“There’s such an issue of privacy in health care, and yet they let all the patients walk around with their derrières sticking out.” This quote within an article by the National Post got me thinking about HIPAA. The Health Insurance Portability and Accountability Act of 1996 is a big flat hammer with excellent intentions. Like EMTALA, however, it too has its side effects. Along with many other ER docs ...

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My family was driving to see our new niece this past Saturday. While passing through a town on the way, we came upon a motorcycle accident.  The rider had been hit by a vehicle and was lying on the pavement with a growing crowd of people who wanted to help.  I’ve done it before.  I did CPR at the scene of a wreck when I was in medical school, and ...

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Did it ever occur to some of today’s physicians that many people work awfully hard and complain a lot less than they do about “burnout” and “work-life balance”? Did it ever occur to them that “work-life balance” is the very definition of a first-world problem, unique to a very privileged class of highly educated people, most of whom are white? Every day, I go to work and see the example of the ...

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The trauma doors flew open, and a middle age man was rushed into the room. All we knew in those moments was that a seemingly lifeless body lay in front of us. There was no pulse and chest compressions were started. After several minutes of no response, another physician hurried out of the room and returned with an ultrasound. Within seconds of placing the probe on the man’s chest, the ...

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What do EMTs do in between calls?  Talented folks, those first responders.

shutterstock_223842769 There are two key scenarios when doctors fail to tell “the whole truth and nothing but the truth so help me God.” Sometimes doctors give a diagnosis we’re not 100 percent sure of and other times we don’t diagnose something we’re almost 100 percent sure of. The truth is complicated and often more gray than black and white. Scenario #1: “You have [insert diagnosis ...

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shutterstock_208716340 I have been an emergency physician for 12 years.  I have had the opportunity to learn from and try to emulate an impressive number of amazing clinical physicians.  These doctors seemed god-like at first, but as my training and career progressed, I realized that they were mostly teaching me through their own experiences. One of my favorite teachers had a humbling saying:  “Good ...

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shutterstock_270431723 Every law, like every drug, has its intended effects and its side effects. EMTALA is a law you perhaps couldn’t care less about, but one that’s kept many a hospital manager awake at night. I’m not a lawyer, politician or administrator and can’t claim expertise on EMTALA subtleties. But I thought I’d touch a couple ways it has shaped our medical lives. The ...

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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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