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Emergency Medicine: Who Should Set The Standard Of Care?

According to the Standard of Care Project at EP Monthly:

The Power of Agreement

We can stop baseless malpractice suits before they get started. How? By having a majority of practicing emergency physicians go on record as to the baseline “standard of care,” beneath which is negligence.

This has been rolling for a while, and I’ve been late to blog it. That does not in any way mean I’m not 100 percent FOR it.

The idea is beautifully simple: The standard of care in emergency medicine (EM) should be set by practicing EM physicians, not case-by case in courts before lay juries with battling experts. (AAEM had the “remarkable testimony” series as a retrospective attempt to shame “experts” who gave, well, remarkable statements under oath, which to date has two cases in it.)

This has the very real advantage of being a clear, concise peer statement that this is/is not the standard of care.

I voted (while at ACEP). If you’re an emergency physician (and you have to cough up some information to determine your bona-fides before you can vote), go to the Standard of Care Project and cast your vote. They’ve set the bar at 30,000 votes, which is ambitious. It’s also worth it.

*This blog post was originally published at GruntDoc*

Another ER Animation

In a better setting than the animation of the ER patient faking a seizure (which was inexplicably set in what appeared to be a convenience store), this one at least looks medical. But I’m a little concerned about the red blood infusion just hanging in the background, not connected to anything. I’m pretty sure the Joint Commission wouldn’t approve of that.

*This blog post was originally published at Movin' Meat*

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*

Emergency Rooms Overused For Routine Care

The Patient Protection and Affordable Care Act (our government’s name for healthcare reform) may make our already crowded emergency rooms swarm with more patients.

A new study from Health Affairs shows that more than a quarter of patients who currently visit emergency departments in the U.S. are there for routine care and not an emergency. New complaints like stomach pain, skin rashes, fever, chest pain, cough or for a flare up of a chronic condition should not be treated in emergency rooms. They are best worked up and treated by an internist or family physician, preferably one who knows the patient. So why are these patients waiting for hours and spending up to 10 times as much money for emergency department care? Read more »

*This blog post was originally published at EverythingHealth*

Electronic Medical Records, ER Wait Times, And The Medical Blogosphere

Here’s a confession: Despite my steadfast advocacy of medical blogging as a means to promote understanding and education, I continue worry a lot about professional liability. Not just whether the things I write could hurt my career, but, in terms of academic output, is blogging a waste of time? What view does my department’s leadership take on blogging?

Still, I’ve continued to support medical blogging as a useful academic endeavor, hoping that someday this support would be borne out. When sites like Sermo and Facebook came along, I despaired that more physician opinions were going to be hidden behind walled gardens, available only to select colleagues or friends.

Then, last week, some revelations — I discovered a member of my department’s leadership was blogging, or at least, had commented on a  blog. How about that! The other revelation? Facebook may be the last great hope for academic discussions to flourish on blogs.

This all arose from a pretty academic question about emergency department implementation of electronic medical records. Does the degree of implementation (full, partial, or none) impact patient wait times in the emergency department? Read more »

*This blog post was originally published at Blogborygmi*

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 Cartoon

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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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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