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 scald.

altJohn Schedin was awarding of 1.8 million by Johnson & Johnson after suffering from bilateral ruptures of the achilles tendons after receiving Levaquin for bronchitis. 

altHow to reduce two of the most common errors of direct laryngoscopy, tube delivery issues, and failing to plan for the epiglottis-only view.

altEPM 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?

Popular Authors

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  • William Sullivan
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