Among reams of coverage on the Ebola outbreak, Politico just published a characteristic story with the headline, “In the world of Ebola, no room for error.” The only problem is that is as soon as you introduce a human element to any system, there will be error. That’s the reality that health care leaders across the United States are grappling with now in a simultaneous effort both to tighten the health ...

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Ebola is frightening but not for the reason you may imagine. A little over a year ago Asiana Flight 214 crashed while landing at San Francisco International Airport resulting in 181 injuries and 3 deaths.  As an emergency medicine resident, this fast-forwarded my training as I took care of many of the patients arriving in our emergency department.  I left that day inspired that I had the education and training to ...

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Helicopter emergency services: A disparity between aviation and medical proficiency As the helicopter emergency services (HEMS) industry enters its fifth decade, there is an 800-pound gorilla in the room and nobody is talking.  The average EMT, fireman and emergency physician too often make the flawed assumption that when it comes to HEMS, the industry is a uniform, high quality, strictly regulated entity.  They assume that all HEMS programs use state of ...

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When treating neo Nazis, should physicians have a choice?What I found most disturbing about the man’s arm was not the deep, stellate laceration on the underside of his biceps. It was the swastika tattoo next to it. “Sir,” I said, “we’ll have you fixed up in no time. I’m going to numb up the wound, irrigate it, then repair the laceration with sutures and send you home on antibiotics and pain ...

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Go into any hospital today and notice that between every great nurse and patient sits a computer terminal. The quantified health movement has created the great digital divide, between the patient and everyone else. The nurse of old used to actually touch the patient. No more. Now, they wheel in a computer console, sit down and record the digital output of the wired up patient, every vital sign, every drug order or ...

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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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There is no excuse for physicians to take advantage of vulnerable patients 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 ...

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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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