Expansion of the Medicaid rolls under the Affordable Care Act has caused more than one state to look at ways to cut healthcare spending. In Washington State, the result has been a clash between physician groups and state health agencies that could to be a sign of battles to come.

altRandy Jotte is ready for a challenge. An emergency physician at Barnes-Jewish Hospital and an associate professor at Washington University School of Medicine in St. Louis, Jotte is competing for Missouri’s vacated 2nd Congressional seat.

When Broadway composer Jonathan Larson collapsed the night before the opening of his magnum opus, Rent, it set in motion a series of errors and unfortunate ED encounters. The result was a multi-million dollar lawsuit and many lessons learned the hard way.   
An Excerpt from Chapter 4 of Bouncebacks! Medical and Legal

What would you do? A new book dissects “bouncebacks” in the emergency department, turning nightmare ED scenarios into Holmesian teaching cases.

altJohn 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.

altThe 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 depression screening.

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.

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