I admitted an elderly woman to the hospital recently. The previous week, she had presented to the emergency department (ED) with chest pain and shortness of breath. For some unknown reason, a urinalysis was obtained and was found to be abnormal. The patient left the hospital with a prescription for cephalexin, in addition to unexplained chest pain and shortness of breath. The patient presented to the hospital this time with, …
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Please stop the over-diagnosis of UTIs
“It should be in my chart.”
I’m sure we have all heard this statement uttered with a subtle (or not so subtle) edge of frustration from our patients after asking a question such as “what medications do you take?” I find clinicians despise this comment because it is interpreted as (a) the patient is not making an attempt to recall his or her medical history, or (b) that the patient doesn’t …
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A case for computers at the bedside
I am a nocturnist (a nocturnal hospitalist). I love my job, but many nights my work can seem unfulfilling. For one, taking care of hospitalized adult patients is primarily spent managing exacerbations of chronic diseases. Therefore, the reality is that most patients will not be cured, only managed. Additionally, there is the loneliness factor, the incessant beeping of my pager, and the fact that I am forced to disturb the …
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How the death of a patient affected this nocturnist
As a hospitalist, like most in health care, I am afflicted by the slow march of thousands of mouse clicks on the electronic health record (EHR) every day I work. But after starting a new job and learning a new EHR, I have become painfully aware of the volume of alerts that pop up when I place orders. Don’t get me wrong: I appreciate being informed that a patient has …
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How EMR alert fatigue overwhelms physicians
