Category Archives: Emergency Medicine

Emergency Medicine

Grit and Goals: DFCM Resident Dr. Hayley Wickenheiser on the … – University of Toronto

After a storied hockey career that culminated in being inducted to the Hockey Hall of Fame, Hayley Wickenheiser pursued another childhood dream: becoming a doctor. She traces her interest in the medical field to her youth, when one of her friends was badly injured after being hit by a truck. There were 30 kids in our neighbourhood, and wed go as a pack to check on her. I remember the doctors and nurses being very kind. We were little and they made it less scary for us. It was at that point that I got a real interest in medicine, says Wickenheiser, who is in her second year of residency at the Department of Family and Community Medicine at the University of Toronto.

Wickenheiser was named to the Canadian womens national ice hockey team at the age of 15 years, but despite being laser focused on the sport during her young adulthood, she felt a pull toward medicine. I always knew I needed a life after hockey and thought that would be a good one, says Wickenheiser, who is training to become an emergency medicine physician.

She will begin her enhanced skill year in emergency medicine at DFCM in July 2023. Wickenheiser says she chose to do her residency at DFCM because of the wide breadth of topics learned and for generalist training that would allow for maximum flexibility in her career. Against a backdrop of fewer graduating medical students ranking family medicine as their first choice when applying to residency, Wickenheiser says she is very happy with her decision. Family medicine is touted as less'sexy' than specialist training, but I think it's the best kept secret in medicine and one of the most underrated routes to choose. I have zero regrets about choosing DFCMit's been amazing. From awesome professional development to preceptor teaching, it's really a choose-your-own-adventure at times. I like that.

After announcing her retirement from the sport in January of 2017, she began medical school that same year at the University of Calgary. The transition was eased by years of preparation. For close to a decade before her retirement, Wickenheiser shadowed an emergency department doctor, which helped her realize her affinity for the specialty. I dont do well sitting all day long, she says. She is quick to rattle off the things that drew her to emergency medicine: Every patient encounter is different. You have to think quickly, work in a team and be very good under pressure. It feels very much like a team sport.

At that point, Wickenheiser, who is widely regarded as the greatest female hockey player of all time, thought she would be done with the sport. Then the Toronto Maple Leafs called a few months into medical school, she says, with a laugh. As an assistant general manager for the Leafs, Wickenheiser oversees 11 staff members and is responsible for the development of not only the franchise players, but of prospects and players from the Toronto Marlies and affiliate Newfoundland Growlers. My job is to make sure its a high-functioning department where were helping the players both on and off the ice to maximize their potential and get them prepared to be successful NHL players. If they already are a successful NHL player, then help them find that one per cent here and there that can elevate their game, she says.

Her workday varies depending on her clinical responsibilities, but in general, she wakes up early and heads to the rink for a workout or because of her duties with the Leafs. If she is doing a family medicine rotation, then she will work an afternoon or evening clinic. If she is doing a hospital-based shift that runs from 8 a.m. until late afternoon, then she will adapt her schedule accordingly.

Wickenheiser says the parallels between sport and medicine are striking. Everything I learned in hockey, I use every day, says the four-time Olympic gold medallist. Medicine is a team game. Youve got to think on your feet. Youve got to handle stress. Youve got to be physically at your best. She also says that using constructive criticism to enhance performance is another common theme. In medicine, youre being told what you need to improve on all the time. Being able to handle that in a productive way is very important to your development as a physician.

One big difference between these two worlds, however, has to do with self-care and wellness. As an athlete, youre celebrated for taking care of your body. In medicine, sometimes it feels like that should be the last thing you should be doing as a physician taking care of everyone else. I think its counter intuitive. Its something I think medicine has to get a lot better at, she says.

When asked what motivates her to stay on this difficult path, Wickenheiser, who grew up on a farm in rural Saskatchewan, says hard work is part of her identity. I dont think of myself as overly smart or special in any way, but one thing I hang my hat on as an athlete and what I do in medicine, is that Im confident I can outwork just about anyone. Its the one thing I know I can control in my life even when there are other things happening that I cant. You can always control your effort.

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Grit and Goals: DFCM Resident Dr. Hayley Wickenheiser on the ... - University of Toronto

Emergency Medicine

Opinion | Emergency Doctors Are Ill Prepared to Handle Psychiatric … – Medpage Today

More than four decades ago, an article appeared in the American Journal of Psychiatry defining the subspecialty of emergency psychiatry (EP). Since those early days, despite some research and consolidation into a new association complementing emergency medicine (EM), the impact on meaningful access to, integration with, and quality of care for psychiatric emergencies has been inconsequential.

In point of fact, one of the factors impeding progress in EP has been, in my opinion, the lack of momentum from the very entity professing support of the critically mentally ill.

Although the American Board of Psychiatry and Neurology offers 15 psychiatric subspecialty certifications, EP is not among those accredited core areas approved by the Accreditation Council on Graduate Medical Education (ACGME). Furthermore, the current ACGME EM residency program requirements do not specify that programs ensure residents have ample experiences treating psychiatric patients. Yet, the majority of EM residents believe, as do their psychiatric counterparts, that their program should offer more education on managing psychiatric emergencies.

Based on these unsettling facts, it appears that EM, as well as psychiatric residents, are expected, in the face of adverse clinical and supervisory experiences, to develop competent skills in treating psycho-behavioral conditions through onthejob training in the ED. Good luck.

Over the last 4 years, I have written about behavioral health emergencies including the simultaneous impacts of unusual presentations, inadequate assessments, stale methodologies, violence against staff, pandemic lockdowns, anaphylactic suicide, and an equation for suicidal lethality. I have introduced an American College of Emergency Medicine (ACEP)-specific and Centers for Medicare & Medicaid Services (CMS) supported algorithm for consistent improvements in risk medical decision-making with revenue cycle management benefits. I have emphasized that the number of behavioral emergency chief complaints, now estimated to be one in every seven patients of approximately 140 million annual U.S. ED admissions, demands competent triage, admirably fast stabilization, and staff safety. These collective educational and protective factors against increasing patient and ED violence, boarding, and burnout cannot be understated.

Clearly, the pathway to positive change in EP is a noble goal from afar, but oh what a mess we've made. The need to address the current U.S. mental health crisis and to climb to even higher levels of workforce supply and proficiency is considerable. But is it too little too late? In other words, is the opportunity for significant change in youth and adult mental healthcare going, going, almost gone?

It is now sadly possible to paraphrase the inimitable Yogi Berra's baseball imagery from "It is getting late early" to "It is now very late early."

The Demand Crisis

Dwindling Supply Coupled With Inadequate Proficiency

Suggestions

It is essential to establish psychiatric emergencies as the legal and medical equivalent of medical emergencies, advocate for ACGME accreditation of current and new EP fellowships, and promote improvements in resident recruitment and training. Clearly, readily available EP expertise represents both a need for the community and advancing the field, but it remains haphazard. Beyond these steps, how do we advance prompt practical ED solutions to meet some of the crisis demands outlined above?

Past recommendations have been plentiful but far less than promised. The following are two innovative paths with direct, measurable, judicious impacts on demand and proficiency.

First, community EDs, with EP input, must immediately integrate risk triage training with local schools, including universities. Combined workshops could address the current ED psychiatry crisis and the overwhelmed mental health system thus improving the balance of patient and hospital consequences to benefits. Increasing awareness of skills required and challenges experienced in respective settings could encourage crosstalk preventative strategies, innovative diagnostic adeptness, and personalized care with timely follow-up and safety benefits.

Second, CMS has, at long last, incentivized behavioral healthcare that focuses on high-risk populations. Implementation of research supported and EP practiced AI ICD-10/CPT coding provides improved provider and hospital revenue benefit. Specifically, ACEP triage guidelines will be available where and when needed. Medical decision-making using social determinants of health on risk underscores non-stigmatizing benefits including staff satisfaction, ED flow efficiencies, and patient safety.

In summary, over 30% of persons who die by suicide are treated in an ED, outpatient specialty, or primary care 7 days prior to death. Undoubtedly, it is only access to competent EP care -- not ED or community care alone -- that holds the potential for transformative, realistic reduction in suicide rates beyond annual Zero Suicide and CDC aspirational projections. These patients deserve definitive care. EP physicians, fellows, and non-EP clinicians deserve excellent support.

Russell Copelan, MD (Ret.), lives in Pensacola, Florida. He graduated from Stanford University and UCLA Medical School. He trained in neurosurgery and completed residency and fellowship in emergency department psychiatry at UC, Irvine and University of Colorado, Denver. He is a reviewer for Academic Psychiatry and founder of eMed Logic, a non-profit originator and distributor of violence assessments. Copelan is also a presenter for the National Association of School Psychologists (NASP) Speaker's Bureau, and a consultant to the American Association of Suicidology.

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Opinion | Emergency Doctors Are Ill Prepared to Handle Psychiatric ... - Medpage Today

Emergency Medicine

ACR, ACEP announce landmark recommendations for addressing actionable incidental findings – Newswise

Newswise Washington, DC (March 13, 2023) The American College of Radiology (ACR) and the American College of Emergency Physicians (ACEP) released new landmark recommendations to help health systems, physicians and other clinicians improve patient outcomes by addressing actionable incidental findings (AIFs) in emergency department imaging.

There were more than 150 million emergency department visits in the United States in 2019. Radiologic imaging was performed in more than half of these encounters.[1] AIFs, defined as masses or lesions, detected by an imaging examination performed for an unrelated reason, are often encountered. However, the reporting and communication of these findings can be challenging.

Unlike other specialties, emergency physicians focus on addressing a patients possible life-threatening conditions and are less directly involved in follow-up care, said Susan E Sedory, MA, CAE, Executive Director and CEO of ACEP. Partnerships at the national and local level can enhance information sharing to help ensure all patients receive the ongoing, quality care they need.

The white paper, Best Practices in the Communication and Management of Actionable Incidental Findings in Emergency Department Imaging, published in the Journal of the American College of Radiology, concentrates on four areas of consensus between the specialties: 1) report elements and structure; 2) communication of findings with patients; 3) communication of findings with clinicians; and 4) follow-up and tracking systems.

Strong communication and collaboration between clinicians when addressing actionable incidental findings is key to providing optimal patient care and preventing adverse outcomes, said William T. Thorwarth Jr., MD, FACR, CEO of ACR. The recommendations created by ACR and ACEP highlight a multispecialty effort between radiology and emergency medicine that aim to improve the reporting and communication of AIFs, which will ultimately benefit the patient.

Radiologists are committed to working with our emergency department and primary care colleagues to improve follow up for incidental findings, said Gregory Nicola, MD, FACR, chair of the ACR Commission on Economics. This is a team effort to ensure that we implement and maintain these recommendations to help us provide the best possible care for patients before, during and after they visit the emergency department.

Imaging is an integral part of emergency care, and incidental findings with recommended follow up are common, said Christopher L. Moore, MD, professor of emergency medicine, Yale School of Medicine. Collaboration between emergency medicine and radiology and a systems approach are essential to ensure that actionable incidental findings dont fall through the cracks. We are proud to have brought together a diverse group, including radiologists, emergency physicians and patient advocates to develop and define best practices to address AIFs.

The recommendations listed in the white paper are meant to be best practices and are not standards.

# # #

About the American College of Radiology

The American College of Radiology (ACR), founded in 1924, is a professional medical society dedicated to serving patients and society by empowering radiology professionals to advance the practice, science and professions of radiological care.

About the American College of Emergency Physicians The American College of Emergency Physicians (ACEP) is the national medical society representing emergency medicine. Through continuing education, research, public education, and advocacy, ACEP advances emergency care on behalf of its 40,000 emergency physician members, and the more than 150 million people they treat on an annual basis. For more information, visitwww.acep.organdwww.emergencyphysicians.org.

[1] Rui, P. & Kang K. National Hospital Ambulatory Medical Care Survey: 2017 emergency department summary tables. 37 (2017).

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ACR, ACEP announce landmark recommendations for addressing actionable incidental findings - Newswise

Emergency Medicine

Men Over 65 at Greater Risk than Women of Skull Fractures from Falls – Florida Atlantic University

Each year, more than 3 million people ages 65 and older are treated in emergency departments for fall injuries.

Each year, more than 3 million people ages 65 and older are treated in emergency departments for fall injuries. Head trauma is the leading cause of serious injury with skull fractures being reported as a serious outcome. According to the 2016 National Trauma Database annual report, females account for 58 percent of these falls.

Because geriatric females have an increased rate of falls and facial fractures, determining if they also are at an increased risk of skull fractures is crucial. Currently, research is sparse on the prevalence of skull fracture due to head injury in this population. Moreover, there is an overall lack of research concerning head injury management guidelines among the geriatric population.

Researchers from Florida Atlantic Universitys Schmidt College of Medicine conducted a study to assess and compare the risk of skull fracture secondary to head trauma in female and male patients ages 65 and older. They prospectively evaluated all patients with head trauma at two level-one trauma centers in southeast Florida serving a population of more than 360,000 geriatric patients.

For the study, researchers examined skull fracture due to acute trauma and compared them by sex as well as patient race/ethnicity and mechanism of injury. Among the 5,402 patients enrolled, 56 percent were female, 44 percent were male. Eighty-five percent of the head injuries sustained were due to falls, and this trend also was seen across race/ethnicity and mechanism of injury. Both females and males had a similar mean age, 82.8 and 81.1 years, respectively.

Results of the study, published in the American Journal of Emergency Medicine , showed that when comparing geriatric males and females, males had a significantly increased incidence of skull fracture secondary to head trauma, due mostly to falls. This outcome was unexpected, as previous research has indicated females are more susceptible to facial fractures. This trend also was seen across race/ethnicity, though results were only statistically significant for whites.

The high incidence of head injury and subsequent skull fractures due to falls is a cause for concern as our aging population continues living active lifestyles, said Scott M. Alter, M.D., first author, associate professor of emergence medicine, and assistant dean for clinical research, FAU Schmidt College of Medicine. As falls caused the greatest number of head injuries and subsequent skull fractures, fall prevention may be an important intervention to consider in reducing morbidity. Although fall prevention education can be addressed in the primary care setting or at assisted living facilities, the emergency department could also represent an opportunity to educate patients and to prevent future death and disability from falls in this population.

Study co-authors are Michelly R. Gonzalez; FAU medical student; Joshua J. Solano, M.D.; associate professor of emergency medicine and clerkship director; Lisa M. Clayton, D.O., chair and associate professor of emergency medicine and program director, emergency medicine residency; Patrick G. Hughes, D.O., associate professor of emergency medicine and associate program director, emergency medicine residency; and Richard D. Shih, M.D., professor of emergency medicine, all within the Department of Emergency Medicine, FAU Schmidt College of Medicine and Delray Medical Center.

This research was funded by a grant from the Florida Medical Malpractice Joint Underwriting Association awarded to Shih as the principal investigator.

-FAU-

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Men Over 65 at Greater Risk than Women of Skull Fractures from Falls - Florida Atlantic University

Emergency Medicine

Ousted WHO Official Takeshi Kasai Has Background in Emergency … – The Japan News

AP file photoTakeshi Kasai addresses the media in Manila on Oct. 7, 2019.

&The Yomiuri Shimbun

16:28 JST,March 9, 2023

Ousted World Health Organization official Takeshi Kasai is a doctor with a background in emergency medicine and an expert in infectious diseases and health crisis management.

Kasai has been dismissed from his post as director of the WHOs Western Pacific Regional Office over allegedly racist behavior, He joined the WHO after working at the then Health and Welfare Ministry.

He released a statement after allegations about racist and abusive misconduct emerged, saying that he never targeted employees of a particular nationality, although he acknowledged being hard on staff. Kasai also denied the accusation that he leaked confidential information.

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Ousted WHO Official Takeshi Kasai Has Background in Emergency ... - The Japan News

Emergency Medicine

5 things we could do right now to ease ER overcrowding (Guest Opinion by Dr. John B. McCabe) – syracuse.com

John B. McCabe, M.D., FACEP, is professor/chair emeritus at Upstate Medical University. In 1987, McCabe was the only physician in Syracuse trained in emergency medicine. He was the first chair of the Department of Emergency Medicine at Upstate, and he practiced and taught emergency medicine in CNY for over 30 years. He has served as CEO at University Hospital and as president of the American College of Emergency Physicians. In retirement, he is the medical director for CAVAC, the Cazenovia Area Volunteer Ambulance Corps, and he volunteers as an ambulance driver, frequently bringing patients to all area hospitals.

Reporter Jim Mulders recent article (Syracuse emergency rooms are jammed, dirty and frustrating; waits are among worst in U.S., Feb. 27, 2023) and the editorial board opinion (ERs are in crisis in Syracuse and across US. When will Washington act? March 5, 2023) described the horrific state of affairs of the emergency departments in Syracuse hospitals.

Unfortunately, Mulder presented an accurate view of ERs that are overcrowded, dirty and chaotic. There are too few staff who, frustrated in their inability to deliver the care they know would be best for patients, may seem uncaring. At the same time, frustrated and angry patients are either waiting to be seen by a doctor or waiting for the hospital bed they have been promised. Patients feel lost in the system.

The inability to care for patients in a timely manner and to move them to an appropriate hospital bed, resulting in severe overcrowding, is not an ER problem. It is a problem of hospital operations and system-wide dysfunction.

There is no simple solution, nor a solution that will change things overnight. The editorial board makes the case for federal, congressional and presidential action. While reasonable, none of these levels of government will yield near-term results. Similarly, the states push for workforce development, although necessary, is the beginning of a training pathway that will take years.

Let me suggest several actions that could make a difference:

1. We could change existing state regulations to allow nursing staff to initiate appropriate diagnostic studies and basic ER treatments before evaluation by a physician. Such decision-making would be based on complaint-driven protocols, a common practice in many states. This change would allow earlier initiation of care, helping to speed patient throughput and improve waiting room conditions. Such a change should be a high priority for state lawmakers and regulators.

2. Hospitals could improve the speed and access to care by ensuring that all medical, surgical, ancillary and support services are available 24/7. With ER overcrowding, it is hard to accept that a patient in a hospital bed, ready to be discharged to home or to a long-term care facility, waits for days to receive a diagnostic study, a piece of durable medical equipment, a specialty service consultation, a home care referral or a needed pharmaceutical treatment.

The same can be said for facilities that receive patients discharged from hospitals. No patient who is ready to go to a nursing home on Friday afternoon should wait in a hospital bed until the following week for transfer.

3. Severe overcrowding does not happen suddenly. It can be anticipated. Previously, Central New York hospitals used an objective scoring system (National Emergency Department Overcrowding Score, or NEDOCS) to regularly assess the state of overcrowding in the ER. Such an objective score should be linked to a written plan that determines how hospital operations will adjust as the ER gets more and more crowded.

For instance, the number and function of social workers, discharge planners, bed supervisors, transport staff and physician staff need to change as crowding worsens. Means to alert the entire system to worsening overcrowding must result in an all-hands-on-deck approach that more quickly moves patients through the system to discharge or transfer. All hospitals should have a mechanism to communicate the status of their ERs to the public, so that patients and their physicians can make informed decisions, in real time, about going there for care.

As another example, hospitals should implement systems to efficiently move ER hallway patients to other hospital locations. While awaiting inpatient beds, such patients could be moved to defined hallway spaces on each inpatient unit. What seems better for the patients: 20 patients waiting for beds in ER hallways, or one or two patients in hallway beds, awaiting a room, on each inpatient floor?

Administrators must be prepared, at times, to make the hard decision to cancel profitable elective admissions or surgeries to free beds and ease ER overcrowding. They should be prepared to utilize preoperative, postoperative and other non-ER spaces to accommodate the overflow of ER patients.

Hospitals can change the mindset in implementing disaster plans. If 20 patients were to show up suddenly from a bus crash or a mass shooting, the disaster plan would kick in, with extra staff and resources being made immediately available to the ER. Why should the presence of 20 sick patients waiting for inpatient beds, in a congested and overrun ER, result in any less of an aggressive approach to care for them?

4. In addition, the physician community as a whole must bear some responsibility for ER overcrowding and must be a part of any viable solution. Many physicians have focused on outpatient care, not on the care of hospitalized patients. Some physicians choose not to cover the ER, as they used to, and not to provide specialty consults on hospitalized patients, as they used to.

With the emphasis on office care, physicians in the community should rethink the all-too-common response of go to the ER when their patients call with health complaints. While perhaps the easiest answer, going to the ER may not be the best approach for an individual patient, for the hospital, or for the ER staff.

Community specialists and subspecialists should recommit to being active partners in systems that deliver comprehensive and timely response for the evaluation, management and disposition of ER patients. It is unreasonable for commonly needed physician specialties, who are plentiful in the community, to be unavailable to patients in our ERs or inpatient units (as noted for GI/ endoscopy services in Mulders article).

5. The typical response of we have no money and no staff doesnt fix anything. Solutions must be found with policy change, creative staffing, innovative thinking, hard decisions, and prioritization of ER care.

This is where healthcare insurers and federal and state governments must step up. These community and civic leaders must realize that the funding decisions they make have real consequences in ER hallways and exam rooms and on the floors of hospitals and nursing homes.

As CEO, I often commented that people in CNY didnt always realize the breadth, depth and quality of medical services available locally. The current circumstances in the ERs are preventing patients from receiving this quality care in a timely manner, if at all.

Finally, as troublesome and difficult as ER overcrowding is for patients, this situation is also grossly unfair to the dedicated ER staff who struggle every day with inadequate resources and poorly functioning systems to provide care to our most needy and vulnerable populations.

It is time for a concerted effort to fix this problem for our patients and for our healthcare professionals.

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5 things we could do right now to ease ER overcrowding (Guest Opinion by Dr. John B. McCabe) - syracuse.com

Emergency Medicine

Stepfather threatened emergency doctor after he killed his stepdaughter, court hears – Daily Mail

A stepfather threatened an emergency doctor when she took notes in hospital after he fatally attacked his two-year-old stepdaughter, a court heard today.

Kyle Bevan, 31, allegedly threatened Dr Nicola Drake after she took notes on their conversation at Withybush Hospital, Wales, where his two-year-old stepdaughter Lola was receiving emergency care after he attacked her.

Mr Bevan is accused of murdering the toddler after he moved in with her mother Sinead James, 30, in 2020.

Dr Drake said he threatened to rip her notes out of 'her hands' if she took 'one step' outside the family room, Swansea Crown Court heard.

She had asked Mr Bevan to give an account of what had happened to Lola on the morning of July 17, 2020.

Giving evidence, Dr Drake said she saw Lola was being managed properly so went to the family room to speak to Bevan and James.

Prosecutor Caroline Rees KC asked: 'Did Kyle Bevan ask any questions?'

Dr Drake said: 'He asked one question about who was paying for them to get to Cardiff.'

Swansea Crown Court heard the doctor asked Bevan to give an account of what had happened to Lola on the morning of July 17, 2020.

But when she started to take notes, Mr Bevan said: 'If you take one step out of this room with those notes, I'll rip them out of your hands'.

Dr Drake added: 'I advised him that it would be shared with external agencies such as social services and that I had a statutory duty, a legal duty, given how serious the injuries were.

Dr Nicola Drake was on-call at home on the morning of the alleged attack when she received a 'trauma call' about Lola James.

The court heard Dr Drake, an emergency medicine consultant, rushed to the hospital to find multiple teams working on Lola.

Lola was being treated at Withybush Hospital in Haverfordwest but was due to be transferred to Noah's Ark Children's Hospital in Cardiff.

Swansea Crown Court heard heard Bevan had been left alone with Lola at the family home when he launched a 'frenzied and extremely violent attack.'

But he failed to call an ambulance immediately and instead filmed a 'disturbing 22 second film' of seriously injured Lola as he tried to prop her up.

Mr Bevan also carried out a series of internet searches asking: 'My two year old child has just taken a bang to the head and gone all limp and snoring. What's wrong.'

The court heard Lola was found to have 101 surface injuries to her body along with a catastrophic brain injury and died four days later.

Mr Bevan was arrested by police and he claimed the family dog had pushed Lola down the stairs at the home in Haverfordwest, Wales.

Her motherSinead James, 30, told police she was asleep when Lola suffered a series of horrific injuries and claimed to have no reason to think Mr Bevan would harm her.

Mrs Rees said Mrs James knew her boyfriend had a 'nasty and violent temper' but chose to 'prioritise her relationship with him over her own daughter's physical safety.'

Expert witness Ian Simmons, a consultant paediatric ophthalmologist, said: 'It is highly unlikely the injuries would have been caused by a fall down 10 carpeted stairs.

'The most likely cause of her injuries is a form of abusive head trauma, possibly with some form of impact'

Earlier the court heard two-year-old girl screamed she 'didn't want to go home' just days before she was killed by her stepfather

Mrs James, of Neyland, Wales, denies causing or allowing the death of a child. Mr Bevan, of Aberystwyth, Wales, denies murder.

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Stepfather threatened emergency doctor after he killed his stepdaughter, court hears - Daily Mail

Emergency Medicine

OPINION: Don’t ‘leaf’ your health to luck – Westside Eagle Observer

With St. Patrick's Day just around the corner, you may be hoping for the faith, hope, love and luck often associated with the holiday. While we wish all of those for you, your health is one thing you can't "leaf" to chance.

While you may be one of those people who only go to the doctor when you're sick, there are five reasons for seeing your primary care provider that could make you pretty lucky.

Well visits can:

1. Save you money long-term. While we can't promise you a pot of gold, we can help you determine if your insurance plan covers annual wellness visits. A recent poll found between 40 and 44 percent of Americans skip medical treatments or avoid seeing a doctor when sick or injured due to cost. A quarter of the nation doesn't even have a primary care provider, though many insurance companies fully cover wellness visits. In addition, studies show that it is far more costly for a preventable disease to go unchecked.

2. Help catch disease early, when it's most treatable. According to the CDC, 70% of American deaths result from chronic disease and nearly half the nation battles heart disease, cancer, diabetes or other preventable ailments. Early detection is vital, as the earlier a disease is identified, the sooner you can begin treatment. For example, one 2021 study found up to 90% of patients could be cured of ovarian cancer if detected in Stage 1.

3. Stave off disease. Wellness visits aren't just about early detection of cancer or heart disease but a way to prevent illness. These visits are an excellent time to get up to date on vaccinations. The CDC reports that flu vaccinations in 2019 and 2020 prevented 7.5 million influenza cases, 3.7 million flu-related medical visits, 105,000 hospitalizations and 6,300 deaths. A quick inoculation can reduce the chances of a future flu-related doctor's visit by as much as 60%. This is also a good time to get boosters for covid, shingles and pneumococcal disease.

4. Save you some time. We're all busy, but making time for your well-being is essential. Well visits are about 20 to 30 minutes. Meanwhile, waiting for an emergency means a much longer wait. U.S. News & World Report found that the nation's shortest median ER wait time was 46 minutes but the longest was 286 minutes. It doesn't take much to spare 30 minutes once a year (or every three years if you're under 50).

5. Provide peace of mind. Don't settle for Googling symptoms -- we all know the results are usually unnecessary doom and gloom instead of rainbows and leprechauns. A visit to your physician can reassure you everything is okay. You can also discuss medications, learn the cause of your insomnia or determine why you're not losing those last few pounds.

So, there's no need to get down on your hands and knees to scour the grass for a four-leaf clover. Instead, you can be proactive about your good health by scheduling regular wellness visits.

A well visit isn't just about establishing a patient's potential health risks. These appointments forge a doctor-patient relationship and allow you to create a health plan together. Schedule your well visit today by visiting NW-Physicians.com. Same-day appointments are often available.

About Siloam Springs Regional Hospital

Siloam Springs Regional Hospital is a licensed 73-bed facility with 42 private patient rooms. It is accredited by the State of Arkansas Department of Health Services and The Joint Commission. Some services include inpatient and outpatient surgery, emergency medicine, medical, surgical and intensive care units, obstetrics, outpatient diagnostic services and inpatient and outpatient rehabilitation. With more than 50 physicians on the medical staff, Siloam Springs Regional Hospital provides compassionate, customer-focused care. SSRH is an affiliate of Northwest Health, the largest health system in Northwest Arkansas. Siloam Springs Regional Hospital is located at 603 N. Progress Ave. in Siloam Springs. For more information, visit NorthwestHealth.com.

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OPINION: Don't 'leaf' your health to luck - Westside Eagle Observer

Emergency Medicine

Del Rios: A ‘boots on the ground’ emergency medicine physician … – University of Iowa Health Care

Marina Del Rios, MD, MS, associate professor of emergency medicine, is the recipient of this years individual Culturally Responsive Health Care Award.

Through her patient care and research, Del Rios is a champion of equity, voice, and empowerment for Black and Hispanic populations, writes Karen Cyndari, MD, PhD, a research fellow in the emergency medicine department who nominated Del Rios for the award.

In this Q&A, Del Rios shares her passion for connecting with her patients and community beyond the emergency department (ED) doors.

Marina Del Rios, MD, MS, receives the 2023 Culturally Responsive Health Care Award for an individual.

Ive always been interested in racial, ethnic, and socioeconomic disparities in health care. Coming from a Latino household that was low income, I definitely have firsthand experience in the challenges of navigating the health care system.

At UIC (University of Illinois Chicago), I took an interest in cardiac arrest, which has now been in the news due to NFL football player Damar Hamlins event and shows that with prompt action lay people can save lives. Much of my work over the last ten years has been focused on disparities in cardiac arrest care and trying to activate communities so that we can increase awareness of cardiac arrest and respond when it occurs.

Now in Iowa, Im partnering with Johnson County Ambulance Services and the Rotary Kerber HeartSafe Community Campaign to train communities on bystander CPR. My current research is looking at what puts a community at riskso we can both prevent the cardiac arrest from happening by looking at different community-level social determinants of health and comorbidities that might put a community more at riskand then using that to create simulation models where we can test out interventions before implementing them in a real population. Were using data to help communities build a more effective response system for cardiac arrest that would limit the inequities that exist in incidence and survival.

There are some recipes that we know increase the chance of somebody surviving cardiac arrest. A very obvious example is bystander CPR. Those first few minutes after a cardiac arrest are critical. An average emergency medical response time is about 7 minutes and thats in a good situationin an urban place like Iowa City. If you live out in a rural county then it might be more like 15 or 20 minutes, so having lay people who are ready and willing to act is crucial to increasing that survival rate.

But at the same time, its not a one-size-fits-all recipe.

There are health systems that have implemented an ECMO (extracorporeal membrane oxygenation) program, or advanced critical care. That works in a place like Johnson County because our survival rates are high to start with. That means a lot of people make it to the hospital and can benefit from that intervention, but other health systems might be better off investing in more basic services to save more lives in their communities. The simulation program were developing considers local contextswhat the comorbidity in that area is, what the resources arebecause if you dont live in a community that has a university hospital then maybe youre better off investing in dispatch-assisted CPR, for example.

Marina Del Rios, MD, MS, in the Emergency Department at UI Hospitals & Clinics.

In my 15 or so years of academic career in different hospitals, Ive always made it a point to try to connect with the neighborhoods I serve. It seems counterintuitive because the emergency physician is usually more worried about the acute care issue that is in front of them but what Ive recognized is that it doesnt matter what I do in the ED; the interventions I put in place are affected by the reality of people before they even walk in through our doors.

Understanding their reality: are they going to be able to afford their medication, are they living in a reality where its going to be difficult for them to see a primary care provider, and how can I facilitate appropriate continuity of care? I think that we often just go for the disease thats in front of us, but medicine is also about the social sciences and understanding peoples social vulnerabilities.

Everyones journey is very personal. The way that I did it in Chicago was through cultural organizations that were part of my own heritage, like getting involved with the Puerto Rican Cultural Center. Here, Ive been getting to know people through some of the churches and schools. It can start with your own church or a hobbysomething that fulfills you in a different way and gives you an opportunity to connect with the community. Now that tends to keep us in our own circles, but a lot of these organizations have partnerships elsewhere, so its in those partnerships that you can branch out and get to know other people.

I always say start small. Our community is very grateful when they see academic physicians step in because theres a sense that you care for them. Giving back also helps with burnout and with your mental health.

Im surprised at how much diversity of languages there is in our city and county. Having been on the patient side with my mother-in-law who does not speak much English and finding a provider who can speak in Spanish has been very challenging. Shes very privileged that she has me and my husband who can go to appointments with her, but at times its been uncomfortable because some of the questions can be very personal. We have great translation services, but we could always use more. With the growing immigrant population in the county thats one aspect that leads to delays and barriers to care and certainly something we can work on.

The other thing that Ive really stressed with the residents is to not depend so much on family members because they very rarely translate word for word what patients are saying. They have their own interpretations, and although theyre important to have in the room for discussion, there are also some delicate questions that family members dont know about and why its so important to really involve the interpreters.

Another thing weve been trying to push in the department is giving the interpreter some context of whats happening with the patient because sometimes that also helps with how they frame questions and how they relay information. Interpreters are part of the care team too and they need to be prepared emotionally about how they engage with the patients.

See the rest here:

Del Rios: A 'boots on the ground' emergency medicine physician ... - University of Iowa Health Care