Francis L. Counselman

Eastern Virginia Medical School

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Catherine A. Marco

Penn State Milton S. Hershey Medical Center

Terry Kowalenko

Medical University of South Carolina

Debra G. Perina

University of Virginia

Earl J. Reisdorff

American Board of Emergency Medicine

Michael S. Beeson

Summa Health System

Robert P. Wahl

Wayne State University

Robert C. Korte

American Board of Emergency Medicine

Judd E. Hollander

Thomas Jefferson University Hospital

Robert Birkhahn

NewYork–Presbyterian Brooklyn Methodist Hospital

Kevin B. Joldersma

American Board of Emergency Medicine

Cooperative Institutions

Eastern Virginia Medical School

American Board of Emergency Medicine

American College of Emergency Physicians

Harvard University

Society for Academic Emergency Medicine

University of Pennsylvania

Massachusetts General Hospital

University of Michigan–Ann Arbor

The Ohio State University

Northwestern University

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The American Board of Emergency Medicine Maintenance of Certification Summit

Journal of Emergency Medicine (2015)

Francis L. Counselman Michael Carius Terry Kowalenko Nicole Battaglioli Cherri Hobgood

Maintenance of Certification

Summit

10.1016/j.jemermed.2015.06.058

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Citations (7)

Academic Departments of Emergency Medicine: The Effects of Managed Care

Academic Emergency Medicine (1998)

Francis L. Counselman Robert W. Schafermeyer Debra G. Perina

To survey academic departments of emergency medicine (ADEMs) concerning the effects of managed care on their operation and practice.A 38-question survey was mailed to the chairs of all 52 ADEMs in the United States requesting information concerning managed care activity and its effects on ADEMs in academic years 1994-1995 and 1995-1996.Forty-seven ADEMs (90.3%) responded. When comparing the 1995-1996 and 1994-1995 academic years, the following changes were noted: decreased overall growth in ED patient volume (38.3% vs 51.1%), larger percentage of respondents reporting an actual decrease in ED patient volume (38% vs 27.6%), less growth in ED gross revenue (43.7% vs 52.1%), larger percentage of ADEMs reporting actual decreased gross revenues (25% vs 12.5%), increase in ED patient acuity (76.6% vs 59.6%), and relative stability in the number of EM faculty (40.4% vs 44.7% reporting no change in faculty number). Two-thirds of ADEMs used mid-level providers (i.e., physician assistants, nurse practitioners), most commonly in a fast-track setting (41%). Thirty percent of ADEMs reported that other academic departments actively directed patients away from the ED, with pediatrics, family medicine, and internal medicine the most active. Ninety-eight percent of ADEMs reported ongoing negotiations between their institution or hospital and managed care organizations (MCOs); only 54.3% of ADEMs were involved in these negotiations. Twenty-eight percent of ADEMs reported MCOs have had an effect on their emergency medical services system, with 37% indicating HMOs routinely discouraged their enrollees from using 9-1-1 services and 16% reporting HMOs provided 9-1-1 services to take patients only to participating hospital EDs.ADEMs have experienced significant changes in nearly every aspect of their practice over the two academic years under study, much of which is due to managed care. ADEMs must take a leadership role in dealing with MCOs.

Academic institution

10.1111/j.1553-2712.1998.tb02669.x

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Citations (5)

Vaginal Swelling After Intercourse: A Case Report

Clinical Practice and Cases in Emergency Medicine (2022)

Michael Bono Dylan Woolum A Shirley Jones Francis L. Counselman

Introduction: A vulvar hematoma is a hemorrhagic fluid collection in the female external genitalia. The majority occur as an obstetrical complication, especially during labor. Non-obstetrical vulvar hematomas are usually the result of trauma, with coitus being the most common etiology. Case Report: We present the case of a 25-year-old woman with significant vaginal pain and swelling after vigorous sexual intercourse. She exhibited tenderness and swelling of the left labia majora and minora. The differential diagnosis included bleeding, abscess, and deep venous thrombosis. Laboratory studies were normal and computed tomography of the pelvis indicated the swelling was most likely due to blood. The patient was taken to the operating room, and approximately 150 cubic centimeters of clot was evacuated. The patient had an uneventful recovery and was discharged home the next day. Conclusion: This case illustrates the unique presentation and challenges in making the diagnosis of vulvar hematoma.

Labia majora

Labia Minora

Ecchymosis

Vaginal bleeding

Etiology

Presentation (obstetrics)

Sexual intercourse

Bloody

10.5811//cpcem.2022.2.55284

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Citations (0)

Tension Hydrothorax from Disseminated Endometriosis

Western Journal of Emergency Medicine (2016)

AnnaKate Deal David P. Evans Francis L. Counselman

CONCLUSIONWe describe the first published case of a tension hydrothorax presenting as a complication of disseminated endometriosis in a young woman.

Hydrothorax

10.5811/westjem.2015.11.28503

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Citations (6)

An unusual cause of altered mental status

Journal of Emergency Medicine (1995)

Francis L. Counselman Scott Derkum

Pneumocephalus

Altered Mental Status

Presentation (obstetrics)

Pathophysiology

10.1016/0736-4679(95)02015-2

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Citations (11)

Can a Point-of-Care Troponin I Assay be as Good as a Central Laboratory Assay? A MIDAS Investigation

Annals of Laboratory Medicine (2016)

W. Frank Peacock Deborah B. Diercks Robert Birkhahn Adam J. Singer Judd E. Hollander

W. Frank Peacock, M.D., Deborah Diercks, M.D., Robert Birkhahn, M.D., Adam J. Singer, M.D., Judd E. Hollander, M.D.,Richard Nowak, M.D., Basmah Safdar, M.D., Chadwick D. Miller, M.D., Mary Peberdy, M.D., Francis Counselman, M.D.,Abhinav Chandra, M.D., Joshua Kosowsky, M.D., James Neuenschwander, M.D., Jon Schrock, M.D.,Elizabeth Lee-Lewandrowski, Ph.D., William Arnold, Ph.D., and John Nagurney, M.D.. Ann Lab Med 2016;36:405-12. https://doi.org/10.3343/alm.2016.36.5.405

Miller

10.3343/alm.2016.36.5.405

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Citations (17)

Malpractice Counsel: Never Too Young to Have a Heart Attack

Emergency Medicine (2017)

Francis L. Counselman

10.12788/emed.2017.0046

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Citations (0)

Ectopic pregnancy presenting as rectal pain

The American Journal of Emergency Medicine (2007)

Eleanor A. Erwin Francis L. Counselman

10.1016/j.ajem.2006.06.007

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Citations (2)

Evaluation of subcutaneous injection of local anesthetic agents as a method of tick removal

The American Journal of Emergency Medicine (1995)

Mark D. Lee Daniel E. Sonenshine Francis L. Counselman

Dermacentor variabilis

Subcutaneous injection

Topical anesthetic

10.1016/0735-6757(95)90232-5

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Citations (12)

Effect of Changes in Graduate Medical Education Funding on Emergency Medicine Residency Programs

Academic Emergency Medicine (2001)

Latha Ganti Robert W. Schafermeyer Francis L. Counselman Paul Blackburn Debra G. Perina

Abstract. Objective: To determine whether changes in graduate medical education (GME) funding have had an impact on emergency medicine (EM) residency training programs. Methods: A 34‐question survey was mailed to the program directors (PDs) of all 115 Accreditation Council for Graduate Medical Education (ACGME)‐accredited EM residency programs in the United States in the fall of 1998, requesting information concerning the impact of changes in GME funding on various aspects of the EM training. The results were then compared with a similar unpublished survey conducted in the fall of 1996. Results: One hundred one completed surveys were returned (88% response rate). Seventy‐one (70%) of the responding EM residency programs were PGY‐I through PGY‐III, compared with 55 (61%) of the responding programs in 1996. The number of PGY‐II through PGY‐IV programs decreased from 25 (28%) of responding programs in 1996 to 17 (16%). The number of PGY‐I through PGY‐IV programs increased slightly (13 vs 10); the number of EM residency positions remained relatively stable. Fifteen programs projected an increase in their number of training positions in the next two years, while only three predicted a decrease. Of the respondents, 56 programs reported reductions in non‐EM residency positions and 35 programs reported elimination of fellowship positions at their institutions. Only four of these were EM fellowships. Forty‐six respondents reported a reduction in the number of non‐EM residents rotating through their EDs, and of these, 11 programs reported this had a moderate to significant effect on their ability to adequately staff the ED with resident physicians. Sixteen programs limited resident recruitment to only those eligible for the full three years of GME funding. Eighty‐seven EM programs reported no change in faculty size due to funding issues. Sixty‐two programs reported no change in the total number of hours of faculty coverage in the ED, while 34 programs reported an increase. Three EM programs reported recommendations being made to close their residency programs in the near future. Conclusions: Changes in GME funding have not caused a decrease in the number of existing EM residency and fellowship training positions, but may have had an impact in other areas, including: an increase in the number of EM programs structured in a PGY‐I through PGY‐III format (with a corresponding decrease in the number of PGY‐II through PGY‐IV programs); a decrease in the number of non‐EM residents rotating through the ED; restriction of resident applicants who are ineligible for full GME funding from consideration by some EM training programs; and an increase in the total number of faculty clinical hours without an increase in faculty size.

Graduate medical education

10.1111/j.1553-2712.2001.tb00178.x

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Citations (2)