Knowing the actual probability that a patient will have a bad outcome can help you communicate risk to a patient or family, and allow them to share in the decision-making process.

altWhen asked about the future of the Patient Protection and Affordable Care Act and the possibility of its repeal, Dr. Steven Stack responded, “The law is a game changer, and we needed a game changer. Instead of repeal, repeal, repeal, we should be looking at how to fix the things that are clearly wrong in it and go forward.”

altI often get asked to give presentations on what I think are the most important articles of the year. Clearly, one’s perspective regarding what is important varies from individual to individual, however, I tend to gravitate to articles that look at systems issues and those that I think can have a major impact on how we practice clinically.

altWhen managing acute and chronic pain in the emergency department, EPs struggle to walk the line between being cold-hearted cynics and becoming sugar daddies.

A response to the backlash following last month’s op/ed “Life Cycle of a Parasitic Specialist” Normally, we would allow an opinion piece to stand as just what it is, an opinion. After all this is America and we still have free speech. However, in this case, the vitriol and vulgarity of the responses to an opinion piece demanded an explanation from the editors who published it.

titleWhat lies ahead for the Patient Protection and Affordable Care Act (PPACA)? Many wonder if it can or will be implemented and whether there is any infrastructure to implement it. Another consideration is Accountable Care Organizations (ACOs).

An in-depth look at how the Affordable Care Act will attempt to cut $1 trillion over the next two decades, and how it will present both obstacles and opportunity for emergency medicine.

The Hawthorne Medical Center emergency department (ED) sees 50,000 patients each year. The fast track, open 16 hours a day, often sends patients to the main ED when it shuts down at 1 AM. The staff is convinced that adding another mid-level is the solution, although the numbers indicate the current staffing should be adequate. Will adding a mid-level solve their issue?

When Karen Sibert, an anesthesiologist with four children, wrote an op/ed piece in the New York Times about the deleterious economical and societal impact of physicians who choose to work part time, my email inbox exploded. Comments were all over the place, from “You’ve gotta be kidding,” to “Wonder if it would have been printed if a man wrote it,” to “Raises some interesting points.”

altA 21-year-old, right-hand dominant male without significant past medical history, presents to your emergency department after a pallet of bricks fell on his left, ring finger, while at work just prior to arrival.  His vaccinations are up to date.  On exam, he has amputated his ring finger just distal to the DIP joint, and bone is exposed  at the site of injury.You’re in small town U.S.A.  No orthopedic service around. What do you do?

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