http://blog.emergispace.com Behind the Curtain in Emergency Medicine Mon, 26 Oct 2009 22:44:46 +0000 http://backend.userland.com/rss092 en In a nut shell the idea behind the public option is that people who have a tough time getting inexpensive insurance (ie small business owners, independent contractors, self-employed, etc.) can buy insurance in a marketplace overseen by the government.  Because that represents over 47 million Americans they should be able ... http://blog.emergispace.com/medicine/health-care-reform-the-public-option/ There are days when it just isn't in you.  I know everyone has these days, but somehow as a doctor you just aren't supposed to.  There is an expectation that if you're any good you will rise above all BS, never let it suck you in, and never let it ... http://blog.emergispace.com/emergency-medicine/sometimes-it-just-aint-in-ya/ 1. The health care system is not nearly organized enough to ration care.  It has taken over a decade, multiple committees, and significant financial incentives and disincentives for items as simple as core measures to take hold nationwide--and these are very simple rules aka 'never events' 2. There is an art ... http://blog.emergispace.com/medicine/10-reasons-nobody-should-be-worried-about-health-care-rationing/ There are few decisions in life that are black or white.  Our entire society seems to live in shades of grey.  At some point in every physician's career one must decide which shade of grey is most comfortable for him or herself.  It is actually impossible to do "the right ... http://blog.emergispace.com/emergency-medicine/doing-the-right-thing-can-be-costly/ The AMA has long oppossed any federal regulation of physician payments and billing.  In fact the medical establishment has rebuked outside regulation and control for over a century.  We are probably the only industry to completely regulate itself on nearly every level.  Maintaining this self-control has been a major priority for the ... http://blog.emergispace.com/medicine/why-does-the-american-medical-association-ama-oppose-governmental-health-insurance/ I truly relish and enjoy my conversations with fellow ED docs about our days.  Sometimes only colleagues who do exactly what you do and see exactly what you see can truly understand what a day in this life is like.  While we are constantly surrounded by patients, nurses, secretaries and ... http://blog.emergispace.com/emergency-medicine/comrades-in-the-trenches/ This is probably the most common thing people ask me when they find out I'm an ED doctor, and I can totally understand the curiosity.  The ED is a crazy world.  Fascinating things happen everyday.  None-the-less, I find it difficult to answer this question in a satisfying way.  When I think of ... http://blog.emergispace.com/emergency-medicine/so-whats-the-craziest-thing-youve-seen-in-the-emergency-department/ And if you can help it, try not to argue about or even really care about anything that annoys you during these periods; and let's face it, after some circadian flip-flops and missing the sun for a few days, just about everything can be annoying.  I finally learned this lesson ... http://blog.emergispace.com/emergency-medicine/never-break-up-after-a-night-shift/ I saw a patient today who has become a semi-frequent flyer.  She has been in for chest pain, had MI's ruled out, received, narcotics, reassurance, the run around, etc on several occasions.  When I first saw her come in I was planning to do more of the same.  After-all, we ... http://blog.emergispace.com/emergency-medicine/does-it-really-need-to-be-this-hard/ We ran out of blank physician charts in the ED today, so we photocopied one and used those copies until the new order came in. As I used the photocopied "chart" today over and over again for each patient I repeatedly noticed the crooked angle of the lines and ... http://blog.emergispace.com/emergency-medicine/electronic-medical-records-emrs/