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In the complex world of modern medicine, it often requires purposeful thought and action to place our patients at the center of the care process. This study serves to remind us how to employ evidence-based patient-centered care during the course of emergency medicine (EM) practice. 

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Recommendations for patient-centered emergency care. CJEM. 2024 Aug;26(8):513-519. doi: 10.1007/s43678-024-00706-3. Epub 2024 Jun 21. PMID: 38904747.

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Physician humility is crucial for tackling modern healthcare challenges, building patient trust, and fostering collaboration in medical environments. However, significant challenges exist in cultivating humility and require substantial individual and collective actions to ensure the integrity of the medical profession, enhance patient care, and support healthcare providers’ well-being.

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Physician Humility: A Review and Call to Revive Virtue in Medicine. Ann Intern Med. 2024 Jul 30. doi: 10.7326/M24-0842. Online ahead of print. PMID: 39074373.

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Residents working in the emergency department were found to do significantly worse on cognitive tests and moral performance after working 5 consecutive night shifts compared to 5 day shifts.

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Effect of serial night shifts on the cognitive, psychomotor, and moral performance of residents in the department of Emergency Medicine. Acad Emerg Med. 2024 Jul 15. doi: 10.1111/acem.14980. Online ahead of print. PMID: 39007435

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Emergency medicine practice is going to be increasingly influenced by artificial intelligence (AI). This article discusses some of the ways we can expect it to impact our practice.

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The AI Future of Emergency Medicine. Ann Emerg Med. 2024 May 22:S0196-0644(24)00043-X. doi: 10.1016/j.annemergmed.2024.01.031. Online ahead of print. PMID: 38795081

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Unprofessional behaviors were reported most often among surgeons when comparing physician specialty subgroups.

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Physician Specialty Differences in Unprofessional Behaviors Observed and Reported by Coworkers. JAMA Netw Open. 2024;7(6):e2415331. doi:10.1001/jamanetworkopen.2024.15331

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In a controlled hypoxemia study, pulse oximetry was falsely elevated in subjects with darker skin pigmentation and low perfusion.

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Low Perfusion and Missed Diagnosis of Hypoxemia by Pulse Oximetry in Darkly Pigmented Skin: A Prospective Study. Anesth Analg. 2024 Mar 1;138(3):552-561. doi: 10.1213/ANE.0000000000006755. Epub 2023 Dec 18. PMID: 38109495.

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This single centre RCT investigated the link between IV cannula diameter and how painful it will be to insert. 18G cannulas were not more painful nor more difficult to place than 20G cannulas across the spectrum of experience levels. Pain and insertion success rates being equal, patients are better off with cannulas that can accommodate higher flow rates.

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Spiced RCT: Success and Pain Associated with Intravenous Cannulation in the Emergency Department Randomized Controlled Trial. J Emerg Med. 2024;66(2):57-63. doi:10.1016/j.jemermed.2023.10.008.

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In a self-described “quasi-experimental” analysis of Medicare claims data, private equity owned hospitals were associated with a 25% increase in hospitalization-acquired adverse events when compared with non-private equity hospitals. Notably, there was a 27% increase in falls, a 38% increase in the volume of central line-associated infections, despite the placement of 16% fewer central lines, and a doubling of surgical site infections despite 8% fewer surgical procedures being performed (underpowered assertion). 

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Changes in Hospital Adverse Events and Patient Outcomes Associated With Private Equity Acquisition. JAMA. 2023 Dec 26;330(24):2365-2375. doi: 10.1001/jama.2023.23147.

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Chair placement near the bedside is a simple intervention that increased the likelihood of physician sitting during patient encounters and yielded higher patient scores in satisfaction and communication.

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Effect of chair placement on physicians' behavior and patients' satisfaction: randomized deception trial. BMJ. 2023;383:e076309. Published 2023 Dec 15. doi:10.1136/bmj-2023-076309.

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These are the top articles from 2023. Enjoy!