The boogey man's voice that is forever urging us to tread cautiously is a part of us, so how can we escape his influence? We can't. But we can balance it, making it less oppressive and allowing us to practice more confidently and less defensively. I present several strategies that experience has taught me to accomplish this.

We go to work each day accompanied by a boogie man whose ceaseless demands that we be cautious can become overbearing. His influence sows seeds of doubt and nurtures within us a paralyzing anxiety that interferes with our decision-making and can expose our patients to harm. In this episode I discuss his genesis.

How did we get to a point where emergency specialist's are having to choose between providing patient care or being sanctioned by their employers and hospitals? In this episode I conclude my discussion of the hijacking of the management sepsis by the surviving sepsis campaign and how this harms unsuspecting patients.

In the early 2000's a pharmaceutical giant began a marketing campaign that re-defined sepsis and its management. In this episode are review this sordid interaction between money and medicine.

During my 30 year practice of emergency medicine, sepsis has transitioned from being a descriptive term for a patient being overwhelmed by infection into a distinct disease process.  Unfortunately this has lead to serious problems.  In this episode I discuss my experience witnessing this transition and how is this change evolved.  

Many patients present to our emergency departments with worrisome symptoms, but we physicians can find no objective evidence that they have disease. In this episode, I present a hypothesis to explain what is causing this confusing situation. By offering our patients an understandable explanation for what is happening to them we can more effectively reassure them and begin the journey toward relief.

Each day  emergency physicians see patients whose potentially serious symptoms cannot be explained after comprehensive evaluations. These patients seemingly have invisible disease. Many such patients return repeatedly convinced they have, as yet, undiagnosed dire medical conditions.  Just what is going on?

We must extract critical information from those who come to us despite difficult circumstances.  In this episode I discuss lessons derived from taking 200,000 histories from patients and  identify several questions that have helped me clarify confusing patient encounters.

Wouldn't it be great if there were a test available that could reliably tell the emergency physician how far down the slippery slope toward death the unstable patient before him/her had progressed?  Oh wait, we have one. Why are we are being told not to use it?

Our specialty faces threats from without and from within. In this episode these threats are further examined and methods of defending our specialty and ourselves are discussed.