Not long ago I noted a certain older patient's name on my schedule. I really dreaded seeing her. It's not that I dislike her--in fact she's one of my favorite patients. It was just that I hated the prospect of seeing her looking as poorly as I knew she would. She'd been through so much: an accident resulting in devastating injuries followed by painful surgeries, and, worst, in the middle ...

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A city is free. A town is celebrating. I sat and watched the local news station announce that the second suspect in the 2013 Boston Marathon bombings had been taken into custody and was being transported to a nearby hospital. I am relieved. And thankful. Then I wonder. I wonder about the hospital that this suspect is being transferred to, and I wonder about my colleagues. What are the nurses, the doctors, and ...

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It has been weeks since the Boston marathon bombings.  The hospitals in that city, by most accounts, were remarkably well prepared, expertly and compassionately caring for the injured innocents.  Emergency response was fluid and efficient.  As tragic as the events of April 15 were, the health care workers of Boston were beacons of inspiration for a city in shock. Yet these heroics do not represent the most impressive actions performed by ...

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Hi. I’m a 44-year old emergency physician. And I’m an addict. My addiction came to light when my Press Ganey scores plummeted after I started to stand up to the chronic pain and frequent ER patients. The fact that I have an addiction was reaffirmed when I went to my state’s Prescription Drug Abuse Summit. When I saw so many professionals from varying fields (medicine, law enforcement, pharmacy, education) assembled, I realized ...

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I did not want to go to the emergency room. I really didn’t.  Resisting the idea, I lay doubled over with the worst abdominal pain of my life for 12 hours, unable to eat or drink or move, and finally vomiting before I considered it. I was well aware that this sequence of symptoms made me a textbook case of appendicitis, but I still consulted an ER doctor to ask: was ...

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Curb prescription drug abuse by following Mayor Bloomberg A version of this column was published in USA Today on April 1, 2013. Prescription drug abuse is a growing national tragedy. One of the biggest culprits is opioid painkillers, such as Oxycontin and Percocet. Shockingly, more than 200 million of these types of drugs are prescribed annually, and they account for more than 16,000 deaths a year.  And for every death, significantly ...

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When you work in an urban hospital, sometimes it’s difficult not to become jaded. There are certain neighborhoods that generate a disproportionate number of patients for some emergency departments. Meth is rampant. Marriage pretty much nonexistent. More bars than there are restaurants. Domestic abuse frequent, but prosecutions rare. Police know people more by their street names than by their real names. South Heights was one of those neighborhoods. The emergency department frequently treats ...

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If I’m learning anything from working locum tenens jobs, it’s that there is a wide, mind-numbing variety of electronic medical records (EMR) systems in place around the country.  At my primary work site, we use Med-Host.  Like every EMR, it has some bugs. But having seen other systems in other places, it’s clearly a Cadillac product in a great, big car lot of Yugos. I’m not going to disparage other systems ...

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Mrs. Smith (not her real name) fidgeted in her chair in my examination room as I scanned the radiology report she had given me. She had visited the emergency room the previous evening with severe abdominal pain that had eventually been diagnosed as gastritis, or swelling of the stomach lining due to a virus. During her evaluation, the ER physician had ordered a CT scan of her abdomen and pelvis. ...

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Brought to you by MedPage Today. 1. 5 Ways Obama's Budget Would Change Medicare. President Barack Obama's fiscal 2014 budget includes a variety of what he says are "manageable" changes for Medicare's 54 million beneficiaries as well as for the hospitals, nursing homes, and other healthcare providers that serve them. 2. Boston Bombing: Finding Evidence in the ER. In the aftermath of Monday's ...

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