How do we know what to believe about anything? In times past we read books, we took classes, we spoke to experts. These days? These days we do the same, but we also search the Internet. And we seem to do it with special fervor when it comes to questions about our health. I can’t throw any stones here. Even a physician has knowledge that is limited to his or her ...

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I have never been the director of any professional group. I have, however, been directed. As such, I have a few tips for those who are directors and administrators. I give you my physician satisfaction system. It is arranged in no particular order. In every physician break room or lounge, there should be a wall for photos of girlfriends, boyfriends, children, spouses, parents, dogs, cats, horses, boats, new shotguns or whatever ...

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It’s a well-known reality of health care economics that Americans spend a lot of money in the last year of life. I suppose that almost goes without saying, since serious illnesses and injuries that result in death are costly, at whatever age they occur. Being hit by a car and dying means you were hit by a car … in your last year of life. And that two weeks in ...

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"Gunshot wound to chest, pulseless, 20 minute ETA." When that's the EMS report, it gets your attention.  Despite the wonderful theatrics of modern medical shows, and the best efforts of real-world, sweat-drenched paramedics, those of us who have done this long enough can translate that report.  For the layperson it means:  "Dead." I saw that last week. And the week before I saw another tragic, unexpected death in a man not much ...

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The following excerpts will give you an idea of what life can be like while practicing emergency medicine in very beautiful, very coveted areas of the United States. I will not name towns or hospitals, as the situations are highly reproducible from place to place and season to season. We’ll just call it St. Resort hospital. If you doubt me, call up your friends who work in such locales, with ...

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I was working at a small hospital when I heard the nurses talking about a new rule. The rule was that the only people who could wear lab coats would be physicians and administrators. It made me laugh a little. I’ve hated lab coats since medical school. I currently sport what a family medicine resident told me was the ER mullet: khakis and polo shirt. (Who knew?) I find it much ...

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My family was driving to see our new niece this past Saturday. While passing through a town on the way, we came upon a motorcycle accident.  The rider had been hit by a vehicle and was lying on the pavement with a growing crowd of people who wanted to help.  I’ve done it before.  I did CPR at the scene of a wreck when I was in medical school, and ...

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When we take our sick or injured loved ones to the hospital, we often hope that they will be admitted. In many instances, this is a very reasonable request. When heart or lung disease are at work, when severe infections, dehydration, fractures or strokes occur, admission may well be the only option. However, sometimes our desire to admit our family members is a throwback to a simpler time in medicine; ...

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shutterstock_85514146 So, there I was yesterday, working frantically to keep myself above the water level of the rapidly rising swamp of patients.  Navigating, haltingly, the onerous and demonic EMR.  So I thought I ordered three nebulizers, but it was only one.  The respiratory tech approached me and informed me that she would put them in, but only this time. That I’d have to ...

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shutterstock_224970232 I have worked in a lot of hospitals over the past two years. Quite a few of the facilities have been critical access hospitals, which is to say that they are very small, typically having fewer than 25 inpatient beds, and are usually somewhere in the boonies. A number of characteristics allow a hospital to qualify as critical access and receive additional ...

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