Without doubt, the future of medicine will include mandatory education for physicians on their conscious and unconscious biases. The politically and culturally progressive nature of medical education and graduate medical education almost ensure that this will eventually be a deeply-ingrained part of our training and our continuing certification. I’m sure that as our culture purports to discover ever new and egregious forms of bias, we will be endlessly reminded, in ...

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We had a pretty busy shop when I was in residency. So busy, in fact, that we had three secretaries working simultaneously -- one for paging, one for order entry, and one for admissions. I haven't been back there in a long time, but I hope the secretarial staff has grown commensurately with the volume and acuity of the ED. But from what I've seen around the country in my ...

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I’m an emergency physician. In common parlance, an ER doc. Which means, like a little kid who will eat dirt on a dare, there’s not much I won’t try in the practice of my profession. Many of my colleagues have had far more challenging careers than me, I assure you. But I have some stories to tell. Cyanide overdose while moonlighting as a resident. Patient nearly dying from bite by ...

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What are the most important things we can teach our kids? These days there are a lot of possible answers. Obviously, STEM skills (science, technology, engineering, mathematics) often lead to lucrative, stable careers; they seem to be tickets to "the good life," or so we’re taught. Languages are helpful. You can’t go wrong with basic computer programming skills. But in a world where people seem increasingly unkind, dishonest, greedy, violent and ...

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So you made a mistake. I know you’re busy beating yourself up about it. I know that after years and years of training in life-saving medicine you’ve also trained yourself to accept the blame for all sorts of things beyond your control. You’re asking, "How could I have missed that," or "Why didn’t I think about that?" You’re wondering why you didn’t give a different drug, order another test or do ...

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It’s hard to put into words the horror we all feel about the events in Las Vegas. So I won’t try. But what I will try to do is point out an often unspoken reality. Which is that those who work in emergency care constantly face terrible things with courage and skill and keep coming back for more. And everyone needs to remember that all those folks society counts on ...

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So I’ve finished up at one job and moved on to another. I was a director for a year, and it was a learning experience. Right now I’m nearing the final approach after working a long run. Last week I had five nights, 12 hours duration each. I stayed in a hotel near the hospital. Then, after two days off at home, I started a run of five days, of ...

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Unless you’ve been living under a rock, you’re well aware that the United States is in the grip of a really big epidemic of opioid abuse.  The epicenter of much of this has been my beloved Appalachia.  My home-town, Huntington, WV, might as well be re-named "Oxycontin," or maybe "Heroinville."  It’s ugly. Enormous amounts of ink have been spilled on this topic, and ...

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I was recently at a meeting where some very influential physicians were discussing a question that I’ve been thinking about for a while: how do we find medical staff for rural emergency rooms and hospitals? It’s a tough question, because, increasingly, it seems that young physicians are trained to work in urban hospitals. Those are also the places these young doctors prefer to practice. Big hospitals and teaching centers in ...

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I used to practice locums medicine; which for the lay person means traveling to different jobs, sometimes several states at a time.   During that time I stayed in a lot of hotels.  But, occasionally, I had more unique accomodations.  Obviously, if you travel enough, you’ll sleep in an airport here and there. No big deal.  I actually like sleeping in airports occasionally.  When you’re stuck, you’re stuck.  Weather or ...

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