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title: Blog & Articles - The Sullivan GroupThe Sullivan Group | Tom Syzek (3)
description: (3)
---
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# Blog & Articles
## Tom Syzek
### Recent Posts
## [The Opioid Crisis: Far from Over](https://blog.thesullivangroup.com/the-opioid-crisis-far-from-over)
October 31, 2018
[](https://blog.thesullivangroup.com/the-opioid-crisis-far-from-over)
\[12 MIN READ\]
For the past two decades, the U.S. has experienced alarming rates of opioid use, misuse, abuse, and overdose deaths, and we are now ground zero for the opioid epidemic. This epidemic is rife with risks for patients, practitioners, insurers, healthcare organizations, communities, and our entire society. This is the first article in a three-part series in which we’ll explore the opioid epidemic, [liability trends related to opioid prescribing,](https://blog.thesullivangroup.com/opioid-prescribing-liability-trends) and strategies to reduce harm from opioid prescribing and abuse.
- [Tweet](https://twitter.com/share)
## [Medical Errors, Communication, and Teamwork: Lessons from Angola](https://blog.thesullivangroup.com/medical-errors-lessons-from-angola)
October 24, 2018
[](https://blog.thesullivangroup.com/medical-errors-lessons-from-angola)
\[6 MIN READ\]
(adapted with permission from the original by Dr. Tim Kubacki at [https://kubackisinangola.com/](https://kubackisinangola.com/))
***Dr. Tom Syzek:*** These days we hear so much about the importance of communication and teamwork in avoiding medical errors and how we deliver care at the end of life, I thought for perspective, I would share this case presentation from Dr. Tim Kubacki. Tim is a friend and colleague who left behind the comfortable life of an emergency physician in central Ohio to serve with his family as a medical missionary for 6 years in the jungle interior of Brazil, and for the past 5 years in medically underserved rural Angola. Tim recounts beautifully this medical case of mistaken identity, driving home the point that communication and teamwork are the essence of patient safety, while at the same time describing the only “end-of-life care” available.
- [Tweet](https://twitter.com/share)
## [A Good Shift is a Choice](https://blog.thesullivangroup.com/a-good-shift-is-a-choice)
October 8, 2018
[](https://blog.thesullivangroup.com/a-good-shift-is-a-choice)
*Adapted from an original blog by Paul Culler, MD, FACEP, FAAFP*
\[2 MIN READ\]
I believe that having a good shift is a choice. In other words, I think that your mental outlook will influence whether you have a good shift or not. I recently heard someone use the phrase, “If you think you will or you think you won’t, you’re right!” This statement alludes to the fact that events will often unfold as self-fulfilling prophecies.
- [Tweet](https://twitter.com/share)
## [Top 10 Risks in Ambulatory Practice](https://blog.thesullivangroup.com/top-10-risks-in-ambulatory-practice)
August 21, 2018
[](https://blog.thesullivangroup.com/top-10-risks-in-ambulatory-practice)
In 2014, there were 885 million physician office visits. Over half of these visits occurred in primary care –family medicine, internal, medicine, pediatrics and others – but there are still hundreds of millions of visits to medical and surgical specialists as well.
Based on information available from journal publications and claims data, we assembled this list of the top ten risk and safety issues pertinent to ambulatory care settings. While this list is not exhaustive, it represents the majority of errors and pitfalls in ambulatory patient safety.
- [Tweet](https://twitter.com/share)
## [Avoiding the Dead Leg: Acute Limb Ischemia (ALI)](https://blog.thesullivangroup.com/avoiding-the-dead-leg-acute-limb-ischemia-ali)
July 23, 2018
[](https://blog.thesullivangroup.com/avoiding-the-dead-leg-acute-limb-ischemia-ali)
Medical errors related to vascular emergencies are common and costly. From head to toe, the vascular system is a fertile field for risk and error waiting to entangle the unwary practitioner.
- Starting at the top, the high-risk vascular entities include a trio of hemorrhages (subarachnoid, subdural, and epidural) and the ischemic duo of TIA and [stroke](https://blog.thesullivangroup.com/rsqsolutions/prevention-treatment-stroke).
- In the chest reside some of the big hitters – acute coronary syndrome, pulmonary embolism, and [thoracic aortic dissection](https://blog.thesullivangroup.com/rsqsolutions/thoracic-aortic-dissection-great-masquerader).
- Moving south into the abdomen, we find abdominal aortic aneurysm, mesenteric ischemia, GI bleeds, retroperitoneal bleeds and traumatic hemorrhages.
- [Tweet](https://twitter.com/share)
## [Beware of the “Dirty Urine”](https://blog.thesullivangroup.com/beware-of-the-dirty-urine)
July 18, 2018
[](https://blog.thesullivangroup.com/beware-of-the-dirty-urine)
Every day in the practice of medicine, hundreds of thousands of urine samples are tested. The maxim that states “all females between ages 10 and 60 with abdominal pain must have a urine pregnancy test” has been ingrained into our cerebral cortexes. Since the times of ancient medicine, the urinalysis has been used to screen for a host of diseases. The urinalysis is a vital tool in evaluating patients. However, as helpful as it is, it has also led many clinicians down the wrong path towards chaos. Two different cognitive medical errors come to mind when interpreting the urinalysis.
- [Tweet](https://twitter.com/share)
## [10 Medical-Legal Basics Every Provider Must Know](https://blog.thesullivangroup.com/10-medical-legal-basics-every-provider-must-know)
July 2, 2018
[](https://blog.thesullivangroup.com/10-medical-legal-basics-every-provider-must-know)
Regulations, rules, litigation, and medical errors are not the most popular topics for the busy clinician. Most of us would rather gargle nuclear waste than spend a precious evening reading about these issues that plague the pure and honorable practice of medicine. However, we avoid such matters at the peril of our patients’ safety as well as our own personal and professional well-being.
Since few (if any) of us will invest in a treatise the length of *War and Peace* on the subject, I have assembled the following short list of “10 Medical-Legal Basics Every Provider Must Know” for the busy physician, nurse, and advanced practice clinician.
- [Tweet](https://twitter.com/share)
## [CASE: Suicide in the Emergency Department](https://blog.thesullivangroup.com/case-suicide-in-the-emergency-department)
February 19, 2018
[](https://blog.thesullivangroup.com/case-suicide-in-the-emergency-department)
Providing care to psychiatric patients in the emergency department is a challenge for many reasons.
- Emergency physicians often receive insufficient training in behavioral emergencies.
- ED personnel are uncomfortable evaluating and treating these patients.
- ED staff may harbor negative attitudes toward behavioral health patients.
- Resources such as consultants and inpatient beds are lacking.
- The hectic ED environment can lead to iatrogenic escalation of psychiatric crises.
For the ED, however, the greatest risk and safety issue related to behavioral health is the appropriate evaluation and protection of the suicidal patient in the ED. We present 2 case studies to illuminate the uncommon but preventable catastrophe of suicide in the ED.
- [Tweet](https://twitter.com/share)
## [Warfarin Complications](https://blog.thesullivangroup.com/warfarin-complications)
February 12, 2018
[](https://blog.thesullivangroup.com/warfarin-complications)
Clinicians issue tens of millions of warfarin prescriptions each year in the U.S., despite the increasing use of alternative anticoagulant medications. Practitioners will continue to encounter warfarin, known both for its irreplaceable value and potential for life-threatening complications. Due to the propensity for permanent disability and death from hemorrhagic complications, litigation is common and costly. Knowledge of the pharmacology, indications, monitoring, drug interactions and complications of warfarin is an essential tool to avoid patient harm, [medical errors](https://blog.thesullivangroup.com/rsqsolutions/malpractice-claims-medical-errors-one-real-target), and the medical-legal vulnerabilities associated with its use.
- [Tweet](https://twitter.com/share)
## [Pediatric Abdominal Emergencies](https://blog.thesullivangroup.com/pediatric-abdominal-emergencies)
January 22, 2018
[](https://blog.thesullivangroup.com/pediatric-abdominal-emergencies)
Infants and children with acute abdominal pain present to emergency departments, urgent care centers and physician offices with a variety of signs and symptoms. Since infants can’t localize pain and pre-school children are often imprecise in their responses, the healthcare practitioner may find it difficult to ascertain the actual dilemma.
- [Tweet](https://twitter.com/share)
[Previous](https://blog.thesullivangroup.com/author/tom-syzek/page/2) [All posts](https://blog.thesullivangroup.com/all) [Next](https://blog.thesullivangroup.com/author/tom-syzek/page/4)
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