Dear health IT staff, I know that, on many levels, physicians must be the absolute banes of your existence.  We are grumpy and resistant to change. And some of us are still confused by graphing calculators, much less complex modern computer systems.  We call you because we forgot our passwords, then because we forgot the new passwords.  We call because the system crashes, and we call because the voice recognition doesn’t ...

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shutterstock_223911598 I have issues with the customer satisfaction paradigm, but it’s not generally hard to make patients happy. Sometimes, though, it can be nearly impossible. It all depends on our own inner life as physicians and human beings. The key to medicine, to being a beloved physician, is to love our patients. This can be a tall order. Human beings are remarkably difficult ...

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I tried to order an echocardiogram yesterday at work.  But it turns out, they only do them on Monday, Wednesday and Friday.  Fair enough.  It’s not an unknown phenomenon.  Some places, surgeons are only available on Tuesdays and Thursdays, cardiologists on the second Wednesday of months with an R. After hours, most hospitals now struggle to have ultrasound at all, unless, of course, one has a first-born child to offer up.  ...

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Tonight I will sleep in bed, all night, with my wife. The hours will pass in pleasant dreams, wrapped in a blanket, warm beside my darling. We are on vacation, and our teenage children will be sleeping in their beds as well; after they have watched enough bizarre videos on YouTube and eaten all the chips in the house. But as I sleep, many of you, my dear colleagues, will be ...

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shutterstock_73550245 I appreciate the need for physicians and others to sleep.  I’ve spent a great deal of my career awake in the wee hours.  In some very real ways, emergency medicine as a specialty exists as a shield between patients and their sleeping (or otherwise engaged) physicians.  But I fear we’re all wearing a little thin.  Because the emergency room has become ...

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shutterstock_229011745People ran to the church for refuge in Medieval times. It was considered a place of safety, a sanctuary from civil punishment. In the church, one could claim a right to justice, food, water and shelter. That role was recognized by church and government authorities alike; doubtless sometimes grudgingly as the wanted escaped harsh punishments. These days, America's emergency rooms have filled ...

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shutterstock_156020384 How often do we have this interaction: "My wife was here yesterday for belly pain.  That doctor didn’t do nothing! Told me she just needed to get over it. I am not happy and something needs to be done about this!" (Frequently spoken by spouse.) Records are reviewed.  Treatment:  Included numerous doses of morphine and phenergan, as well as fluids and Zofran.  Frequent warm blankets were ...

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shutterstock_138915506 When I was in college and decided I wanted to go to medical school, I kept a picture of a medical transport helicopter on my desk. It represented the excitement I wanted to experience one day. When I was in medical school, I loved nothing better than watching in the chaos of the trauma bay, helping as the blood spurted to ...

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shutterstock_210984577 Emergency medicine, like every specialty, is its own religion. And on many levels, it tracks right along with the progression of religions from their ancient origins to their modern incarnations. Our unique profession grew out of a pressing need for physicians who could provide immediate and life-saving care to the sick and injured, at all hours of the day or night. The ...

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shutterstock_137204036 Medicine is not about money, except when it is. When I was in my residency training, pharmaceutical reps still roamed the land. Vast herds of gorgeous young women in tight skirts and stilettos traveled through doctor's offices, clinics, hospitals and residencies all over creation. Their appearance was always a thing of joy, especially for sleepy, hungry physicians-in-training. Someone would run to the ...

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