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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After having read the article by Marjorie Stiegler, MD entitled "Stop the hostility among health care professionals," I wanted to talk briefly about a group that was not mentioned, but needs to have a voice speak out for them. The EMTs and paramedics that serve this country as paid professionals and volunteers in ambulance services and fire departments all over this nation. Yet, I sometimes find that EMTs and ...

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Because of their beauty, their amazing biology, and their use in developing medicines, venomous animals are found in captive collections far beyond their native ranges. Fortunately, accidents involving them are rare. But people who take care of such animals need to be prepared for an emergency, and if they wait until the last minute things can go very wrong. Speaking as one who receives emergency calls, I offer the following ...

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I am constantly coming across articles of physicians with strong voices. Physicians that are jaded.  Physicians that didn’t go into medicine to be defined by patient satisfaction surveys. Physicians that didn’t go into medicine expecting that people wouldn’t trust in their training because the Internet begs to differ. Physicians that cringe at the drive-through mentality that patients can present with diagnoses in hand and demands for tests to be done. Physicians ...

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Valley Medical Center was an iconic hospital and a great place to learn the craft of emergency medicine.  It was an old TB hospital that eventually became Fresno’s county hospital.  Sitting at the corner of Cedar and Kings Canyon avenues VMC was nothing to look at.  However, the combination of rampant poverty, violent gangs, and severe shortages of both doctors and nurses, made it an ideal place to do residency. In ...

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As health care reform drives more insured patients into the system, access to care is more critical than ever. And in protecting patient access to care, fair payment is one of the most pressing issues facing emergency physicians today. Emergency medicine providers are in a unique position when it comes to providing patient care. Unlike physicians in private practice who can screen patients to make sure they’ll be ...

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An observation that I and many of my emergency medicine colleagues have made about vacations: We need them. We need them for wellness, to recharge, to recover. Great saves, terrible tragedies, we witness it all and it can wear on you. Unfortunately, when vacation plans are made, it is not uncommon to find oneself working even more shifts before the break to offset our absence on the schedule, making the ...

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The human experience is an exercise in connection. Nothing is seen, heard, or felt in isolation. This is what can make womanhood in a large urban city so challenging. A catcall is not a single comment, heard on a single morning about the tightness of your jeans or the way your hair falls; but instead carries with it every unsolicited thing you’ve ever heard about your body, a shadow of ...

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Medical school and medical training attempt to teach subjective humans how to think and practice medicine objectively. This may be one of the unique fallacies of modern medicine, but that’s a subject for a different blog. Nevertheless, even in the highly emotional field of emergency medicine I’m usually pretty chill. That is, until someone’s dying, and then all of my equanimity can go flying out the window, for better or worse. Such ...

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June, 2003, and I am 18 years old, just a few days from graduating from high school. In his home in Bridgehampton, Kurt Vonnegut is sitting at his kitchen table railing against the injustices of the American health care system. When he finishes, he takes my hand and says, "Don't worry, you're going to make a fine doctor." November, 2015, and my feet are blocks of cement as I slowly make ...

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