As emergency physicians, we write prescriptions for patients that we discharge home for all manner of presenting complaints. I used to believe that the overwhelming majority of these prescriptions would be filled by the patient after discharge. It turns out I was wrong. Research estimates that patients discharged from emergency departments (EDs) fail to pick up their high urgency prescriptions, like antibiotics, nearly 35 percent of the time. This is problematic ...

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This week, the community of women physicians was rocked by the death of one in our midst, an anesthesiologist, intensivist, medical school faculty member, and mother, in an apparent domestic violence homicide. Dr. Casey Drawert (yes, we will say her name) was a highly accomplished physician married to a "prominent businessman" adding to the media-stickiness of the story.  Her success clashes with our deeply entrenched biases about the demographics of domestic violence victims. Yet ...

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We walk down the halls, time and time again, each encounter a new discovery, mystery, or typical presentation.  As ED providers, we see new faces, entwined with “frequent flyers” that have become in a weird way part of the family.  Our job is often loosely entangled with our identity and existence.  It becomes hard to have dinner conversations without discussing therapies, changes in health care, Obamacare, or “unusual cases.”  We ...

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I am an ENT surgeon, a friend of the author, the patient, and their daughter, whose intervention saved his life. This is a smart, loving family caught in a terrible vortex of terrible medical care until they pulled themselves out, and a story that physicians must read, as we struggle to reinstate humanity and humility into our noble profession. Here is Paul's tale, as told by his wife. *** On a mid-December ...

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“We are witnessing a paradigm change, an unchecked slide into an era in which the scale of global forced displacement as well as the response required is now clearly dwarfing anything seen before.” - Antonio Guterres, United Nations High Commissioner for Refugees The global political upheaval caused by the Syrian refugee crisis could potentially mask a critical issue that has all the signs of a catastrophic public health disaster -- the health of ...

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Hospitals are places of long-standing hierarchies where some people are made to feel important and others … not so much. A long time ago, I was told nurses used to stand when a white coat walked into a room. (Imagine that now. Laugh. Snort. Choke. Cough.) In those days, in the patient care setting, white coats were synonymous with importance. These days, non-clinical hospital administrators, various technicians, and Clinique make-up counter ...

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In honor of Black History Month, the folks at Diverse Medicine created a new documentary series, Black Men in White Coats.  In this installment, we meet Dr. Brian Williams, a trauma surgeon at UT Southwestern Medical Center.

I know we all bemoan the chief complaint of vaginal bleeding when it pops up on the board. Your heart sinks even more when it is followed by the dreaded home pregnancy test. No ED provider is going to love seeing patients with first trimester bleeding. More than anything, I loathe the drag it takes on my time and productivity. Labs, urine, moving them to the appropriate room for the ...

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In my practice of facilitating cancer support groups, all I do is listen to patients and their families. Consequently, I hear much about the nature of their care. They generally speak favorably about its technical aspects, and indeed these are often awesome. But when they complain, it's uniformly -- and I mean one hundred percent -- about communication. One man has been trying to get an appointment with a pulmonologist for ...

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I walk out of a room filled with emotion and despair.  A battle lost but the war rages on.  I’ve seen miracles, often only a daily basis.  Life is precious but peculiarly fragile while resilient and strong. Every emergency provider understands the feeling after a patient has passed.  It’s the unexplainable reverence and daunting silence as I put on the white coat.  It’s the echoing footsteps that never go away ...

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