Yes, you heard me right. Well, what I mean is that no matter what you think of the Happy Hospitalist (and his controversial posts concerning getting awoken for critical lab values, his observation of a patient in impending respiratory arrest, and his idea to prevent kids from becoming ER abusers by taking away their stickers […]

    Although they are spending more time with their patients, according to a new study published in the Archives of Internal Medicine, primary care doctors (whose income has decreased by 10% adjusted for inflation from 1995 to 2003) are not meeting quality measures.  Despite the perception, doctor visits have increased on average from 18 minutes […]

OK, What the hell was in the water this weekend? Each shift we had one bad intracranial bleed. First, the post from yesterday, the 50 y/o with a subarachnoid. Second, a middle aged woman with a very large intraparenchymal bleed from uncontrolled hypertension. Third an elderly, yet functional man who fell down while on Coumadin […]

So, I saw my last quarter’s Press - Ganey report (patient satisfaction scores) and was a bit shocked. Apparently over the last year I have been in the top tier of all ER providers across the county (over the 95th percentile overall each quarter). Suddenly now, according to these folks, I am among the […]

You know it is sad when we have to admit patients to various units (usually specialty units like psych and peds) to “keep up the census” in order to justify us (the hospital) keeping the units opened (and thus, I imagine, to continue to receive state and or federal subsidies). It does not even […]

OK, here is a new record for me. How many cardiac arrests have you known a patient to have (and survive)? I mean, real asystolic/vfib/vtach arrests where miraculously one is brought back from the dead?
The other day we had a 46 year old guy come in with is TWELFTH! Twelve in the […]

It seems these days that the way to get things done in this country is to work through the courts instead of the legislature. This has been done successfully of late in several states by advocates for same-sex marriage. Now, California Emergency docs have sued their state for fair compensation from the state’s medicaid […]