Send us a textDr. Rob Rodriguez, MD Professor of MedicineAssociate Dean of Clinical & Population Health ResearchUniversity of California Riverside School of MedicineThe MMWR ArticleDiscusses his groundbreaking study examining vaccination screening in emergency departments across America. The research reveals a critical public health opportunity as 86% of ED patients aren't up-to-date on their vaccinations, yet nearly half would accept them if offered during their visit.• Vaccination has saved more lives than any other public health intervention• For 25-30% of Americans, emergency departments are their only healthcare access point• Study conducted across 10 EDs in 8 cities focused on non-critically ill adult patients• About half of patients were unaware of vaccines recommended for their age group• Implementation could increase vaccination rates from 14% to potentially 48%• Automating the screening process is the next step to avoid burdening ED staff• Government funding for vaccines significantly increases uptake rates• Recent political shifts have reduced emphasis and funding for vaccination researchIf you're interested in joining this public health mission or have thoughts to share, please contact Dr. Rodriguez through the link in our show notes.Support the show
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August Updates and Book Suggestion!
Send us a textMel give some updates and his book selection for this summer!Everything is Tuberculosis by John GreenInvictus.Reviews landing Page is live.Support the show
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Healthcare's Frontline Heroes Need Help Too
Send us a textThis is a reproduction of the Caring Greatly Podcast. The 100th episode and the interviewer Liz Boehm.Dr. Mel Herbert, emergency physician, educator and medical consultant for the hit TV drama "The Pit," shares how the show portrays the realities of emergency medicine and healthcare's biggest challenges. The conversation reveals how healthcare professionals are pushing for system-wide change, especially in addressing clinician mental health needs.• Emergency departments serve as society's 24/7 safety net but are facing unprecedented staffing and capacity challenges• Wait times at prestigious hospitals now routinely reach 12-24 hours due to system-wide issues and patient boarding• "The Pit" accurately portrays healthcare challenges including workplace violence, administrative pressures, and resource constraints• Clinicians carry an "emotional backpack" of trauma from witnessing death and suffering without adequate mental health support• Dr. Herbert advocates for mandatory mental health support for all healthcare workers to eliminate stigma• Emergency medicine consistently ranks highest in burnout and suicide rates among medical specialties• The profit-driven healthcare system contributes to systemic problems that harm both patients and providers• The show helps patients and families understand what really happens in emergency departments• Media portrayal of healthcare challenges can drive public understanding and potentially influence policy changeWatch "The Pit" to support continued storytelling about healthcare's frontline workers and the challenges they face.Support the show
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Unfunded Mandates: How ER Docs Bear the Cost of America's Healthcare Crisis
Send us a textDr Gillian Schmitz former ACEP president and current vice chair of education at Naval Medical Center San Diego, examines emergency medicine's financial crisis and its consequences. She identifies the fundamental contradiction in how America treats emergency care as a universal right while funding it as a privilege, creating an unsustainable system where nearly 70% of ED patients don't cover their care costs.• Former ACEP president with extensive experience in civilian and military emergency medicine• Healthcare in America faces a fundamental conflict between right vs privilege approaches• Nearly 70% of emergency department patients don't pay the full cost of care• Insurance companies making billions while avoiding fair payment for emergency services• Boarding and overcrowding have reached dangerous levels affecting patient safety• Physician groups facing consolidation as independent practice becomes financially nonviable• Potential solutions include better insurance accountability and reconsidering funding models• Some physicians consider unionization and collective action as necessary steps• Media portrayal through shows like "The Pit" helps public understand emergency medicine challengesWe need the public to understand how emergency care is funded – or not funded – and the impact of this unfunded mandate on the entire healthcare system. Without addressing the root cause, boarding, violence, and consolidation will continue to worsen.Support the show
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The Real Crisis in the ER: Systemic Dysfunction vs Financial Concerns
Send us a textThe ACEP and RAND StudyInterview with David Schriger, Peter Viccellio, and Al Sacchetti, MD'sFour decades of emergency medicine experience reveals how the specialty continues to normalize dysfunction while failing to articulate what emergency care should look like. Veterans explore solutions to the systemic problems that have kept emergency departments "at the breaking point" for over 30 years.• Emergency physician compensation ranks around 16th among medical specialties—not the financial crisis some portray• Working conditions, not compensation, represent the true crisis in emergency medicine today• Emergency departments generate 33-50% of hospital revenue, but this value is rarely recognized by administration • Physicians have accepted and normalized dysfunctional practices like hallway medicine instead of demanding change• Simple solutions like elective scheduling smoothing and enhanced discharge programs work but aren't widely adopted• Emergency medicine needs to define and demand what optimal practice should look like• The healthcare system tries to solve 7-day-a-week problems with 5-day-a-week solutions• Hospitals contain chaos in emergency departments to maintain predictability on inpatient floors• Emergency physicians increasingly moving into hospital leadership roles where they can implement systemic improvementsListen to our next episode where we'll explore how new emergency physicians can advocate for better workplace conditions despite institutional resistance.Support the show
Mel Herbert, MD, and the creators of EM:RAP, UCMAX, CorePendium, and the collaborators on "The Pitt" and many of the most influential medical education series present a new free podcast: “Dirty White Coat.” Join us twice a month as we dive into all things medicine—from AI to venture capital, long COVID to ketamine, RFK Jr. to Ozempic, and so much more. Created by doctors for clinicians of all levels and anyone interested in medicine, this show delivers expert insights, engaging discussions, and the humor we all desperately need more of!
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