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Cartoon: That Moment When You Realize Your Child Took Your Emergency Training Very Literally

How Our Progress Since 9/11 Has Benefitted Public Health Efforts

The events of 9/11 will forever be engrained in our memories. The attacks on the twin towers, Pentagon, and the anthrax attacks which followed were unimaginable at the time. Ten years after these tragic events, what’s changed?

September 11 Newspapers and Headlines

We now know that terrorist threats are ever present and that our nation must be in a constant state of vigilance in order to protect our communities. We’ve come a long way since 2001 in bolstering our nation’s ability to prepare for and respond to catastrophic events whether natural, accidental, or intentional. We are also learning more and more every day that the resources we need for the big disasters are much the same as the ones we use for everyday public health activities.

Check out my list of top 5 accomplishments in the years after the 2001 attacks: Read more »

*This blog post was originally published at Public Health Matters Blog*

Judging Illness Severity And The Financial Implications Of Dialing 911

Nora misjudged the height of the stair outside the restaurant, stepped down too hard, jammed her knee and tore her meniscus.  Not that we knew this at the time.  All we knew then was that she was howling from the pain.

There we were on a dark, empty, wet street in lower Manhattan, not a cab in sight, with a wailing, immobile woman.  What to do?  Call 911? Find a cab to take her home and contact her primary care doctor for advice?  Take her home, put ice on her knee, feed her Advil and call her doctor in the morning?

Sometimes it is clear that the only response to a health crisis is to call 911 and head for the emergency department (ED).  But in this case – and in so many others we encounter with our kids, our parents, our co-workers and on the street – the course of action is less obvious, while the demand for some action is urgent.

The question “which action?” has become more complicated of late because:

  • In some communities, there are alternatives to an ambulance or a drive to the nearest ED, such as Urgent Care centers.
  • Disincentives exist for going the route of the ED: in many cash-strapped municipalities we are charged for the cost of ambulance ride; we risk not having our ED visit covered by insurance if we make the wrong decision or fail to notify our health plan in a timely manner.  Or we don’t have insurance and the ED care is expensive.
  • Some of us have a number of clinicians who could guide us about ED versus self care on any urgent health matter, plus our health plan may have a nurse advice line that could do the same.  Which among them to call?  How long will it take to get an answer in the middle of a busy workday or a late night?
  • Many of us have no primary care clinician to call. Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

911 Disclaimers Are Absurd

I’m sure you’ve seen them on medical blogs:  Disclaimers that remind readers to call 911 in the event of emergency.

But is someone choking on a hot dog really going to dial up KevinMD or SeattleMamaDoc for help?  Does anyone really believe that 33 charts is the place to deal with your acute airway obstruction when you have a just a couple of minutes to live?

Here’s my theory:  I suspect that the first attorney who came up with the 911 disclaimer did so as some sort of perverse joke.  And rather than seek the input of their own lawyers, all those who followed simply copied the this original language believing it to be judicious and most conservative.  Now it’s the longest running gag in legal history. Read more »

*This blog post was originally published at 33 Charts*

Online ER Booking: Is There A Real Emergency?

This is so wrong.

You can’t make this stuff up.

It seems an emergency department in Memphis, Tennessee is now taking online reservations for their services. Yes, you heard that right, you can now hop online and select the time you would like to be seen for your “emergency”. Just pay $15.00 and you can give your chief complaint, your medical history and your list of medications ahead of time, saving you time and trouble when you pop in with your pesky problem!

What if the problem is serious?

The computer won’t let you register and flashes a “Call 911″ sign at you.

But wait! There’s more!

If you are not seen within 15 minutes of your scheduled time, you money is cheerfully refunded!

I’m not kidding. Read more »

*This blog post was originally published at Emergiblog*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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Unaccountable: A Book About The Underbelly Of Hospital Care

I met Dr. Marty Makary over lunch at Founding Farmers restaurant in DC about three years ago. We had an animated conversation about hospital safety the potential contribution of checklists to reducing medical errors and his upcoming book about the need for more transparency in the healthcare system. Marty was…

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