Emergency physicians have historically been ambivalent about
inappropriate ED utilization. We deplore it but are reluctant to address
it because we believe that there may be no alternative for these
patients, that excessive risk or the threat of an EMTALA violation are
prohibitive, or that it may cost us practice revenue. But failing to
address an issue of critical importance to our hospital customer is the
first step on the path toward losing the contract.
In 2009, Emergency Physicians Monthly polled 5,000 readers online to
determine if and when EPs altered the tests they ordered out of fear of
litigation. The poll, which garnered 385 responses, may not have been
scientifically valid, but it confirmed what most of us know intuitively –
that there is a significant cost to defensive medicine. Now, the
Pennsylvania College of Orthopedic Surgeons has added fuel to the fire,
publishing a study that confirms the very same thing.
EPM executive editor Mark Plaster sat down with emergency medicine
opinion leaders for a candid discussion about continuing medical
education – do we need it, who does it best, and what would the ideal
methodology look like?
24-year-old Hannah A. is “playing tag” in the front yard at 3 a.m. one
cold February Sunday night during a rain storm. She slips, falls, and
horribly breaks both bones in her left leg. Incidentally, she also has a
nasty burn on her right forearm that she says is from a hot water
John Schedin was awarding of 1.8 million by Johnson & Johnson after suffering from bilateral ruptures of the achilles tendons after receiving Levaquin for bronchitis.
How to reduce two of the most common errors of direct
laryngoscopy, tube delivery issues, and failing to plan for the
EPM investigates why starting salaries for women emergency physicians appear to be nearly $13,000 lower than male counterparts.
Emergency physicians may be the “jack of all trades” but we are the
kings and queens of conflict management. If we define conflict as the
simple mismatch between two parties’ expectations, EPs start holding
court before we have even buttoned up our white coats.
Every shift, emergency physicians care for patients they don’t know in a
time-pressured and overcrowded environment. Given that the majority of
patients in the emergency department have non-life-threatening
conditions, physicians are easily lulled into a false sense that the
patient laying before them has a benign condition.
EHR drug-drug interaction warnings may ultimately save lives, but does
the collateral damage of “alert fatigue” negate the benefit?