ACEP Now (Formerly ACEP News)

Great article about Stuart Clive, MD, regarding postponing retirement. (ACEP Now, Approaching Retirement, Emergency Physician Weighed the Moral Math of One More Year,” May 2026). I had a somewhat similar situation. I retired from the Veteran’s Affairs (VA) emergency department in Kansas City in 2022. I have kept working some “fee basis” part-time shifts each month in Kansas City and Topeka, Kansas, in the VA emergency departments.

With great interest, [we] read the recent ACEP Now article, “Workplace Violence in the ED: In Search of Lasting Solutions.” The legislative progress described the No Silence on ED Violence campaign, and ACEP’s peer support network represent meaningful, hard-won gains that address real gaps. The article is right to highlight these as genuine progress. Yet the dominant framework remains oriented toward legal deterrence and post-incident response.

On one hand, artificial intelligence (AI) tools in the emergency department (ED) are our benign helpful assistants. AI-powered ambient scribing technology is widely available, making inroads on human scribes, and AI is also increasingly integrated with underlying digital systems.

The patient with chest pain hesitates before agreeing to admission. Another asks whether the CT scan is truly necessary because they are worried about the bill. A diabetic patient waits weeks before seeking treatment because of the deductible reset that occurred in January 2026. They cannot afford another round of medical expenses.

A 22-year-old woman presents after being sexually assaulted. She reports that she was bitten and strangled by the perpetrator during the assault. The patient has bruising to her face and a semi-circular bruise on her chest. She has faint petechiae on her face but no bruising is evident on her neck. The forensic nurse is called and brings a sexual assault evidence kit and an alternative light source to the room.

With health care issues top of mind for voters and a record 50 physicians running for Congress, the National Emergency Medicine Political Action Committee (NEMPAC) has a critical role in the upcoming election cycle. Many physicians entering politics in 2026 cite desires to influence health care policy by drawing on their clinical experience.

(See original article here.) When parents are clearly informed that the procedure may be uncomfortable and could cause the child to cry, and they still consent, I do not believe the physician is acting inappropriately. Given the close proximity of the genital area and the possibility of a resisting child, inadvertent contact and minor local irritation can occur despite appropriate technique.

I read with interest the article “Extensor Tendon Repair by Emergency Physicians” by Erin Dooley, MD, and J. Michael Smith, MD, in ACEP Now in March 2026 and found it to be a helpful review of extensor tendon lacerations/repair. However, the article recommends the use of a forearm blood pressure cuff to achieve hemostasis during single-digit extensor tendon repair.

FIGURE 1: A 9-year-old boy with forehead swelling. (Click to enlarge.) A 9-year-old, fully vaccinated boy presented to the emergency department (ED) accompanied by his mother for forehead swelling. He had a minor fall and hit his head about two weeks prior without loss of consciousness or vomiting. Four days later, the mother noticed the swelling had not improved despite applying ice. They denied any fevers, headaches, erythema, or neurological changes.

Emergency physicians are accustomed to making high-stakes decisions in diagnostic gray zones. Few scenarios are more frustrating than the persistently unresponsive, post-cardiac arrest, or otherwise altered patient in whom nonconvulsive seizure remains on the differential, yet timely electroencephalography (EEG) is unavailable. For many hospitals, the traditional answer has been to transfer.