This summer, new resident physicians begin their training all across the United States. Today, our future family physicians and pediatricians, neurosurgeons and emergency physicians, plastic surgeons and laser tattoo removal specialists (OK, not really a specialty, just a sideline) will begin learning how to be physicians, having completed four years of expensive college and four years of even more expensive medical school. Anxiety-filled and debt-ridden, they will embark on four ...

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It’s peculiar, I think, that we live in a time of physician shortage and yet some things remain abundantly clear: 1. Physicians can’t work together to fight, either for their own good or the good of their patients. 2. Like hostages, or abused spouses, they just keep going back for more of whatever bad policies they endure. 3. They are devalued. Now, this isn’t about money. I’m not enough of a medical economics expert ...

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I have met, in the emergency department, some fierce individuals. Sometimes they can be terrifying.  Their clothes, their manner, their demeanor, the way they pace, all suggest potential danger.  They seem clearly capable of violence.  They look at me with distrust, expecting to be disrespected, dismissed, treated harshly. Sometimes, they are covered in piercings; a thing alien to me.  Other times, the symbology on their clothes speaks volumes.  My colleagues in ...

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It’s easy to be excited about facts when they support our own opinions. It’s nice to believe that uncomfortable facts are fake. Likewise, it’s comforting to believe that everyone who disagrees with us is ignorant. When the truth is so obvious, we say, "How could anyone but an uneducated bumpkin deny it?" And yet, it seems that much of our knowledge is incomplete and that our deeply held beliefs may be ...

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I know a bit about the opioid epidemic ravaging America. My wife and I grew up in West Virginia and follow the news from home. I practice emergency medicine in rural South Carolina, and have worked in Georgia, North Carolina, Kentucky, and Indiana. I have seen the enemy, and it is terrible to behold. The genesis of the epidemic has been covered over and over. It is a complex problem with ...

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I am convinced that I have one of the best jobs a writer can possibly have. I practice medicine, in an emergency department. My life, every day, is filled with conversation with humans. I see their faces and touch their hands. They bring me their children, their very children (!) and trust this stranger to make their precious ones well. I hear their stories! Such stories. Of sorrow and sadness. Loss ...

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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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