Part 1 in a series about the cold, hard numbers behind some of our most common ED practices

This is the third in a series of columns dealing with non-allergic, potentially serious reactions caused by antibiotics. In the column dealing with macrolides, the increased risk of sudden death was noted. Clearly, the absolute numbers of deaths associated with macrolides has to be small, but it makes sense to take this fact into consideration when prescribing these antibiotics to those prone to arrhythmias (such as patients with congestive heart failure).

If you are an emergency physician and you Google yourself, you’ll find a host of companies offering the world a chance to “rate” you as a doctor. On a scale of 1 to 5 stars, “How would you rate your overall experience?” asks eHealthScores. “Does the provider listen to you and answer your questions?” asks HealthGrades. The internet is replete with these sites, and now even mega-review sites like Yelp have gotten in the mix, stacking physician reviews right next to write-ups on bars and nightclubs.

While travelling along the interstate between who-knows-where and woebegone—a long way from any EMS services—you come across a rollover accident that has just occurred. For some reason you’re not carrying any medical equipment. (Why not?) One of the van’s former occupants is in respiratory distress from a chest injury and needs a chest tube. When you ask, a trucker who has also stopped says that he has some tubing in his truck. So, now you need a scalpel.

CASE STUDY: Clearing Athletes for Return to Play
New legislation in Pennsylvania has mandated greater scrutiny of student athletes who suffer on-field concussions. An interview with Dr. Michael Garfinkel

alt24 year old male presents with laceration to the right elbow after rollover MVC. He has stable vital signs and no other injuries. Plain films reveal no fracture or dislocation and no foreign bodies. He has full ROM and is neurovascularly intact. Your intern suggests local infiltration of Lidocaine for analgesia, copious irrigation and primary closure.

altDid you know that the macrolide group of antibiotics (erythromycin and all its cousins) could kill you? Drop dead – sudden death. Well there is a growing body of literature saying just that.

“I am not sure that any research should be performed in emergency department settings, and I suspect that many grant review study sections feel the same way. Patients come to the ED with an acute problem and they need clinical care, not research protocols and consent forms.”

altOn March 22, the U.S. House of Representatives passed HR-5 – the Protecting Access to Healthcare Act – by a vote of 234-173. The Act, which went strongly down the party line (only 11 democrats voted for the bill) had broad support from ACEP as well as the AMA and a range of other medical organizations.

As an emergency medicine (EM) practice management consultant I”m frequently asked “How can we determine what’s fair to pay for physician administrative duties?”  It’s an emotional subject in every group because it involves the discussion of each member’s relative value to the business enterprise side of the practice.

Popular Authors

  • Greg Henry
  • Rick Bukata
  • Mark Plaster
  • Kevin Klauer
  • Jesse Pines
  • David Newman
  • Rich Levitan
  • Ghazala Sharieff
  • Nicholas Genes
  • Jeannette Wolfe
  • William Sullivan
  • Michael Silverman

Subscribe to EPM