altCan emergency physicians identify tests and procedures whose necessity should be questioned? In light of high-radiation, low-yield tests, we can – indeed we are obligated – to do more than that.

Deeply ingrained gender traits make it difficult for many female emergency physicians to successfully negotiate their contracts. Here are five negotiating pitfalls, and strategies for breaking the cycle.

"The bottom line is the person came for care. The degree that you put judgement into that is the degree to which you are not keeping up with the intent of what medicine really is." -Greg Henry, MD 

altA 43-year-old male presents after a mechanical fall down five stairs with a fall on outstretched hand injury to his left wrist. There is an obvious deformity. No other injuries were identified on complete physical exam and the patient’s neurovascular exam is intact.

From movies to music to clothing lines, the widespread promotion of the glorified “pimp and Ho” culture has unwittingly created an unacceptable tolerance and ignorance to the reality of the sex slave industry in the United States. Unfortunately, the misperceptions about prostitution are pervasive even among healthcare workers, who are missing valuable opportunities to recognize and offer aid to victims of sex trafficking.

With payment reform at the gate, emergency medicine needs to find ways to promote the more judicious use of advanced imaging tests like CT scans, or other groups will make the rules for us.

In April of this year, the American Board of Internal Medicine Foundation took a baby step in the cause of lowering the high cost of medical care by initiating the Choosing Wisely campaign. The campaign asked physician specialty boards, including ACEP, to identify “five tests or procedures commonly used in their field, whose necessity should be questioned and discussed.”

A campaign called Choosing Wisely has gotten some attention of late because of its stated goal of reducing health care costs by eliminating tests and procedures that are not “necessary.” Since ‘Choosing Wisely’ launched, nine medical specialty organizations have offered up their top five items for the chopping block.

altThirty years ago a surgical airway was considered the ultimate means of rescue ventilation and rescue intubation. Today, it is neither. The LMA, similar devices, and the King LT (or Combitube) have become the default means of rescue ventilation when mask ventilation fails.

altIn the coming years, there will be major changes in the way doctors and hospitals are paid. Namely, several government programs – along with contractual changes between health systems and private insurers – will focus on rewarding value over volume.

Popular Authors

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