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Emergency Medicine

This page shows you the most recent publications within this specialty of the MedWorm directory.

Research and Reviews in the Fastlane 050
This study compared bedside US by EPs vs radiology US vs CT as the INITIAL test in patients expected with nephrolithiasis. It found there was no difference in serious outcomes between the groups, but the rate of serious outcomes was overall very low. Obviously patients that got only an US had lower radiation exposure and lengths of stay. But what is interesting is that 40% of patients with an initial ED US went on to get a CT also. This study does not state that patients should ONLY undergo US, just that it should be the INITIAL test. If it cuts down on our CT ordering, it sounds like a good start. (Zack Repanshek) Recomme...
Source: Life in the Fast Lane - September 29, 2014 Category: Emergency Medicine Authors: Jeremy Fried Tags: Cardiology Clinical Research Emergency Medicine Infectious Disease R&R in the FASTLANE Radiology Resuscitation critical care Education Intensive Care literature recommendations Research and Review Source Type: blogs

Inside EMS Podcast: Pediatric Resuscitation
On this week’s episode of Inside EMS, co-host Chris Cebollero and I discuss the latest EMS news and events, and welcome Dr. Peter Antevy to the Guest Table. Peter is a pediatric emergency physician, and the developer of the Handtevy Pediatric Box resuscitation system. Dr. Antevy debunks the common fallacies of pediatric resuscitation, namely that ... (Source: A Day In the Life of An Ambulance Driver)
Source: A Day In the Life of An Ambulance Driver - September 28, 2014 Category: Emergency Medicine Authors: ambulancedriverfiles Tags: Inside EMS Pediatrics Podcasting Source Type: blogs

Emergency room doctors can safely use bedside ultrasound
I have been following the progress of bedside ultrasound (using ultrasound as a diagnostic tool during my physical exam of patients) as it gets a foothold in standard medical practice since I first started learning to do it about 3 years ago. Every so often a study comes out which warms my heart as it proves that less (radiation, expense) is more in treating patients. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - September 27, 2014 Category: Journals (General) Authors: Tags: Physician Emergency Radiology Source Type: blogs

Ask Me Anything with CDC Director Tom Frieden
Thomas Frieden, MD The Ebola outbreak in West Africa is an international public health emergency. As the world responds, there is a risk that American responders working on the ground may be exposed to the virus or become ill. This summer, two American health care workers infected with Ebola while working in West Africa were successfully […] (Source: The Health Care Blog)
Source: The Health Care Blog - September 26, 2014 Category: Consumer Health News Tags: Physicians THCB Ebola Environmental infection Infection control procedure Norovirus Water Source Type: blogs

Best of Medical Blogs - monthly review
The “Best of Medical Blogs - monthly review” is a monthly summary of the best posts from medical blogs. Please email your suggestions for inclusion to clinicalcases AT gmail DOT com. Best of Medical Blogs (BMB) is meant to continue the tradition of the Grand Rounds carnival (discontinued in 2008).The Last Reprogramming No one writes quite like @doctorwes - it's a must read... http://buff.ly/1qzv6I95 lessons learned by a successful physician bloggerFamily comes first - the online community is virtual - it is not real. The cost of free is immense. Learn to say NO. Multi-tasking is a myth. Value your time – no...
Source: Clinical Cases and Images - Blog - September 26, 2014 Category: Universities & Medical Training Tags: Best of Medical Blogs Source Type: blogs

Engaging Patients: Interviews With Patients, Providers, And Communities Across The Country
As the Affordable Care Act (ACA) reaches deeper into the daily lives of Americans, one impact is sure to hit home. The ACA encourages patients and providers to become more active partners in making the crucial strategic decisions over improving individual health. Three new videos, produced in partnership with Health Affairs and the Patient Centered Outcomes Research Institute (PCORI), show how people all over the United States are learning that involving patients – teaching them, soliciting their input, and communicating with family-members and other caregivers right from the start – can result in better, more efficien...
Source: Health Affairs Blog - September 25, 2014 Category: Health Management Authors: John Dimsdale Tags: All Categories Personal Experience Primary Care Quality Source Type: blogs

IOM Report Calls For Transformation Of Care For The Seriously Ill
The new Institute of Medicine (IOM) report on care near the end of life in the United States was released last week. I had the privilege of serving on the Committee for the last two years, involved both in the writing of the report itself and in coming to consensus on its recommendations. The name of the report and the charge to the Committee from the IOM was focused on “end of life.” However, the title, “Dying in America,” is something of a misnomer. The report itself focuses extensively on people with serious and chronic illness with indeterminate prognoses, why the current health care system fail...
Source: Health Affairs Blog - September 24, 2014 Category: Health Management Authors: Diane Meier Tags: All Categories Chronic Care End-of-Life Care Health Care Costs Health Care Delivery Nonmedical Determinants Palliative Care Payment Policy Spending Workforce Source Type: blogs

Healthcare social media #HCSM - top articles
Here are my suggestions for some of the top articles related to healthcare social media (#HCSM) in the past 2-4 weeks:5 lessons learned by a successful physician blogger: Family comes first - the online community is virtual - it is not real. The cost of free is immense. Learn to say NO. Multi-tasking is a myth. Value your time – not in monetary terms – but in terms of self-preservation. Learn who to trust. Accept assistance - You are not a one man show http://buff.ly/1pGpEsDWikipedia contains errors in 9 out of 10 of its health entries - Wikipedia is the main source for many med students. Scientists compared disease in...
Source: Clinical Cases and Images - Blog - September 24, 2014 Category: Universities & Medical Training Tags: #HCSM Source Type: blogs

Pull Your Own Oxygen Down First
Disruptive Women UK will be launching Tuesday, September 30th in the House of Commons. This post is a part of a series running up to the launch welcoming Disruptive Women UK. Almost everyone reading this will have heard the instruction given before taking off on any air flight, “in case of emergency pull your own oxygen mask down first before helping others.” Over recent months I have repeated this phrase often – not, I hasten to add because I am now moonlighting as an Airline stewardess – no, because it is a phrase I give to doctors when talking to them about how to stay mentally and physically healthy in these tr...
Source: Disruptive Women in Health Care - September 24, 2014 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: DW UK Source Type: blogs

Global Health Update: High Bed Occupancy Rates And Increased Mortality In Denmark
High levels of bed occupancy are associated with increased inpatient and thirty-day hospital mortality in Denmark, according to research published in the July issue of Health Affairs. Authors Flemming Madsen, Steen Ladelund, and Allan Linneberg received considerable media attention in Denmark for their research findings. For one major Television channel, it topped Germany’s victory in the World Cup finals. In another story from the Danish newspaper, Information, Councillor Ulla Astman, Chairman of the North Denmark Regional Council and second highest ranking politician, who runs all of the Danish public hospitals, report...
Source: Health Affairs Blog - September 24, 2014 Category: Health Management Authors: Tracy Gnadinger Tags: All Categories Global Health Hospitals Research Source Type: blogs

“I want to give up my son”: Is that child abuse?
The case A thirty-five-year-old female presents to the emergency department on a weekend afternoon with the following chief complaint: “I want to give up custody of my son.” The patient is well dressed — and so is her four-year-old son, who is sitting comfortably on the bed playing a video game on his mother’s cell phone. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - September 24, 2014 Category: Journals (General) Authors: Tags: Physician Emergency Source Type: blogs

Emergency surgery policy briefing
Royal College of Surgeons (RCS) - This briefing sets out the main challenges facing emergency surgery, and the high-level actions the Government and other policy-makers can take to support patients who require emergency surgical care. It highlights concerns about variations in mortality rates following emergency surgery and argues for clearer protocols and standards on how patients undergoing emergency surgery should be treated and for the NHS to measure outcomes for patients much more rigorously by publishing audits. Briefing Press release (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - September 23, 2014 Category: UK Health Authors: The King's Fund Information & Knowledge Service Tags: NHS measurement and performance Patient safety Quality of care and clinical outcomes Source Type: blogs

Research and Reviews in the Fastlane 049
This study found that women with higher BMI (> 25) were at an increased risk for medication failure (OR 3.60). The authors recommend that women with higher BMIs should be offered copper IUDs (not realistic in most EDs). Alternatively, some agents are more effective and may be viable options. Recommended by: Anand Swaminathan The R&R iconoclastic sneak peek icon key The list of contributors The R&R ARCHIVE R&R Hall of famer You simply MUST READ this! R&R Hot stuff! Everyone’s going to be talking about this R&R Landmark paper A paper that made a difference R&R Game Changer...
Source: Life in the Fast Lane - September 22, 2014 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Alternative Medicine Cardiology Education Emergency Medicine Infectious Disease Obstetrics / Gynecology Pre-hospital / Retrieval Resuscitation critical care Intensive Care literature R&R in the FASTLANE recommendations Research a Source Type: blogs

Healthcare Update Satellite — 09-22-2014
More updated from around the web at my other blog at DrWhiteCoat.com Study in the journal Pediatrics shows that about 10,000 children are hospitalized each year for accidental medication ingestions. Three quarters of those hospitalizations involved 1 or 2 year olds. Twelve medications were responsible for 45% of all pediatric emergency hospitalizations for accidental drug ingestions. Opioids were not surprisingly the top classification prompting hospitalizations, but buprenorphine and clonidine were the top two medications – responsible for 15% of all hospitalizations. The rate of hospitalization for buprenorphine pr...
Source: WhiteCoat's Call Room - September 22, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs

The pressure to admit patients from the ER will only grow
Once again government regulators have put in place well-meaning rules without anticipating the consequences. We all hate sitting around in the emergency department waiting to be seen and to be treated. On October 15, 2014 as part of the new Affordable Health Care Act and the patient satisfaction portion, hospital ERs will have about 180 minutes from the time you arrive and sign in to evaluate you , treat you and make a disposition or decision. The game starts on October 15th but already hospital administrators have their systems operating to prepare to comply. If you fail to comply the hospital will be punished financially...
Source: Kevin, M.D. - Medical Weblog - September 21, 2014 Category: Journals (General) Authors: Tags: Physician Emergency Primary care Source Type: blogs

FACEMs at Night: A Mattress Stuffed with Flaw
This is the second of two perspectives on whether FACEMs should work night night shifts, for the first, see Anand Swaminathan’s ‘FACEMs at Night: An American Perspective‘. Let us take ourselves one fact. One, simple, undeniable fact. One cannot, after all, dispute a fact. A fact, according to most reputable definers of words (and a few, which are my more preferred sources, disreputable ones) is a truth. A thing that is universally known to be true. Merriam-Webster (American, I know, but in light of it’s lexicographically poetic etymology, we must forgive its murderous spelling) defines it as ‘a true ...
Source: Life in the Fast Lane - September 21, 2014 Category: Emergency Medicine Authors: Michelle Johnston Tags: Australia Emergency Medicine consultant emergency physician FACEM night-shift Source Type: blogs

FACEMs at Night: An American Perspective
This is the first of two perspectives on whether FACEMs should work night night shifts, for the second, see Michelle Johnston’s ‘FACEMs at Night: A Mattress Stuffed with Flaw‘. My father, an active general surgeon who has been in practice for almost five decades often recounts stories of “the good ‘ole days” when it was interns and junior residents who cared for patients most of the day. Supervising physicians were uncommonly found in patient care areas (except the operating room). Residents made critical decisions, often without the necessary training, and they and their patients lived (or died) wi...
Source: Life in the Fast Lane - September 21, 2014 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Australia Emergency Medicine anand swaminathan consultant emergency physician FACEM night-shift Source Type: blogs

Cost-benefit analysis: A case where conservative management wins
We speak of everyday decisions in terms of cost-benefit analyses. Many of our patients can’t afford a healthy meal, let alone a hefty hospital bill, thus making cost awareness increasingly relevant. But on the day that I met Mr. R., it wasn’t the financial aspects of his care that concerned me. I was thinking about the patient, his family, and two roads diverged in a hospital ward. I was thinking of the road less traveled, and the greener pasture oft overlooked. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M...
Source: Kevin, M.D. - Medical Weblog - September 20, 2014 Category: Journals (General) Authors: Tags: Physician Emergency Palliative care Source Type: blogs

MKSAP: 72-year-old unconscious woman in the ER
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 72-year-old woman is evaluated in the emergency department for loss of consciousness. Her son, who brought her in, says she seemed confused and agitated when he spoke to her on the telephone less than 2 hours ago. The patient has an 8-year history of type 2 diabetes mellitus. She had strict glycemic control (average hemoglobin HbA1c level, 6.2%) until last month when she had an infected ulcer between the third and fourth toes of the right foot that resulted in amputation of the middle toe 1 week ago. According...
Source: Kevin, M.D. - Medical Weblog - September 20, 2014 Category: Journals (General) Authors: Tags: Conditions Diabetes Emergency Endocrinology Source Type: blogs

Different Parts Of The Same Elephant: Medicaid Research And State Expansion Decisions
Debates about Medicaid expansion betray an underlying fundamental disagreement not only about the Affordable Care Act (ACA) but about the Medicaid program itself. Medicaid, unlike Medicare, lacks the near-universal buy-in to the fundamental value of the program to beneficiaries’ health and well-being. As a means-tested (read welfare-related) program, Medicaid raises concerns and disagreements regarding work (dis)incentives, labor market effects, the “deserving” poor, and how this relates to the construct of health care as a right and a public good. The Medicaid program serves as a centerpiece of the ACA and of the na...
Source: Health Affairs Blog - September 19, 2014 Category: Health Management Authors: Donna Friedsam Tags: All Categories Medicaid Policy States Source Type: blogs

Pacemaker Panic #2
ECG Exigency 016 A 68-year old woman presents by ambulance to the Emergency Department. Per the ambulance crew, she was brought from home after experiencing 7 out of 10 chest discomfort and weakness. She has a history of hypertension that is well controlled with furosemide, and has a pacemaker because her “heart used to go funny.” The ambulance crew are basic life support only, so the patient has received 324mg of aspirin, and oxygen by nasal cannula. Upon arrival she is seated upright on the stretcher breathing rapidly, with the following vitals: heart rate 107, blood pressure 180/110, respirations 20 and slightly lab...
Source: Life in the Fast Lane - September 19, 2014 Category: Emergency Medicine Authors: Mat Goebel Tags: Cardiology Clinical Case ECG Education Emergency Medicine EKG failure hyperkalaemia hyperkalemia pacemaker pacer pacing ppm Source Type: blogs

Prolonged (63 minutes) Ventricular Fibrillation, Followed by Unusual Cardiogenic Shock
In this study, 5% of VF arrest was due to PE: V fib is initial rhythm in PE in 3 of 60 cases.  On the other hand, if the presenting rhythm is PEA, then pulmonary embolism is likely.  When there is VF in PE, it is not the initial rhythm, but occurs after prolonged PEA renders the myocardium ischemic.--Another study by Courtney and Kline found that, of cases of arrest that had autopsy and found that a presenting rhythm of VF/VT had an odds ratio of 0.02 for massive pulmonary embolism as the etiology, vs 41.9 for PEA.         (Source: Dr. Smith's ECG Blog)
Source: Dr. Smith's ECG Blog - September 19, 2014 Category: Cardiology Authors: Steve Smith Source Type: blogs

Pediatric Asthma: An Opportunity In Payment Reform And Public Health
Editor’s note: The post is informed by a case study, the third in a series made possible through the Merkin Initiative on Physician Payment Reform and Clinical Leadership, a special project to develop clinician leadership in health care delivery and financing reform. The case study will be presented on Wednesday, September 24 using a “MEDTalk” format featuring live story-telling and knowledge-sharing from patients, providers, and policymakers.  The Clinical Challenge: A Chronic, but Manageable Illness Asthma affects 7 million children – more than 10 percent of kids in the U.S. – and is the most common chronic ch...
Source: Health Affairs Blog - September 18, 2014 Category: Health Management Authors: Kavita Patel, Steve Farmer, Meaghan George, Frank McStay, and Mark McClellan Tags: All Categories Children Chronic Care Health Care Costs Health Care Delivery Health Reform Medicaid Medicare Nonmedical Determinants Payment Policy Public Health Quality States Source Type: blogs

This is what population health looks like
It is a beautiful day here in my little college town. The sun is shining and at 11 a.m. it is about 78 degrees with a barely perceptible breeze. People are out walking on Main Street and riding their bikes. The mountain nearby calls: I can go for a hike today with my dog and still be within 20 minutes or so of the hospital to respond to calls. There are two patients on the hospitalist service in our fine critical access hospital, and one of them is going home later this morning. She is bright and cheerful, with progressive Alzheimer’s disease and chronic lung disease from a long gone habit of smoking 3 packs of ciga...
Source: Kevin, M.D. - Medical Weblog - September 18, 2014 Category: Journals (General) Authors: Tags: Policy Hospital Hospitalist Primary care Source Type: blogs

Value Extractors, "Super-Managers," Vampires and the Decline of the US and US Health Care
Appearing during the last few weeks were a series of articles that tied the decline of the US economy to huge systemic problems with leadership and governance of large organizations.  While the articles were not focused on health care, they included some health care relevant examples, and were clearly applicable to health care as part of the larger political, social, and economic system.  The articles reiterated concerns we have expressed, about leadership of health care by generic managers, perverse executive compensation, the financialization of health care, in part enabled by regulatory capture, and the abando...
Source: Health Care Renewal - September 18, 2014 Category: Health Management Tags: boards of directors executive compensation financialization generic managers Pfizer regulatory capture Renaissance Technologies Source Type: blogs

Another Example of Defensive Medicine
The ultrasound images above show a circular clot in the superficial femoral vein. The image on the left is without compression and the image on the right is with compression. Normally blood vessels flatten out when compressed. Since the vessel did not flatten with compression it confirmed the presence of a blood clot. While discussing a case with one of the nurses with whom I work, I saw how once again defensive medicine had affected my medical practice. I gave a few examples of defensive medicine in a post several years ago and I also mentioned how sometimes doctors have to prove a negative when dealing with patients. Bot...
Source: WhiteCoat's Call Room - September 18, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Defensive Medicine Patient Encounters Source Type: blogs

Sneak Peak: Failure to Cope: The Hidden Curriculum of Emergency Department Wait Times and the Implications for Clinical Training
Conclusions The authors suggest that the emphasis on wait times resulted in more importance being placed on “getting the patient out” of the ED than on providing safe, compassionate, person-centered medical care. Resource constraints were hidden within a discourse that shifted the problem of overcrowding in the ED to patients with complex chronic conditions. The term “failure to cope” became activated when overworked physicians tried to avoid assuming care for high-needs patients, masking institutionally produced stress and possibly altering the way patients are perceived. (Source: Academic Medicine Blog)
Source: Academic Medicine Blog - September 18, 2014 Category: Universities & Medical Training Authors: Journal Staff Tags: Issue Preview clinical training emergency medicine hidden curriculum wait times Source Type: blogs

Top stories in health and medicine, September 18, 2014
From MedPage Today: I, Intern: New Questions, New Mistakes. It feels surreal to Emily Lu, MD, when she discharges patients from the emergency department at San Francisco General Hospital and tells them to see her in a month. U.S. Ebola Response: Troops, Training, Supplies. Calling the Ebola epidemic in West Africa a “potential threat to global security,” President Barack Obama said the U.S. will send 3,000 military personnel to help combat the outbreak. New Inflammatory Diseases Seen. Two previously unrecognized autoinflammatory syndromes characterized by periodic fevers and other systemic symptoms have been ...
Source: Kevin, M.D. - Medical Weblog - September 18, 2014 Category: Journals (General) Authors: Tags: News Diabetes Endocrinology Infectious disease Source Type: blogs

Who should be receiving therapeutic hypothermia?
Thanks to the popularity of medical television shows, most people have witnessed hundreds of fictional cardiac arrests in their lifetime. In most of these scenes, the patient loses consciousness, and the medical team rushes to the bedside: “He’s in v-fib.” “Get me the paddles.” The team performs urgent chest compressions for a few seconds.  Then they place the metal paddles on the victim’s chest: “Clear!”  Kathump. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - September 17, 2014 Category: Journals (General) Authors: Tags: Conditions Emergency Neurology Source Type: blogs

The death certificate didn’t say enough
August 17, 2010. Maris is a 57-year-old woman in excellent health.  She has not seen a doctor in years. Divorced, she lives by herself, but spends occasional evenings with her daughter and son-in-law.  A successful businesswoman, Maris gardens, serves on the board of a community theater and plays a mean game of bridge. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - September 17, 2014 Category: Journals (General) Authors: Tags: Physician Cancer Emergency Source Type: blogs

Why is there an influx of physician job offers in my inbox?
If you’re a 3rd- or 4th-year resident, chances are you’re no stranger to unsolicited job offers showing up in your email inbox. Maybe it’s a few a week, or maybe it’s a few a day, but they are always there. The emails find you. I’ve been out of residency for years and I’m still getting them. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - September 17, 2014 Category: Journals (General) Authors: Tags: Physician Emergency Source Type: blogs

PhRMA and DOJ Go Back and Forth Over Off-Label Speech and the First Amendment
A whistleblower’s False Claims Act (FCA) suit in the Eastern District of California has caught the attention of the Pharmaceutical Research and Manufacturers of America (PhRMA) and subsequently the Department of Justice, both of whom have filed amicus curiae briefs in the federal court. PhRMA re-responded to DOJ just last week, underscoring the case's importance. See that response here: PhRMA-Brief-Solis-v-Millennium.  Whistleblower Complaint Frank Solis, a former sales rep at Schering-Plough (now part of Merck) and Millennium Pharmaceuticals, alleged that the two manufacturers illegally marketed ...
Source: Policy and Medicine - September 17, 2014 Category: American Health Authors: Thomas Sullivan Source Type: blogs

Observations from being “the family.”
It’s been a trying week for our family. You learn things when your people need healthcare. It’s an entirely different perspective. I am doctor; I’ve been a patient, but this was the first time being “the family.” Without going into details, (see her guest post), my wife Staci came to need the best that American healthcare has to offer. Let’s say it was a non-preference-sensitive decision to proceed with a major surgery. As I write this, things are stable and well here at home. Here are some observations of the experience: People in the business of delivering healthcare are good people. Early on in the course, b...
Source: Dr John M - September 16, 2014 Category: Cardiology Authors: Dr John Source Type: blogs

Research and Reviews in the Fastlane 048
This study looked at one institution’s discrepancy rate between EP and radiologist plain film reads over 10 years. They found overall an ~3% discrepancy rate on all plain films. This of course does not mean the radiologist was correct in every discrepancy. But it does show we agree most of the time. Most interestingly, the rate of discrepancies requiring emergent change in management was a mere 0.056%! Recommended by: Zack Repanshek Prehospital/Retrieval Braude D et al. Air Transport of Patients with Pneumothorax: Is Tube Thoracostomy Required Before Flight? Air Med J. 2014 Jul-Aug;33(4):152-6. PMID: 25049185 C...
Source: Life in the Fast Lane - September 15, 2014 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Anaesthetics Cardiology Education Emergency Medicine Pediatrics Pre-hospital / Retrieval Public Health Respiratory Resuscitation Toxicology and Toxinology critical care Intensive Care literature R&R in the FASTLANE recommendati Source Type: blogs

Why I Still Don’t Hate Being A Doctor
Judging from recent articles, surveys, and blog posts, the medical profession is remarkably demoralized. Typical complaints range from “feeling like a beaten dog” to “living in humiliating servitude,” to being forced to practice “treadmill medicine.” Interestingly, the public response to these complaints is largely indifferent. The prevailing attitude (if the “comments sections” of online articles and blog posts are representative) seems to be unsympathetic: “Poor doctors, making a little less income and not being treated like gods anymore? You have to do extra paperwor...
Source: Better Health - September 15, 2014 Category: American Health Authors: Dr. Val Jones Tags: Opinion Concierge Medicine Demoralization Direct Pay Doctors Dr. Jauhar Hate Medicine Job satisfaction Locum Tenens Patient Satisfaction Physicians Quit Medicine Work Environment Source Type: blogs

An Apple a Day: What the iPhone Can Teach Us About Health Care
What took Apple so long to get in to health care? Here’s my suggestion from 5 years ago: The day before my daughter Elise’s 15th birthday, the new iPhone went on sale.  My birthday was 4 days later.  So Elise figured out we should buy each other an iPhone to mark our big days.  She planned (and saved) for months.  She spent weeks talking to friends, researching apps on line, planning for such accessories as protective covers, and educating herself on how to maximize her minutes. When the big day came, we made our way to the Apple store and stood shoulder to shoulder with hundreds of others waiting on a ver...
Source: Disruptive Women in Health Care - September 15, 2014 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Uncategorized Source Type: blogs

Healthcare Update Satellite — 09-15-2014
This study should be required reading in every emergency medicine residency in this country. In fact, the concepts in the studies should be tested on the emergency medicine board exams. Now if the study only compared the type of a patient’s insurance with the likelihood of emergency department recidivism. How else can the media try to tarnish this guy’s reputation? The doctor who oversaw Joan Rivers’ fatal endoscopy was once *sued* 10 years ago. Gasp. The former patient’s attorneys are really trying to create their 15 minutes of fame. They alleged that 10 years ago the patient received no informed ...
Source: WhiteCoat's Call Room - September 15, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs

Gauntlet Status: Thrown
Stingray from Atomic Nerds, 3rd place winner (missing 2nd place by only three bucks) of the 2012 Kilted to Kick Cancer Fundraising Challenge, has graciously offered a case of his Emergency Medical Bock to our fundraising prize packages for 2014. I’ve tasted this stuff, folks. Nectar. Of. The. Gods. From his stouts, porters, reds, ambers ... (Source: A Day In the Life of An Ambulance Driver)
Source: A Day In the Life of An Ambulance Driver - September 14, 2014 Category: Emergency Medicine Authors: ambulancedriverfiles Tags: #DunkYourJunk Blogorado Charity Kilted to Kick Cancer Source Type: blogs

Ebola Update from CDC Director Thomas Frieden
Thomas Frieden, MD The Ebola outbreak in West Africa is an international public health emergency. As the world responds, there is a risk that American responders working on the ground may be exposed to the virus or become ill. This summer, two American health care workers infected with Ebola while working in West Africa were successfully […] (Source: The Health Care Blog)
Source: The Health Care Blog - September 14, 2014 Category: Consumer Health News Tags: THCB Ebola Environmental infection Infection control procedure Norovirus Water Source Type: blogs

What is a gomer? And why should you know about it?
Ever wonder what a “gomer” is? While certainly passé and unprofessional, does it shed light into the frustrations both doctors and patients have with end-of-life care? Emergency physician and author Brian Goldman explains the origins and use of such medical slang in his book, The Secret Language of Doctors. Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - September 12, 2014 Category: Journals (General) Authors: Tags: Video Hospital Palliative care Source Type: blogs

Same Care No Matter Where She Gives Birth: Addressing Variation In Obstetric Care Through Standardization
This study, along with other disturbing statistics, underscores the significant need for improvements in maternity care. Maternal Morbidity and Disparities Since 1990, the maternal mortality ratio in the U.S. has more than doubled. We now rank 64th in the world, with 28 maternal deaths per 100,000 live births. American women are also suffering severe maternal morbidities at higher rates: more than 60,000 women a year experience a life-threatening condition during childbirth. Potential explanations for these troubling trends include improved reporting mechanisms and escalating rates of chronic health conditions like obesity...
Source: Health Affairs Blog - September 12, 2014 Category: Health Management Authors: Priya Agrawal Tags: Access All Categories Disparities Hospitals Public Health Source Type: blogs

CDC Update for Health care workers: Ebola Environmental Infection Control Procedures
Thomas Frieden, MD The Ebola outbreak in West Africa is an international public health emergency. As the world responds, there is a risk that American responders working on the ground may be exposed to the virus or become ill. This summer, two American health care workers infected with Ebola while working in West Africa were successfully […] (Source: The Health Care Blog)
Source: The Health Care Blog - September 12, 2014 Category: Consumer Health News Tags: THCB Ebola Environmental infection Infection control procedure Norovirus Water Source Type: blogs

Mortality Rate Increases With Emergency Department Closures
This article begins to look at the substantial potential effects of ED closures on actual patient outcomes and adds important evidence that should spark debate among policy makers, inform decisions, and hopefully prompt further investigation. (Source: Health Affairs Blog)
Source: Health Affairs Blog - September 11, 2014 Category: Health Management Authors: Jason Shapiro and Lynne Richardson Tags: All Categories Emergency Medicine Hospitals Public Health States Source Type: blogs

Five Absurd Overreactions to the Surge in Child Migrants
Alex Nowrasteh The surge of unaccompanied migrant children (UAC) that dominated the news cycle in June and July of this year has receded – so much so that many emergency shelters established to handle the inflow are shutting down.  At the height of the surge, many commentators and government officials expected 90,000 UAC to be apprehended by the end of the fiscal year (FY).  As the end of the FY approaches, the number of apprehended UAC stands at roughly 66,000 - far below the estimates. Now that the surge has receded, here are some of the most absurd overreactions to it.  Never before...
Source: Cato-at-liberty - September 11, 2014 Category: American Health Authors: Alex Nowrasteh Source Type: blogs

Crowding in emergency departments
The College of Emergency Medicine -This guideline is to assist managers and clinicians who are trying to reduce crowding in their hospital emergency departments. The guideline explains the causes and consequences of crowding and offers suggestions to reduce the effects of crowding and improve the safety of an emergency department. Guidance The College of Emergency Medicine - press release (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - September 11, 2014 Category: UK Health Authors: The King's Fund Information & Knowledge Service Tags: Patient safety Quality of care and clinical outcomes Source Type: blogs

2014 PhRMA Research and Hope Awards Celebrate Groundbreaking Achievements in HIV/AIDS, While Recognizing the Continued Work Needed for a Cure
Last night, the Pharmaceutical Research and Manufacturers of America (PhRMA) honored individuals and organizations for their work in the field of HIV/AIDS at the 2014 PhRMA Research and Hope Awards.  The event served as both a celebration of groundbreaking achievements as well as a call to continue the hard work that is still required to put an end to HIV/AIDS. The evening featured a conversation with President George W. Bush and PhRMA president and CEO, John Castellani. During President Bush’s time in office he launched an initiative to combat AIDS in Africa called the President’s Emergency Plan for AIDS Relief ...
Source: Policy and Medicine - September 11, 2014 Category: American Health Authors: Thomas Sullivan Source Type: blogs

Birth Control Pills Should Be Available Over The Counter, But That’s No Substitute For Contraceptive Coverage
In recent weeks, some opponents of the Affordable Care Act’s (ACA) contraceptive coverage guarantee have promoted the idea that oral contraceptive pills should be available to adult women without a prescription. Sens. Kelly Ayotte (R-NH) and Mitch McConnell (R-KY), for example, recently introduced the so-called Preserving Religious Freedom and a Woman’s Access to Contraception Act, a bill that would urge the Food and Drug Administration (FDA) to study whether to make contraceptives over the counter (OTC) — though for adults only. Making birth control pills available over the counter, if done right, would meaningfully...
Source: Health Affairs Blog - September 10, 2014 Category: Health Management Authors: Adam Sonfield and Sneha Barot Tags: Access All Categories Coverage Health Care Costs Health Reform Insurance Pharma Policy Source Type: blogs