Starting your first PEM job? Treat yourself to a college football game

You've finished years of training and finally have that job you've been working towards. You’re doing your first shift as a new PEM attending and a child arrives to your ED with a high fever and a rapidly progressing rash. Is he the needle in the haystack with meningococcemia? Or is he one of the hundreds of children in your community with an enteroviral infection? Should you start antibiotics and notify your nearest ICU colleagues? Or should he be discharged home with supportive care? Is there any evidence available to help with these vital decisions? Just as your heart rate is returning Read more [...]

The Police State We Call Health Care

I have some news for you. We are living in a police state! I am sorry, as I know it hurts to hear that we choose to live in bondage. Don’t be fooled by shiny title of being a health care professional, the pennies on the dollar we get paid from the ridiculous pool of money we generate, and the lifestyle that we were promised but rarely experience. We are watched 24/7 because of the title we carry. We are judged for every word we say, whether at work or outside work. We are evaluated by students, patients, residents, co-workers and supervisors. I have not seen any evaluation for a patient, Read more [...]

MD Cents: Check Up Time  

As physicians we all hope that our patients are getting regular check ups! For us as PEM providers, those regular well child checks allow our generalist colleagues to dole out the immunizations, provide anticipatory guidance, and identify trouble spots early while there may still be time to take corrective actions. Whenever we take our kids in for a well child check we try to have a few questions to ask the pediatrician to answer for us and internally are hoping to hear—everything looks good! Just like we need regular reassessments of our physical health, our financial health deserves regular Read more [...]

It’s PEM Academic Meeting Season and John Oliver Rails on Bad Science

Whether you’re asking the questions, teaching trainees, or incorporating evidence into your daily practice, many of us in PEM rely on sound research. With many recovering from the nerdy hangover of the recent Pediatric Academic Societies meeting and this week’s Society for Academic Emergency Medicine meeting activities, I have been thinking about how to digest the all of the posters, platform presentations, and calls for further studies on every topic. John Oliver—Daily Show correspondent turned incredulous HBO news anchor—dedicated a 20-minute segment on how science is interpreted and Read more [...]

Guns and Kids: We should talk about this

I recently read a shared Facebook post from a father who expressed his pride in his five year-old son, who recognized that friends were playing with a “real gun” found in a bedroom and informed his father. He went on to boast that it was because he had taught his son to use guns at an early age that the child acted so responsibly. The post had massive numbers of supportive comments and shares, along with many derogatory comments towards “those anti-gunners.” I saw no commentary about the gun owner’s poor judgement in leaving a firearm in a room where preschoolers and toddlers are Read more [...]

Nights- the best part of our job (April fools)

As I finish up my overnight and write this post I will quote my colleague nights are the worst and the best part of being a PEM doc (Mark X Cicero). While over 15 million americans work overnights we are some of the few with the wonderful "rotating schedule" of nights to days and back to nights. THE WORST- after a night some of us become the walking dead... and a real life zombie after two in a row! For those of us in academics we have to suffer through meetings and doze off during conversations.     As I approach my 40th birthday tomorrow nights are becoming slightly more painful Read more [...]

Answer: “Pains in the neck”

This post is in response to the post “Pains in the neck.” To summarize, this was a 4-year-old boy who was brought into the ED for right neck swelling that is erythematous and painful. An ultrasound was performed and the following images were obtained: Thank you to everyone who took the quiz! For question #1, 57% of you guessed correctly that this was an image of lymphadenitis, rather than parotitis (17%), Lemierre’s disease (17%) or a peritonsillar abscess (10%). For question #2, 30% of you guessed correctly that increased peripheral vascularity is associated with Read more [...]

MD Cents: What is Your Time Worth?

Time is Money—Benjamin Franklin I have often heard people quote Benjamin Franklin when talking about time.This is often in the context of a work life balance lecture at a national conference or hospital CME program. At first this quote seems to push one to maximize the time at work, but on my second glance made me see it in an entirely different light. I began to think of the time our job can cut into the time we have to spend on different pursuits. Obviously, we need a job to fund those pursuits and our job is one that is immensely rewarding, but nonetheless it still has a time cost in terms Read more [...]