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
“Hey sweetheart,” my wife said cheerily as I stared into my coffee. “Today’s your day.”
“Huh?” I said blankly. It had been a long night and all I wanted was to eat my breakfast in peace and go to bed.
“It’s your birthday, silly.
EPM executive editor Mark Plaster sat down with emergency medicine
opinion leaders and informaticists for a candid discussion about the
future of electronic medical records (EMR) featuring Rick Bukata, MD;
Bruce Janiak, MD & Nicholas Genes, MD, PhD
Have you ever arrived at the hospital for your shift with the sinking
feeling that the odds were stacked against you? Sometimes it’s a quick
look at the ambulances lined up waiting to drop off patients. If I walk
by the waiting room I can sometimes get the feeling of whether people
are waiting patiently or whether there is a sense of anger and
Year after year, the suit rate against Medical Justice members has been
well below the national average. The average doctor is sued at a rate of
8-10% per year. Medical Justice members are sued at a rate of under 2%
per year. And Medical Justice is top-heavy with high risk specialists
from high risk states. How do they do this?
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