Beyond Burnout: Physician Depression and Suicide

Beyond Burnout: Physician Depression and Suicide

The statistics on physician suicide are frightening. Each year approximately 400 physicians commit suicide. That is more than one per day and roughly the equivalent of two entire classes of graduating medical students. Suicide accounts for 26% of deaths among physicians aged 25-39 - more than twice (11%) that of same age group in the general public. When screened, approximately 10% of medical students and physicians report current suicidal thoughts. Why are these numbers so high in the medical profession? Dr. Casey MacVane helps shed some light on this neglected crisis and what we can do to help our suffering colleagues.

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Journal Club March 2018 - Risk Stratification and Work Up of Non-accidental Trauma

Journal Club March 2018 - Risk Stratification and Work Up of Non-accidental Trauma

The evaluation of a child for non-accidental trauma (NAT) is an infrequent, yet high risk endeavor for emergency physicians.  Abusive head injury is the most common cause of death in cases of non-accidental trauma and up to 30% of cases of child maltreatment are misdiagnosed at first health care contact.  There is a growing body of literature that helps to frame the workup and risk stratification of children at risk for NAT.  This month’s journal club focused on 3 articles centered on risk factors and diagnosis of abusive injuries. 

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Feature Film(s) - Pediatric Point of Care Ultrasound in the Emergency Department

Feature Film(s) - Pediatric Point of Care Ultrasound in the Emergency Department

Dr. Rachel Rempell is a pediatric emergency medicine physician in Boston, Massachusetts and is affiliated with Boston Children's Hospital. She is board certified in pediatrics, pediatric emergency medicine and completed an ultrasound fellowship with a focus on pediatrics.  We were fortunate to have her as a guest speaker for our grand rounds where she gave us a tour of the current landscape of pediatric point of care ultrasound in emergency medicine. 

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Journal Club February 2018 - Contrast-Associated Nephropathy. The Risk is …. Well, Maybe not as High as We Thought

Journal Club February 2018 - Contrast-Associated Nephropathy.  The Risk is …. Well, Maybe not as High as We Thought

Computed tomography (CT) is a commonly used imaging modality in the US. In 2013, greater than 74 million CT scans were ordered.  Although recently there has been a decrease in the need for contrast for certain diagnostic needs, contrast remains very important in the diagnosis of pulmonary embolus, aortic pathology, infectious processes, and other soft-tissue pathology. Acute kidney injury (AKI) has been a concern for many years and the teaching has been that contrast can increase the risk of acute kidney injury.  Recent literature has addressed this issue and this month’s journal club offers a synopsis of these articles.  

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Difficult Discussions - Death notification and End of Life Care

Difficult Discussions - Death notification and End of Life Care

Professionalism and related personal attributes such as ethics, humanism, and communication have played a central role in the major critiques and calls for reform in medical education over the past century.  The Association of American Medical Colleges currently recommends professionalism and interpersonal skills (including communication) as core competencies to be included in the curricula of medical schools.  In part 2 of "difficult discussions", we share our approach for two difficult patient discussions - death notification and end of life care. This was recorded at the 2017 Tufts University School of Medicine Capstone Course.

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Difficult Discussions - Medical Error Disclosure and Refusal of Medical Care

Difficult Discussions - Medical Error Disclosure and Refusal of Medical Care

Professionalism and related personal attributes such as ethics, humanism, and communication have played a central role in the major critiques and calls for reform in medical education over the past century.  The Association of American Medical Colleges currently recommends professionalism and interpersonal skills (including communication) as core competencies to be included in the curricula of medical schools.  In part 1 of "difficult discussions," we share our approach for two difficult patient discussions - medical error and refusal of medical care. This was recorded at the 2017 Tufts University School of Medicine Capstone Course.

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Combating the Crisis - Not Your Osler's Endocarditis Anymore

Combating the Crisis - Not Your Osler's Endocarditis Anymore

IV drug use (IVDU) is on the rise, along with those diseases which occur from its use (osteomyelitis, septic arthritis, endocarditis, skin and soft tissue infections, spinal epidural abscess).  Until we can turn the tide of the opiate wave, we must be able to diagnose and treat the diseases that occur from IVDU. We are excited to introduce a new series of educational posts dedicated to helping the emergency provider care for patient with opiate addiction. In today's inaugural post we review the contemporary epidemiology of infective endocarditis and its association with IVDU.

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Feature Film - Wound Care Pitfalls in the Emergency Department

Feature Film - Wound Care Pitfalls in the Emergency Department

Matthew Delaney is an emergency physician who also helps run a wound care clinic.  With these dual roles, he has gained a unique perspective on both acute and chronic wounds that present to the emergency department.  In this feature film, he discusses some pearls and pitfalls of wound care in the emergency department. 

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So You Diagnosed Your Pediatric Patient With A Concussion… What Do You Tell The Parents Now?

So You Diagnosed Your Pediatric Patient With A Concussion… What Do You Tell The Parents Now?

In the United States an estimated 300,000 sports-related concussions occur annually. Many of these are young athletes who are referred to the emergency department for evaluation. While there are robust clinical decision aids to clarify the need for a CT brain, the literature around concussions is a bit murkier. Recently, athletes who sustained a concussion were recommended to avoid exercise and vigorous cognitive activity until their symptoms resolved entirely. Several studies over the last several years have challenged these recommendations. Dr. William Meehan is the director for the Micheli Center for Sports Injury Prevention. We were fortunate to “pick his brain” regarding questions we are often asked by the parents of the young athlete . . . when can their child return to play? When can they return to their full course work at school?

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