It’s from 2006, but new to me.
Ramblings of an Emergency Physician in Texas
We are darned close to ‘the future is now’. (The only way to improve this would be for the AICD to send its info for critical alarms without requiring the patient to act, but that’s another can ‘o worms).
It’s one of those calls you never want to get as an electrophysiologist:
“Doc, I got four shocks from my device yesterday.”
Nice post, and your ED colleagues thank you!
Interesting. I didn’t realize this needed legislative approval, and that they hadn’t lined up a bill sponsor.
Plans to establish an MD medical school at the University of North Texas Health Science Center in Fort Worth went nowhere in this last session of the Legislature, but a bill establishing the new UNT School of Pharmacy passed and was signed into law without opposition or ?fanfare….Legislative action is necessary because in 1993, when the UNT Health Science Center was established, legislation specified that it was to include the Texas College of Osteopathic Medicine and would award the doctor of osteopathy degree.Now UNTHSC is seeking to expand and add the allopathic (MD) degree as well as the osteopathic (DO) degree, in partnership with all the major hospitals in Fort Worth.
My friend, who got me into blogging a long time ago (you can and should blame him) has started a new effort. “Beyond the Clinical“.
How I Missed A Large Tumor and How You Will Too
He had severe right chest and shoulder pain.
His doctor had said it was the tunneled dialysis catheter. “If the pain gets worse go to the ED to get it removed.”
When you have a minute, go have a look, and bookmark it. Recommended.
I think this is a good, if incomplete list. Good place to start, though.
Physicians will not achieve their highest potential for success if they lack the following 3 key traits. Successful physicians have these traits.
Dr. Edwin Leap (he of the excellently written and quite frequently updated EdwinLeap.com has started a second blog, to which he seeks submissions.
I think from the title of his new effort, Impeding progress, you can get a feel for what he’s after.
Interesting idea, and while it’ll give all of a place to vent our spleens, I find blogs that are all negative rants to be cringeworthy after a while. I’m sure Dr. Leap (whom I met at ACEP this year, and he didn’t know me from Adam), will do a good editorial job.
So, go hither and submit your case of impeding progress!
Dr. Au is hear from…
Becoming a doctor requires hard work and sacrifice, but a system that expects their doctors to be committed to their jobs to the exclusion of all else is flawed. And maybe there’s quite simply nothing wrong with young doctors at all, rather something wrong with the historical culture of medicine, such that the idea of doctors as human beings can inspire so much debate.
Laugh if you want, this helps my life, at least at work.
For months after starting my current gig, I would sometimes get to work with everything in all my pockets, and sometimes not.
I’d forget my ID, or my pen, or my phone, or my…well, there you go.
Then my OCD started to kick in, and, a Mental Checklist was born.
I now have to get 6 things, and set them on the table or I screw it up every time.
Last week I apparently went against the checklist, and halfway through the shift realized I’d lost my ID. Of course, after about a combined half-hour of fruitless search I gave up, and found it in my bag on the way out. Geez.
Yeah, it sounds stupid. But if it’s stupid and it works, it’s not stupid.
A really really good piece by Doc Gurley. Read it and appreciate how much work goes into just identifying their HUMSers.
The most costly user of publicly financed emergency health services in San Francisco – a “frequent flyer” in emergency room parlance – is 49, Caucasian, schizophrenic, and addicted. He has been listed in at least two concurrent city systems as homeless either continuously or episodically for 16.6 years. He’s a frequent caller of ambulances…
Absent other information, the referred to ‘rodent poison’ is probably a superwarfarin. It’s like regular people-coumadin, but superconcentrated. It kills rodentia by causing them to bleed to death.
Which makes the ‘gas effect’ seem really odd, but possibly explainable.
A patient who apparently ingested rodent poison and is emitting potentially harmful gasses has created a hazardous material situation at St. Joseph Mercy Hospital in Ann Arbor.
The man is isolated in his room in the medical intensive care unit on the hospital’s sixth floor, 5301 McAuley at East Huron River Drive, hospital spokeswoman Lauren Jones said this afternoon.
Two thoughts: 1) I sincerely hope this patient recovers, and 2) if this is just upper GI bleed smell someones’ going to have rotten egg smell on their face.
I looked up superwarfarins, found a couple of interesting case reports, but none that talk about abnormal gases.
(For the uninitiated, the smell of digested blood is amazingly awful. It’ll make experienced, hard ED staff retch). I can understand why the smell would set off alarms, except that it’s not that uncommon, so it shouldn’t be a surprise.
It’ll be interesting to see what come of this.
Lighting matches in the hospital is a nono, by the way.
ShadowFax is doing all EP’s a favor by explaining one of the more frustrating, and opaque areas of Emergency Medicine, group insurance. His group self-insures (apparently), and he knows way way too much about it:
One of the more painful elements of running a group practice is the ritual abasement before the god-like executives at the insurance company annual malpractice insurance re-bid. It’s kind of like a visit to the dentist: guaranteed to be uncomfortable and with the potential for a very unhappy surprise. Also, it leaves your face numb and drooling. The only thing that matches it in pain is writing the check every quarter, year after year, and then looking back at your actual, you know, losses, and seeing that you have paid for insurance way way more than you ever lost in liability claims. It’s got the all visceral satisfaction of lighting a pile of money on fire.
He’s got another, just as informative follow-on post, and the promise of at least one more. Frankly, it’s a primer for groups who are considering this (and AFIK, mine isn’t).
Nice to be noticed, though.
Health officials are investigating two confirmed cases of measles, the first in Tarrant County in 17 years.
Goody. I was tested years ago and was a vaccine responder, but still.
To take a bite out of their guesswork, U.S. News tapped its latest annual evaluation of the nation’s nearly 5,000 hospitals and, for the first time ever, ranked the best ones in the 52 U.S. metropolitan areas with 1 million or more residents. Today’s release of those rankings represents the largest expansion of U.S. News Best Hospitals since the annual rankings began more than two decades ago.
Update: Hmm, that article over-spoke. Here’s more what’s happening, from the WSJ: they’re just getting less support, not running away.
Google Health being dropped is a setback for Electronic Medical Records EMRS in three ways: 1 Widespread adoption through cloud access; 2 Time-to-market and payback; and 3 Cross-industry collaboration.
My summary: Google couldn’t find any way to make money doing this, so they bowed out.
I think that’s a completely rational decision for them to make. Unfortunate for the world, but that’s business.