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Dr. David Klein

Dying With Dignity: Instituting a Moment of Silence in the ER

A little over a year ago, my father died in his sleep. He ate dinner in his assistant living facility one night, told his fellow residents he was tired and went to sleep. The next morning, he was found lifeless in his bed. He must have passed away in his sleep, most likely peacefully and […]

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Checking Your Cognitive Biases in the ER

Emergency clinicians are faced with a challenging task. During a busy shift, there can be significant pressure to evaluate and treat patients quickly, without giving each case the care it warrants. Thus, physicians often categorize patients early into a specific diagnostic pathway. At some point, however, with each evaluation, we must pause to assess the […]

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The National Clinical Governance Board: Our Answer to a National Problem

Emergency physicians know well the realities of evidence-based guidelines in emergency departments throughout the country: either there is wide variability in their use and uptake, or there just aren’t any evidence-based guidelines. Patients don’t often think about it when choosing emergency departments – they mostly think about the wait time – but it’s there. Two […]

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Two Types of Thinking Physicians Use in the Emergency Department

There is a natural tension to decision-making in the emergency department. In a busy ED with multiple patients to assess and keep track of, it can be difficult to dissect every patient’s complaints and make clinical decisions both quickly and effectively. Emergencies, by definition, must be dealt with fast. For this, whether they are fully […]

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Four Lessons for Hospitals from a Trip to Disney World

Recently, I returned from a trip to Disney with my family. It was my third time at the parks, but this trip was different. My wife and I were thrilled to have brought our three children, son in law, and, most importantly, our two grandchildren. Seeing my three and a half year old grandson, Erez, […]

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The New World of Patient Satisfaction: Even Ice Chips Matter

“My wife died uncomfortable and alone. She died thirsty!” The man who spoke those words came in to the Emergency Room recently where I was working a shift. He was accompanied by his wife, a 70-year-old with high sugar, weakness, and nausea. The team worked to get her seen under the presumption that her diabetes […]

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Preparing for the Unknown: A Lesson in Palliative Care

During a recent lunch with my daughter, a senior at the University of Maryland, she shared her frustration with a question she often receives: “So, what are your plans for next year?” She commented that while her life experiences through present day have been memorable, each stage has been predictable. Now, for the first time, […]

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