Emergency medicine

2,327 articles · Since 2004

Articles, page 69

I wonder about the mental effects of amplified noise

December 17, 2012Dec 17, 20122

I grew up in Connecticut. It was in a town just like Newtown. It was safe and it was quiet. I am a father and a grandfather. My life is surrounded with children. This weekend has been tough. You try…

I grew up in Connecticut. It was in a town just like Newtown. It was safe and it was quiet.

I am a father and a grandfather. My life is surrounded with children.

This weekend has been tough. You try to read or write something, but the mind wanders. Then you feel sadness. The more you think about the specifics, the sadder it gets. Your heart aches.

Our nation feels it. I recently …

Physician voices

Do we make gun ownership a fifth vital sign?

David Mittman, PA

December 17, 2012Dec 17, 201210

Please read the next few lines closely. This is not about the Constitution. Not about the "right to bear arms" or banning guns. Not about you answering this with some canned speech either way. Nor is it about having the…

Please read the next few lines closely. This is not about the Constitution. Not about the “right to bear arms” or banning guns. Not about you answering this with some canned speech either way. Nor is it about having the answers. What it is about is the fact that even in small town America our neighbors have now learned what the big cities have known for a long time. It …

Physician voices

How a psychologist explained Sandy Hook to his children

Dominic A. Carone, PhD

December 17, 2012Dec 17, 2012

The shootings at Sandy Hook Elementary School in Newtown, Connecticut have been traumatizing for the entire nation. While we have unfortunately become used to hearing about school shootings and other public mass shootings in the U.S., the brutal murder of…

In fact, the moment …

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Physician voices

Newtown, CT will not be the last time tragedy strikes

Mike Sevilla, MD

December 16, 2012Dec 16, 20129

I will say this up front: Newtown, Connecticut will not be the last time tragedy strikes. For good or bad, in this age of social media including twitter, it is easier to track the coverage of this story and people’s opinions about it. I have been thinking about this constantly today, and talking with my friends and neighbors about what happened this morning.

Outlining the problems setting up this tragedy …

Physician voices

Locum tenens prepared me to volunteer in undeveloped countries

Renée Volny, DO, MBA

December 16, 2012Dec 16, 2012

For the majority of physicians in the U.S., taking their skills abroad and providing care via medical missions in undeveloped countries is usually not an option. For me, that was always an option. I am an OB-GYN who works as a locum tenens, a traveling physician who temporarily fulfills the duties of another. This has provided me the flexibility to have …

Medical education

How my ER rotation turned me into a primary care doctor

Stella Safo, MD, MPH

December 14, 2012Dec 14, 20125

It's Saturday night at an emergency department (ED) in Boston, MA, and I am faced with a medical student’s dream dilemma: which one of the many interesting cases should I observe? Should I watch trauma surgeons operate on the 17-year-old…

It’s Saturday night at an emergency department (ED) in Boston, MA, and I am faced with a medical student’s dream dilemma: which one of the many interesting cases should I observe? Should I watch trauma surgeons operate on the 17-year-old gunshot victim or work with the ED docs to assess whether a 59-year-old woman is having an acute stroke? That is exactly what I adored about emergency medicine as a …

Medical education

To the health professionals during hurricane Sandy: Thank you

Jessica Gold

December 12, 2012Dec 12, 20122

It's 3:30 am and my clock alarm is singing some song that I used to like. I roll over to turn it off all the while thinking to myself: “I am waking up to stand for the next 12 hours…

It’s 3:30 am and my clock alarm is singing some song that I used to like. I roll over to turn it off all the while thinking to myself: “I am waking up to stand for the next 12 hours straight holding a retractor. No one is going to care that I am there, and if I am even acknowledged …

Health policy

Hurricane Sandy’s profound impact on population health

David B. Nash, MD, MBA

December 8, 2012Dec 8, 20122

Of all the complex, costly, and downright intimidating issues in U.S. healthcare today, Super Storm Sandy tops my list as the scariest. Even though hospitals from the Carolinas to Maine deployed their emergency plans and had extra providers on site…

Of all the complex, costly, and downright intimidating issues in U.S. healthcare today, Super Storm Sandy tops my list as the scariest.

Even though hospitals from the Carolinas to Maine deployed their emergency plans and had extra providers on site to deal with the expected influx of patients, those in the hardest hit areas couldn’t withstand such a powerful storm surge.

Like many …

Health policy

How Obamacare will create a new normal for medicine

BirdStrike, MD

December 7, 2012Dec 7, 201214

The 2012 Presidential election is over. Obamacare is the law of the land and is certain to remain so. There was tremendous uncertainty not knowing whether the law would be repealed, revised or remain. Many of us opposed the bill, and there certainly are negatives. Like it or not, it is time to “get over it,” and not a second later than now. …

Health technology

Why the iPad Mini is the tablet physicians have been waiting for

Iltifat Husain, MD

December 6, 2012Dec 6, 20122

I was skeptical about the iPad Mini. I’ve used my Retina display iPad (3rd generation) for the past six months and been satisfied with the experience. I’ve used it in the hospital setting during rounds, and even while talking to…

I was skeptical about the iPad Mini. I’ve used my Retina display iPad (3rd generation) for the past six months and been satisfied with the experience.

I’ve used it in the hospital setting during rounds, and even while talking to patients in the ER. I’m able to easily pull up Epic’s EMR using the Citrix app, and I can easily store the iPad …

Physician voices

My experience with a scribe in the emergency department

Shadowfax, MD

December 6, 2012Dec 6, 201220

I have a lovely pen. It's a Mont Blanc Meisterstück fountain pen. My group bought it for me on my tenth anniversary as a partner in our emergency medicine practice. It's a luxury I would never have paid for myself,…

I have a lovely pen. It’s a Mont Blanc Meisterstück fountain pen. My group bought it for me on my tenth anniversary as a partner in our emergency medicine practice.

It’s a luxury I would never have paid for myself, though I have loved and used fountain pens since I was in college. Ironically, about the time I got it, the window …

Physician voices

If Atlas shrugs off healthcare, it will be a dark day

Edwin Leap, MD

December 5, 2012Dec 5, 201235

Most modern American are familiar with the classic political novel, Atlas Shrugged. Love or hate it, the novel had a great impact on political thinking in the West. If you haven’t read it, or aren’t familiar, one of the fundamental…

Most modern American are familiar with the classic political novel, Atlas Shrugged. Love or hate it, the novel had a great impact on political thinking in the West. If you haven’t read it, or aren’t familiar, one of the fundamental questions author Ayn Rand asks is this: what if the producers and innovators of society simply stopped trying? What if they …

Physician voices

ED boarders: A new focus to mitigate overcrowding

Ishani Ganguli, MD

December 3, 2012Dec 3, 2012

The crowded emergency department (ED): It has become a symbol for our fragmented, inefficient health care system. In the wake of Hurricane Sandy, the visual has become more familiar than we'd like - the young and the old slumped forward…

The crowded emergency department (ED): It has become a symbol for our fragmented, inefficient health care system.

In the wake of Hurricane Sandy, the visual has become more familiar than we’d like – the young and the old slumped forward on rigid plastic chairs in the waiting room, occupied stretchers lined up in tandem in the hallway. Some of these patients are sick enough to warrant a hospital admission but languish …

Health policy

How insurers take advantage of the EMTALA mandate

Myles Riner, MD

November 27, 2012Nov 27, 2012

Emergency care providers (emergency physicians and specialists on-call for the ER) are at a significant disadvantage when it comes to trying to get paid fairly for services rendered to enrollees of commercial health plans. Most other health care providers are able to: 1) screen prospective patients to make sure they will get paid appropriately for the care, 2) elect not to care for a plan’s enrollees, or participate in a …

Physician voices

A physician takes his flu vaccine under protest

Doug McGuff, MD

November 27, 2012Nov 27, 201226

To hospital administration, I am writing this letter to inform you that when I take my mandated influenza vaccine I will be doing so under protest and with the understanding that failure to do so could result in loss of…

To hospital administration,

I am writing this letter to inform you that when I take my mandated influenza vaccine I will be doing so under protest and with the understanding that failure to do so could result in loss of my ability to earn income for myself and my family. Unfortunately, I do not qualify for any of the exemptions allowed by our facility. Since I am not religious, I have …

Physician voices

A rare case when needs of the dying should be secondary

Monica Williams-Murphy, MD

November 27, 2012Nov 27, 20125

I pulled the stifling surgical mask off my face as I left my last patient’s room. I had just finished suturing a complicated facial laceration and was bone-tired from the evening. Glancing at the clock, I saw that mercifully, my…

Collapsing into my chair to finish up my charting, I was slightly annoyed when my nurse held a clip-board in front of my face, “Here is your next …

Physician voices

More than half of my ER shift was spent on entering data

WhiteCoat, MD

November 21, 2012Nov 21, 20126

I work at several hospitals and each uses a different electronic medical record system. When I switch from hospital one to another, I obviously have my favorite EMR systems and my not so favorite EMR systems. In the previous post, I was using the EMPOWER charting system, which I liked for its simplicity, but disliked because of the layouts of the charting interface and some of the macros it contained.

After …

Physician voices

Repeated story syndrome: Finding the right balance for patients

Ishani Ganguli, MD

November 21, 2012Nov 21, 20127

The other night, a patient gave me a piece of his mind. Mr. Q was a middle-aged man debilitated by days of nausea, vomiting and intractable belly pain. That morning, his wife finally convinced him to get medical attention and drove him to our emergency department. On arrival, he sat in a cubicle in the waiting room and explained his story to a triage doctor: how he was doing well …

Physician voices

5 steps to establish a partnership for shared diagnosis

Leana Wen, MD

November 18, 2012Nov 18, 2012

In a recent post, you met Catherine, a young woman who came down with a stomach bug but was ushered through numerous blood tests and a CT scan, only to be even more confused than ever. You saw how shared decision-making needs to begin with the process of establishing a partnership for shared diagnosis, because diagnosis is the first and most critical step to your medical care.

Here …

Physician voices

The volume of low acuity patients in the ER is not a myth

Shadowfax, MD

November 8, 2012Nov 8, 20125

I had an interesting twitter chat the other day with one of my colleagues, a young ER grad studying healthcare policy by the name of Seth Trueger. The Twitter conversation wound up involving about a dozen ER docs and nurses.…

The point in contention is an interesting one: we know the nation’s ERs are overwhelmed and overcrowded. That’s old news. We also …

Emergency medicine

Articles, page 69

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