Warning: Long post and a little “soapbox-y”

When I work in the ED, I document exam findings such as “appears anxious”, “dysphoric”, etc often.  While moved by the story of Alyssa’s death, I don’t think the lesson I take away is that documenting “anxious” in her chart was a true contributing factor, and I will continue to document psychiatric exam findings.

My rational is this:

#Though not all physicians are trained or qualified to make psychiatric diagnosis, I do believe that all are trained and qualified to perform an at least basic psychiatric examination and find/document findings such as mood, affect, speech, though process and content (the basic elements of a psych exam).

#The exam findings are IMPORTANT.  A patient who appears anxious may be anxious from their supra-ventricular tachycardia, thyrotoxicosis, cocaine intoxication, or hypovolemic shock.  Anxiety as an exam finding or symptom and does not equal… Continue reading →

As someone who seldom has time for reflection and writes prose even less frequently, this blog post or subsequent blog post will not be a shining achievement.  With that disclaimer aside, the first day of the Marseille Experience Summer Camp has been an important start to re-invigorating my energy and determination to improve the quality of care at my own institution.  Residency is demanding and it is easy to allow the fatigue and complacency with systems that never seem to budge overcome whatever passions for change you have.  While the formal lectures have been great, the moments before, between and after lectures talking with the esteemed faculty one-on-one has been my most valued time at Marseille so far.