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The Practice Of Medicine: When A Funeral Provides Perspective

Here’s my column in this month’s Emergency Medicine News:

I have practiced with the same group, in the same hospital, for 17 years. Because we have been together so long, our group is a family. So it was with enormous grief that we buried our founder, Dr. Jack Warren, 11 years ago after a tragic car crash. That wound is still open, but we still tell stories about his humor, his compassion, and his grace.

As I write this I am tending another wound, or I should say our group is tending another. A second partner passed away last week. Unlike the sudden horror of the first death, the second was progressive, as our friend and partner, Dr. Howard Leslie, left us by degrees, the victim of metastatic melanoma. Jack and Howard founded our group before any of the rest of us arrived. Both of them are buried in the same wooded, hillside nature preserve. Pieces of our group, pieces of ourselves, interred in the red-clay earth. Just as they practiced before the rest of us, so they went to sleep before the rest of us. I think they’ve gone ahead to show the way. So they can one day help us adapt to peace the way they helped us adapt to practice.

But both deaths remind me of partnership. Medicine today is chaotic and difficult for many reasons. Part of the problem is that government and regulatory bodies overwhelm us and litigation threatens us. Part of the problem is that we, and our patients alike, have untenable hopes and impossible standards for the practice of medicine. Read more »

*This blog post was originally published at edwinleap.com*

Hot Topic: Certification Of ER Doctors

Texas is at the center of a heated national battle over the training emergency physicians need in order to advertise themselves as “board certified.” Via the Houston Chronicle:

At stake is the welfare of patients requiring immediate medical attention. Leaders of the traditional board say allowing physicians without proper training to advertise themselves as board-certified would mislead the public. Leaders of the alternative board say the proposed rule change will undermine the ability of Texas’ rural hospitals to staff their emergency departments with board-certified ER physicians.

A final verdict may only come, given one board’s already delivered threat, in a court of law.

At stake also are the careers of a lot of practicing Emergency Physicians, many of whom I’m proud to call friends and colleagues. (And it’s not just docs at rural hospitals, they’re in nearly every ED in Texas, and your lesser state).  They practice high quality Emergency Medicine, and I have no qualms about the practice of those who are alternately boarded. Read more »

*This blog post was originally published at GruntDoc*

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Latest Book Reviews

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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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