Tag: emergency-department

Sometimes the Best Emergency Medicine is No Medicine at All

February 3rd, 2012
by:

I was recently reminded by a patient experience that the best medicine sometimes is no medicine at all. I cared for a young woman who had been seen the last few nights complaining of shortness of breath. When it was obvious that she had normal breath sounds, no wheezing and normal oxygen level I started […]

read article

Posted in Quality Efficiency Utilization

Leading from the Front in a New Emergency Department

January 31st, 2012
by:

I recently spent a week working clinically at our new hospital partner, Bristol Hospital, in Connecticut. I worked along many other experienced, seasoned physicians and leaders. In fact, nearly all of our group’s top leadership and senior partners have worked clinical shifts in the Emergency Department there in recent weeks. And “leading from the front,” so to […]

read article

Posted in Leadership

After 20 Years in Emergency Medicine, The Worries and Tools I Take to a New ER

January 24th, 2012
by:

When I completed my training nearly 20 years ago, I always wondered what type of emergency department I would work in. Two decades later I can say I’ve worked in a lot of different emergency departments, seven of them to be specific. They range from bustling suburban hospitals to small rural facilities to busy trauma […]

read article

Posted in Life in the ER, Quality Efficiency Utilization

Death at UMass Memorial: Is the Problem “Alarm Fatigue,” or Something Bigger?

September 27th, 2011
by:

Last week, the Boston Globe reported on the second death in four years at UMass Memorial Medical Center related to “alarm fatigue.” Anyone who works in a hospital, particularly an area like an emergency department where critical patients are seen, can understand how a tragedy like this happens. Monitor alarms go off all the time. The […]

read article

Posted in Quality Efficiency Utilization

Emergency Medicine – Where Do We Go From Here?

May 30th, 2011
by:

We cost too much. We take care of URIs and ankle sprains. We don’t coordinate care well. We use too many resources. We’ve all heard it in the media, even our President taking passing shots at the usefulness and cost effectiveness of emergency care. Of course the reality is federal law requires us to see […]

read article

Posted in Future of Healthcare, Quality Efficiency Utilization

It’s the Simple Things that Make All the Difference

November 2nd, 2010
by:

Humility is one of the great virtues of an ER doc. As many of us know we work in a fishbowl and there is no shortage of armchair quarterbacks ready to point out all we did wrong in caring for a patient. That never bothered me very much as I take comfort in the fact […]

read article

Posted in Life in the ER

The Time to Act is Now

October 15th, 2010
by:

On Wednesday, I spent my morning at the Health Services Cost Review Commission (HSCRC) in Baltimore listening and testifying to the proposed changes that will be occurring over the next several years to the health care delivery system in Maryland. It was the first in a series of ‘public comment’ sessions designed to help guide […]

read article

Posted in Future of Healthcare

Prescription Monitoring Programs Changes Opioid Prescribing Behavior – AKA Sometimes a Little Big Brother is a Good Thing

October 6th, 2010
by:

A recent article in Annals of Emergency Medicine involves the change in prescribing patterns when a prescription monitoring program is put in place. After reviewing past prescriptions, emergency physicians changed opioid prescribing plans for 41% of patients. Many states have instituted prescription monitoring programs to limit potential fraud and abuse of controlled substances. In 2006, Ohio instituted a […]

read article

Posted in Quality Efficiency Utilization

The Perils of Preventive Medicine

September 24th, 2010
by:

I recently came across a great post by Amy Tuteur on the perils of preventive medicine. I found Dr. Tuteur’s comments insightful and illustrative of many things we do in medicine. We think there is always hope in doing the right thing: eating right, exercising, not smoking and limiting our alcohol intake. All prudent suggestions, which I […]

read article

Posted in Life in the ER