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Dr. Vipul Kella

Emergency Medicine Physicians At the Center of Achieving the Triple Aim

It is amazing to me how far emergency medicine has come as a specialty. Until the 1970s, emergency rooms were staffed by low-level resident interns who moonlighted for extra money or physicians who couldn’t find work elsewhere. After finally getting recognized as a specialty, the specialty still spent a few decades finding its way: developing […]

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The Most Difficult Emergency Procedure

When I graduated residency and started my first job, I walked around the ED confidently, chest slightly pumped up at all times. I knew I was well-trained. If there was a sick patient, I was going to resuscitate them. If there was an impossible central line that was needed – I was going to get […]

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Thoughts on Choosing Wisely and Overuse

About five months ago nine physician specialty groups got together and decided to examine specific tests and procedures that are commonly used but not necessary in their respective fields.  They named their organization “Choosing Wisely”, and compiled a list of over 45 specific recommendations on practices that should be curtailed.  Examples included “lumbar series in […]

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The Decline and Fall of Triage in the ER

The national trend toward overcrowding in emergency rooms is having an interesting effect on a process that was conceived to handle a large number of injured patients: triage. One might expect that as more and more patients flow into the ER, the process of triage would become even more central to the smooth flow and […]

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Leadership in the ED: Being a Floor General for Your Team

In sports, the most successful athletes are not necessarily those that have had the best individual statistics, but are those that have managed to make their teammates better around them: Magic Johnson, Isaiah Thomas, or to use a hot new name – Jeremy Lin.  These athletes epitomize selfless leadership on the court. While their own […]

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