ER doctor sues psychiatrist

From the Register-Guard:

An emergency room doctor in Coos Bay is suing a Eugene psychiatrist for more than $2 million over an alleged mis­diagnosis that required the doctor to temporarily withdraw from practicing medicine.

The lawsuit filed by Dr. Susan Haney in Lane County Circuit Court accuses Dr. Howard Sampley of mistaking the side effects of a medication for a mental disorder and then reporting Haney to the state Medical Board. The board opened an investigation, and Haney agreed to withdraw from her medical practice while that took place.

Four months later, Haney was reinstated with no restrictions. She continues to practice medicine.

What Harry Reid’s Hospitalization Teaches Us About Emergency Health Care

From the Huffington Post:

Stroke is a serious health risk for everyone, the fourth leading cause of death and a leading cause of disability. Now, Harry Reid’s illness has just reminded us of how we should prevent stroke and care for stroke symptoms.

Always in the news, Senator Harry Reid was admitted to the hospital on Dec. 20, 2013. Fortunately, he was found only to have exhaustion, and has been discharged. But Harry Reid’s courageous decision to rapidly get to the hospital is a lesson to all of us: Everyone is at risk for stroke, you should take steps to prevent stroke, and when you have symptoms suggesting a stroke or think you might be getting one, get to the hospital fast… and by paramedics if possible!

Poor access to primary care, anxiety play big role in ED use

From Modern Healthcare:

Experts hope that the healthcare reform law’s insurance expansion in 2014 will reduce the need for Americans to visit the emergency department to get care. But a new survey suggests that anxiety and poor access to primary care—not just lack of insurance—play a substantial role in driving patients to the ED, calling into question the degree to which expanded coverage will reduce ED use.

The Center for Studying Health System Change found that insured adults with access to primary and urgent care said fear, not convenience, was far more likely to send them to the emergency room. Adults with trouble reaching a primary-care doctor were more likely to turn up in the emergency department, the survey found (PDF).

Emergency Medicine: If you want to save your damaged smile, act fast

From the Columbus Dispatch:

I have heard from dentists and dental patients alike that the fear of losing teeth is common. This can manifest itself in nightmares in which you lose a front tooth, or perhaps all your teeth.

This is one reason we see so many patients in the emergency department with dental concerns — especially those related to traumatic tooth loss.

The costs — financial, emotional and time-related — can be staggering. And they can be compounded by well-intentioned yet wayward attempts to fix a tooth that has been knocked out.

Work cardiac resuscitations in the field, not the ambulance

From Emergency Medicine:

In almost all cases, it’s best to stay on the scene to work a cardiac arrest resuscitation until the return of spontaneous circulation or efforts are stopped because of futility, according to Dr. Brent Myers, director of emergency medical services in Raleigh/Wake County, N.C.

The probability of neurologically intact survival is at least 10-fold higher, and by some estimates up to 35-fold higher, when resuscitation is achieved in the field, instead of en route to the emergency department, Dr. Myers said at the annual meeting of the American College of Emergency Physicians. Neurologically intact survival quadrupled to 11.5% for patients in ventricular fibrillation and to 40.8% for those with ventricular tachycardia after the approach was adopted in Wake County, he reported.

‘Out of Network’: More Money but Some Problems

From MedPage Today:

(A spin on a Notorious B.I.G. song? Really?)

Out-of-network physicians are usually reimbursed at a lower rate if they treat patients in the plan. However, they can make up for this loss — and then some — by balance billing those patients, something in-network physicians can’t do.

In fact, it’s the opportunity to get a more reasonable reimbursement than they could ever receive in network that drives many physicians to drop insurer contracts. But it’s a controversial tactic, because the extra payments come directly from patients’ pockets.

Statistics gauge emergency room speed

From the State:

ProPublica, a non-profit journalism operation, has crunched the numbers reported by hospitals to the federal government and posted them in an easy to navigate database online at

Minnesota’s health care spending brakes sharply

From the Star Tribune (hat tip: Dr. Menadue)

Spending on doctors, drugs and other medical care in Minnesota grew a tiny 2 percent from 2010 to 2011, capping a three-year period that marked the slowest growth since the state started keeping track in the mid-1990s.

The slowdown was so dramatic that it leaves the state in a position to pay back $50 million spent on money-saving health care reforms it created in 2008 — reforms that appear to have helped contain medical outlays.

Health law rollout poses challenges for rural hospitals

From Advisen FPN (hat tip: Dr. Menadue):

Aultman Orrville Hospital, formerly Dunlap Community Hospital, in Orrville, is one of Ohio’s 34 critical-access hospitals.

CAHs are small, rural hospitals that offer essential services such as 24/7 emergency care, according to the Medicare Rural Hospital Flexibility Program.

Under the Affordable Care Act, hospitals such as orrville are facing uncertain changes, said Matthew Stewart, associate vice president of finance and CFO for the hospital.

“A lot of small hospitals just won’t be able to survive in the new landscape,” he said.

Compassion fatigue has impact in ERs as well

From the Colorado Business Journal:

Caregivers may experience compassion fatigue when they are continually exposed to traumatic injuries, often seen during war, and also inside hospital emergency rooms.

Memorial Hospital Nurse Kathleen Flarity also works as a commissioned colonel in the Air Force Reserves. She has studied compassion fatigue since being deployed to Afghanistan.

“I just finished 33 years in the military,” Flarity said. “I have watched countless friends and colleagues, both in the military and civilians, suffer the effects of caring for the wounded and caring for critically ill and injured patients.

“It’s not normal for a 19-year-old respiratory therapist to take care of … a triple amputee.”

Her extensive experience led Flarity to study compassion fatigue, allowing her to learn how to help prevent it and to treat caregivers who experience it.