Emergency Medicine

We can’t expect large medical centers to absorb every case

Edwin Leap, MD

Physician

September 22, 2020

My small community ED has a fairly high acuity. As such, I was recently trying to transfer a couple of patients, one of whom was an NSTEMI, pain-free but with a rising troponin. In the process of trying to arrange things, I learned that our main regional referral center was holding a staggering 150 patients in their own ED, all waiting for inpatient beds.

I’ve spent the majority of my career …

Why everyone needs a six-word story

Alexie Puran, MD

Physician

September 21, 2020

Being humane makes you a hero.

It is a privilege to serve.

Be the voice, for those without!

Six words. One Story. These are examples from the My Six-Word Story Project, an innovative activity that supports the psycho-social well-being and emotional resilience of our healthcare professionals. My Six-Word Story has the power to reconnect us to our purpose and connect us as a community.

“It’s your reaction to adversity, not adversity itself that determines …

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Why everyone needs a six-word story

I am tired. But I still love emergency medicine.

Catherine Agustiady-Becker, DO

Physician

August 30, 2020

I love being an emergency doctor. I loved my residency, my co-residents, and my attendings.

I love my training: watching, learning, treating.

I love the emergency department, the vastness, and the variability of emergency medicine.

But I am tired.

I am tired of feeling like a workhorse, a production line made to just churn patients in and out.

I am tired of being told that my worth as a doctor is based on my time …

Why it’s so important to look at the big picture

Joy Hallmark, MD

Physician

July 11, 2020

One of the last things my dad said to me before he passed was, “remember to always look at the big picture.” He said this many times throughout my childhood and teenage years, but it never quite resonated until I was thinking about it in retrospect.

As I near the end of my intern year, my dad’s words hold true. As an emergency medicine resident, I am often running on adrenaline. …

Who should be the first responders to mental health crises?

Amira Athanasios, MD

Policy

July 2, 2020

First and foremost, a mental health crisis is a medical emergency well within the sector of public health. Therefore, the question of who should respond to mental health emergencies is one in which physicians and all medical providers should have a say. Medical providers should not only be aware of the systems in place to respond to mental health crisis but must advocate for patient safety as a measurable outcome …

How working as a flight attendant made me a better physician

Alexie Puran, MD

Physician

May 25, 2020

June 2020 will mark 15 years of my departure from flying the friendly skies. I have had the privilege of working as a flight attendant for JetBlue Airways from 2001 to 2005. Today, I am proudly grounded as a physician specializing in pediatric emergency medicine.

Gratitude is a positive mindset where you see your life and experiences as a gift. Practicing gratitude is a powerful way to reduce stress and build …

A physician wedding in the age of COVID

Toby Terwilliger, MD

Physician

May 23, 2020

April 2020 was to be a month of personal milestones. I would be traveling to Mexico with sixty closest friends and family to marry the woman of my dreams. Twelve days later, I would celebrate my thirtieth birthday. Suffice it to say, I was looking forward to April with the excited anticipation of a child on Christmas Eve.

But that was before COVID. Before all eyes were focused on the novel …

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A physician wedding in the age of COVID

An emergency room nurse diagnosed with PTSD

T. C. Randall, RN

Conditions

May 19, 2020

An excerpt from The View From The Wrong Side Of The Day: A Story About Nursing, PTSD And Other Shenanigans.

I’m not exactly sure when things first started to get bad for me. Thinking back, it was all rather like the analogy of the frog in the …

Bearing witness: the physician’s role in a time of crisis

Josh Mugele, MD

Physician

May 15, 2020

Like many physicians not initially on the front line of the COVID-19 pandemic, I watched with growing dread as stories from doctors and nurses started coming out from hot spots first in China then in Italy and then Seattle and New York. Seeing their faces and hearing their voices, I was struck by their exhaustion and fear but also by their sense of responsibility and duty. I wanted to help, …

Is there a doctor on board? Yes, but we might not be the right doctor.

Andrea Bischoff, MD

Conditions

April 17, 2020

My husband and I travel internationally at least three times a year to give courses with live surgical demonstrations of colorectal conditions in children.

During the past 13 years making those trips, we had our share of hearing the famous announcement in the plane: “Is there a doctor on board?”

Those have happened in many different scenarios including having been on call the night before and therefore being on an almost semi-coma …

A thank you to emergency physicians

Michael Ruzek, DO

Conditions

April 10, 2020

I want to write a letter of thanks for all the sacrifices you have made for our nation during this COVID-19 pandemic.

Thank you for all the lives you have saved.

Thank you for fighting to save all the lives that were lost.

Thank you for leaving your homes each day, not knowing if or when you will hold your children or see your spouse …

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A thank you to emergency physicians

The fragile economics of America’s emergency departments

Jesse Pines, MD and Arjun Venkatesh, MD

Conditions

April 2, 2020

On the front lines, America’s emergency departments (ED) are currently in at the center of a crisis treating patients with COVID-19. Emergency physicians and other clinicians are placing themselves and their families at risk. Yet, there is also another important crisis facing hospital-based EDs: surprise billing legislation. Certain forms of surprise billing legislation have the potential have a substantial and negative impact on how America’s EDs are supported, and our …

The ethics of being a doctor on board

Jocelyn Worley, MD

Physician

March 30, 2020

It was Christmas Eve, and where most people are home with their families, residents are all too familiar with spending holidays inside the hospital. As such, I was traveling back to Austin for an early morning shift on hospital service, when I encountered an ethical dilemma that has stuck with me since.

A mere 20 minutes after the plane took off, I heard the dreaded words: “A passenger requires medical attention. …

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The ethics of being a doctor on board

As society shuts down, hospital workers continue to fight the pandemic

Anonymous

Conditions

March 17, 2020

Collectively across our country, as society shuts down, physicians, along with our brave co-workers in the hospital, will be going to work to combat the largest pandemic we have seen in our lifetimes. While such a crisis frightens us all, it has also served as a soul-renewing time for medicine. Over the next several months, our tribe worldwide will be risking their health and lives to serve and treat patients …

Who are responsible for outrageous medical bills? Hint: It’s not doctors.

Ashima Vohra, MD

Physician

March 14, 2020

Over the last few years, there has been a slew of articles about patients receiving surprise bills after ER visits. One woman was charged $5,751 for an ice pack and a bandage. An infant was charged $937 for an antibiotic ointment. Who sends bills like that? Is it the ER doctors? No. It’s large corporations.

ER docs want to help you regardless of …

Do patients addicted to drugs truly have capacity?

Gregory Jasani, MD

Conditions

March 4, 2020

Is it time to rethink how we determine the capacity of our patients who are addicted to drugs? I recently began debating this question after I took care of a young woman with endocarditis. She had a long history of IV drug abuse that had led to the development of endocarditis. She had been admitted one week earlier and was being prepared for surgery, but she left against medical advice …

Doctors: It’s OK to sometimes suck

Navpreet Sahsi, MD

Physician

March 4, 2020

I’m here today to let you in on a little secret. It’s not something that I’m particularly proud of, and it’s work that I’m always trying to improve upon. But it’s true. And today you’re about to find out something I’m desperately trying to hide.

So here it is. Yes, I’m a doctor. And yes, I’d like to think that I’m pretty good at my job. But you know what? There …

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Doctors: It’s OK to sometimes suck

The art of diagnosis is like a riddle

Raj Waghmare, MD

Physician

February 26, 2020

“I have a riddle,” Paul says, as the dining room falls silent.

“You’re at the bottom of the stairs. And on the wall, there are three light switches labeled one, two, and three. There’s a room upstairs with three lamps, labeled X, Y, and Z.

You can turn on and off as many switches as you want while you’re downstairs, but you can only go upstairs once. And once you’re upstairs, you …

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The art of diagnosis is like a riddle

Urgent care is emblematic of problems in our health system

Rosalind Kaplan, MD

Policy

February 23, 2020

Working in urgent care, I’ve started supervising some of the other providers at sites other than my own — 19 sites in all in Pennsylvania and Delaware — so I hear about a lot of patient situations.

The urgent care site where I work is in an affluent area. Most of our patients are employed or retired and have health insurance, though I have certainly encountered a number of patients …