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.

titleAbdominal 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.

altIn 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 operations experience.

For the third time this week Ms. A, a 49 year old with a history of alcohol dependence and untreated bipolar disorder presents to your emergency department (ED) for suicidal ideations. Of course it is Friday night, or rather, Saturday morning, your department is over capacity and Ms. A is being uncooperative with both the triage nurse and the security staff attempting to maintain order.

altDecompression Sickness (DCS) is a condition caused by the change in absorbed gas volume upon depressurization that releases gas bubbles into tissue and vasculature (1). This process can occur in divers who quickly arise from depth or who perform repetitive dives. The most common presentation of DCS in shallow dives is referred to as DCS Type 1 and is characterized by localized deep joint pain.

An entitlement culture is one which says, “you owe me” because of who I am or what status group I belong to. While some have argued that such a mentality has been on display in the Occupy Wall Street movement – young people believing that they are “owed” a job because a small percentage of the population earns a lot of money – they are certainly not alone.

Why should we care about benchmarks? They are a way to be proactive in evaluating and improving your practice before you get criticized, fired, or have your compensation reduced.

Rolling in like a Trojan horse, CMS is proclaiming that its new ramped up benchmarking efforts are primarily motivated by efforts to improve quality. In reality, they are really focused on cost-reduction.

altAs part of EPM’s commitment to encouraging emergency physicians to become more effective advocates for our patients and our specialty, we’ll be running a series of interviews with the emergency physicians who will be candidates for congressional office in 2012.

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