New Opiate Prescriptions and Downstream Risk of Misuse

New Opiate Prescriptions and Downstream Risk of Misuse

In patients given a new opiate prescription in the ED, 13.7% had persistent or high risk use over the next year. Higher doses led to greater risk, but even appropriate lower doses were associated with up to a 10% risk.

#ThisIsOurLane - Physicians and Gun Violence

#ThisIsOurLane - Physicians and Gun Violence

The physician response to an incendiary tweet by the NRA last week has been striking. It has led to the hashtag #ThisIsOurLane, as the NRA admonished physicians to “stay in their lane” regarding gun policy. This is a review of the position statement by the American College of Physicians on reducing firearm deaths and injuries that sparked it all.

Urgent Care Siphons Off Emergency Patients

Urgent Care Siphons Off Emergency Patients

From 2008 to 2015, low acuity care in commercially insured patients has dropped 36% in EDs and increased 140% in non-ED settings, dominated by an increase in urgent care but also, less so, by increases in retail clinic and telemedicine utilization.

Why SEP-1 CMS "Quality" Metrics Are Dumb

Why SEP-1 CMS "Quality" Metrics Are Dumb

Sepsis bundles like the CMS SEP-1 guidelines are too restrictive, requiring an all-or-nothing approach to achieve compliance. These bundles fail to prioritize the most important bundle components while penalizing providers for meaningless omissions that have no impact on mortality.

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