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By Dr. Paul Kivela

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This is a list of thoughts and articles that are relevant to emergency medicine healthcare policy and the home of  “EM News You Can Use.”

Medically Sound

With Dr. Paul Kivela

Eskatamine is potentially prohibitively expensive

  August 16, 2019

There has been a tremendous number of articles and a lot of interest in the use of ketamine in the treatment of depression and chronic pain. This prompted many drug companies to invest and Johnson and Johnson developed a new product to treat depression. However there are always challenges with new products especially effectiveness, side… Read More


Over half the states are in the medical...

  August 16, 2019

To get an update of what states are in the compact go to https://imlcc.org/. The Interstate Medical Licensure Compact offers an expedited pathway to licensure for qualified physicians who wish to practice in multiple states. The IMLC mission is to increase access to health care for patients in underserved or rural areas and allowing them… Read More


Opioid-Related Mortality in the United States 

  June 2, 2018

From June 2018 JAMA Between 2001 and 2016, the number of opioid-related deaths in the United States increased by 345%, from 9489 to 42 245 deaths (33.3 to 130.7 deaths per million population). By 2016, men accounted for 67.5% of all opioid-related deaths, and the median (interquartile range) age at death was 40 (30-52) years. The… Read More


More deaths from illicit opiates than prescription opioids

  May 2, 2018

From May 1, 2018 LA Times and JAMA The U.S. opioid crisis has passed a dubious milestone: Overdose deaths involving synthetic opioids like illicit fentanyl have surpassed deaths involving prescription opioids. This switch occurred in 2016, according to data published Tuesday in the Journal of the American Medical Assn. And it seemed to happen pretty suddenly.  Data from the National… Read More


Where There’s Wildfire, There’s Smoke | NEJM

  March 11, 2018

A March 8, 2018 in NEJM looks at the potential health effects of the smokes form wildfires.  This Perspective article was entitield “The New England Journal of Medicine — Where There’s Wildfire, There’s Smoke.” This article looks at the increased number of wildfires and their potential health effects.  The recent Napa wildfires Fine particles are… Read More


Physicians decry consequences of consolidation – Modern Healthcare

  February 20, 2018

A February 20, 2018 issue of Modern Healthcare reported on a letter that Consolidation throughout the healthcare industry was increasing costs by driving more care from private offices to the more expensive location of hospitals, the Physicians Advocacy Institute warned in a letter to Congress. Healthcare organizations have been joining forces to try to get ahead of the… Read More


Medicaid Expansion helps Dental Care but also increases...

  January 19, 2018

Abstract OBJECTIVE: To evaluate the effect of Medicaid coverage on dental care outcomes, a major health concern for low-income populations. DATA SOURCES: Primary and secondary data on health care use and outcomes for participants in Oregon’s 2008 Medicaid lottery. STUDY DESIGN: We used the lottery’s random selection to gauge the causal effects of Medicaid on… Read More


Are Free Standing ERs the answer to rural...

  January 19, 2018

A January 2018 report presents a conclusion that not all rural communities need critical-access hospitals. Rural/Critical Access hospitals can maintain up to 25 inpatient beds, but researchers with the Bipartisan Policy Center and the Center for Outcomes Research and Education found only three to five of those beds were occupied on average in the seven states… Read More


Los Angeles County Department of Mental Health-Homepage Detail

  January 17, 2018

LA County Mental Health Resources are an important part of the solution to help prevent suicides in Southern California.  Is this a model system that is effective and also sustainable?  Is this a poison control model that might work in other parts of the country?  Is this like a trauma center referral solution? This a… Read More


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