I once thought that having made a diagnosis and recommended its treatment that I could now move to the next patient. Experience has taught me however, that it is now that the crucial work begins.
Ready or not artificial intelligence is here. Does this mean that physicians are soon to be out of a job? On this episode I explain why our positions are secure, at least for now....
After a month to process my emergency appendectomy, on this episode I describe my "take aways" from my encounter, or should I say collision, with modern American medicine.
I have had little experience being a patient... until now. On this episode I share what it was like on the other end of the stethoscope, or in my case the scalpel.
Hospital administration continually reminds me that emergency medicine is a business. If so, this begs the question - what are we selling? On this episode I describe why my recent experience suggests that what we are selling is not really what our patients are looking to buy.
Enormous pressure is being applied to turn emergency departments and the specialists who run them into something the were not meant to be. This shift in focus threatens both our medical system and our patients. On this episode I describe these changes and their origins.
On this episode I present an epitaph for the Coronavirus pandemic. I describe how and why it ended and discuss how we were convinced to make sacrifices and fight in a war that never existed.
After two episodes spent defining the problem, on this offering I outline a prescription to treat our sick society. We have the tools, do we have the will to try something new?
If recent events reflect an American society that has become sick, what is the illness affecting us and how did it arise? On this episode I argue that our attempts to engineer a " Great Society" have collided with human nature and the results have not been those expected.
Do recent events prove that our society is sick? I believe that they do. Does 40 years of experience caring for sick individuals justify my comentary discussing why it is sick and what can be done to cure it? Decide for yourself.
Emergency physicians report the highest levels of burnout among medical specialities. So how am I still tolerating and even enjoying (sometimes) going off to work after forty years? On this episode I explain why I've been lucky.
Things seem to go more smoothly when the "voice of authority" can be trusted to guide us along. But can it? Not if opposing viewpoints are ignored or repressed.
Can insights inspired by butterflies help us avoid the chaos that too often reigns in our emergency departments? On this episode I discuss "the butterfly effect" and why respecting it can help protect emergency physicians and patients alike.
An emergency physician must know what to do under trying circumstances. But before this can be done , he must first know what is happening and when to do something must be done. On this episode, I relate how I began to learn these skills working a part time job in medical school.
As I struggled to become an effective emergency physician, I realized that my only hope was to put into practice the many lessons I had learned along the way. I now realize that everything I needed to know, I did not learn in medical school alone. On this episode I discuss other experiences that gave me the tools that I now use every day in my practice, and for that matter, my life.
On this episode I kick off the fifth year of the podcast by reflecting upon what has made spending my adult life practicing emergency medicine a satisfying endeavor. After several offerings recounting concerns about my specialty, it is time to celebrate some of the reasons I go to work.
What percentage of the patients that we admit to the hospital do we harm? On this episode I reveal why when those charged with making the decision to admit forget the answer to this question, our specialty and our whole medical system pay the price.
The hypothesis: Emergency physicians are providing less effective care now than twenty years ago. The Proof: longer wait times, more overcrowding, more cost, less job satisfaction. Who's to blame: us (among others) In this episode I take a hard look inward and discuss where emergency medicine has sabotaged itself.
Covid 19 has exposed a dirty little secret that emergency physicians have helped keep for decades- there is not enough to go around. Unfortunately the way things are headed, those best equipped to deal with the reality of limited medical resources are being pushed aside - with predictable consequences.
The specialty of Emergency Medicine sprang into being in order to fill a need. I'm concerned that we've lost sight of that need as we train those to whom we will pass the torch. On this episode I begin a discussion of how and why our specialty developed and why keeping our fragile medical system afloat rests on our shoulders.
Pretending that there exists an "opiate crisis" obscures our society's real, much more difficult health crisis. On this episode I discuss what these real problems are and why accepting the delusion that opiates are the issue is leading us down a treacherous path.
Overdose deaths have tripled since our society acknowledged and declared war on an "opiate crisis". Not surprising since much bigger problems are to blame. In this episode I outline why beginning with the false premise that opiates are to blame only obscures our understanding of our troubles and thwarts our efforts to achieve positive change.
Unquestionably Americans are tragically dying of drug overdoses each day. In this episode I explain why calling this an "opiate crisis" is a smokescreen that obscures the problem making it more difficult to solve and perhaps making it worse.
What will be the aftermath of the coronavirus pandemic? On this episode I offer predictions regarding what to expect as we survey the post Covid 19 landscape. The central theme : we ain't seen nothing yet...
One year ago there was no data or experience to guide us as we struggled to defend ourselves against the Covid 19 pandemic. We therefore relied on our leadership's best guesses. In this episode I argue that it is time for individuals use the lessons learned in 2020 to replace guesswork and decide for themselves how best to protect themselves and their families.
In the year since the first patients with Covid 19 arrived in our emergency departments, physicians have learned some hard lessons about treating this disease. In this second installment of my "state of the pandemic address" I discuss what works...and what doesn't.
Data collected in 2020 has allowed us to paint an objective picture of the Covid 19 pandemic that seems quite different than the portrayal fed to us by the mainstream media. What this data shows and why it is distorted by the evening news are explored on this months offering.
The rate of successful resuscitation of patients having a cardiac arrest in the hospital have not improved during the last 40 years that hospital personnel have been relying on ACLS protocols. In this episode I discuss why ACLS fails and what it will take to move forward.
Ever thought in detail about how people die? I suppose that for most this morbid subject is not dwelled upon, but for 40 years it has been a big part of my job. Experience has taught me that people die in many ways. And this is a problem since most medical personnel are trained to understand one model of the dying process and it is one that they are unlikely to often encounter. On this podcast I outline a different scheme for understanding this process that will finally allow caregivers to progr...
What happens when non emergency specialists provide recommendations to guide emergency care? Spoiler alert: ...nothing good. And no better (or worse) example of this exists than ACLS.
