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.
As I arrived to work I saw that the parking lot and the waiting room were packed. This is not supposed to happen at this place. “I’m getting too old for this,” I mumbled to myself as I dropped
my 2am lunch in the frig and grabbed a handful of charts. I’d raced
through an hour of charts before it dawned on me that they were filling
the rack as fast as I could empty it.
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?
With less access to primary care and multiple gatekeepers adding to the expense of health care, perhaps EPs should be the final stop for many ED patients.
Long after the elected legislators have cast their votes, the agency administrators write the rules and regulations that interpret the law and give it meaning. The Accountable Care Act is poised to fundamentally change how we practice emergency medicine, but the scope and impact of those changes will be determined by the rule writers.
Mid-level providers, such as physician assistants and nurse practitioners, are gaining popularity – and authority – in the emergency department. To explore the issue of using mid-level providers to extend the reach of emergency physicians, we brought together four experts to take part in a dialogue, moderated by EPM executive editor Mark Plaster. Read the full transcript of the roundtable here.
Last spring a group of physicians and medical societies filed suit in
federal court to overturn a state law that bans healthcare professionals
from asking patients about whether they own a gun. On first blush, it
seems like the reasonable and responsible thing to do. The government
has no place in telling doctors what they may or may not ask a patient,
“Did you know that sleep walking will get you disqualified from the
Navy?” I asked my wife in response to her usual “What did you do today?”
interrogatory. It was drill weekend and I had just finished one of my
rare day shifts serving at the Naval Academy clinic.
Over the years I’ve gotten many calls like this one. “Will you look at
this case? Something very bad happened and I think someone screwed up.”
They seldom say it quite that bluntly, but that’s what they mean.
It was my first night at a new emergency department, so I was just
getting used to the system and the people. Everything seemed to be going
along smoothly. The staff was great and very welcoming. The patients
were pleasant and generally not so sick as to create a stressful first
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