ACEP News - June 2008 - (Page 2)

NEWS IN THE ARENA ACEP NEWS • J U N E 2 0 0 8 I’m a Wimp I missed a day of work the other week. my missed shift the day after. I woke up feeling well, but by midday Thinking back over the past 20 years, I knew I was coming down with some- I’ve actually missed work quite a few times thing. It was gastroenteritis or foodborne because of significant illness. Two serious illness of some type, and by dinner time infections, a cholecystectomy, and atrial (or no dinner time, in this case) fibrillation put me on the disI was sure that I would be abled list. The insurance comworthless the next day. Worse panies lost money on me. than that, I thought I might be The worst was when I was contagious. the director of a small group, While I was piling on the and I had a prolonged illness at covers, I asked my wife to call the same time one of my partmy director to give him the ners had recurrent hyperemebad news. There was no cajolsis gravidarum. ing or whining about how hard My partners took control of it is to get people to come in on the situation and didn’t comBY DAVID F. short notice. He even offered to plain. Even my pregnant partner BAEHREN, M.D. have me come in for an IV. Not came in to get hydrated before wanting to be considered someone worthy she worked some of her shifts. I’ll always of getting kicked off the wagon train, I sur- remember their dedication and support. vived without one. (Yes, it can be done!) This is not the routine in all groups. In The shift was covered, and all was well. some places, there is the sentiment that I worked the following day and made up only wimps take a sick day, and only your own death is a valid excuse for missing a shift. This has never made sense to me, on several levels. First, we come close enough to our patients and coworkers to tell what deodorant they wear (or don’t wear). Why risk exposing your patients to illness or starting an epidemic in your department? I think that fits under the do-no-harm part of our oath. Second, whenever I’m sick, my mental wheels get a little rusty. I catch myself trying to pour orange juice on my cereal, and I forget why I went upstairs to get something. I can tell not all the neurons are talking to each other. In our fastpaced environment, we don’t do anyone a favor by showing up to give a mediocre performance. Finally, it’s not like the schedule never gets changed. The same people who think you’re a wimp for not coming in with a fever of 102° are the ones who always want to switch weekends for LETTERS Staying Palm I wish to comment on Dr. Robert Blankenship’s article recommending handheld data devices (“A Paradigm Shift in PDAs,” PDA Corner, March 2008, p. 20). Like him, I have been a longtime Palm device fan because of Palm OS’s simplicity and reliability. He is recommending against Palm OS now because Palm has fallen behind other companies in moving to wireless technology. I will stick with Palm as long as I can, for two reasons. First, I agree with him that we do not want to carry a pager, cell phone, PDA, and planner. However, I am more than happy to carry a cell phone and a Palm that perform all four functions. I use them both so much that battery life would be a big issue if I used a single device. Second, sometimes a device comes along that does its job so well that improvements are not needed. Such is my Palm Zire 72, which so completely meets my needs that, before the company stopped making it, I bought a second to use when I wear the first one out. It runs Epocrates, Pepid, and several little medical applications. It has a camera to capture interesting wounds or xrays. It rarely crashes, and when it does, the reboot is fast. My phone is a BlackBerry with a smaller screen and buttons too tiny to reasonably input data. The “high-speed” Internet connection is too slow to be of much use. So, until they are no longer available, I will stick with the Palm OS. John Reuwer, M.D. Radford, Va. PAIN RELIEVERS a ski trip or some such thing. I’ve never felt put out to fill in when someone is sick. I’ve gone as far as getting emergency privileges to help when a fellow director had a concussion from an accident. We owe this to our colleagues. We all know that the store never closes, and somebody must be there. This is part of what we do. Some of the glue that holds groups together and creates camaraderie is the knowledge that your colleagues will be there for you in a pinch. It’s a great feeling to know that your fellow physicians understand that it is unwise to work when you are ill and that they don’t belittle you for taking a day or two to be a human being. There is an overall wellness and work satisfaction factor also. Working when we are ill makes us bitter about our workplace. We feel singled out and take on a self-righteous posture: “I’m sicker than half the patients in here.” We’ve all heard someone say that. Although it provides a moment of humor, it’s not good for us as physicians— and it’s worse for our patients. Our patients are always better served when we arrive well and rested, with no chip on the shoulder and no “I once worked with pneumonia, so don’t bother me with your scabies” attitude. Working when sick makes us less empathic doctors, and taking the time to heal ourselves brings us closer to our patients. Our careers are long. Chances are we will get sick a few times and need time off. The tennis game or appointment with the accountant can wait while you help out when someone is ill. Be generous and empathic, and you will be healed a little yourself. ■ DR. BAEHREN lives in Ottawa Hills, Ohio. He practices emergency medicine and is an assistant professor at the University of Toledo Medical Center. Your feedback is welcomed at David.Baehren@utoledo.edu. “We don’t have a treadmill, so the stress test here is waiting two hours to see a doctor.” ACEP NEWS AMERICAN COLLEGE OF EMERGENCY PHYSICIANS Medical Editor in Chief Robert C. Solomon, M.D., FACEP Executive Director Dean Wilkerson Director of Communications Ron Cunningham Communications Manager Nancy Calaway EDITORIAL ADVISORY BOARD James G. Adams, M.D., FACEP, Illinois MAJ Robert Blankenship, M.D., FACEP, Washington Michael J. Bresler, M.D., FACEP, California Randall B. Case, M.D., FACEP, Texas Andy S. Jagoda, M.D., FACEP, New York Sharon E. Mace, M.D., FACEP, Ohio Catherine A. Marco, M.D., FACEP, Ohio John S. Milne, M.D., FACEP, Washington Susan B. Promes, M.D., FACEP, North Carolina Carlo L. Rosen, M.D., FACEP, Massachusetts Tracy G. Sanson, M.D., FACEP, Florida Col Gerald R. Schwartz, M.D., FACEP, North Carolina Knox H. Todd, M.D., FACEP, New York Mary Jo Wagner, M.D., FACEP, Michigan Richard E. Wolfe, M.D., FACEP, Massachusetts ACEP NEWS, an official publication of the American College of Emergency Physicians, provides cutting-edge reports from clinical meetings, FDA coverage, clinical trial results, expert commentary, and reporting on the business and politics of emergency medicine. Each issue also provides material exclusive to the members of the American College of Emergency Physicians. Content for ACEP NEWS is provided by International Medical News Group and Elsevier Global Medical News. Content for NEWS FROM THE COLLEGE is provided by the American College of Emergency Physicians. The ideas and opinions expressed in ACEP NEWS do not necessarily reflect those of the American College of Emergency Physicians or the Publisher. The American College of Emergency Physicians and Elsevier Society News Group, a division of Elsevier Inc., will not assume responsibility for damages, loss, or claims of any kind arising from or related to the information contained in this publication, including any claims related to the products, drugs, or services mentioned herein. Address Changes: Send editorial correspondence and address changes to ACEP NEWS, P.O. Box 619911, Dallas, TX 75261-9911; acepnews@acep.org; 800-798-1822. POSTMASTER: Send change of address (with old mailing label) to ACEP NEWS, Circulation, 60 B Columbia Rd., 2nd flr., Morristown, NJ 07960. ACEP NEWS (ISSN 1551-9171) is published monthly for $175.00 per year by Elsevier Inc., 60 B Columbia Rd., 2nd flr., Morristown, NJ 07960. Periodicals postage paid at Morristown, NJ, and additional offices. Phone 973-290-8200, fax 973-290-8250. ©Copyright 2008, by the American College of Emergency Physicians ELSEVIER SOCIETY NEWS GROUP, A DIVISION OF INTERNATIONAL MEDICAL NEWS GROUP President, IMNG Alan J. Imhoff Director, ESNG Mark Branca Executive Director, Editorial Mary Jo M. Dales Executive Editor, IMNG Denise Fulton Executive Editor, EGMN Kathy Scarbeck Publication Editor Terry Rudd Publication Associate Editor Jay C. Cherniak VP, Medical Education Sylvia H. Reitman Senior Director, Marketing and Research Janice Theobald Circulation Analyst Barbara Cavallaro Executive Director, Operations Jim Chicca Director, Production and Manufacturing Yvonne Evans Production Manager Judi Sheffer Art Director Louise A. 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ACEP News - June 2008 Contents News - Time to Move Tricks of the Trade - Revealing Tips Focus On - Dengue Fever Practice Trends - EMTALA Results

ACEP News - June 2008

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