Tag: er

The Decline and Fall of Triage in the ER

April 13th, 2012
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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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Posted in Quality Efficiency Utilization

Medicaid Rule for Emergency Departments Used a Hammer to Tighten a Screw

April 4th, 2012
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There are a thousand places to look for cost savings in healthcare, but this week in Washington State officials grappled with one of the most visible of those: emergency care. Thankfully, Washington Governor Christine Gregoire has suspended implementation of a rule that would have denied emergency rooms payment from Medicaid if the patient was diagnosed […]

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Posted in Future of Healthcare

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

March 20th, 2012
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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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Posted in Life in the ER

We Want Our Healthcare Like We Want our Fast Food

February 24th, 2012
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With due respect to those patient souls among us, America is, in general, an impatient nation. That includes how we think about our healthcare. This is why I read with some interest, and some amusement, stories like “A real ‘doc fix,’” published this week in the New York Times. Basically it says we need to […]

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Posted in Quality Efficiency Utilization

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

January 24th, 2012
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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 […]

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Posted in Life in the ER, Quality Efficiency Utilization

Doctors are Ready to Cut Costs – But Are Patients?

November 28th, 2011
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USA Today this week published another story on the continuing theme of innovative health systems and physician leaders who are finding big cost savings while providing better patient care. I know most if not all physicians are interested in providing more cost-effective care, but a recent encounter in the ER led me to wonder whether […]

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Posted in Future of Healthcare, Life in the ER

Does Emergency Medicine Really Matter?

November 15th, 2011
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I’m always curious when people ask what I do and I say I work in an ER: what exactly do they imagine I do there? They may picture us treating sniffles, ankle sprains, and the uninsured. At least, that’s what some in media and politics would have them imagine. You want to know what I […]

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Posted in Future of Healthcare, Life in the ER

Child, Scalp, Laceration, Vacation – When the Patient is Your Son

August 17th, 2011
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If there were four words I was hoping to combine on our family vacation this past week, it is safe to assume they would not be the four listed above. My 19 month-old son, Chance (aptly named), decided to take a header off a kitchen chair and struck the back of his head while we […]

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Posted in Life in the ER

Emergency Medicine – Whom Do We Serve?

March 30th, 2011
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I give a talk to new employees regarding service in emergency medicine. One of the questions I pose is whom do we serve when we practice emergency medicine? Seems like a simple question. We serve patients that come to the ER desiring care. At the most basic level that is indeed what we do. Like […]

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Posted in Leadership, Life in the ER

Body Language and Caring for Our Patients

September 7th, 2010
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The next patient was a 25 year old female in room 2. The nurse’s note read, “severe abdominal pain – rates it a 10 out of 10.” Like any good emergency medicine physician, I was already considering the differential diagnosis prior to entering the room. Severe pain in a young female could be an ectopic, […]

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Posted in Life in the ER, Patient Satisfaction