Dear drunk driver, Tonight, I am tired. Tired from lack of sleep, tired from the long hours, and tired from bearing witness to your destruction. Tonight, you caused an accident while under the influence of alcohol. And you are badly injured, requiring emergency surgery. Your liver is hard, cirrhotic, and unforgiving. Although I can get you through this first surgery, I know you will not survive. I know over the next few days, ...

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Medicine is plagued by a form of prejudice called “specialism.” (Yes, I just made up that word, but it fits.) In medical school we were united; we were all in the same boat; we were a team making our way through the gauntlet together. And then it came time to choose a specialty. A satirical article by “Lord Lockwell” circulated on social media recently called, “Medical Specialties as Game ...

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For my entire life as a physician, from medical school, through residency and now until this 22nd year in practice, I have subscribed to the idea that I should have a chaperone when performing breast, pelvic or rectal exams on women. I was taught to do this from the beginning, and I still do it. Why is this? On some level, the woman being examined probably feels more at ease having ...

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shutterstock_70391227 The following article is satire. LAS VEGAS, Nevada -- As times have become harder for emergency departments around the country, one local hospital, Snooty Hospital and Casino (SHC), has come up with a solution to capture precious reimbursement from individuals with “enhanced diagnosis and treatment goals.” When checking into the ED either by ambulance or at the front desk, patients now have the ability ...

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shutterstock_76711840 A couple of weeks ago I was on-call and had to go down to the emergency room to see a patient. Before I entered the room, I was told that the patient was accompanied by her long-time physician who was a bit “crazy and old school." “Hmm … that’s strange … why would her physician be in the room with her?” I ...

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While working at small rural hospital I was once again faced with the emergency physician’s dilemma.  Admitting  a patient and being told to write holding orders.  In the midst of a very busy department, I sat with a nurse who guided me through the ridiculously complex and counterintuitive electronic orders system.  All this so that the admitting doctor wouldn’t have to log onto the computer, from home mind you, and trouble ...

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shutterstock_149598137 By now, everyone in health care is accustomed to the idea of patient satisfaction data and the multi-million dollar industry ($61 million in annual revenue for Press Ganey alone) which exists thanks to the health care leaders and policy makers who embrace it.  Most physicians believe it is absurd to use it as a marker of quality care, but have accepted ...

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medpagetodayFrom MedPage Today:

  1. Nicotine Replacement in Pregnancy: How Risky? The absolute risk of major congenital anomalies was similar among infants born to smokers and those born to women on nicotine replacement therapy (NRT), but respiratory problems were worse in the latter group.
  2. AS Activity Tied to Future Risk for Heart Disease. Early ...

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Dear Bill Maher, I respect your First Amendment right to exercise free speech. In regards to your recent comments on doctors, however, your words don’t matter. Here’s why. There is a concept known as the beauty of medicine; I attempt to capture it in the following paragraphs. If you present to the emergency department with acute chest pain, we will work you up for heart attack, blood clot of the lungs, blood vessel ...

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The sad thing is, I hardly remember the patient. Everything about her is just an overhead pediatric trauma alert followed by the flurry of cutting clothes off, throwing IV lines, and calling out our primary and secondary survey -- "blown right pupil," "unequal breath sounds," "gross deformity to left ankle," and then, "no pulses" -- followed by the age-old barbaric resuscitation efforts that are now muscle memory to us, as ...

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