I 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.
When managing acute and chronic pain in the emergency department, EPs
struggle to walk the line between being cold-hearted cynics and becoming
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.
What 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.”
A 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?
In recent years, the growth of emergency medicine around the globe has
been exponential, with nearly 70 countries now granting some form of
formal recognition to the field. At the same time, interest in Global
Emergency Medicine (GEM) as a unique subspecialty of emergency medicine
has also grown rapidly over the past decade.
The CDC reports that 123.8 million patients visited an emergency
department last year. That’s 41.4 visits per 100 population. That number
has risen every year despite numerous, concerted efforts by the
government and the insurance industry to stem the rising tide. Could it
be that patients see what the politicians and planners seem to be
missing, that the model of emergency care by qualified specialists, when
and only when you need it, is a good model for health care delivery?