[4 MIN READ]

“I just wish they would let us be doctors.” These words came from the mouth of my colleague while we were working together in the emergency department one night. He was sharing his frustrations with his scribe at the time, lamenting the nostalgic and romantic idea of having the freedom to practice as a physician! His phrase resonates with so many physicians, and in its sentiment lies the very essence of physician burnout, loss of engagement, and the destruction of the fabric of medicine! Allow me to explain.

[9 MIN READ]

I certainly don’t pretend to have the answer to the question of how to eliminate the opioid epidemic. There are legislative, regulatory and policy issues far greater than any one of us, but what can the medical community do? This was the call to action by Stephen Stack, President of the AMA, who also happens to be an emergency physician. Dr. Stack clearly labels this as an epidemic and says we have to do something.

[5 MIN READ]

In a recent blog entitled “The Opioid Crisis: Far From Over,” I reviewed the genesis, magnitude and impact of the opioid crisis in America. Now I will switch gears a bit and look at the trends in the liability of opioid prescribing.

Civil Liabilities

First there’s civil liability, which can and does result in fines and judgment awards. One potential civil liability is overprescribing opioids in quantity and/or frequency over long periods.

[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, and strategies to reduce harm from opioid prescribing and abuse.

[6 MIN READ]

(adapted with permission from the original by Dr. Tim Kubacki at 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.

[5 MIN READ]

Education is a vital to your department’s ongoing clinical performance improvement plans. But the presence of a plan alone isn’t the change catalyst. Through our twenty years of working with large health systems across the country, we have seen that facilities that successfully engage their staff in a new training program have a much higher likelihood of implementing change and positively impacting patient outcomes.

Here are 8 strategies to engage learners in your training program so your staff, patients and facility can receive the benefit you intend.

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.

[4 MIN READ]

Behavioral neuroscientists talk about the moment, the exact second we make a decision and act upon it. They describe in almost obsessive detail all the neuronal pathways and neuronal firings that occur in our brain. They talk about influences of past and present, knowledge acquired and remembered, skills honed and sculpted, abilities, beliefs, social backgrounds, immediate stressors, mood, medications, current/immediate/past circumstances, possible future implications, and so much more. If you stop to think about it, what goes into that second of acting upon a decision, whether by words or actions, is really a reflection of present, past and future in all of us. Such a truly amazing phenomenon.

Now, take a minute to ask the patient if he or she cares about it?

[4 MIN READ]

The Problem

The term “Never Events” was used in 2001 to describe a subset of medical errors that, ideally, should never occur. Also known as “Serious Reportable Events,” they encompass a wide variety of surgical, device, patient protection, care management, environmental, radiologic and criminal events. The Agency for Healthcare Research and Quality currently defines 29 such events,[i] one of which is defined as “Unintended retention of a foreign object in a patient after surgery or other procedure.” The Joint Commission (TJC) lists 31 types of sentinel events; of such events voluntarily reported to TJC, the most common is “Unintended Retention of a Foreign Body.”[ii] In a review of paid malpractice claims from the National Practitioner Data Bank, Mehtsun and associates[iii] found that of 1,126 surgical retained foreign body events, 5% resulted in death, 16% in permanent injury, and 78% in temporary injury. This simply cannot be allowed to continue.

[3 MIN READ]

According to Sir William Osler, “Medicine arose out of the primal sympathy of man with man; out of the desire to help those in sorrow, need and sickness.” I will highlight two words: “primal sympathy.”

Empathy and sympathy have been researched extensively in the human brain. To summarize, being altruistic, having sympathy, and being empathetic are primal instincts in us; these instincts are no different than hunger or thirst.