Practice Management
Urgent message: When a physician is dubbed “Tom the Terror,” turning a blind eye can send patients and staff heading for the exit, wreck your reputation, and spark a lawsuit. Here’s what to do instead.LEONARD D. GOODSTEIN, PHD, ABPP, and JOHN SHUFELDT, MD, JD, MBA, FACEP Tom P. is a competent, board-certified emergency physician. He is liked and respected by his patients. But Tom‘s relationships with staffers at the urgent care center where he still …
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Urgent message: Acute stridor in pediatric patients is alarming to children, parents, and healthcare providers alike. Differential diagnosis is the key to initial evaluation and management of this worrisome symptom. Here is how to think it through. JERRI A. ROSE, MD, FAAP Stridor is an externally audible sound caused by abnormal air passage during breathing.1 It results from turbulent airflow through large airways. When a normal respiratory volume of air passes through narrowed airways, the …
Read MoreLee A. Resnick, MD, FAAFP An E. coli outbreak, believed to have originated from a crop of bean sprouts in Northern Germany, has killed at least 36 people across Europe. Watching the public health “crisis” unfold, I can’t help but think of the 1993 comedy “Groundhog Day.” Phil Connors (Bill Murray), an egotistical meteorologist from Pittsburgh tasked with covering the annual Groundhog Day in Punxsutawney, Pennsylvania, finds himself caught in a time warp in which …
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This 21-year-old patient presented with chest pain on the left side and fever. View the image taken and consider what your diagnosis would be.
Read MoreThe patient, an otherwise healthy 16-year-old, fell and suffered a blow to the wrist one hour prior to presentation.
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This 4-year-old patient suffered a blow to the head. View the image taken and consider what your diagnosis and next steps would be.
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This 33-year-old patient presented with pain in the left side of the chest. The patient was vomiting and not tolerating PO. View the image taken and consider what your diagnosis and next steps would be.
Read MoreJOHN SHUFELDT, MD, JD, MBA, FACEP While treating patients in the emergency department, I occasionally marvel at the changes I have witnessed over my 25 years in medicine. Sometimes I think, “Thank God I did not treat you 25 years ago, because if I had, I would have done (fill in the blank), it would not have worked, and you would have probably hated every second of it.” I am as old as Moses, so …
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Urgent message: Although pancreatitis is a common cause of abdominal pain, many of its signs and symptoms are shared by other intraabdominal conditions. Most patients can be handled on an outpatient basis if diagnosis is accurate, as this case illustrates. MICHAEL TALKAR, MD Abdominal pain is a common and varied presentation in urgent care. A history and physical exam can be used to triage the majority of emergent cases. Strong communication is vital to ensuring …
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