From the Editor's Desk
The Personalities in Your Resuscitation Room
In this article, I ask you to look around your resuscitation room and try and put yourself into the other participants’ shoes and see the resuscitation from their perspective. I want you also to consider the many personalities, goals, and expectations of the other people in the room and consider each of their goals and objectives. I find that many of the issues which arise out of difficult resuscitations have little to do with the medicine but more to arise from each member of the teams’ expectations and perceptions of what did, or what they think, should, or could have happened. Read more.
The Greatest Act of Forgiveness Which I Have Ever Witnessed
I realized that despite the senseless violence which had occurred and the devastating impact it would have on this young family, that there was still goodness and kindness in this world. Frankly, it humbled me and made me feel ashamed for my anger. Read more.
The Agency Trap
Unless your hospital is extremely unusual, you have been dealing with the wave after wave of agency nurses coming through your emergency department and the rest of your hospital. Nurses are desperately needed everywhere and they seem to have disappeared. The bidding war of incentive pay, sign on bonuses, and other means of attracting nurses to our hospitals has reached insane levels and yet has not produced the number of nurses needed to staff our hospitals. Many hospitals have closed beds due to understaffing and surgeries are delayed. The level of patient boarding in emergency departments is untenable. Every hospital administrator is frantically trying to scour the Earth trying to find any available nurse. Nursing shortages are not new but it seems Covid has pushed us over the brink to a new and unsustainable level. Read more.
Thanks for Saving My Life. Sorry I was an A--hole
Remember that as an emergency physician you get to do cool stuff. No matter where you work or what the administrative, pay, or nursing situation is right now you still get to do really wonderful things. Many cases which are run of the mill for us would quickly overwhelm many other physicians. Our skill set is impressive and was not gained easily. Read more.
Politics Makes for Strange Bedfellows
In the past year, Common Sense has started a series of articles focusing on advocacy and politics. These have been a series of interviews of various political figures. These politicians have ranged from members of the U.S. Congress, state elected officials, to even an AAEM member who is running for the U.S. House of Representatives. The topics covered during these interviews try to emphasize health care related matters especially those which would be of interest to the membership of AAEM.
These articles have generated some concerns by some of our members and I wanted as the editor to address these concerns with my opinion concerning this issue. Read more.
The Beatings Will Continue Until Morale Improves
Every hospital has their own system of dealing with complaints and also of scoring and rating patient satisfaction. The intention of examining complaints and patient satisfaction scores is on the surface a reasonable one if done properly. Who would say that they do not have room for improvement and that there are not patients who did not receive good service or have a legitimate complaint? Every one of us would like to make our patients happy along with improving their health and quality of life. However, we have gone astray. Read more.
You Are the Plaintiff
This lawsuit, if successfully litigated, could eventually benefit every emergency physician in America. The prospect of turning back corporate management groups (CMGs) including the negative role played by private equity in the business of emergency medicine could receive a significant boost by this lawsuit. This is a case which I think is vital for you to know about and advocate for in as many ways as possible. Read more.
Are Emergency Physicians’ Brains Different?
Emergency physicians are used to not knowing all of the facts. Our professional brain is trained to gather all of the immediately available data which can reasonably be obtained within the time constraints of the emergency department and then decide and act. This timeframe can be seconds or minutes but not usually more than a couple of hours. We do not have the luxury of expansive history gathering, data collection, discussion, and reflection. Read more.
We Need To Take Care of Our Children
The statement above was made at a recent AAEM Board of Directors meeting. It may sound like a strange statement to be made at such a meeting but it carries great significance. Most physicians believe that there is a duty for each physician to encourage, mentor, educate, protect, and to take care of the next generation of physicians. Read more.
The Emergency Physician as Plaintiff
Political activism in support of emergency medicine can take many forms. Traditionally, political activism by physicians has taken the form of membership in county, state, and national medical societies who lobby various branches of state and national governments related to specific issues and bills, which are pending. Some more involved physicians write or call their state and national elected officials asking for their support or opposition to bills pending in the respective state legislatures or in our nation’s capital. Read more.
The New Threat
Well another Scientific Assembly has concluded in St. Louis. The very fact that it was held at all was a minor miracle with all of the uncertainties and challenges which COVID presented. The discussion and decisions which had to be made to make this meeting happen were significant, but AAEM held a hybrid in-person and virtual meeting and over 400 emergency physicians gathered in St. Louis for the conference. Read more.
Diversity of Priorities and Talents
This last year will be one of those times long from now that you will tell your grandchildren stories about and reflect on the trials and tribulations, which you have faced. I suspect this will be similar to our elders reminiscing about the Great Depression, Pearl Harbor, the Kennedy Assassination, or similar epic type events from our communal past. The turmoil related to COVID, George Floyd, and the 2020 election will probably stand out in our minds forever. Read more.
Could Things Be Any Worse?
I recently had a discussion with a group of emergency physicians from various parts of the country and from all sorts of practice types. I respect the opinions and the wealth of experience of this group and of course was also interested in their COVID-19 experiences both good and bad and how their practices had been impacted by the virus. Read more.
A Test, a Shot, and a Prescription
Each emergency physician needs to develop a strategy to deal with the numerous patient and personality types which we can encounter in the average shift. There are of course the chronic pain patients, the worried mother, the anxious overly concerned son, the histrionic patient, the medically savvy (at least in their mind) patient, and this list goes on and on. Read more.
The Rape of Emergency Medicine
I would like to propose a challenge to each of you and it is to read a book. Have you ever read Jim Keaney’s “The Rape of Emergency Medicine?” If so, how long ago? Maybe now is the time to read it for the first time or to reread what to many was the call to arms for action when the Academy was founded. Read more.
People are People
So how do you spend your COVID downtime? Some of us have been working extremely hard in extraordinarily difficult circumstances. Other emergency physicians who work in less affected areas have seen huge decreases in patient volumes or decreased hours and shifts. Read more.
Making a Difference
Let’s think back to when you opened that envelope and learned that you had been accepted into medical school. You dreamed of saving lives and helping people and making your mother proud. No matter where any of us ended up in our medical career, I think all of us at some point were idealistic and thought that we could “make a difference.” Read more.
The Moral Dilemma of COVID-19
Certainly, there is only one issue which is dominating all thoughts, prayers, and efforts on our planet right now and it is COVID-19. Hopefully where you are, your life and practice will only be incredibly inconvenienced and that your family, your community, and your hospital will be spared the worst of this pandemic. Read more.
A Thick Skin
An essential skill for the wellness of any emergency physician is the ability to cordially and professionally interact with the doctors in person or on the other end of the phone whom we contact for admissions, consults, and follow-up. This skill is difficult to teach, but is essential for success from both a professional standing and wellness point-of-view. Read more.
The Meaning of an Election
We are approaching election season again, which in our current world brings up many mixed emotions, and sadly can tend to disintegrate into complaints and allegations related to the system and the individuals involved. Read more.
The State Board
The issue of independent practice for nurse practitioners seems to be heating up around the country. Many states have already enacted statutes which give nurse practitioners the right to practice independently of a physician. Read more.
Provider Satisfaction
Your practice, I am sure, is being graded and evaluated based on some sort of patient satisfaction score. You and your department probably receive quarterly to even daily reports of your ability to “wow” your patients. Read more.
The Fox and the Hedgehog
We all know that an emergency department is a stressful place to work. During any shift we can see, and personally experience, an array of responses to
stress and challenges... Read more.
Emergency Medicine Wellness Bill of Rights
Sitting in an airport after leaving the latest AAEM Scientific Assembly is a place for me to reflect upon the last several days... Read more.
AAEM Opposes NP and PA Independent Practice
Talk to any emergency medicine resident, and you’ll hear how the incredible burden of student loans looms over them... Read more.
The Gap
AAEM completed a membership survey of the active membership in an effort to know what our members are thinking... Read more.
The Tribe
In my last article, I discussed the sadly common feeling of despair in our specialty... Read more.
I’m Mad as Hell and I’m Not Going to Take It Anymore!
If you have never seen the brilliant movie, Network, you should find it and watch it as soon as you can... Read more.
Pilgrimage
A pilgrimage is a journey or search of moral or spiritual significance. Read more.
The Real Threat?
Emergency medicine will face many significant challenges in the coming years... Read more.
The Hamster Wheel
Do you ever feel like a hamster running endlessly on a wheel while you are working a shift in the emergency department? Read more.
What is ACEP Thinking?
An emergency physician who grew up in the 21st century may not know or appreciate the complex history of emergency medicine. Read more.