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FCEP.org is back up and running as its own website! Features include:
EMpulse Online: Now you can read and share stories online. EMpulse Fall 2019 and Winter 2020 are online, and previous issues will be uploaded throughout the year, creating an EMpulse Archive.
Florida's EM Residency Programs Guide: This page lists every ACGME-accredited EM residency program in the state. Additionally, every program has its own fcep.org page featuring that program's EMpulse articles.
News Center: Now you can quickly find the most recent announcements and newsletters from FCEP and EMRAF!
Browse through your new website now at fcep.org.
COMING SOON: A redesigned emlrc.org will be launching at the end of January. Both websites will complement each other instead of duplicating content. Stay tuned.
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House Speaker Oliva opened Florida's 2020 Session with scathing remarks on freestanding ED's (FSEDs), scope of practice for APRNs and more. Read portions of his speech below:
"Each day [the Healthcare Industrial Complex] finds new ways to attract patients and public dollars. The newest iteration is stand-alone ER's. These facilities are primary care substitutes at emergency room prices. They are highly profitable because they can charge significantly higher rates. How do I know this? I have actually had hospital executives boast of their stand-alone ER's and their effects on the bottom line. The audacity is such that they advertise them openly on billboards listing the wait times. Clearly this isn't intended for anyone in an actual emergency as I can't imagine one would have time to shop. This is done to lure us in to their facilities for far less emergent conditions. Moms and dads take their children there for sore throats and earaches and fevers.
"But if we are being honest, we share a good measure of the blame. We often allow and even provide the conditions necessary for this abuse. One very notable example of negligence on our part (is)... Florida's archaic and backwards approach to scope of practice. Florida is one of a handful of states that still prevent health care professionals from practicing what they are educated, trained and certified to do. In spite of truly overwhelming evidence, Florida resists. This kind of protectionism on behalf of special interest groups is not just wrong, it is costly and it is dangerous.
"... I am standing here saying that an advanced nurse practitioner who has at least a four year degree in nursing, a graduate degree, in many cases, a doctorate in nursing and 2,000 hours of clinical, supervised residency to be allowed to practice what they studied! Allowing advanced nurse practitioners to practice independently will have an immediate positive effect on access and affordability.
"It is a stain upon a state that prides itself on leading to even humor talk of patient safety coming from interest groups when we now know beyond a shadow of a doubt of its safety and efficacy. Or worse, to use phrases like, 'if you want to be a doctor, study to be a doctor.' Thirty states have out-grown this backwards policy, Thirty! It is high-time we allow health care professionals to practice to the extent of their training!"
Read his full speech here.
FCEP is against bills that inappropriately expand scope of practice, such as HB 607: Health Care Practitioners (Rep. Pigman), which has passed through the Health Care Appropriations Subcommittee. We cannot stress the importance of attending Emergency Medicine Days this year — you must advocate for yourselves and your profession.
EM Days Online Registration Closes Friday
Emergency Medicine Days 2020
January 27-29, 2020
Hotel Duval in Tallahassee, FL
By Chuck Buck at RACmonitor
To welcome the new year, UnitedHealthcare (UHC) has announced that starting April 1, 2020, they will use a proprietary software program to evaluate all professional claims submitted for emergency department visits with the Level 5 evaluation and management (E&M) code 99285.
According to guidelines from the American Medical Association (AMA), a Level 5 emergency department visit requires a comprehensive history, a comprehensive examination, and medical decision-making of high complexity...
Yet the UHC announcement notes that the Optum Evaluation and Management Professional (E&M Pro) tool will determine the "correct" code based solely on the patient's age and the diagnoses submitted on the claim — and if the tool determines that the submitted diagnoses justify a lower-level code, the claim will either be automatically adjusted to the lower-level code or denied "based on the reimbursement structure" in their contract.
Read more of this article here and the UHC Bulletin here.
EM Reimbursement & Innovation Summit
February 27-28, 2020
EMLRC in Orlando, FL
Approved for AMA PRA Category CreditsTM
Learn More & Register Now
ACEP is accepting nominations for the Disaster Medical Sciences Award, which recognizes individuals who have made outstanding contributions to the field of disaster medicine. This includes contributions to the development, promotion, maturation, education, or humanitarian mission of disaster medicine on a state, national, or international level.
All entries must be submitted no later than March 1, 2020. Any member of the College may nominate themselves. Non-members and non-physicians may also be considered. The award may be given posthumously.
The award is presented each year at the Disaster Medicine Section business meeting at Scientific Assembly.
CBS News (1/13, Morgan) reports that the "current flu season is on track to be one of the worst in recent history, in terms of the number of people inflicted." In addition, the season might be particularly bad for children, because "pediatric deaths are double what they were at this time last year, with 32 reported fatalities so far."
"...We've seen a shift in the predominant strain which is usually influenza A. This year it's influenza B," Tara Narula said on CBS. "That hasn't happened since the 1992-1993 flu season. And we know that influenza B tends to affect children more. They tend to have more severe reaction to influenza B."
Newsweek (1/13, McCall) reports that type B influenza "has been predominating the season for the first time in 27 years," according to the CDC. The agency has reported a large increase in influenza B cases this season, which can be particularly deadly for children; 21 of 32 pediatric deaths this season have been attributed to influenza B.
Cannabis and Cannabidiol Health Effects
By Paula Mueller, MD
1.0 CME available (ACCME, FBON, FEMS, FPA, CAPCE)
Expires January 18, 2020
Watch Now | All Course Information
Cannabis is the most commonly cultivated, trafficked, and abused illicit drug worldwide. Used for both recreational and medicinal purposes, its exact effects continue to be a subject of debate. More recently, the use of cannabidiol, a key active ingredient of cannabis, has seen increasing media coverage for its purported health effects. But what exactly are those effects, and are they what they claim to be? Learn about what treating this patient population looks like for the emergency medicine professional.
Florida PEDReady produces an enewsletter called the PEARL for EMS agencies, emergency departments and any other healthcare providers. Can you spare 10 minutes a week to brush up on pediatric education? Subscribe Now!
UPCOMING FCEP & EMLRC EVENTS
|JAN. 27-29, 2020
||Emergency Medicine Days | Learn More
||Hotel Duval in Tallahassee
|FEB. 27-28, 2020
||Emergency Medicine Reimbursement & Innovation Summit | Learn More
To see the full calendar, click here.
Lansing State Journal
Only 14% of people discharged from an emergency rooms across the country are prescribed opioids, a new federal health study found. One explanation for the decrease is emergency department providers' response to the opioid epidemic, the study said. Dr. Brad Uren, an Ann Arbor emergency physician and chairman of the legislative and regulatory committee of the Michigan State Medical Society, said many doctors became more aware of the risks associated with opioids and changed their habits. "The discussion just generally was 'How can we find a better way to do this?'" Uren said.
U.S. News & World Report
Today, despite expansion in health insurance coverage, ERs are seeing a larger and aging population, sicker patients who arrive in immediate danger with more chronic conditions, physician shortages as we expand care, a need for more expensive technical tools, and an unsustainable trend in costs and expenditures. Partial rescue from these challenges may be coming from the most unlikely of sources: artificial intelligence. These aren't robots, but smart apps and tools that can reduce cognitive ER burdens, while increasing diagnostic speed, precision and accuracy.
CNN via KDRV-TV
Pediatricians across the United States are sounding the alarm about unusually high numbers of young children being admitted to emergency departments due to respiratory syncytial virus infection or RSV, a common virus that causes cold-like symptoms. Most people recover in a week or two from the infection, but for infants, RSV can be serious.
The number of alcohol-related deaths has grown rapidly in recent decades, according to a new analysis of death certificates. The research, published in Alcoholism: Clinical & Experimental Research, is from the National Institute on Alcohol Abuse and Alcoholism, part of the National Institutes of Health. The yearly total of alcohol-related deaths for people ages 16 and over more than doubled, from 35,914 in 1999 to 72,558 in 2017. There were almost 1 million such deaths overall in that time. While middle-age men accounted for the majority of those deaths, women — especially white women — are catching up, the study found. That's concerning in part because women's bodies tend to be more susceptible to the effects of alcohol.
During his freshman year at the University of California, Davis, Marco Martinez started hyperventilating regularly. The incidents worsened, becoming seizure-like episodes and ending in trips to the emergency room. During each hospitalization, the doctors were stumped. No one thought to test for kratom.
The Washington Post
Justin Barad never would have guessed that he'd help operate on a gorilla during his residency at the UCLA Medical Center, where he was training to be an orthopedic surgeon. Yet in August 2014, The Los Angeles Zoo and Botanical Gardens needed specialists to help Jabari, a 400-pound gorilla who was limping and unable to put weight on his leg. The zoo's request was an unusual one, even by industry standards, but unpredictability is commonplace in the medical world. His experience with Jabari is one of many reasons Barad sought a solution for surgeons and doctors so often faced with unknowns. These moments drove him to dedicate his career to making surgery training more efficient by using video game technology.
Becker's Health IT & CIO Report
Various healthcare organizations have asked CMS to address inadequate EHR usability and increase system safety requirements, according to a Pew Charitable Trusts report. In 2019, CMS issued an open request for comments on how to improve patient safety through EHR use. The technology poses usability concerns, including default drug measurement settings and unclear medication lists, which can exacerbate medical errors. These issues can be the result of EHR system design, customization or an improper implementation by the organization.
Like in other places, the emergency department at the Rainy Lake Medical Center is where people come if they think they're having a heart attack or have broken their arm or find themselves in a mental health crisis. But unlike some hospitals, there's no special emergency department for people in crisis and no inpatient beds for psychiatry patients in International Falls, Minnesota, a city of 6,000 people near the Canadian border. The shortage of mental health care in rural areas means patients in need of inpatient psychiatric care are often waiting days to be transferred to beds far from home. It's a situation that’s challenging for patients, families and healthcare providers, one with no obvious solution.
The "normal" body temperature of 98.6 degrees Fahrenheit is actually not so normal. New research finds the average human body temperature of Americans has dropped. "What everybody grew up learning, which is that our normal temperature is 98.6, is wrong," said Dr. Julie Parsonnet, a professor of medicine as well as health research and policy at Stanford University School of Medicine. The 98.6 degree standard was established by a German doctor in 1851. Recent studies have indicated that's too high; research on 35,000 British people found their average was 97.9 degrees.
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