shutterstock_224970232 I have worked in a lot of hospitals over the past two years. Quite a few of the facilities have been critical access hospitals, which is to say that they are very small, typically having fewer than 25 inpatient beds, and are usually somewhere in the boonies. A number of characteristics allow a hospital to qualify as critical access and receive additional ...

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shutterstock_139886491 1.  Wait times in most emergency departments are ridiculous. But, if you have a real emergency, you won’t have to wait. If you have abnormal vital signs, a worrisome ECG, or concerning chief complaint, you will be seen long before the person who checked in with a sore throat to get a work excuse. Patients with chief complaints like “GSW abdomen” and “found down/unresponsive” don’t wait to ...

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shutterstock_126678482 Natalie Fuelner created a well-written article in the Bangor Daily News describing some of the tribulations many new parents go through with young children. One weekend, her toddler fell face first onto a metal patio table. Immediately, the toddler’s face is full of blood. The dad panicked. Natalie was a “trembling mess” on the inside. Their physician neighbor wasn’t available to look at the child. ...

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shutterstock_286268375 Flying on a return trip from Chicago to San Francisco, I can’t help but feel a little on edge. It’s not the fear of flying that is leaving me a little less relaxed than the pleasant, middle-aged woman peacefully slumbering in the seat next to me. It’s the possibility of hearing the announcement few doctors are comfortable hearing during travel: “Is ...

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How does heartburn turn into a multi-thousand dollar workup?  The simple answer: defensive medicine.  See how this scenario plays out daily in this latest episode from Healthcare Not Fair.

shutterstock_277040312 american society of anesthesiologists A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Summer is immortalized in popular culture for good reasons -- no other season can match it for the variety of fun and exciting activities it brings. Unfortunately, that variety of activities and the large volume of ...

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shutterstock_166402376 We are data druggies. We spend our days like desperate junkies crawling the carpet, sifting through the shaggy strands of patient histories with shaky fingers in search of facts. Every word our patients utter we feed to the never-ending demands of the electronic chart. We find a fact and we enter it. The database grows. Someone somewhere adds another question we are supposed to ...

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shutterstock_95651341 There can be little doubt that these days that political correctness has run rampant. Terms like "racist," "sexist," or "homophobic" are thrown around so frequently and early now that one has to wonder what is actually being accomplished. If you were to ask a physician what PC label they most fear, it would be "disruptive." Let's face it. We are no longer ...

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shutterstock_116541763 You could hear a pin drop. The awkward silence at a dinner table after my pager went off. Eyes locked on me. For a split second, the laughter ceased, forks held in mid-air, chewed food, half-swallowed. The nervous system of every doctor adapts to the sound of his or her pager during residency. Early in training, widening pupils and hair-raising palpitations fade ...

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Do you remember Mad Libs from when you were a child? A story is filled with blanks, and as you fill them in with inappropriate and ridiculous words, you laugh until you can't see straight. You laugh until you can't breathe, and your parents beg you to stop! Let's be children again. Share these with the nurses, and give the shift a little levity. Pain medication. You see, doctor, my pain specialist ...

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