The optimism of those emergency physicians who have supported the expansion of Medicaid through the Affordable Care Act is built on the assumption that ‘some pay’ is better than ‘no pay’. And, of course, if it were that simple, they would be correct. But I would humbly submit that we need to take the problem apart a little more to see the details before drawing such conclusions.

If emergency physicians are going to have a chance at influencing healthcare policy in Washington, they’re going to need to get serious about organizing and fundraising.

We have always been clinicians, but modern emergency physicians have also become the most skilled managers in the healthcare system. It’s time we capitalize on those talents and proactively learn from the management industry.

altIn talking with physicians from all over the country, I have found that most say that charting via an electronic medical record system is the invention of the devil. Only rarely will an emergency physician say that they go faster with an EMR than with what they were charting with previously. And whenever I hear a physician assert this, I generally wonder how efficient they were in the first place.

altIndication creep seems to be the natural course for medical advancement in the United States. The FDA gives an inch of approval, and we take a mile. tPA is no different. But this article is not about the controversy surrounding the efficacy and safety of tPA. The issues with tPA have gone way beyond professional disagreements about efficacy, safety and time windows.

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