Emergency medicine

2,327 articles · Since 2004

Articles, page 68

Don’t get frustrated with the uncertainties of medicine

January 10, 2013Jan 10, 2013

A few months ago, when I thought I should throw it all away and go to law school, an acquaintance who is a lawyer said something unexpected. He said "law school is learning how to think like a lawyer and…

A few months ago, when I thought I should throw it all away and go to law school, an acquaintance who is a lawyer said something unexpected. He said “law school is learning how to think like a lawyer and deal with the uncertainty within the law.” Uncertainty? A law is a law right? Don’t speed. Don’t drink and drive. Write thank-you notes. Turns out the law often requires interpretation, …

Physician voices

People are fallible, but health systems need not be

Kenneth Lin, MD

January 8, 2013Jan 8, 201312

When I heard in October that Superstorm Sandy was projected to make landfall somewhere in the vicinity of DC and Maryland, I prepared for the worst. I stocked up on non-perishable goods and evacuated to higher ground. (The rest of…

I put fresh batteries into two flashlights and installed a flashlight app on my smartphone for good measure. Although I …

Physician voices

Medical malpractice: Equating standard of care to best practice

Shadowfax, MD

January 8, 2013Jan 8, 2013

I review a lot of cases in my professional life. Some of them are just ones that our QA group comes across in our practice. Some are cases related to our liability policy. Some are cases I’m sent for review, or educational cases I present. We see a lot of cases which could have been done better, or in which the …

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Health policy

Why linking patient satisfaction with dollars is misguided

John Mandrola, MD

January 8, 2013Jan 8, 20134

I hope my patients are satisfied. This is everything. Improving the lives of people is why doctors do what they do. How much we help our patients is the metric. It’s the peg we hang our self-esteem on. So yes,…

So yes, of course, patient satisfaction is really important.

But that doesn’t mean it’s a good idea to link it with dollars.

In fact, on a list of well-meaning but really dumb …

Physician voices

The role of alcohol in health costs

Edmund Kwok, MD

January 6, 2013Jan 6, 20132

Defined as someone “having the faculties impaired by alcohol, those of us who work in an acute healthcare facility are witness to many illustrious examples of drunk patients coming through our doors. Underaged kids passed out at a house party?…

Underaged kids passed out at a house party? Yup. Raging alcoholics who are brought into the ER at least once a week? Sure. Elderly women who secretly binges on wine …

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The role of alcohol in health costs

Health technology

Protect yourself against fraudulent EHR documentation

Robert Hitchcock, MD

January 5, 2013Jan 5, 20139

As physicians, we know that no matter what care we provide, Medicare and private payers are going to do what they can to reduce payouts. For the health of the nation, healthcare spending simply cannot continue on its current trajectory. Reform measures such as accountable care organizations, bundled payments and penalties for potentially preventable complications and readmissions may help reduce expenditures, …

Health policy

Medicare made the rules and now punishes doctors for following them

Shadowfax, MD

December 29, 2012Dec 29, 201258

I wanted to expand on something I wrote recently, which relates to my other sort-of-recent post on upcoding. I wrote, about scribes and compliance: Knowing that the scribe cannot document a complete ROS unless I actually did that ROS, I…

I wanted to expand on something I wrote recently, which relates to my other sort-of-recent post on upcoding. I wrote, about scribes and compliance:

Knowing that the scribe cannot document a complete ROS unless I actually did that ROS, I am more compulsive about making sure I hit all ten systems. (Even when it’s not clinically relevant. Such is the Kafkaesque world we live in.) And I make sure to do

…

Health policy

Fix our health system: Be like Switzerland

Cedric Dark, MD, MPH

December 26, 2012Dec 26, 201242

I was working in the ER this weekend when one of my nurses asked me a simple question: “How would you fix the health care system?” Obviously, this is a complex problem requiring complex solutions, but in an environment where at any minute a heart attack or a stroke could disrupt a conversation I prepared a sound bite for an answer.

“Do …

Physician voices

The insanity of pain management in the ER

William Jantsch, MD

December 23, 2012Dec 23, 201249

One of medicine’s ethical traditions is to relieve suffering whenever possible. I believe in this, and try to treat all of my patients as I myself would want to be treated under similar circumstances. My dilemma is, even after practicing…

My dilemma is, even after practicing medicine for over 30 years, the definition of a “suffering patient” has become a moving target.

On the one hand, I hear arguments primarily from governmental agencies that presume to “advocate for …

Physician voices

At the end of life, never underestimate the power of a map

Monica Williams-Murphy, MD

December 23, 2012Dec 23, 20125

When you set out on an unfamiliar journey, you will need a map to get to your desired destination. You may pass landmarks, but not know exactly where you are unless you are able to identify these landmarks on your…

You may know …

Conditions and diseases

Why the media will slow the healing of Sandy Hook

MedPage Today

December 22, 2012Dec 22, 2012

When Newtown children returned to area elementary schools less than a week after the massacre at Sandy Hook Elementary, the cameras were watching, a reality that may slow healing in the Connecticut community. Although there's no literature that's specific to…

Although there’s no literature that’s specific to the effects of a media frenzy after a school shooting on children’s psychological recovery, there’s plenty of other applicable evidence, according …

Physician voices

Stop the proliferation of guns by ending the fear

James C. Salwitz, MD

December 19, 2012Dec 19, 20122

"I kissed my daughter as she left for school today and realized it might be the last time I would ever see her.” -New Jersey mom, three days after the Sandy Hook, CT shootings On December 14, 2012, twenty school…

“I kissed my daughter as she left for school today and realized it might be the last time I would ever see her.”
-New Jersey mom, three days after the Sandy Hook, CT shootings

On December 14, 2012, twenty school children died of the Gun Disease, shot making gingerbread houses. As guns beget guns, firearm injury and death spread like a virus. Doctors, the healthcare system, have failed to protect the most …

Physician voices

As an oncologist, I thought I had the words to console the survivors

Don S. Dizon, MD

December 19, 2012Dec 19, 2012

On Friday morning I was seeing a patient, chatting about the holidays. She had given me a gingerbread house making kit for my kids -- which she had done annually since I had become her doctor. "You are doing so…

On Friday morning I was seeing a patient, chatting about the holidays. She had given me a gingerbread house making kit for my kids — which she had done annually since I had become her doctor.

“You are doing so well,” I declared, “Have a very Merry Christmas!”

“You too!” she said as we hugged and she left the examination room.

At 12pm …

Physician voices

Are the healing professions doing enough to curb gun violence?

Bob Doherty

December 19, 2012Dec 19, 2012

Is the medical profession doing enough about gun violence? Are any of us? This is the question that we all must ask ourselves, in the wake of the incalculably sad massacre of little school children in Newtown, Connecticut. I have…

Is the medical profession doing enough about gun violence?

Are any of us? This is the question that we all must ask ourselves, in the wake of the incalculably sad massacre of little school children in Newtown, Connecticut.

I have struggled for days now to find the right words—how can I, or anyone else for that matter, find the words to describe the indescribable shared grief we have about the indescribable horror …

Physician voices

Did I shoot them? Am I bleeding? And does all bleeding stop?

Linda Brodsky, MD

December 19, 2012Dec 19, 20122

I remember the first gunshot wound I treated in the emergency department at Jacobi Hospital in the South Bronx 35 years ago. Only one of two I saw that month in the second busiest trauma ER in the country. Gang…

We couldn’t save him. I was devastated. My chief resident, an aspiring trauma surgeon, took me aside and matter of …

Physician voices

The only words that explain Sandy Hook: Pure evil

BirdStrike, MD

December 18, 2012Dec 18, 201230

Since the massacre of innocent school children and those that gave their lives educating and trying to protect them this past Friday at Newtown Connecticut’s Sandy Hook Elementary School, I've struggled to make sense of this calamity as much as…

Since the massacre of innocent school children and those that gave their lives educating and trying to protect them this past Friday at Newtown Connecticut’s Sandy Hook Elementary School, I’ve struggled to make sense of this calamity as much as much as anyone.

As a physician who has worked to save the lives of sick and injured children, and as a father of children the same age as those massacred in …

Physician voices

Both mental health and guns deserve our attention

Jennifer Gunter, MD

December 18, 2012Dec 18, 20124

The Newtown school shooting. It’s a tragedy that a mass shooting requires a qualifier, but this is America so we need to be specific as not to be confused with Aurora, Columbine, Arizona, or Virginia Tech. Colorado massacres require a…

There are 2 common elements with all these massacres: mental illness and guns (not hunting rifles, but firearms designed to cause maximin human carnage in the shortest amount …

Physician voices

A gun owner responds to Sandy Hook

Edwin Leap, MD

December 18, 2012Dec 18, 2012237

"Hi, I’m Edwin, and I own firearms!" Right now, in the shadow of the horrors of the Sandy Hook shooting, it feels as if every gun-owner is on edge. Some are apologizing, distancing themselves from gun advocacy groups. Some are…

“Hi, I’m Edwin, and I own firearms!”

Right now, in the shadow of the horrors of the Sandy Hook shooting, it feels as if every gun-owner is on edge. Some are apologizing, distancing themselves from gun advocacy groups. Some are saying all the right words, “well, my target gun is locked in a safe.” Like telling your Baptist Preacher grandpa, “my whisky is in a cabinet and is only for medicinal …

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A gun owner responds to Sandy Hook

Conditions and diseases

Sandy’s wrath is no match for nurses’ strength

Barbara Ficarra, RN, MPA

December 18, 2012Dec 18, 2012

While Hurricane Sandy’s fury wreaked havoc on the Northeast and caused massive destruction, one thing is for sure: Sandy’s wrath is no match for nurses’ strength. Nurses’ role in the media is often overlooked because it often focuses on the…

While Hurricane Sandy’s fury wreaked havoc on the Northeast and caused massive destruction, one thing is for sure: Sandy’s wrath is no match for nurses’ strength.

Nurses’ role in the media is often overlooked because it often focuses on the heroic activities of the doctors. Health care isn’t a competition between nurses and doctors. Doctors and nurses are colleagues. Health …

Physician voices

Who’s responsible for Newtown? We all are, to some degree

Jeffrey Parks, MD

December 17, 2012Dec 17, 20125

The events in Newtown, Connecticut will hopefully jump start a national conversation. That's about the only solace I can take from the senseless murder of 20 schoolchildren in a classroom. This conversation ought to transcend minutiae like the specifics of…

The events in Newtown, Connecticut will hopefully jump start a national conversation. That’s about the only solace I can take from the senseless murder of 20 schoolchildren in a classroom.

This conversation ought to transcend minutiae like the specifics of gun laws and gun show loopholes (although there will be a time for redressing these inanities). I don’t want to hear about …

Emergency medicine

Articles, page 68

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