain injury with herniation. His pupils were fixed and dilated on arrival to the emergency department, which meant that he was not a candidate for any neurosurgical intervention. And …

Read more…

28
pages