In June 2014, the first patient with Ebola arrived at Liberia’s county hospital, Redemption. As tensions grew around the city of Monrovia, administrators at JFK Hospital began to devise plans for handling patients with suspected Ebola. Officials from the CDC then came and gave us lectures. They discussed prevention of spreading and what our plans would be in the event of a potential outbreak. Before that moment, there were no ...

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Preface: I love to write about many things. People, pets, children, family, nature. But over and over I come back to a theme: my colleagues in our specialty and the forces arrayed against us. I’m not trying to be the toxic voice, the endless complainer. But if people like me don’t beat the drum, then nothing will ever change for the better. In this column I will continue to explore issues ...

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“They need you in room 13,″ she said when I answered the phone and I ran back to the ICU.  The patient was coding and for each minute that felt like an hour, we tried, and failed, to save her.  She wasn’t breathing, her heart wasn’t working, and despite the 30 people gathered in the room, in the end, she died. Running a code, as we call it, means that someone is ...

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Patients are being stuck with huge and unexpected medical care bills in circumstances where they have no say in selecting the physician who is billing them, and no way for them to know in advance which services the physicians would render or what it would cost them, says the New York Times. Mr. Peter Drier received a “surprise $117,000 medical bill from a doctor he didn’t know” for services relating to ...

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How did a Dallas hospital miss Ebola? Maybe we shouldnt be surprised. The first “wild” Ebola case in the United States has occurred in Dallas, Texas. The patient, who is from Liberia and had contact with a pregnant Ebola victim in his native country, was initially sent away from the emergency department (ED) of a Dallas hospital after reporting there with viral symptoms. He told the triage nurse that he had just arrived ...

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Ebola in Texas: A fascinating story of system errors Ebola is in the United States!  Everybody (please don't) panic!  Quarantine all Texans!  Though that might be a good idea anyway (just kidding).  More on Ebola in general in another post if I have time. First off though, we've found out more information about the sequence of events leading to the hospitalization of the patient, Thomas Duncan.  Apparently, he came ...

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An ER missed Ebola.  Heres how it could happen to you. How did the emergency department staff of a Texas hospital see, and discharge, a patient infected with Ebola? Despite the fact that blame spreads through hospitals faster than hemorrhagic fever viruses, I’m not interested in pinning down a single person, or a single thing, which may have allowed that to happen. I am very interested, however, in offering a few insights ...

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Ebola in the ER: What you should and shouldnt worry about As an ER doctor, right now I'm thinking a lot about Ebola -- it's in the news, in my inbox, and in questions from my patients.  Whether it's an outbreak, a flu epidemic, or a bombing -- we in the ER see them first, and so I'm always thinking about how we'll be ready. So, what concerns me, and what doesn’t? Ebola patients in the ...

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The ER demonstrates the inverted priorities of American society We fling open the doors of America’s emergency departments to help those who can’t afford health care.  We have legislated this protection: No person can be turned away for financial reasons.  This is very compassionate, and represents the higher angels of our culture.  Alas, it also is emblematic of the stupider demons of government.  You see, the ER demonstrates the inverted priorities ...

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About a year ago, I shared details of my own out of pocket medical expenses and concluded that we have to have to be more transparent with our patients (and potential patients) about the costs they will face for our services. The urgency of price transparency as a business imperative and a professional responsibility has only increased since then. Consider that we are now a year in to the implementation of the ...

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