All these posts about EM docs and missing cases in women. Here are my thoughts:

Every single missed case is an opportunity to learn. Even if its about your own bias. Stop being so defensive. In my career Ive learned way more from cases I messed up on than cases Ive bragged about.

Good learning point, never make a DEFINITIVE diagnosis of something you cant prove. What test did you use to prove someones pain is just menstrual cramps? What test did you do to diagnose reflux? We often dont make a final definitive diagnosis. We rule out the bad ones.

We can rule out diseases, but if the diagnosis isnt proven, its better to just explain to the patient that the diagnosis isnt certain, life threats were ruled out, and why followup is important.

We cant make every diagnosis in the ED. Patients understand that when you explain it to them. Just be honest. Take them seriously, but explain the limitations we have in terms of diagnostics. Some diseases take months to figure out. We have a few hours.

Unless someone is filling a bunch of narc rxs from a bunch of different docs and is openly lying to you about it, dont call people drug seekers in the chart. Its gonna look real bad in a deposition.

If you go into a room with the belief the complaint is nothing, you are immediately putting yourself in a disadvantaged position. Our minds seek to justify our own bias. Always think worst first and work from there.

That is all. Sorry to those who had bad experiences in the ED. Maybe the ED doc did everything right and just didnt explain it well. Or maybe they didnt. Who knows. But everyone can learn from mistakes. Everyone. Thanks for sharing your stories.