Co-Workers Not the Cause of Your Burnout: A Reply

From the Editor: We recently published a Letter to the Editor from a veteran of Pediatric Emergency Medicine  critical of an AAP session that seemed to imply PEM burnout was due our burned out co-workers in the ED. Dr. Charles Samenow, the speaker referred to in the letter, wrote us to respond. His letter is published below. We appreciate the comments made about our session and for the opportunity to continue the dialogue. The idea that “interaction with co-workers” was the primary reason for physician burnout was not an intentional message.  Actually, in support of this author’s Read more [...]
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Answer: ‘It’s Artifactual’

This post is in response to the post “It’s Artifactual” To summarize, this was an eleven-year-old boy who was brought into the ED for left foot pain with a concern for a foreign body in his foot.   An ultrasound was performed and the following images were obtained:   Thank you to everyone who took the quiz! For question #1, 52% of you guessed correctly that the foreign body visualized was wood, and not glass (29%) or plastic (19%). For question #2, 57% of you guessed correctly that posterior enhancement is an artifact not commonly seen with foreign bodies, Read more [...]

MD Cents: Student Loans Stink, Wouldn’t It Be Great to Not Have Any?

Some people are blessed to graduate from undergraduate and medical school without student loans. This may be from smarts, talent, generous family members, hard work, or other reasons. I was not fortunate enough to graduate without student loan debt. The average amount of student loan debt after medical school is $180,000! Let's say that again--$180,000. That is the average--meaning that half of graduates have more than $180,000 in student loan debt. What can you do to avoid having a second mortgage in student loan debt when you graduate? First, live frugally to minimize the amount of loans Read more [...]

Blaming the Victim for Burnout in PEM

The following is a Letter to the Editor. Opinions expressed in Letters to the Editor reflect the opinion of the author and not necessarily that of PEMNetwork staff. Dear Editor, I recently attended a session called “Burnout in PEM” during the Annual AAP Meeting in Washington D.C. The session was the main reason I decided to attend the meeting (other than the usual feeling of schadenfreude derived from hearing about my colleagues’ daily problem, mostly similar to my own). I recently turned sixty, have practiced PEM for half of my life (yes, I did attend the Eagle Lodge Conference Read more [...]
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It’s Artifactual

An eleven-year-old boy is brought into the ED by his parents after he complained of left foot pain earlier that day. The boy does not recall any trauma, but the parents do note that they are moving into a new home and that their house is a mess. On exam, you note some erythema on the heel of his foot. While waiting for an XR, you perform an ultrasound and obtain the following images: http://lng801.polldaddy.com/s/fb-artifacts Thank you for playing! Answers and explanations will be posted in a few days. If you want to see YOUR image included in the next Image of the Month, please Read more [...]

Tricks and Treats and a Visit to the ER

In the 1980's, my mother used to make me wait to eat my Halloween candy until she could sort through it for needles. Sound like an urban legend? Well it is...almost! Due to media sensationalism by Ann Landers, Dear Abby, and even the New York Times urban legends of malicious candy tampering ran rampant during my youth. Take, for example, that plump red apple that Junior gets from a kindly old woman down the block. It may have a razor blade hidden inside. The chocolate candy bar may be a laxative, the bubble gum may be sprinkled with lye, the popcorn balls may be coated with camphor, the candy Read more [...]

Are We Killing Our Profession in The Era of ACGME Regulations?

A decade ago when I started my medical training, we celebrated, as residents, the impact of duty-hours regulations on our daily lives. We were the first generation to experience the winds of change. This change was prompted by the famous case of Libby Zion in my home state of New York. The death of this young girl lead to an unprecedented ripple that changed the world of medical training in the United States. Since then the Accreditation Council for Graduate Medical Education (ACGME) implemented rules and regulations to limit residents’ fatigue and work hours. This was an important step Read more [...]

MD Cents: Who is Wealthy?

Many people define a wealthy person in many different ways. It depends on whether you define wealthy in terms of emotional, spiritual, relational, or financial issues. As this series deals with finances I took some time to ponder this over the past weeks. I just finished a book titled, "The Millionaire Next Door," by Thomas Stanley and William Danko. It was written in 1996 but has fascinating insights into millionaires' lifestyles. In their book, they define someone as financially wealthy if their net worth is $1 million or more. How do you define your net worth? Net Worth = Assets - Liabilities Net Read more [...]