MMXII

Happy New Year! A momentous year? It is the 200th anniversary of the War of 1812. My grandniece will enter first grade. I will celebrate my 36th wedding anniversary and my 60th birthday. 2012 is the year of my 35th medical school reunion. We citizens will be inundated with exaggerations, half truths and damn lies as this is an election year.

My friends and former colleagues will be moving into their new ER. More rooms, more space, a new entrance and the same inept administration. The patients will be waiting at least as long but will be more likely to be on a stretcher than in the waiting room. I treated a young woman recently who lives 5 minutes from LGH and has a primary care doctor on the LGH medical staff. She had been vomiting and having diarrhea. She called the LGH ER and was told that the wait was at least 3 hours. Unless the policy has changed, giving wait estimates is not allowed. She drove 20 minutes to NVMC and was placed on a stretcher on arrival and was seen and began treatment within 5 minutes. Press-Ganey gold.

Today I received an e-mail from the ER director of LGH. It was a reminder of the schedule and agenda for the next two ER department meetings. The fact that I haven't been a member of the LGH ER department since June 2011 seems to have escaped his attention. He, of course, was the person who fired my aged ass. Removing me because I was labelled a "disruptive physician" does not seem to have resolved any of LGH's ER problems.

It has been a strange winter. Warmer than usual and with almost no snow. The flu season seems relatively benign. A particularly nasty and wide spread gastroenteral virus is keeping the ER census  high. Many health care workers have experienced the misery of this "GI bug". A national dilemma of shortages of common medications has added to the burden of this epidemic. NVMC ran out of injectable Zofran.

The reports in the mainstream and medical press has given many reasons for the shortages. The drugs are all generic and therefore have much lower profit margins that newer, patented meds. Middlemen, who take their cut between the pharmaceutical manufacturers and the hospitals, clinics and pharmacies, seem to be price gauging. Money is the root of all evil.

One of my new duties is reviewing charts for patients who return to the ER within 48 hours. Many are for continuing symptoms of their initial visit. Some ran out of their pain meds and need more of the same. The purpose of this quality assurance exercise is to try and find issues that may lead to better clinical practices. The slow pace of the night shift af NVMC gives me time to do my part to improve care for our patients.

The world's oldest ER doc wishes everyone a Happy, Healthy and prosperous 2012.