I took a fantastic emergency medicine (EM) job when I finished residency.  There was no question in my mind that it was the best job within a hundred mile radius, maybe more.  When I first started, my expectations were met.  My group held a contract to staff a busy but well-staffed suburban emergency department, and had held that contract for almost 20 years when I signed.  The hospital was independent, ...

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Like many boys born in the 60s, my heroes were often frontiersmen.  I grew up watching the Daniel Boone television series, with Fess Parker.  (I can hear the theme song in my head as I type.)  I watched the Disney production of Davy Crockett, and had a comic book of the same.  I never missed a chance to watch John Wayne die on the walls of the Alamo (also as Davy ...

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I adored the physical exam in medical school. We were taught the exam by sections, and I devoured one after another. No matter how much I had learned about physiology, it was during our physical exam sessions that I finally started to feel like I was learning how to be a doctor. We were getting the tools we needed to really take care of patients. We would have the means ...

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5 a.m. on a Friday morning, during a lull in my overnight shift, I got a text from my friend Julie (name changed). “Steve had a massive heart attack.” Me back: “OMG, what happened.” Julie: “Not sure, he called my mom, he thought he was going to die. Now they are doing a CT scan.” And so it went on. As I waded through the information, Julie thought she understood I realized that she ...

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Currently, in American health care, experts are wringing their hands in confusion.  I mean, people have insurance, right?  And yet, health care is still expensive and dang it, people just keep going to the ER.  Visits are climbing everywhere, and I can speak from personal experience when I say that we’re tasked with more and more complex and multi-varied duties in the emergency departments of the 21st century. I’m not a ...

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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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