Burnout: Emergency Medicine Hit Hardest

From MedPage Today:

Rates of burnout vary markedly by specialty, but generally the highest rates are found among front-line physicians: family medicine, general internal medicine, neurology, and emergency medicine, and the lowest rates were found among pathology, dermatology, general pediatrics, and preventive medicine, according to a survey of burnout among U.S. physicians.

The mean average of those reporting burnout was 45.8%, but the emergency physicians had the dubious distinction of being the specialty with the highest burnout rate: more than 60%.

A change of heart: As evidence mounts, fewer doctors perform unnecessary angioplasties

From the Star:

A study published this month in the Journal of the American Medical Association finds that the number of elective angioplasties has fallen by a third in just five years. That mean tens of thousands of people are avoiding a procedure that may have done them little or no good but that costs on average $27,000 and may require years of drug therapy to avoid complications.

Meanwhile, a second new study in the New England Journal of Medicine finds that even after 15 years, patients who chose medication and lifestyle changes over angioplasty were no more likely to die than those who chose the procedure.

Michigan Freestanding ED Closes

From MLive:

The emergency department at Bronson Vicksburg Outpatient Center will close Dec. 31, 2015.

Laura Howard, system director of Bronson Healthcare, said Bronson Methodist Hospital will be closing its satellite emergency department because the Vicksburg location has been experiencing a steady decline in the number of emergency patients it sees each year, as well as in the acuity of illnesses and injuries it treats.

More school nurses carrying Narcan

From WCVB:

School nurses are increasingly preparing to join the frontlines in the battle against heroin addiction.

MetroWest Daily News says as heroin and prescription opioid abuse continues to ravage communities across the nation, a growing number of schools are equipping their nurses with the overdose-reversing drug naloxone, often referred to by the brand name Narcan. More than half the school districts in Massachusetts have joined the trend.

Emergency Physicians Experience Burnout

From MedPage Today:

Rates of burnout vary markedly by specialty. The highest rates were found among front-line physicians: family medicine, general internal medicine, neurology, and emergency medicine. The lowest rates were found among pathology, dermatology, general pediatrics, and preventive medicine.

“It matters to patients that physicians are burnt out; they deliver suboptimal care,” she told MedPage Today. “They are also more likely to cut back on clinical work hours, and more likely to leave current clinical practice. That impacts access and continuity.”

South Dakota braces for heroin epidemic

From the Argus Leader:

Police officers and emergency personnel would be allowed to carry medicine that reverses opioid overdoses under rules that will be considered next week by the state’s medical licensing board.

The South Dakota Board of Medical and Osteopathic Examiners meets Thursday in Sioux Falls for a public hearing on the issue. The backdrop to the hearing is a surging heroin epidemic that hasn’t hit South Dakota yet, but one that officials are bracing for.

Meanwhile, people also are dying from overdoses of prescription painkillers.

Best Practices for Prescription Drug Monitoring Programs in the Emergency Department Setting

From Annals of Emergency Medicine:

Prescription drug monitoring programs are generally underused in emergency departments (ED) and nationwide enrollment is low among emergency physicians. We aimed to develop consensus recommendations for prescription drug monitoring program policy and design to optimize their functionality and use in the ED. We assembled a technical expert panel with key stakeholders in emergency medicine, public health, and public policy. The panel included academic and community-based emergency physicians, a pediatric fellowship–trained emergency physician, a medical toxicologist, a public health expert, a patient advocate, a legal expert, and two state prescription drug monitoring program administrators. We compiled prescription drug monitoring program policies and characteristics and organized them into domains based on user–prescription drug monitoring program interaction. The panel convened for 3 rounds in which the policies and characteristics were introduced, discussed, and modified in an iterative fashion to achieve consensus. The process yielded policy recommendations and design features, with majority agreement. The panel made 18 policy recommendations within these main themes: enrollment should be mandatory, with an automatic process to mitigate the workload; registration should be open to all prescribers; delegates should have access to prescription drug monitoring program to alleviate work flow burdens; prescription drug monitoring program data should be pushed into hospital electronic health records; prescription drug monitoring program review should be mandatory for patients receiving opioid prescriptions and based on objective criteria; the prescription drug monitoring program content should be standardized and updated in a timely manner; and states should encourage interstate data sharing. An expert panel identified 18 recommendations that can be used by states and policymakers to improve prescription drug monitoring program design to increase use in the ED setting.



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