In recent months, the University of California has gained significant attention for taking a strong stance in support of open access publishing of UC research as it negotiates new agreements with major journal publishers.
Until 2019, the Emergency Medicine ACGME (Accreditation Council for Graduate Medical Education) program requirements stated that institutions were required to provide protected non-clinical time for core faculty. Specifically, core faculty could not be required to generate clinical or other income to support that protection. These core faculty could not average more than 28 clinical hours per week, or 1344 clinical hours per year. In the new proposed program requirements, the requirement to ensure this non-clinical time has been removed.
The true intent of the ACGME Milestones is to represent the developmental trajectory of a resident over time. The variability in faculty ratings, which may initially seem frustrating, are instead intentionally important to the process of monitoring development in our trainees. There is no perfect assessment tool and there will be variability in assessments. And that’s okay.
This paper provides an overview of the importance of grant funding within medical education, followed by a stepwise discussion of strategies for creating a successful grant application for medical education-based proposals.
Like the fable of the blind men and the elephant, each of whom, feeling a different part of the elephant, described it in very different ways, clinical reasoning is a vast, complex construct that is described and used in different ways by different people
Healthcare organizes doctors and patients into a system where that relationship can be financially exploited and as much money extracted as often as possible by hospitals, clinics, health insurers, the pharmaceutical industry, and medical device manufacturers.
In this issue of WestJEM, Smith and colleagues present a prospective observational evaluation of anticoagulation prescribing practices in non-valvular AF. Patients presenting to one of seven Northern California EDs with AF at high risk for stroke were eligible unless admitted, not part of Kaiser Permanente of Northern California (KPNC), or already prescribed anticoagulation
I want to take this opportunity to update our readers, reviewers, and supporters regarding the growth and stature of the Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health (WestJEM). We continue to grow and thrive, extending our scope and reach throughout the nation and the world.
Currently, emergency departments in Imperial County treat three times more pediatric asthma visits than elsewhere in California.5,6 Recently, there has been new governmental, academic, and community interest in this issue, and as emergency physicians we have a unique opportunity to become involved in the health of the Salton Sea as well as the surrounding community.
Author Affiliation Nick T. Sawyer, MD, MBA University of California, Davis, Department of Emergency Medicine, Sacramento, California; California American College of Emergency Physicians Board of Directors John D. Coburn, MD The Permanente Medical Group, South Sacramento Kaiser, Department of Emergency Medicine, Sacramento, California; California American College of Emergency Physicians Board of Directors Under-triage is a […]
Author Affiliation Gary A. Johnson, MD SUNY Upstate Medical University, Department of Emergency Medicine, Syracuse, New York Much attention has been directed toward super utilizers of emergency department (ED) and hospital services. Often these patients have a chronic illness with significant potential for acute morbidity. In many settings, adults with sickle cell disease (SCD) […]
The WestJEM Blog and Podcast Watch presents high quality open-access educational blogs and podcasts in emergency medicine (EM) based on the ongoing Academic Life in Emergency Medicine (ALiEM) Approved Instructional Resources (AIR) and AIR-Professional series.
Volume 16, Issue 6, November 2015.
Jeffrey N. Love, MD, et al.
Emergency medicine (EM) educators have many
masters. These include our hospital administrations who
expect efficient patient care reflecting the priorities of safety
and quality, the accreditation council for graduate medical
education which has introduced a new competency-based
standard by which our learners must be educated, and last but
not least, our learners that are using new educational modalities
based on expanding digital platforms. To be successful,
educators must satisfy each of these masters against the
backdrop of increasing regulations, decreasing funding and
information technology that appears to decrease our time with
patients and perhaps learners in clinical practice.
Volume 16, Issue 6, November 2015.
Eric S. Holmboe, MD
Emergency medicine (EM) has always been on the frontlines of healthcare in the United States.
I experienced this reality first hand as a young general medical officer assigned to an emergency
department (ED) in a small naval hospital in the 1980s. For decades the ED has been the only site
where patients could not be legally denied care. Despite increased insurance coverage for millions of
Americans as a result of the Affordable Care Act, ED directors report an increase in patient volumes
in a recent survey.1
EDs care for patients from across the socioeconomic spectrum suffering from a
wide range of clinical conditions. As a result, the ED is still one of few components of the American
healthcare system where social justice is enacted on a regular basis. Constant turbulence in the
healthcare system, major changes in healthcare delivery, technological advances and shifting
demographic trends necessitate that EM constantly adapt and evolve as a discipline in this complex
Volume 16, Issue 3, May 2015
Larissa S. Dudley, MD
Anaphylaxis is a rapidly progressing, potentially life threatening allergic reaction that has been increasing in prevalence, most commonly triggered by foods, medications, and insect stings. Allergies in children are increasingly more common. Unfortunately, anaphylactic reactions are under-recognized, due to overlooked or under-appreciated symptoms, and therefore under-treated with epinephrine.1 For several years, epinephrine has been established as the drug of choice for anaphylaxis.2 Even a few minutes delay in the recognition and treatment of anaphylaxis can lead to hypoxia or death. Therefore, healthcare professionals and laypeople alike should be able to recognize the signs and symptoms of anaphylaxis and have accessible resources to initiate treatment.
Volume XV, Issue 1, February 2014
Aimee Moulin, MD, et al.
In 2009 Alameda placed 11.0 involuntary holds per 1,000 population, while the next highest county in California only placed 6.4 per 1,000 population.5 This may suggest instead that some of Alameda’s mental health patients would not have been placed on an involuntary hold in other California counties in the first place, increasing the proportion of lower acuity psychiatric emergencies and thus accounting for the high discharge rate.
Volume XV, Issue 1, February 2014
Scott Zeller, MD
As Moulin and Jones correctly indicate, there is no delineation of the relative acuity of the study patients to those seen in other emergency settings in California. However, we are unaware of any established metric to provide such a comparison for this patient population, and no such categorization was noted in any of the other boarding time studies cited in the article.
Volume 16, Issue 1, January 2015
Christopher A. Griggs, MD, MPH et al.
Prescription drug abuse is a leading cause of accidental death in the United States. Prescription drug monitoring programs (PDMPs) are a popular initiative among policy makers and a key tool to combat the prescription drug epidemic. This editorial discusses the limitations of PDMPs, future approaches needed to improve the effectiveness of PDMPs, and other approaches essential to curbing the rise of drug abuse and overdose.