I am in Boston for the ACEP conference. I know, I should be seeing the foliage but who has time? I am eating lots of great seafood. Chowda of course. And I just ate at "No name," a soup nazi type locale with great food and little ambiance. Yum.

But I have learned a lot too, and will chronicle that here:
  1. Doctors are nerds who don't care about baseball, bc nobody seems to care that I am a yankee fan wearing my yankee clothes in public.
  2. Paul Begala is freaking funny. He gives the best Bill Clinton impersonation. And he managed to calm a skeptical crowd and be informative as well. In his opinion, health care reform will happen bc if it doesn't democrats are done. Put a fork in it done. So if they want future viability something will be passed. But not when obama says so.
  3. Only 12% of patients in ERs are non-urgent. ERs area extremely efficient and relatively low cost for the service it provides. Where else can you get seen, examined, tested, diagnosed, treated & admitted or discharged in just a few hours? In the "outside world" a patient goes to Dr. A, who says wait and see. The the patient comes back and is sent for some testing. Two weeks later tests come back with no answer as to what is going on. Outpatient CT scan ordered. A few weeks later test is done. Eventually scan is read by a radiologist. A few weeks later your doctor communicates the results to you. This is beyond their capabilities so you are sent to a specialist. The specialist orders an MRI. That takes a few days. When you suddenly worsen they say go to ER. Where we get you taken care of in just a few hours.

    It may cost a lot to go to the ER, but it only costs four times as much to run an ER as to run a medical practice. We are a one-stop shop for good health care. Which is why docs in the community and patients trust us do diagnose and treat ailments that "could" be treated as an outpatient-though much slower.
  4. Universal healthcare leads to INCREASED ER visits. An average of 8% in Massachusetts.
  5. A little prevention goes a long way: A study shows that if at 15mo of age checkup, parents are educated re: auralgin topic anesthetic for ear pain in children, then when child has pain, parents treat and wait instead of rushing to ER or doctors office. 80% decrease of ER visits for otitis media as a result. And 40% decrease in pediatrician visits as well. WE SHOULD ALL BE DOING THIS
  6. Children 3-36months of age do not need blood cultures. 'nuff said.
  7. Irritable babies should get urinalysis and culture, as 10% are positive despite no fever symptoms.
  8. LPs are not needed for febrile seizures if 3-36mo of age
  9. No matter how you clip your badge to the loop that goes around your neck, it will always spontaneously flip around to the backside. Unless you want it to be on the backside, in which case it will show your name.
  10. KevinMD and Shadowfax are a nice hang, and I learned a lot from their years of blogging experience (see future blog where I will figure out how to add a pic I took of them).
  11. When doing a lecture, the audience will only remember 3-4 points. If you try 5 points, they remember nothing.
  12. You DON'T need contrast when doing a CT for appendicitis. And you CAN give them opiates for pain without altering their exam findings.
  13. And Dr. Hoffman and Dr. Bukata remind me of those muppets in the balcony.
  14. www.epmonthly.com is totally classy and I am proud to be associated with them and honored to have my voice heard (and even respected!) amongst the greats in Emergency Medicine.
  15. I probably should not have had that second glass of wine...(after the 2 mojitos-yummy made by John at the Birch bar at the westin waterfront). Tylenol works better for hangovers than advil. (that's not a scientific study)
  16. My book "How to Survive a Medical Malpractice Lawsuit" has a date for release! April 2010. No cover yet. But I have an ISBN number. Very exciting. And a pretty advert they were handing out that I will scan it in and post that on the website in a few days.