My professional college beclowns itself

A fisking of a paranoid, ill-considered and frankly stupid idea a 9th grader would be ashamed to put forth. From the American College of Emergency Physicians ‘leadership’.

ACEP Clarifies Campaign Rules

By James M. Cusick, MD, FACEP

Chair, Candidate Forum Subcommittee of the ACEP Council

ACEP is a member-driven organization with a representative body of our peers – the ACEP Council – chosen through component bodies, including our chapters (1 representative per 100 members), our Sections of Membership, and other aligned organizations.

There follows some boilerplate language designed to get you to tune out.

None of this is aimed at the author, BTW, I have no doubt he was asked to write this and didn’t make this decision. This is about the College and a terrible decision that reflects poorly on it.

In addition, protections were incorporated into the rules to keep candidate interviews in ACEP publications. Our goal is to avoid candidates being put in the position of commenting on College policy without adequate preparation and to ensure that the campaign process is fair and equal for all candidates.

Wait, what? Candidate interviews for ACEP positions can only be in ACEP house organs? Is Stalin in charge? And for the rationale of “…being put in the position of commenting on College policy without adequate preparation and to ensure that the campaign process is fair and equal for all candidates” means ‘we intend to cover up for the candidates we really want to win, and the gaffes from the unworthy will be published in bold print, but rest assured if you’re our selection it’ll totally be glossed or even left out’.

Count on that. And that’s bollocks.

It’s the biggest horse shit this college has dumped in quite a while, and that isn’t how I want my college to represent itself because that’s how it represents me. Really, if you’re running for President of ACEP, you should be able to handle a non-coddled interview. Seriously, you’re going to say they’re too fragile to be interviewed ‘without adequate preparation…’ and then expect them to deal with legislators and their staffs who are dealing with skilled negotiators and people who know what they are there for? No thanks, I’d rather know the warts and all right up front, not filtered through the ACEP info-seive.

Certain candidates may unfairly benefit from coverage in non-ACEP publications, while some may be disadvantaged. In order to ensure a fair election, campaign questions and the vetting of candidates is the responsibility of ACEP, its Council and its Council Committees.

Umm, no, it’s the right of all of ACEP to know who’s running for office, what their unfiltered views are, and how they handle themselves with tough questions from tough questioners. It’s called campaigning, it’s not the pinewood derby. The very idea that ACEP can make an election totes fair by limiting the questions and answers to their own publications is laughable, were it not so tragically and pathetically sad. If you’re worried someone has an unfair advantage, Editorialize in ACEP Now, and their 150 avid readers can spread the word. But this entire approach is insulting to the intelligence and spirit of ER docs in our great nation.

(Any of you ER docs want to make sure your patients are only presented one at a time, with discreet illnesses and injuries, with a pre-selected choice card of correct diagnoses? No? It’s because we live and work in the real world, and that’s an absurd proposition, like this).

Also, and some may not be aware, but this is most likely a reaction to the excellent challenge by Dr. Greg Henry, ACEP Past-President and fixture asking for a robust questioning in his April 28, 2014 article ACEP, let’s set a real agenda. Read that article, and the kind of questions he wanted to ask, then you’ll see this in-house gag order for what it is: cover for their chosen.

If you’re a candidate for president and you buy into these rules, I know you’re not ready for the job.

If there are specific questions you would like asked of the candidates prior to the election, please send them to communications@acep.org. The Candidate Forum Subcommittee will consider them, the selected questions will be posed to candidates and their responses will be made public.

Really. You’re not only going to vet the answers and decide what goes out you’re going to control the questions, too? Here are a couple for you: a) boxers or briefs, and b) puppies or kittens?

I for one would like to have someone bathed in the knowledge of fights won and lost ask our presidential candidates hard questions about the tough choices facing ACEP, but we will absolutely not get it with this format. On purpose.

Hell, we’ll be lucky to find out if they like puppies.

 

via ACEP Clarifies Campaign Rules « The Central Line.

Amusing typo

Flew on American Airlines yesterday and today.

The plane both ways was an Airbus A319, a smallish but perfectly nice plane. It had a really fancy infotainment system built into the back of the seats, and I enjoyed following the flight with this view selected:

IMG_0217

but there was something bugging me about one of the menus, so on the return flight (where an hour ground delay once we loaded up gave me some time to actually look) I found what had been making something in my brain itch:

IMG_2268

I sent this to @AmericanAir while waiting for the plane to park (their people-less parking system apparently doesn’t work in rain), and they were nice with the response:

Good for AA for having SoMe savvy people around!

Another reason I like my job

Colleagues I can call on and count on.

Recently I was the 11p doc in my ED (the overnight shift), and I knew what my evening had in store when Colleague/suspect1 said “It’s been slow all day”. Oy.

At 11:03P the charge nurse (who deserves a Medal for her actions that night) said ‘you’re getting a level 1 medical and two level 1 trauma transfers in the next five minutes’, and that was in addition to the waterfall of regular patients who heard the word ‘slow’ and ran like very sick possessed zombies to our ED.

The medical was a great case I would have loved had I had no other duties: CHB, external pacer dependent, and I did the right thing for this patient: I called the procedure doc, and turned that patient’s care over to him (the one who caused this, Colleague1). (I knew what this patient needed, it’s an intubation/cordis/float the pacer/etc, and that’s 20 minutes straight of terrific procedures while letting the department drown). He did as well as you’d think. Maybe better than I would have done.

The other colleague star was Golleague2, the 9P, who never peeped that I wasn’t sending him home, or really even taking his workups. In fact, toward the end of the night he did a lac or two for me, and I kept Colleague1 busy until 3 with procedures. Terrific to have people you can count on.

This isn’t about me, or even these two great colleagues (though I thank both of you profusely), it’s really about all of us. Giving means getting, and I and our mutual patients got the best that night, and get it when we work and play well together.

It’s a great place to work. Thanks to you all.

Happy Fathers’ Day, dad

Thanks for not strangling me, even when I deserved it.

Germany, 1976ish

Germany, 1976ish

It was the first pizza any of us had had to use a fork for, which is (I think) the reason for the bemusement.

Anyway, happy Fathers’ day.

ED patient: word to the wise

If your driver has a personality disorder, it will reflect on you. It’s unavoidable.

please ask them to wait for you in the waiting room. Or in the car. Or on Venus.

(EMS not included).

Definition of cold: Killing a Patient to Save His Life – NYTimes.com

For the record, I’m all for this, providing it pans out in trials…

PITTSBURGH — Trauma patients arriving at an emergency room here after sustaining a gunshot or knife wound may find themselves enrolled in a startling medical experiment.

Surgeons will drain their blood and replace it with freezing saltwater. Without heartbeat and brain activity, the patients will be clinically dead.

And then the surgeons will try to save their lives.

Researchers at the University of Pittsburgh Medical Center have begun a clinical trial that pushes the boundaries of conventional surgery — and, some say, medical ethics.

By inducing hypothermia and slowing metabolism in dying patients, doctors hope to buy valuable time in which to mend the victims’ wounds.

via Killing a Patient to Save His Life – NYTimes.com.

Tesla Supercharger in San Marcos, TX

Got to visit this supercharger on a recent trip, thought this might be useful.

The map is a touch odd (I came in from the North):

helpful map

Yes, it gets you to the right area, it’s just a touch odd…

Turn left (North) here:

turn here

It’s about 1/2 a mile behind the mall from the turn. It was completely empty when I arrived, one other charging when I left (didn’t meet them):

San Marcos charging station

And as you’d expect, the car was completely charged before we finished our salads. Nice place!

Happy Anniversary!

Our youngest and her husbands’ first anniversary!

Congrats to you both, from all of us.

33 Charts — medicine. health. social media.

Well put!

After a recent presentation on social physicians, someone asked why there were so many emergency medicine physicians on blogs and social media?  Good question.  From content to conversation, ER docs are heavily represented in public spaces.  And it’s as much about passion and participation as raw numbers on any given platform.

What is it about emergency medicine physicians that has lead them to flex their muscles and reach out beyond the confines of their emergency centers?

via 33 Charts — medicine. health. social media..

Yrs. Trly. gets a mention.

You Can’t Yelp Your Doctor – The Daily Beast

Some of the country’s best doctors have the worst patient satisfaction scores. Here’s why.Part of being a doctor is learning to suppress your feelings. You get good at being what people need you to be. But it slowly transforms you into something you couldn’t have foreseen—a sort of Stepford doctor—pleasing everyone with your perfect smile and agreeable demeanor, hoping that your patient satisfaction survey will be favorable, no matter the cost.

Press Ganey is one of the top providers of patient satisfaction surveys, according to the Forbes article, Why Rating Your Doctor Is Bad For Your Health.The government has bet big on these surveys, as a recent article in Forbesnotes. Armed with the idea that “patient is always right,” Washington figured that more customer satisfaction data “will improve quality of care and reduce costs.”

That turns out to have been a bad bet.

via The Mask Your Doctor Hides Behind – The Daily Beast.

Read the whole thing, but it’s what your doctors, especially the hospital based ones, have been saying since day 1.

Squirrel season

It’s on. Three shots, three hits, 40 yards.
Air rifle is a TalonSS made by AirForce AirGuns right here in Fort Worth, Texas!

20140518-181748.jpg

They were filled with water only, I’m not a barbarian.

Google Glass handed out to medical students at UC Irvine – CNET

I have a question.

The fledgling Google Glass is slowly working its way into the mainstream, and one place that people should get used to seeing the device is in hospitals.

Several medical institutions have already been testing the computer-enabled eyeglasses to see if the devices enhance doctors’ work. But the School of Medicine at the University of California, Irvine, is taking it one step further by issuing Google Glass to its students.

Irvine will be the first medical school to fully incorporate Glass into its four-year curriculum. Its first- and second-year students will use the device in their anatomy and clinical skills courses, while third- and fourth-year students will wear Glass during their hospital rotations.

via Google Glass handed out to medical students at UC Irvine – CNET.

Will the students be tested with the same Glass they were allowed to use while studying? I have concerns this would be a four year training session for Glass, not actually learning so they could go without it. (As opposed to their smartphones, I realize).+

Report a Litterer | Don’t mess with Texas

Drive safely while collecting that information!

Even after more than 25 years of the Don’t mess with Texas® campaign, litterbugs still roam the roadways, tossing trash from their car windows and letting litter fly out of their truck beds. We’re talking about cigarette butts, fast food wrappers, and the like. They’re small, but they’re still trash.

via Report a Litterer | Don’t mess with Texas.

Department of Health And Human Services Threatens Blogger Over Satirical Posts | Popehat

Your tax dollars in action. Threats against satirical bloggers.

The blog Addiction Myth is devoted to a very out-of-the-mainstream proposition about medicine: that the entire concept of drug and alcohol addiction is a scam perpetrated by law enforcement, rehab groups, and the entertainment industry. By contrast, the United States Department of Health and Human Services is devoted to mainstream medical and scientific propositions1 It is perhaps inevitable that these two worldviews would conflict one day.But it was not inevitable that HHS’s Office of General Counsel would bumptiously threaten Addiction Myth over obviously satirical posts. That, given minimal good sense, could have been avoided.

via Department of Health And Human Services Threatens Blogger Over Satirical Posts | Popehat.

Police: Woman drives wounded abductor to Fort Worth hospital | Breaking News | News from…

She’s nicer than I would have been…

FORT WORTH — A man being treated for a self-inflicted gunshot wound Monday morning was arrested and will be charged with aggravated assault with a deadly weapon, an official said.

Fort Worth police did not release the man’s name, but spokeswoman Sharron Neal said that he was brought to Texas Health Harris Methodist Hospital Fort Worth by a woman he was trying to abduct when he accidentally shot himself in the arm.

via Police: Woman drives wounded abductor to Fort Worth hospital | Breaking News | News from….