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Emergency Medicine Cardiovascular Care Venous Thrombosis Critical Care Pulmonary Embolism Medical Expert Witness

Provides Opinion & Testimony In:

Board Certified Emergency Medicine, Cardiac Life Support, Advanced Life Support, Trauma Life support, cardiac failure, Cardiovascular Care, venous thrombosis, Critical Care, pulmonary embolism

Expert Witness No. 3550

Massachusetts

Education

  • 1984-1988 AB
    magna cum laude Mathematics and Philosophy Harvard College, Cambridge, MA
  • 1989 Mathematics and Philosophy Hebrew University,
    Jerusalem, Israel
  • 1990 Law Harvard Law School, Cambridge, MA
  • 1991-1992 Post-baccalaureate Columbia University, New York, NY
  • 1992-1996 MD Medicine Harvard Medical School, Boston, MA

Postdoctoral Training

  • 07/96-06/00 Residency Emergency Medicine University of Cincinnati, Cincinnati, OH
    2006 Certificate
    Program Leadership Development for Physicians in Academic Health Centers Harvard School of Public Health, Boston, MA
  • 2009 Certificate
    Program Lean Practitioner Training Brigham and Women’s Hospital Center for Clinical Excellence/ GE Healthcare, Boston, MA
  • 2011 Certificate
    Program Change Acceleration Process Brigham and Women’s Hospital Center for Clinical Excellence/ GE Healthcare
  • 2015-2016 Certificate
    Program Brigham Leadership Program Brigham and Women’s Hospital / Harvard Business School, Boston, MA

Faculty Academic Appointments

  • 07/00-06/06 Instructor Medicine Harvard Medical School, Boston, MA
  • 7/06-11/14 Assistant Professor Medicine Harvard Medical School
  • 11/14- Assistant Professor Emergency Medicine Harvard Medical School

 

Appointments at Hospitals/Affiliated Institutions

  • 07/00- Associate Physician Emergency Medicine Brigham and Women’s Hospital, Boston, MA
  • 10/09 – Faculty International Emergency Department Leadership Institute (IEDLI), Harvard Medical School/BWH,
    Boston, MA

Other Professional Positions

  • 2005- Consultant Gerson Lehrman Group, New York, NY
  • 2008-2011 Speaker Network for Continuing Medical Education, Secaucus, NJ
  • 2008- Consultant Guidepoint Global, New York, NY
  • 2012- Physician Coach and Speaker Studer Group, Gulf Breeze, FL

Major Administrative Leadership Positions

  • 2004-2006 Associate Clinical Director, Department of Emergency Medicine Brigham and Women’s Hospital, Boston, MA
  • 2006-2014 Clinical Director, Department of Emergency Medicine Brigham and Women’s Hospital
  • 2007- 2016 Course Director, Introduction to Clinical Medicine Health Sciences & Technology (HST) Program, Harvard Medical School, Boston, MA
  • 2012-2015 Vice Chair, Clinical Affairs, Department of Emergency Medicine Brigham and Women’s Hospital
  • 2012-2104 Course Director, Design Meets Process: The Emergency Department of the Future Harvard Medical School / Harvard University Graduate School of Design, Cambridge, MA
  • 2014-2105 Course Director, Emergency Medicine Process Improvement Program (EM-PIP) Brigham and Women’s Hospital
  • 2015- Director, Patient Experience and Provider Engagement, Department of Emergency Medicine Brigham and Women’s Hospital

Committee Service

  • Local
  • 2001- Emergency Medicine Faculty Brigham and Women’s Hospital
  • 2005-2009 Recording secretary
  • 2011-2015 Chair, Clinical Operations Group
  • 2002-2014 Institutional Review Board, Panel B Partners HealthCare, Boston, MA
  • 2004-2015 Operations Committee, Department of Emergency Medicine Brigham and Women’s Hospital
  • 2006-2015 Chair
  • 2009- Co-Chair/ Patient & Family Advisory Council
  • 2004-2015 Management Committee, Department of Emergency Medicine Brigham and Women’s Hospital
  • 2005-2011 Chair, Information Systems (IS) subcommittee
  • 2008- Standing Member, Quality Improvement (QI) committee
  • 2009-2011 Chair, Expansion/Redesign Committee
  • 2005-2008 Premedical Advising Committee, Cabot House Harvard College, Cambridge, MA
  • 2005-2009 Clinical Practice Leaders Committee Brigham and Women’s Hospital
  • 2005-2010 Trauma Continuous Quality Improvement (CQI) Committee Brigham and Women’s Hospital
  • 2005-2015 Physicians’ Council Brigham and Women’s Physicians’ Organization (BWPO), Brookline MA
  • 2013-2015 Co-chair
  • 2005-2014 Pharmacy and Therapeutics Committee Brigham and Women’s Hospital
  • 2008-1014 Member, Sedation and Analgesia Subcommittee
  • 2011-2014 Member, Drug Safety Subcommittee
  • 2005-2014 Intensive Care Unit (ICU) Leadership Committee Brigham and Women’s Hospital
  • 2009- Co-Chair, Task force on ICU admissions
  • 2005-2015 Medical Staff Executive Committee Brigham and Women’s Hospital
  • 2006-2009 Ethics Committee Brigham and Women’s Hospital
  • 2006-2014 Billing Compliance Committee Brigham and Women’s Hospital
  • 2007-2012 Disaster Committee Brigham and Women’s Hospital
  • 2009-2015 Emergency Medicine Leaders Partners Healthcare
  • 2009-2014 Co-Chair, “Best practices” subcommittee
  • 2010 – Peer Review Committee, Department of Emergency Medicine Brigham and Women’s Hospital

Standing Member

  • 2010 -2012 Patient Affordability Committee Partners Healthcare
  • 2010-2012 Taskforce on re-admissions
  • 2011-2015 Utilization Review Committee Brigham and Women’s Hospital
  • 2012-2015 Taskforce on Threat Awareness and Response Brigham and Women’s Hospital Co-Chair
  • 2013-2015 MD Connect Steering Committee Brigham and Women’s Hospital
    Co-chair
  • 2014-2017 Mortality Review Committee Brigham and Women’s Hospital
  • 2017-2018 Patient Experience Design Team Brigham Health

Regional 

  • 2004-2015 ED Directors Forum Massachusetts College of Emergency Physicians, Waltham, MA
  • 2005-2009 ED Boarding Task-Force Massachusetts Hospital Association, Burlington, MA

National

  • 2000-2009 Benchmarking Group University HealthSystem Consortium Chicago, IL
  • 2001-2004 Member, Heart Failure Benchmarking

Project Steering Committee

  • 2015-2016
    Clinical Endpoints Committee Boston Clinical Research Institute
  • 2016-2017 Clinical Event Adjudication Committee Harvard Clinical Research Institute / Baim Institute for Clinical Research
  • 2016-2017 Emergency Quality Network (E-QUAL) American College of Emergency Physicians

Professional Societies

  • 1992- American Medical Association
  • 1996-2004 Society for Academic Emergency Medicine
  • 1996- American College of Emergency Physicians
  • 2004- Member, Clinical Policies Subcommittee
  • 2008 Fellow

Editorial Activities

  • Ad hoc Reviewer
  • Annals of Emergency Medicine
  • The Journal of Emergency Medicine
  • Internal and Emergency Medicine
  • American Journal of Cardiology
  • Journal of Cardiac Failure
  • Thrombosis and Haemostasis
  • European Journal of Clinical Investigation
  • Italian Journal of Emergency Medicine
  • Critical Pathways in Cardiology
  • JAMA Psychiatry

 

Other Editorial Roles

  • 2010, 2013 Guest Editor Emergency Medicine Practice
  • 2014 Guest Editor MD Conference Express

Honors and Prizes

  • 1984-1988 John Harvard Scholarship Harvard College Academic achievement
  • 1987 Phi Beta Kappa Harvard College Academic achievement
  • 1988 American Student Grant Fulbright Scholar Program Academic achievement
  • 1996 Medical Student Excellence Award Society of Academic Emergency Medicine Academic achievement
  • 1999 Emergency Medicine Resident Scholarship Rhône-Poulenc Rorer Clinical achievement
  • 2001 Esther B. Kahn Young Investigator’s Award Department of Emergency Medicine, Brigham and Women’s Hospital Clinical research
  • 2002-2005 Top Consultant Annals of Emergency Medicine
  • 2002, 2007, 2010, 2014, 2015 Partners in Excellence Award Brigham and Women’s Hospital Leadership
  • 2011 Physician Recognition Award Brigham and Women’s Hospital Physicians Organization Clinical innovation
  • 2012 Finalist, Bernard Lown Award for Excellence in Teaching Brigham and Women’s Hospital Clinical teaching
  • 2012 Healthcare Organization of the Month Studer Group Leadership
  • 2015 Pillar of Excellence Award Studer Group Leadership
  • 2015 Distinguished Clinician Award Brigham and Women’s Hospital Clinical Excellence

Teaching of Students in Courses

2001 – Emergency Medicine
(ME535M.23) Harvard Medical School
3rd and 4th year medical students 2-hour lectures/labs
3 – 4 sessions per year
2001-2006 Introduction to Clinical Medicine
(IN710M.23)
2nd year medical students Harvard Medical School
4-6 hours of precepting per week for 8 weeks

2002 – 2005 Emergency Medicine
(SU705J) Harvard Medical School
4th year medical students 1-hour lecture/lab
once per semester

2003- Observed Structured Clinical Examination Harvard Medical School
4th- year medical students
5- hour sessions
twice per year

2007- Introduction to Clinical Medicine Harvard Medical School
(IN710M.23)
2nd year medical students 1-2 hours of lectures per week for 8 weeks

2009- Introduction to the Care of Patients Harvard Medical School
(HT220.0)
1st year medical students 8 hours of mentoring and instructing per semester

2016 – Transition to the PCE Harvard Medical School
2nd year medical students 12 hours of instruction per semester
2018 – Core Faculty for Clinical Skills Assessment Harvard Medical School
OSCE sessions for HMS 1-4 48 hours / year

Formal Teaching of Residents, Clinical Fellows and Research Fellows

2001- Advanced Cardiac Life Support Brigham and Women’s Hospital / Massachusetts General Hospital, Boston, MA
Residents 3-hour training, annually

2001- EKG analysis Harvard Affiliated Emergency Medicine Residency (HAEMR), Boston, MA
Emergency medicine residents 1 hour seminar, annually

2002- Congestive heart failure HAEMR, Boston, MA
Emergency medicine residents 3 hour simulation lab, annually

2002- Acute coronary syndromes HAEMR, Boston, MA
Emergency medicine residents 3 hour simulation lab, annually

2003- EM Oral Boards review HAEMR, Boston, MA
Emergency medicine residents 3 hour simulation, annually

2004 Emergencies in hemodialysis patients
Emergency medicine residents HAEMR, Boston, MA
3 hour simulation lab

2004 Difficult airway management
Emergency medicine residents HAEMR, Boston, MA
3 hour simulation lab

2004 – HAEMR Journal Club HAEMR, Boston, MA
Emergency medicine residents 2 hour conference, annually

2005 Informed consent and refusal of care in the ED HAEMR, Boston, MA
Emergency medicine residents 3 hour simulation lab

2005 – Resident report HAEMR, Boston, MA
Emergency medicine residents 1 hour case reviews, 3 – 4 sessions annually

2006 Digoxin toxicity BWH, Boston, MA
Emergency medicine and internal medicine residents 1 hour conference

2007 Neurologic emergencies HAEMR, Boston, MA
Emergency medicine residents 3 hour simulation lab

2007 Atrial fibrillation HAEMR, Boston, MA
Emergency medicine residents 3 hour simulation lab

2008 Clinical-pathological conference HAEMR, Boston, MA
Emergency medicine residents 1 hour presentation

2008 Cardiac stress testing HAEMR, Boston, MA
Emergency medicine residents 1 hour lecture

2008 Ob-Gyn emergencies HAEMR, Boston, MA
Emergency medicine residents 3 hour simulation lab

2009 Oncologic emergencies HAEMR, Boston, MA
Emergency medicine residents 3 hour simulation lab

2009 Intra-osseous line placement HAEMR, Boston, MA
Emergency medicine residents 1 hour procedure lab

2010 Valvular heart disease HAEMR, Boston, MA
Emergency medicine residents 1 hour lecture

2010 A case of severe hyponatremia BWH, Boston, MA
Emergency medicine and internal medicine residents 1 hour case conference

2010 Capnography HAMR
Emergency medicine residents 1 hour procedure lab

2011 An atypical case of ST-elevation MI BWH, Boston, MA
Emergency medicine and internal medicine residents 1 hour case conference

2013, 2014 Oncologic emergencies HAEMR, Boston, MA
Emergency medicine residents 3 hour simulation lab

2014 Acute Coronary Syndromes HAEMR, Boston, MA
Emergency medicine residents 1 hour lecture

2015 Gynecologic emergencies HAEMR, Boston, MA
Emergency medicine residents 3 hour procedure lab

2015 EKGs in Toxicologic Emergencies HAEMR, Boston, MA
Emergency medicine residents 2 hour lecture

2015 Orthopedic emergencies HAEMR, Boston, MA
Emergency medicine residents 1 hour lecture

2016 – Patient engagement HAEMR
1 hour lecture

2016 Why diagnosis matters HAEMR
1 hour lecture

2017 Challenges in patient-doctor communication HAEMR
1 hour lecture

2017 Key words at key times HAEMR
1 hour lecture

Clinical Supervisory and Training Responsibilities

  • 2000- Clinical supervisor Emergency Department, Brigham and Women’s Hospital (BWH), Boston, MA
    Emergency medicine residents ~20 hours/week
  • 2000- Clinical supervisor Emergency Department, BWH
    Rotating (off-service) residents ~20 hours/week
  • 2000- Clinical supervisor Emergency Department, BWH
    3rd and 4th-year medical students ~20 hours/week

Other Supervisory and Training Responsibilities

  • 2002-2006 Advisor, BioMatrix program/ Massachusetts Institute of Technology, Cambridge, MA 10 hours per semester for Pre-med students
  • 2005-2009 Non-resident Tutor, Cabot House/ Harvard College, Cambridge, MA 20 hours per semester for Pre-med students

Formal Teaching of Peers (e.g., CME and other continuing education courses)
Those presentations below sponsored by outside entities are so noted and the sponsor is identified.

  • 2001 Finer points of ECG interpretation Lecture
    6th Annual Emergency Medicine into the 21st Century Conference, Harvard Medical School Boston MA
  • 2001 Evaluation and management of acutely decompensated heart failure Lecture
    6th Annual Emergency Medicine into the 21st Century Conference, HMS Boston, MA
  • 2004 Difficult airway lab Simulation session
    Annual Emergency Medicine into the 21st Century Conference, HMS Boston, MA
  • 2005 Introduction to simulation for emergency physicians Simulation session
    10th Annual Emergency Medicine into the 21st Century Conference, HMS Boston, MA
  • 2006 Hidden ischemia in the chest pain patient Lecture
    Clinical Decision Making in Emergency Medicine: An Evidence-Based Conference, Brigham and Women’s Hospital Ponte Vedra Beach, FL.
  • 2006 Acute decompensated heart failure Lecture
    11th Annual Emergency Medicine into the 21st Century Conference, HMS Boston, MA
  • 2006 Penetrating neck trauma Simulation session
    11th Annual Emergency Medicine into the 21st Century Conference, HMS Boston, MA
  • 2007 Case studies in infectious disease Lecture
    Clinical Decision Making in Emergency Medicine: An Evidence-Based Conference, BWH Ponte Vedra, FL
  • 2007 Emergency skills training: STEMI Teleconference
    Rural Health Emergency Telemedicine Collaboration, Harvard Humanitarian Initiative Boston, MA

    2007 Signs, symptoms, presentations: Life-long Learning and Self-Assessment (LLSA) review Seminar

  • 12th Annual Emergency Medicine into the 21st Century Conference, HMS Boston, MA
  • 2008 Management of the non-stented unstable angina patient Webinar
    Excellence in Vascular Events Research and Technology (EVEREST) Peer-to-Peer Program, BWH Boston, MA
  • 2008 Chest pain cases: the ECG holds the secrets. Lecture
    Clinical Decision Making in Emergency Medicine: An Evidence-Based Conference, BWH Ponte Vedra, FL
  • 2008 The chest pain dinner-debate Panel discussion
    Clinical Decision Making in Emergency Medicine: An Evidence-Based Conference, BWH Ponte Vedra, FL
  • 2008 Ethical dilemmas in the Emergency Department: the challenge of informed consent Lecture
    13th Annual Emergency Medicine into the 21st Century Conference, HMS Boston, MA
  • 2009 Wide-complex tachycardias: not as complex as they seem Lecture
    Rocky Mountain Winter Conference on Emergency Medicine, BWH Copper Mountain, CO
  • 2009 The ECG: Five deadly conditions that you will miss. Lecture
    Clinical Decision Making in Emergency Medicine: An Evidence-Based Conference, BWH Ponte Vedra, FL
  • 2009 Emergency department staffing models Seminar
    International Emergency Department Leadership Institute (IEDLI), HMS Boston, MA
  • 2010 Designing the 21st-century emergency department: form and function. Lecture
    Rocky Mountain Winter Conference on Emergency Medicine, BWH Copper Mountain, CO
  • 2010 Dysrhythmias -1, 2, 3: The ECG, the diagnosis, the intervention Lecture
    Clinical Decision Making in Emergency Medicine: An Evidence-Based Conference, BWH Ponte Vedra, FL
  • 2010 Update in acute coronary syndromes Lecture
    15th Annual Emergency Medicine into the 21st Century Conference, HMS Boston, MA
  • 2011 The ECG in cardiopulmonary emergencies Lecture
    Clinical Decision Making in Emergency Medicine: An Evidence-Based Conference, BWH Ponte Vedra, FL
  • 2011 Atrial fibrillation: cutting edge therapy, 16th Annual Lecture
    15th Annual Emergency Medicine into the 21st Century Conference, HMS Boston, MA
  • 2011 Case studies in emergency department flow Seminar
    International Emergency Department Leadership Institute, (IEDLI) HMS Boston, MA
  • 2012 Atrial fibrillation: real-world challenges for the real-world emergency physician Lecture
    Western States Winter Conference on Emergency Medicine, BWH Park City, UT
  • 2012 Decompensated heart failure: why getting it right matters now more than ever Lecture
    Western States Winter Conference on Emergency Medicine, BWH Park City, UT
  • 2012 Fundamentals of queuing theory and simulation Lecture
    Design Meets Process: The Emergency Department for the Future, HMS/ Harvard Graduate School of Design (HGSD) Boston, MA
  • 2012 Atrial fibrillation: real-world challenges Lecture
    Clinical Decision Making in Emergency Medicine: An Evidence-Based Conference, BWH Ponte Vedra, FL
  • 2012 Cardiac cases: the ECG and the risk Lecture
    Clinical Decision Making in Emergency Medicine: An Evidence-Based Conference, BWH Ponte Vedra, FL
  • 2012 The rapid rule-out Lecture
    Emergency Medicine: Update on Current Practice, MGH Boston, MA
  • 2012 Staffing an emergency department to optimize patient flow Lecture
    Design Meets Process: The Emergency Department for the Future, HMS/HGSD Boston, MA
  • 2013 Process design, metrics, and goals Lecture
    Design Meets Process: The Emergency Department for the Future, HMS/HGSD Boston, MA
  • 2013 Anti-arrhythmics: when, where, and why Lecture
    Clinical Decision Making in Emergency Medicine: An Evidence-Based Conference, BWH Ponte Vedra, FL
  • 2014 Anti-arrhythmics for atrial fibrillation Lecture
    Western States Winter Conference on Emergency Medicine, BWH Park City, UT
  • 2014 Emergency department strategies to prevent unnecessary readmissions for heart failure Lecture
    Western States Winter Conference on Emergency Medicine, BWH Park City, UT
  • 2014 When doctors don’t listen: how to avoid misdiagnoses and unnecessary tests Lecture
    Western States Winter Conference on Emergency Medicine, BWH Park City, UT
  • 2014 Redesigning care in the Emergency Department Lecture
    Quality, Safety and Process Improvement: Building a High Performing Organization Boston, MA
  • 2016 ECG: remember that patient? subtleties of the missed MI Lecture
    Clinical Decision Making in Emergency Medicine: An Evidence-Based Conference, BWH Ponte Vedra, FL
  • 2016 Acute Coronary Syndromes Lecture
    ACLS Refresher Course, MGH Boston, MA
  • 2016 Case studies in DVT and PE Seminar
    AC Forum VTE Educational Event Boston, MA
  • 2016 Words that work: How to communicate to patients about diagnostic imaging Webinar
    American College of Emergency Physicians (ACEP) Emergency Quality Network (E-QUAL) Boston, MA
  • 2017 Venous Thromboembolism in the Emergency Department Seminar
    AC Forum VTE Educational Event Boston, MA

Current Licensure and Certification

  • 2000 – Massachusetts Medical License
  • 2001, 2011 Diplomate, American Board of Emergency Medicine
  • 2010 Fellow, American College of Emergency Physicians
  • Practice Activities
  • 2000 – 2004 Emergency Medicine Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA 11 shifts per month
  • 2005 – 2006 Emergency Medicine Department of Emergency Medicine, Brigham and Women’s Hospital 9-10 shifts per month
  • 2007 – Emergency Medicine Department of Emergency Medicine, Brigham and Women’s Hospital 6 – 7 shifts per month
  • 2010 – Urgent Care Brigham and Women’s / Mass General Health Urgent Care Center, Foxborough, MA 1 shift per month

Clinical Innovations

Emergency Department Front-End Redesign
2009-2012 I led team that re-engineered patient flow in the ED, achieving dramatic improvements in door-to-provider time and overall patient satisfaction, by focusing on the patient experience and involving the staff in design, testing and implementation of new processes. This transformative work has been recognized and awarded at the local, national, and international level and this model has been adopted by many other EDs.

Emergency Department Patient & Family Centered Care
2011- I successfully partnered with The Studer Group to establish standards for engagement and communication. Established Patient & Family Advisory Council to guide clinicians in customer-focused activities. This model of patient and family engagement has subsequently been adopted in other departments at Brigham and Women’s Hospital.

Emergency Medicine Process Improvement Program (EM-PIP)
2013 – 2015 I led the design and implementation of team training, modeled on GE-Healthcare’s “Lean Practitioner Training” and “Change Acceleration Process” courses. Established EM-PIP as a fast-paced, immersion program, providing participants with an understanding of process analysis, rapid-cycle improvement and managing teams through the span of real-world, ED-based projects. The first three multidisciplinary teams will presented their results in Spring, 2014. Round two began in Fall, 2014 and will be presenting in January, 2015. Based upon our success, this model will be introduced to other departments throughout the institution.

Program for Patient Experience and Provider Engagement (PPEPE)
2016- The BWH EM Program on Patient Experience and Provider Engagement is a new effort in Emergency Medicine to address the critical gaps and opportunities in providing a higher quality experience for patients and staff in the emergency department. The Program has three main goals: (1) to improve patient perception of care in the emergency department, as measured by existing metrics, EM specific surveys and other tools; (2) to enhance the engagement of all staff, including faculty, PA’s, house staff, nurses, technical and administrative staff by refocusing attention to how and what we communicate to our patients and among one another’ and (3) to build upon a culture of caring and intentionality throughout the institution.

Education of Patients and Service to the Community
Available on full CV

Local Invited Presentations
Available on full CV

Educational Material for Patients and the Lay Community
Available on full CV

Recognition
Available on full CV

Peer reviewed publications in print or other media
Available on full CV

Clinical Guidelines and Reports
Available on full CV

 

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