—Susan Nedza, MD, MBA, FACEP

Re: ‘Your Employer Should be an Open Book’

When I look for a job, I am concerned about adequate staffing and an accurate volume. Many recruiters are given a volume and you start and the volume is 50 percent higher. Also, there should be an orientation, but sometimes to a new department there is little or none. Is it a toxic environment? Many things like, “what if the ICU is full,” [we] are not oriented to. Can you get a stat consult for a specialist? What if the hospitalist refuses to admit? An attending emergency physician needs to know [these things]. Our patients always come first and [for us] to deliver the best care. You get the feeling that what the recruiter only wants is the commission. They should want us to be satisfied with the job.

—Steven M. Winograd, MD, FACEP

Re: ‘How To Identify and Work With Neglected Children in the ED’

As a retired PEM physician, I want to thank the authors for this excellent reminder that child abuse and neglect includes medical neglect. With today’s fractured and fragmented care, the ED is often the only common point of care for these children. Keep alert to physical signs of abuse and neglect. But also take a few minutes too review the EMR when dealing with frequent flyers with chronic medical conditions.

—Edward Walkley, MD, FACEP, FAAP