When I began my career some 25 years ago, my measure of success was pretty simple: take better care of my patients. The average emergency medicine clinician will treat 75,000 patients over a 25-year career. That’s a staggering number of lives to touch.
 
At some point early in my career, I realized there were different ways to serve patients. For me, it began as helping to establish a pediatric emergency department where none existed. So instead of impacting 3,000 patients a year, I’ve helped influence the care of over 15,000 children by building a better system of care at one hospital. More...

Emergency physicians know well the realities of evidence-based guidelines in emergency departments throughout the country: either there is wide variability in their use and uptake, or there just aren’t any evidence-based guidelines.

Patients don’t often think about it when choosing emergency departments - they mostly think about the wait time - but it’s there. Two patients, each with the same complaints and same risk factors may get completely different treatments depending on which emergency department they walk into. More...

When is peak recruiting season for emergency medicine residents? It depends. Everyone knows about when it starts and roughly when it ends. The first residents to sign usually do so in the summer, and the last are usually picking up the rear sometime in January (on the East Coast, that is).
 
But it's that start of the season that changes from year to year. Sometimes it starts early, with a rush of residents signing in June and July. Sometimes, though, it all seems to start a little later, with the rush coming in September. More...

I've been an attending physician 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...