Should prescription painkillers be restricted in the ER?Mayor Michael Bloomberg recently introduced new restrictions on opioid painkillers for New York City public emergency departments. I give my take on the issue in a USA Today column: ER key to curb painkiller abuse.

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 ...

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Make small bets during the era of health reform A good hockey player plays where the puck is. A great hockey player plays where the puck is going to be. –Wayne Gretzky Recently, I attended an end-of-year review with one of our hospital partner’s executive team. We reviewed our performance for the past year, and discussed mutually strategic goals and how to improve upon our excellent service. As part of the conversation turned ...

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I happened to read an article in the Columbus (Ohio) Dispatch where Ohio coroners are complaining because some doctors, including emergency physicians, are refusing to sign death certificates listing a patient’s cause of death. The coroners are concerned because they are being “burdened” with hundreds of extra cases every year that they must handle. And if other doctors don’t sign off on the cause of death, sometimes it ...

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We worship at the feet of pain and pills I just finished reading Neil Gaiman’s fascinating novel, Gods of America.  I first learned about his work by watching the movie Stardust, then reading the novel. One of the themes of Gods of America is that the deities of the old world came to America in the hearts of their followers, but over time lose their followers and thus their power.  A war is arranged between the ...

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Let me tell you about this fabulous new test – it's far better than the old tests, I've got a decade's worth of research publications to show you, plus it's a floor wax and a dessert topping. Who am I?  Why, I'm simply an academic clinician, advocating for this test because it's the next great thing to help us tailor treatments to patients.  Does it matter that I'm on the unofficial ...

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My kid and I are outside in the front yard blowing bubbles, enjoying the blue skies and 70 degree weather when she says, “Cool Daddy! Look, there’s a police car coming down the street. Oh, cool! I think he’s coming to see us!” Uh, oh, I think to myself. Despite my kid’s excitement, I know that rarely does anything good come delivered by a policeman. My wife is inside, my one ...

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I began the medical school application process 10 years ago.  I was 23, single and most of my role models worked full time.  I had no idea that a part-time medical career lay in my future.  Quite a bit has changed since the days of hoping and praying and crossing my fingers for a medical school acceptance letter.   In the past 10 years I have, at varying times, declared ...

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Everyone knows that life in the ER is fast-faced, extremely busy, and ever-challenging. When things get crazy, it becomes habit for busy physicians to see patients as “the chest pain in room 6” or “the broken wrist in the hallway.” We turn people with their amazing lives and fascinating stories into a nameless number and a “chief complaint”. It’s a practice that’s easy to justify—after all, taking a long ...

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Sometimes as human beings, despite all the layers we consciously build upon the shell of our souls to shelter us, define us, and project an image to others of what we hope we are, our basic inherent quality of goodness emerges on its own free will. A kind word, a gentle touch, a hint of a smile, an understanding patience--these are all things that escape uncontrollably in moments where our ...

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When you are sorrowful look again in your heart, and you shall see that in truth you are weeping for that which has been your delight.  -Kahlil Gibran Dear Debbie, You cared for my mom briefly in the ICU.  You might not remember me, but I remember you. My mother, a healthy 54-year-old woman came down with the flu on Christmas. Within a week, she had died in the ICU after a ...

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