Discussion with Emergency Room Physician Brittany A. Lamb, MD

Get an insiders perspective on life in the Emergency Room and how we can plan, prepare, and adapt for ourselves, our loved ones and our clients

• Learn how to make a plan for their care in advance, so you can act instead of react.
• Know you made the best choices you could in the situations you were given. 
• Gain control over the decisions you must make that will affect their life and yours.

Link to Podcast

Brittany Lamb, MD

• Website: https://blambmd.com/
• brittanylamb@blambmd.com

Questions Asked (see more in chat below)

• "I have used Holy Cross Hospital and Water Reed Military hospital emergency rooms several times and both were terrible, giving wrong diagnosis and botched treatments. Is there an organization that rates hoslpitals, specifically emergency room services."
• how can we access the class you're teaching for free so that we can think about the questions you're passionate about?
• Do you think you could come out and do a physical presentation on what you offer and talk about this informtion to my independent seniors who live in an aging in place active community for people 62 and over?
• What city are you in?
• I'm in Atlanta, so your presentation would be virtual online...
• Do you or another organization provide education to physicians on when to send their patients to the ER? I have had several situations where a specialist has not looked at test results for 2 weeks...then checks these at 4 PM on a Friday and send the person to the ER! And the patient is sent home from the ER and told to see the specialist!

 Chat Transcript

12:06:39    

Hi,  Louis Tenenbaum here from the HomesRenewed Coalition, driving the Home Modifications for Accessibility Act, HR 7676. This is a movement to incentivize Americans to make their homes safer and more accessible as the foundation to Aging in Place. Think solar and hybrid car type incentives for longevity!

12:06:55     From  Steve Gurney - ProAging Community : From Amanda Waggy to All Panelists 12:03 PM

Hello from Brady Marsten with Ashleigh at Lansdowne!!

12:07:04     From  Steve Gurney - ProAging Community : From Vivian Green korner to All Panelists 12:03 PM

Vivian From New Jersey

12:07:07     From  Joshua Rosales : Good afternoon!

Joshua Rosales

jrosales@aitscorp.us

www.aitscorp.us

240-396-2111

(We're an MSP providing IT/Cybersecurity services, IT project management, Fractional IT onsite/remote support to long-term care facilities, healthcare, retirement communities, CCRS)

12:07:09     From  louis tenenbaum   to   Hosts and panelists : thanks Steve,  I need to pay better attention

12:07:19     From  Steve Gurney - ProAging Community : From Mike Houle to All Panelists 12:03 PM

Hi all, Mike Houle from Silver Spring, MD.

12:07:52     From  Janet Neslon : Go Noles!

12:08:14     From  Amanda Waggy : Go Noles!!

12:08:35     From  Sara Geber   to   Hosts and panelists : Good morning! (I'm in CA).  This is Sara Zeff Geber, author of Essential Retirement Planning for Solo Agers. I am very interested in what Brittany has to say and its application to solo aging.

12:08:55     From  Steve Gurney - ProAging Community : From Sara Geber to All Panelists 12:08 PM

Good morning! (I'm in CA).  This is Sara Zeff Geber, author of Essential Retirement Planning for Solo Agers. I am very interested in what Brittany has to say and its application to solo aging.

12:09:18     From  Kathleen Steed : Fortunately, I do not have a car and I do not drive.  As far as cooking, I also do not have a stove.  I hope that the ER is not in my future, but it always is good to know.  (Where is Dr. Lamb’s hospital located?)

12:09:23     From  Lindsey Vajpeyi : Hello everyone! Dr. Lamb is awesome, and I am excited to hear her speak! Lindsey from Insight Memory Care Center in northern VA. lindsey.vajpeyi@insightmcc.org

12:10:17     From  Dixcy Bosley : Thrilled to have this program… So important to address planning  before folks  land in the ER.

12:11:11     From  Arlene Polangin : This is what I want to hear: your experiences in the current emergency rooms today.  I lived in the emergency room at Suburban with my young children growing up.  Dementia care is a separate topic in my mind.

12:12:37     From  Mike Houle   to   Hosts and panelists : Steve, this is a great format. You've done leading edge work with eldercare education and marketing - especially using the various online apps and platforms. I have finally set aside the time to join you today - I have a feeling I will be coming back regulary.

12:12:58     From  Jennifer FitzGerald : Hello everyone from Jennifer at Georgetown Home care, serving Virginia, Maryland and DC with private duty home care services. 703.328.5465  jenniferfitzgerald@georgetownhomecare.com

12:14:10     From  John Schumacher : Hi all.  Great topic.  John Schumacher, PhD, University  of Maryland, Baltimore County (UMBC)

12:14:29     From  ROSE ADAMI-NOWAK : Hi, Rose Nowak from Johns Hopkins Care at Home, Potomac Home Health Care and Support serving Maryland and the District of Columbia. Glad to be here!

12:15:23     From  Kate Chutuape : Thanks for mentioning that Steve. Related to that, we're hosting a Healthy Aging Lecture in November on this very topic - where do you go for care, what are the differences, what can you expect, etc.  Nov 18 at 11 AM

12:17:09     From  Arlene Polangin : Our younger son pulled a knife across his brother's thumb.  Blood all over the house as his brother ran shrieking.  We ran to Suburban Hosp. ER.  They said he almost hit an artery and if he had, the thumb could have be lost.

12:19:26     From  Dixcy Bosley : A pediatric ER is extremely stressful b/c any illness or change of condition  in a child is perceived as critical for any parent.

12:19:54     From  Mike Houle   to   Hosts and panelists : Three cheers for every single ER Doctor and Nurse I have ever encountered. You are a special breed and I don't know how you manage to do what you do, day in and day out. I've travelled to many third World countries, and believe me - when it come to health care, the West Is Best!

12:20:07     From  Steve Gurney - ProAging Community : From Mike Houle to All Panelists 12:19 PM

Three cheers for every single ER Doctor and Nurse I have ever encountered. You are a special breed and I don't know how you manage to do what you do, day in and day out. I've travelled to many third World countries, and believe me - when it come to health care, the West Is Best!

12:22:17     From  Janet Neslon : Dr. Lamb, that is exactly how I feel as an RN who worked in the hospital setting and in the insurance industry. I feel I can have more impact by educating about how to navigate the healthcare system.

12:23:04     From  Dixcy Bosley : Do you feel  that  homebound care movement for seniors help reduce the need for ER visits?

12:23:08     From  John Schumacher : There is a Geriatric Emergency Department Accreditation group  https://www.acep.org/geda/    Lists GEDs.

12:26:07     From  Marianne Dougherty : Most health care providers in rural areas of PA tell people to go to the Emergency Room if the office is closed.

12:26:38     From  John Schumacher : One other resource  https://gedcollaborative.com/

12:28:47     From  Mike Houle   to   Hosts and panelists : Steve, I really liked your question about how WE can be better patients in the ER. Doctors are only human, and het we expect them to perform miracles 24/7 - often on little to no sleep.

12:30:06     From  Steve Gurney - ProAging Community   to   Mike Houle and all panelists : thanks buddy! great to see you here!

12:30:33     From  Irene Rutter   to   Hosts and panelists : Thanks John

12:30:33     From  Mike Houle   to   Hosts and panelists : Yessir Mr. Steve!

12:30:39     From  Dixcy Bosley : Homebound seniors who receive medical care at home typically have bought into the “slow medicine “ concept  that avoiding ER visits/ hospitalizations is a priority. When you  warrant homebound care, you likely don’t want to extend your decline by over-treatment in tertiary care system ( often influenced by defensive medicine/ excess care). Less is more

12:30:47     From  Ruth Shea : I work as a Geriatric Social Worker at MedStar House Call Program. We serve about 500 frail elders in Washington, D. C. We provide primary medical care at home. There are studies that demonstrate that the house call programs prevent many un necessary hospital visits. We manage many comorbidities.

12:30:48     From  Steve Gurney - ProAging Community : https://blambmd.com/

12:31:07     From  Laura Heinrich : I worry that my DNR wish will not be honored in ER if I have even mild dementia.  Anything I can do in advance?

12:34:27     From  Kathleen Steed : Thank goodness for the establishment of Urgent Care centers.  My last visit to an ER was because my hand had been bitten by a dog, before Urgent Care existed.  It was a long day.

12:35:31     From  Sharyn Casapulla : You are amazing Dr. Lamb!!

12:36:12     From  louis tenenbaum : Dr Lamb's discussion is a great mirror/microcosm for aging process and experience in general for all those who work with older clients. Complexity, dynamic, time sensitive, decision makers, prep and advance decisions, goals, family issues. Thank you!

12:36:14     From  Dixcy Bosley : NOVA is so fortunate to have such a thoughtful young physician

12:36:20     From  Mike Houle   to   Hosts and panelists : Great content, Dr. Lamb. Thanks for sharing your insights with us here today.

12:36:57     From  Victoria Hathaway   to   Hosts and panelists : I hope Brittany will discuss the MOLST

12:37:11     From  Janet Neslon : Great point!

12:38:37     From  Dixcy Bosley : Tatoo DNR to your chest…..or AND.   Allow Natural Death

12:39:13     From  Sue Maddox : Working as a care management nurse and managing medicare pts in private practices one of my main functions is to help keep pt doing well with their chronic medical  conditions to prevent unnecessary ER visits. My 46 yr nursing background has given me the wisdom to encourage and manage my patients from afar. The issue today is that there are so many inexperienced "people" just a  body filling the gap who have no wisdom and knowledge it is extremely a dangerous time for healthcare. I have friends who call me all the time for "advice" before going to the ER--People need true healthcare guidance to navigate their healthcare putting all the business aspect of healthcare a side. The past 3 years have really caused more unnecessary strain and as a nurse I am ashamed of the unethical practices that have caused this "all

12:39:55     From  Kathleen Steed : On the other hand, I have attended a local Urgent Care across the street from me on two different occasions when I needed a Covid test.  The first time, an MD came in and asked me a couple of questions and left.   On my second time, I told them I had no need to see a physician, and I left.  Later, to my horror, when I looked online, I found two records with faked information, as if I had had a full medical exam.  Was the doctor listing a visit that did not happen because ProHealth required him to do so?  Or did the MD decide to fake an exam on his own?  In any case, I would be wary to visit this Urgent Care for anything other than the Covid test because of faked exam.

12:40:42     From  Steve Gurney - ProAging Community : POLST = Portable Medical Orders https://polst.org

12:41:36     From  Karen Dotson : POST is for individuals in their last year or two of life.  It is a physician's order and Virginia does not provide it to individuals.

12:41:36     From  Kathleen Steed   to   Hosts and panelists : Can we save the chat?  I do not see the three little dots.

12:41:36     From  Steve Gurney - ProAging Community : Maryland MOLST https://app.smartsheet.com/b/publish?EQBCT=184ea510a456427fa6311a2997d6cd92

12:43:00     From  Karen Dotson : www.virginiapost.org

12:47:08     From  Kathleen Steed   to   Hosts and panelists : Is Dr. Lamb available to speak on a Zoom class to other senior organizations?  If so, is her contact information available on the post-session sources you will send?

12:47:10     From  Sara Geber : Good morning! (I”m in CA).  This is Sara Zeff Geber, author of Essential Retirement Planning for Solo Agers. This is great information for solo agers who often need to make these preparations for themselves. Solo agers should also think about having a designated neighbor/friend/relative to take them to the ER if necessary and arm them with this critical information.

12:48:15     From  Dixcy Bosley : For ER patients who have high deductibles, how can we help clinicians be more judicious about what diagnostics are essential and what is less relevant information?  MDs and RNs sometimes forget that patients actually  are at the mercy  of a fee for services system?

12:51:16     From  Sue Maddox : On a daily basis I help families and patients access Palliative care/hospice care in situations where people keep going to the ER and with this care they stop going to the ER and have an excellent continued care experience at home by a Nurse practitioner doctors nurses etc. all of which is covered by Medicare. If only more ER staff/CM etc would broach this care choice.Those of us who truly care will always be there for our patients!!Thankfully

12:52:14     From  Sue Maddox : I worked with Amy during an internship years ago. She is Great!!

12:53:43     From  John Schumacher   to   Hosts and panelists : If helpful to anyone Steve,  just published a book on "Creating A Geriatric Emergency Department"  https://www.cambridge.org/core/books/creating-a-geriatric-emergency-department/8A860CD9BADB4E1C1509BDB49B814159

12:55:46     From  Dixcy Bosley : Slow medicine  is well described in a great book. Finish Strong  by Barbara Coombs Lee     Basically suggests slow down decisions on tests and treatment.    Consider alternatives,  benefits and burdens, and honor values of patient

12:55:50     From  Kathleen Steed : This is a great YouTube video from Geeks on Tour on Digital Estate Planning:  https://www.youtube.com/watch?v=yGLj-JbzjNg

12:55:52     From  Steve Gurney - ProAging Community : Dr. Lamb contact info: EMAIL

brittanylamb@blambmd.com

12:55:58     From  Mike Houle   to   Hosts and panelists : This could be an all-day webinar! Excellent. I would like some pointers as to how we (and any accompanying family members) can be better patients/consumers. Thanks!

12:56:01     From  Steve Gurney - ProAging Community : https://blambmd.com/contact/

12:56:02     From  John Schumacher : Great work  you are doing Dr. Lamb.  Keep it up.

12:57:02     From  Arlene Polangin : Steve, I need  to leave.  This was interesting.  Thank you.

12:58:30     From  Dixcy Bosley : Exactly!

12:59:02     From  Steve Gurney - ProAging Community : From John Schumacher to All Panelists 12:53 PM

If helpful to anyone Steve,  just published a book on "Creating A Geriatric Emergency Department"  https://www.cambridge.org/core/books/creating-a-geriatric-emergency-department/8A860CD9BADB4E1C1509BDB49B814159

12:59:04     From  Sue Maddox : Dr Lamb you obviously are a Great Ethical Practitioner this is a great service for all seeking care esp. in the elderly. UTI's etc can be managed well with out ER visits and the danger of being exposed to more infection etc. Kuddos to you!!

13:00:51     From  Vivian Green korner   to   Hosts and panelists : Excellent informative presentation, thank you Dr. Lamb

13:00:54     From  Sue Maddox : EXCELLENT PRESENTATION !!

13:01:28     From  mindy mitchell : This was great! So helpful and thought provoking!

13:01:29     From  Kathleen Steed   to   Hosts and panelists : Virginia?

13:01:34     From  Dixcy Bosley : Brittany….teach medical students

13:01:50     From  Mike Houle   to   Hosts and panelists : Five Stars! ⭐️⭐️⭐️⭐️⭐️

13:01:55     From  Kate Chutuape : Thank you for this terrific discussion!

13:02:04     From  Sharyn Casapulla : THANK YOU!!! THIS WAS WONDERFUL!!

13:03:06     From  Irene Rutter   to   Hosts and panelists : Great presentation, very helpful.  Thank you.

13:04:04     From  Shirley Snowden : Thank you so much!  Dr. Lamb.  Steve, thanks for another great session!

13:04:05     From  Janet Neslon : I am a professional independent patient advocate.

13:04:16     From  Janet Neslon : I will have to check out that recording.

13:05:17     From  Cathleen Wagaman : Very good presentation

13:05:36     From  Robin Edwards : Great presentation. Thank you!