EPs skeptical as more states move forward with their own reforms. 
Q.The really difficult patient
 I found out a patient I discharged yesterday died. I know I probably shouldn’t have discharged that patient, but I knew the internist would refuse the admission and the nurse was putting pressure on me. I feel trapped–and I feel awful. Do you have any tips on how to handle this in the future?
-JA, Atlanta, GA 
Perform these facial blocks like an experienced dentist…your patients will thank you.
Whether you love or hate patient satisfaction surveys, there are a few ways to avoid survey biases and make the most of the your numbers. 
A specialty divided on the fundamental issues of healthcare insurance reform can finally agree on one thing: The time for change is now.
Non-ABEM/AOBEM EPs won a strategic victory in October when the ACEP certification section voted to create a fellowship track for legacy physicians.
“Apparently I offended a nurse the other day when she questioned my orders. Even though I overheard her badmouthing me to others, I’ve been asked to apologize. I feel she should apologize to me— after all I’m the doctor. What should I do?”
JB, California
Dear Jeannette,
I’m a third year resident who was recently ending a difficult busy shift and was stuck trying to admit my final patient - an elderly male with diverticulitis. I was caught in a stalemate between the surgical and medical team and after four calls felt like I was hitting my head against a wall. As I turned around to ask my attending for help he snapped at me because the booking wasn’t complete. I could feel my eyes well up and made a quick escape to the bathroom where I sobbed for a few minutes, and then berated myself for a few more. I’m a good physician but worry that crying at work may negatively affect my reputation.
Two separate cases are underway, in Texas and Florida, through which AAEM hopes to challenge the contract management giant.
altPhysician activist Ron Elfenbein, MD, sounds off on how patient sat scores are bringing the emergency department to its knees.

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