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April 11, 2014 / E.

Learning to work ON the system.

Guest post by Krishan Y.

I am currently at the midpoint of a five-year RCPSC residency specializing in emergency medicine. I’d like to briefly share my experience to date as a medical resident in Canada. The major focus encompasses gaining valuable experience providing high quality patient care, often by working long hours. The best learning typically comes in the clinical setting. ED shifts are always busy yet with a vast array of medicine to ensure there are always learning opportunities. I meet patients from all walks of life, with issues ranging from relatively minor to life threatening. One of the many reasons I entered the specialty was the team environment – working with your colleagues towards a common goal.


Every week there is dedicated teaching to ensure that we become competent and highly skilled consultants in EM. The sole focus has been on learning as much as possible so that I can confidently treat my patients in accordance with the highest standards. Along the way, I’ve gotten to know many colleagues and have continued to refine my own personal approach to communicating with patients and coworkers. Somewhere in the mix, I make time for family and friends. I do my best to maintain a healthy, balanced lifestyle.

In short, what I envisioned as a resident training in a specialty is that at the end of 5 years of rigorous education and clinical experience, I would develop the skills and competence to independently provide high quality care for my patients. Yet there have been calls to reexamine postgraduate medical training in order to groom clinical leaders in a structured and evidence-based manner.[1]

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April 1, 2014 / E.

Teaching Young Doctors about Healthcare Beyond the Bedside: A Novel Program

Residency training in Canada is considered one of the most robust in the world. Medical knowledge and clinical skills introduced in medical school are put to the test in the real world, and refined over many years under the supervision of experienced staff physicians. However, traditional residency programs underemphasize many of the non-clinical aspects of medical practice.


In fact, a quick poll of residents within our own Royal College Emergency Medicine training program revealed that many had absolutely little/no idea of how our healthcare system is structured, why healthcare costs are rising, or how a hospital functions…yet many of these young doctors will someday be expected to take on leadership roles sometime in their careers.

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March 3, 2014 / E.

Transitions, collaboration and a whole new world view.

Guest post by Linda B.

My life, as of late, has gone through a huge transition. As transitions go, it’s been a good one and actually relatively smooth but I have felt a bit disjointed. This week I stumbled upon a blog by Dr. Strader discussing thoughts on physician service. His thought is that the true requirement of a physician is to be a thinker. Solve the problem. Determine the next course of action.


This, somehow, made things much more clear to me. Let me explain.

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February 5, 2014 / E.

Taking Healthcare for Granted.

Sometimes I wonder if we take our healthcare services for granted … at least those of us in Canada. Maybe it’s just my imagination, but it seems like more and more patients we’ve seen coming into the ER are increasingly demanding, angered with unrealistic expectations, and overall ungrateful.


What used to be a rare occurrence has now become so common that I expect some variation of the following first words out of a patient’s mouth: “…finally! Can’t believe I’ve waited X hours to see a doctor! This is ridiculous!…”. Worse, the patients who are most rude are those who have waited no more than a few hours, for something that even a lay person can recognize as not being a medical emergency.

I think people forget how fortunate they are to have 24/7 access to an emergency healthcare team, whenever they want, and without ever having to worry about paying for each visit.

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January 9, 2014 / E.

New Year, New Stuff.

Happy New Year! 2013 has gone by in a flash, filled with many interesting healthcare related stories and discussions. As a quick recap, this blog has published articles on topics ranging from ER wait times (see our most popular post of the year here) and mandatory flu shots for healthcare workers, to opinions on TV shows about nurses and how physicians should dress. While the majority of readers were from Canada, the United States, and the U.K., visitors from a whopping total of 99 countries came cruising by our blog!


So what’s in store for 2014?

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November 26, 2013 / E.

Extra Health Tax on Extra Risky Behaviors?

Recently I came across an interesting news piece that reported on a published research article documenting an unusually high rate of injuries requiring prehospital and emergency room utilization as a result of a Tough Mudder competition. You can find the actual article published in the Annals of Emergency Medicine here. For those of you who are unfamiliar, the Tough Mudder race (similar to others like the Spartan Race, etc.) is an extreme obstacle course competition open to pretty much anyone who wants to participate. But unlike other physically demanding activities like marathons and triathalons, participants often fail to train properly prior to the event – in fact many join viewing it as the occasional fun weekend activity with a team of friends (yes, some call running through 10,000V of electrical wires and jumping down 15+ feet fun).


The results of the study made me wonder about the effect these events (which some would argue are voluntarily “high risk” activities) have on our public healthcare system, especially in light of our current wait times situation; each acute orthopedic injury requiring surgery, for example, would potentially bump/delay someone else who’s been suffering in pain and off work for months on a waiting list for an elective hip or knee replacement. Does that seem entirely fair and reasonable? I posed this question on Facebook – and unsurprisingly, opinions are quite split and polarized.

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November 7, 2013 / E.

Scrubbing out the noise around ‘Scrubbing In’.

Guest post by Vicki Meyouhas.

They don’t put boring people on reality TV” responded by husband when I said that MTV should have cast me, or one of my many intelligent, responsible and ethical nurses to star in their new reality TV show ‘Scrubbing In’.


He didn’t mean to offend me, of course, but there was a lot of truth to it. I doubt the buzz, the ratings and sought-after viewers would have responded quite the same to a boring (maybe stable and normal is a more fitting term) nurse on her time off. Just imagine the scene, a nurse finishing her shift, commuting home (perhaps on her bicycle for the added excitement?) getting dinner ready, maybe doing a load of laundry, maybe ironing some scrubs, having dinner with her husband, reviewing the mundane details of their respective days, finishing it all off with an episode of How I Met Your Mother. No, this would not get MTV ratings, and that is exactly why they cast who they did.

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September 3, 2013 / E.

Symptoms and No Diagnosis.

Guest post by James Worrall.

Why is there so much suffering that we cannot explain?

Asked another way, why are there so many symptoms and so few diagnoses?


As an emergency physician, I see many patients who arrive at the hospital with chest pain, abdominal pain, numbness of the extremities, or other potentially worrisome complaints, and yet no cause is found. In fact, I estimate that we only make a diagnosis in one of ten patients with chest pain. When the patient asks me, “What’s causing this pain, doctor?” how am I to respond?

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August 19, 2013 / E.

Healthcare Costs of War.

Ever wonder how much a country spends on healthcare as a result of going to war? It is not just the costs associated with the actual wartime period. Rather, they extend much longer beyond – and at an exponential rate that may surprise you.

The folks at MBA Healthcare Management have put together an interesting infographic to highlight just how much the U.S. (which is already the world’s greatest healthcare spender by a long shot) is allocating as a result of recent wars and conflicts. Check it out!

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August 7, 2013 / E.

Virtual ER not yet Reality.

I was recently asked for an opinion on an article that was published on LinkedIn, boasting “the virtual ER is here today, saving time and money“. Could this really be true? When a patient is facing a medical emergency, can he/she really access an emergency room virtually, without the wait while lowering overall cost to the system at the same time?


Sounds too good to be true.

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