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A Solution to the SGR: Value-Based Medicare Payments You have probably heard of the SGR, or Sustainable Growth Rate. It is a formula that was put in place in 1997 as part of the Balanced Budget Act t
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Developing the Physician Advocate While most of you will have graduated and moved into practice by the time all these changes take place, it is important to remain informed about the current challeng
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Adult-Sized Problems It was one of my first shifts of residency after spending a few years with the U.S. Marines. Until recently, I had not treated a patient under the age of 17 since my internship t
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Understanding Alcoholic Ketoacidosis A 49-year-old male with a history of alcohol abuse presents to the ED with complaints of generalized abdominal pain and vomiting for the last 36 hours. The patien
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A Different Perspective Ian and I found out we were pregnant on the Sunday after Thanksgiving – one month along; everything seemed to be going right in life, and this just felt like it was meant to b
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A Reflection on Mental Health and Emergency Medicine After a knock on the door, I entered the hospital room to find Lisa, a 12-year-old patient who was seated on the exam table, eyes fixed on her sho
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A Temporal Problem: Diagnosing and Treating Viral Encephalitis in the ED Case Report A 49-year-old male presents to the emergency department with two days of confusion, agitation, and speech abnormal
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12 Ways to Prosper in Emergency Medicine After 35 years in emergency medicine, you gain a little more than just medical knowledge. The day in and day out, grueling aspects of our chosen field can som
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Backboards: Do They Really Have Your Back? Spinal immobilization has long been considered standard practice for pre-hospital trauma patients. Placing patients on long spinal boards is one of the most
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Practical Tips: When and How to Use a Femoral Nerve Block An 82-year-old female shows up  in your ED with severe hip pain    after a fall at home. You already know what the x-ray is before you see it