June 13th, 2010 by Edwin Leap, M.D. in Better Health Network, Opinion, True Stories
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I was about to leave work a few nights ago when EMS was dispatched to a 10-50, which is a motor vehicle accident.
Enough years in emergency care and that tone makes your radar, but doesn’t create much of a blip. Many of those crashes have EMS arrive, only to discover no injuries. Some have patients transported, with minor problems that lead to their speedy evaluation and discharge from our ER. A few have serious, life-threatening injuries. They take all our speed, skill and attention to save life and limb. And often, require transfer to other facilities.
But this last call was none of those. Around 1AM the radio traffic crackled back to dispatch (which we could hear in the emergency department): “Probable Signal Nine.” Signal Nine means the victim is dead at the scene. Not “Dead On Arrival” (DOA) at the hospital, but no hospital necessary.
I knew the paramedics were finished when they asked dispatch to call for the coroner. And my heart sank a little. For all that a multi-trauma is work, I’d rather do it anytime than have someone die, and someone learn of the death. Read more »
*This blog post was originally published at edwinleap.com*
May 29th, 2010 by Edwin Leap, M.D. in Announcements, Better Health Network, True Stories
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To those who haven’t heard, an icon of emergency medicine has passed away.
Carol Rivers, M.D. died last week following a cardiac procedure. Carol was an outstanding clinician and educator, and one of the founders of modern emergency medicine as we’re fortunate to know it today.
Carol was perhaps best known for her board preparation guides, which helped many a terrified physician to navigate his or her emergency medicine board exams. I know her expertise helped me when I took my first American Board of Emergency Medicine (ABEM) exam. Read more »
*This blog post was originally published at edwinleap.com*
May 24th, 2010 by Shadowfax in Better Health Network, Health Policy, News, Opinion
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There’s just so much hidden and buried in the Affordable Care Act (ACA) that it’s like trying the find all the goodies in an Easter egg hunt. ACEP News pointed out one hidden goodie, nicely illustrated in this article from Kaiser Health News:
Under the new health law, insurance companies must extend several new protections to patients who receive emergency care. One of the biggest guarantees: Patients who need emergency treatment will have their costs covered at the same rate, regardless of whether they are treated at “in-network” or “out-of-network” hospitals.
The law also bars health plans from requiring prior authorization for emergency services. And it mandates that plans follow the “prudent layperson” rule. For example, if a person goes to the ER with chest pain, but ends up being diagnosed with indigestion, the claim has to be covered because going to the hospital under those circumstances made sense.
The provisions go into effect for every health plan issued after Sept. 23 – six months after the law was enacted — that offers emergency coverage.
This is potentially quite significant. As with so many things, the devil is in the details, and the implementation is not yet actualized. Read more »
*This blog post was originally published at Movin' Meat*
May 15th, 2010 by DrWes in Better Health Network, Opinion, True Stories
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2:30AM: The beeper sounds. “Please call the ER x2222.” Why are they calling me? I’m not on call. A flash then a clap of thunder outside. “Your patient from a few days ago is here in the ER.”
The mind races. You remember the case clearly. No problem at all. What could be going on? You ask 20 questions, you get 20 answers. All of the bases have been covered. “Doin’ better now,” you’re told. “We’ll just admit ’em and you can see ’em in the morning.” Hesitantly you return to bed, mind racing. Read more »
*This blog post was originally published at Dr. Wes*
May 12th, 2010 by Edwin Leap, M.D. in Better Health Network, Health Policy, Opinion, True Stories
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There is discontent in the house of medicine. So many physicians struggle. They seem to wade through uncertainty every day — uncertain about diagnoses, about pain, about disposition. We find ourselves uncertain about our jobs, our futures, our finances.
The consultants we call are uncertain about their practices and whether they can remain viable in the coming years as medicine evolves into something we may find unrecognizable.
Some days, as I enter my 17th year of practice, I don’t know if I can bear to walk around our little department for 10 or 20 more years, like some gerbil on an exercise wheel. I am uncertain if I can bear the weight of more entitlements, more confabulated stories, more regulations, and manufactured drama. I wonder if I can endure decades more of circadian assaults on my brain. Read more »
*This blog post was originally published at edwinleap.com*
