What would you do? A new book dissects “bouncebacks” in the emergency department, turning nightmare ED scenarios into Holmesian teaching cases.
John McGoff, MD, is an emergency physician from Indiana who has spent
his career running a community emergency department, serving in the Air
Force National Guard, and serving in a variety of civic leadership
posts. In 2008, McGoff – frustrated by the poor leadership in his
district – attempted the Herculean task of unseating a 13-term
congressman from his own republican party.
Physicians are now receiving nearly $200 million in payments as a result
of a record-breaking settlement reached last January in a historic
court challenge led by the American Medical Association against
UnitedHealth Group. Under the settlement’s terms, UnitedHealth is paying
$350 million to help compensate patients and physicians for 15 years of
artificially low payments for out-of-network services.
The FDA-approved drug dabigatran is being marketed as a safe alternative
to Coumadin. But without a proven reversal agent available, it has the
potential to create a new set of complications, and send unsuspecting
patients right back to the ED.
I didn’t know what to expect. I was excited, curious, but also somewhat
apprehensive about being a woman in Saudi Arabia. The reason for my
visit was the ‘2nd Up to Date Emergency Medicine Practice’ conference,
sponsored by the King Fahad Medical City in Riyadh.
The emergency department (ED) is not an ideal place for patients with
depression to seek help. Waiting times, busy staff, and a greater
likelihood of a fleeting interaction with a physician coincide with the
reality that many emergency physicians do not receive training for
In a recent emergency medicine listserv exchange several posters
commented on the widespread abuse of emergency physicians made possible
by their lack of due process “rights.” Perfectly innocent emergency
physicians, nay even model citizens it was alleged, had been terminated
on the spot purely on the whim of some grumpy hospital administrator
with not a word of protest from the contract management group.
Abdominal pain is one of the most frequent complaints that present to
the emergency department. With every physical examination of the abdomen
we note if there is pain in the right lower quadrant (RLQ) over that
most famous of landmarks, McBurney’s point.
At the ACEP Scientific Assembly this year, I spoke to a group of
physician assistants and advanced practice nurses. I gained many
insights into the uniqueness of their role and their place in Emergency
Medicine. The first thing I learned was that terminology is evolving as
their training and scope of practice is evolving.
In 2010, Rep. Joe Heck became the first emergency physician (and first
osteopathic physician) elected to the US Congress. In addition to his
emergency physician skills, Rep. Heck brought to Washington a unique
skill set developed through years of military and specialized medical