Failure of private hospitals to care for the uninsured resulted in informal ED to ED referrals, which meant up to 20% increased volume in public EDs for certain diagnoses, particularly orthopedic issues.  This led to duplicate testing, increased cost, complications, delays in care, and poor treatment of the most vulnerable patients.

Know the laws in your state and hospital policies that govern what your responsibility is in regard to working with law enforcement.

Gun shows in Nevada were associated with more firearm related violence in nearby California.  Whereas gun show in California did not correlate with increased gun violence locally.  Authors concluded that this may have been due to stricter gun laws in California.

Female surgeons had small but significantly improved 30-day mortality and other surgical outcomes over male surgeons, all other factors being equal.

Why do people seek emergency or urgent care?  This quick systematic review of the literature identified 5 reasons.

Patient satisfaction is important.  But the most commonly used metric in the US, the Press Ganey survey, may not be a good measure of individual emergency physician and clinician performance.  Giving emergency clinicians feedback on their Press Ganey scores, ostensibly so they could take steps to improve, did not lead to appreciable score improvements.

From 2006 - 2012, admission rates for low-risk chest pain dropped 41%.  This may have been due to decreased reimbursement for such hospital stays.

One of the most important tasks we do in sepsis care, after identifying it, is to start appropriate antibiotics as soon as possible.  This is associated with mortality reduction.

Get ready to face the backlash from this bash of ED billing practices.  Internal Medicine just threw us under the bus.

Statewide, non-specific mandates may help a little.  Local and departmental policy change, with provider buy in, is even better.