I've been an Attending in Emergency Medicine in or around our nation’s capital for the last 16 years. Throughout my career as an African American woman, whether in academia or in leadership meetings, I have often been the only one. I've been the only woman often and even more frequently the only African-American.

It would be overstating to say that this has been ideal or always comfortable. I’ve gotten quite used to it, actually, and have followed my passions in Emergency Medicine and life generally in ways such that being the only has become mostly background noise as I go through my day. More...

On January 1st of this year, MEP Health became a founding partner in US Acute Care Solutions. Four months later, one thing is abundantly clear, if it wasn’t already: if you’re not comfortable with change, you’re probably working in the wrong industry. Some might say you’re living in the wrong century.

Our decision to help form a new, national acute care company took some by surprise. And, it raised the question of whether we had acted out of short term interests, rather than getting ahead of long-term industry trends. More...

A new generation of female physicians is reshaping perceptions of our profession: what it takes to succeed, and therefore what sorts of skills, temperaments, and character types belong in our field. The changing demographics of emergency medicine physicians begs a consequential question: should female emergency physicians embrace their femininity on the job?

There is the nascent #ILookLikeaSurgeon campaign that started on Twitter and grew to its own domain aimed at breaking down the stereotype that surgeons are all of the Caucasian, male, alpha-types of old. What will the equivalent movement be for emergency medicine? And what obligation do female EM residents and attendings have to represent our profession on the job and when we negotiate for new jobs? More...

Over the last decade, I’ve studied, trained and practiced my craft in the emergency department, dedicated to doing my best for each patient. In that time, I’ve also realized that while I am a part of the medical care system, I am not actually part of a health care system. While my goal is to give my patients the best chance to be healthy, the system and science in which my practice is rooted seem too content to manage disease, watching it wax and wane. I find this unacceptable. I’ve watched from the inside as health care has struggled to live up to its name, despite our successes. More...

It's been described as "a cyclical arms race," as well as a Game of Thrones-style struggle for dominance over the healthcare kingdom. Whatever you call it, the widespread consolidation of health insurers on the one side and hospitals and health systems on the other leaves clinician groups with a difficult choice to make. They can grow organically by winning new business, hang a for sale sign in the window and hope for the best or join with other like-minded groups who share their values.

Our team has chosen the latter. More...

The Wall Street Journal’s Dec. 1 story on observation care is relatively even-handed and does a good job at bringing to light the highly complex web of regulation, which has gotten a little slice of the U.S. health care system to where it is today. The gist of the story is rather straightforward: 30-day readmissions have fallen significantly since Obamacare, while the number of visits which classify as observation status has gone up. The implication is that patients aren’t actually being given better treatment, they’re just being reclassified under a different status. More...

Ever notice how quickly things can change in the ED?

One minute things seem to be well under control, the next minute several alarms are going off, three nurses are simultaneously asking for you, and there are no inpatient beds available. How’d that happen so quickly?

In emergency medicine, we are experts in change – metamorphologists as well as emergentologists. We are all intimately familiar with the anatomy of that moment of change – how it feels, how it progresses, and how it follows its own drumbeat. More...

Whether it’s the first time you’ve attended or you’ve experienced that four-day long whirlwind in the past, the reality is this: ACEP is a multi-day scientific assembly like no other. There are a lot of informative classes to attend, great people to meet, top-notch dinners to enjoy—and drinks every night. And this year, ACEP takes place in Boston—one of the country’s oldest cities—which has some of the best eats and architecture! Still, as recent grads and residents, you should also consider ACEP a four-day interview for your next job. It’s a networking opportunity that you should take seriously. More...

 

Former CMS Administrator Thomas Scully speaking at Observation Care '15.

The future of healthcare is for physicians, not hospitals.

That’s the message former Administrator for the Centers for Medicare and Medicaid Services (CMS) Thomas Scully emphasized at the Observation Care ’15 symposium. Scully, who was one of the principal architects of Medicare Part D, said the current trend toward hospital and health system consolidation won’t turn out well. More...

Editor's Note: the following is an excerpt from Dr. Robbin Dick's forthcoming book on Hospital Capacity Management. Dr. Dick is MEP's Director of Observation Services. He will be speaking on hospital capacity management and other subjects at MEP's third annual observation medicine conference, Observation Care '15.

Bed assignment often sets the pulse for the entire hospital, affecting every patient and every department from minute to minute, yet is often poorly managed. More...