I Dream of Julene, or Can Physicians Ever Really Retire?


It began with the routine sorting of admissions. As first year post-grads on a three-month long internal medicine rotation, the three of us each picked up, in rotation, two early morning admissions. My first was a pretty straightforward cellulitis case, and most everything that needed to be done had been done in the ED. The second patient was a 79-year-old woman who was ‘found down’ by an apartment neighbor who heard her cries through poorly insulated … Continue reading

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Lifting All the Boats in Emergency Medicine

rising tide lifts all boats

Like many specialties, especially those engaged in hospital based practice, emergency medicine finds itself facing a number of challenges related to health care and payment reform, the most immediate of which is to maintain its current share of health care revenues in the face of resistance on many levels.  There will always be a role for emergency physicians in managing seriously and critically ill and injured patients, but there is a real question about the ability … Continue reading

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Prime vs. Kamala Harris: Duking it Out Over Charity Care

Reddy vs. Harris

Today Prime Healthcare rejected the conditions that California Attorney General Kamala Harris placed on the purchase of Daughters of Charity’s six-hospital system, placing the future of these hospitals in doubt.   In rejecting the $843 million proposed deal to rescue these hospitals, Prime called the conditions placed on the sale “so burdensome and restrictive that it would be impossible for Prime Healthcare — or any buyer — to make the changes needed to operate and save … Continue reading

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Partisan Politics: Paralysis From the Neck Up

Round 2015

I recently heard a great talk about the partisan paralysis in Congress by former Senator from Maine Olympia Snowe, a Republican politician who (mostly) walked the walk of bipartisan legislating. Her analysis of the origins and impacts of the partisan impasse in Washington was compelling, and I am looking forward to reading her new book, ‘Fighting for Common Ground, How We Can Fix the Stalemate in Congress’.   I, and the rest of the audience attending … Continue reading

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The Under-appreciated Role of the ED in Terrorism Response

Responding to Terrorism

As new threats arise from Al Shabaab and ISIS encouraging attacks by isolated radical volunteers at specified targets throughout the western world; media outlets and pundits are recommending all sorts of mitigation measures: everything from heightened security measures to increasing vigilance by the public to counter-publicity. Unfortunately, no matter what we do to prevent this tragic violence, it is likely to erupt in some anticipated or unlikely venue and challenge us to respond to the ravages of … Continue reading

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