Hospital medicine

5,188 articles · Since 2004

Articles, page 107

A nurse masters the art of medical slang

January 12, 2014Jan 12, 20143

An excerpt from ASSUME THE PHYSICIAN: Modern Medicine's "Catch-22". “What did you learn today?” I asked, fearing the answer. I was suspecting a recitation about the new methods of documenting nursing competencies, or a delineation of the process by which…

An excerpt from ASSUME THE PHYSICIAN: Modern Medicine’s “Catch-22”.

“What did you learn today?” I asked, fearing the answer.

I was suspecting a recitation about the new methods of documenting nursing competencies, or a delineation of the process by which she helped the hospital maintain its “magnet” status to attract more nurses to work here. Or perhaps she had learned a new set of pharmacy rules that replaced …

Physician voices

Bringing health care technology to the developing world

Varun Verma, MD

January 12, 2014Jan 12, 2014

This post is a question, an invitation and a challenge. How can we bring technologies we take for granted back home to those in the developing world? Many before me have spoken with outrage about the reality of two worlds:…

The situation is more complicated since even poor people may have some technologies like cellphones now, but vital lifesaving technologies …

Health technology

Why I will never take EMRs for granted again

James C. Salwitz, MD

January 10, 2014Jan 10, 2014

One of the spinoffs of being an oncologist is that you do not to take the world for granted. Each morning, I walk around the yard and smell the morning breeze. I am thankful for my children, my wife and my own health. I am thrilled, if occasionally skeptical, to have the opportunity to pay taxes in a country that I love. So, who would believe I would take our …

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Health policy

Bridging the gap between planning and reality

Paul Levy

January 8, 2014Jan 8, 2014

A colleague once said, “Every plan is excellent, until it’s tested. It’s execution that’s the problem.” And so it is. Clay Shirky wrote an excellent article about the gulf between planning and reality. Although the focus was on the misadventures…

A colleague once said, “Every plan is excellent, until it’s tested. It’s execution that’s the problem.” And so it is.

Clay Shirky wrote an excellent article about the gulf between planning and reality. Although the focus was on the misadventures of Healthcare.gov, the US government’s insurance exchange website, the broader lessons that he presents are worthy of consideration in many other settings.

Shirky notes: “The management question, when trying anything new, is ‘When does reality …

Health policy

Solving the high rates of hospital readmissions

Suneel Dhand, MD

January 6, 2014Jan 6, 201414

Statistics show that about 1 in 5, or 20 percent of all Medicare patients are readmitted to hospital within 30 days of discharge. That’s a staggering number, not to mention all those patients that are readmitted frequently during the course…

The problem of frequent hospital readmissions is actually one that exists all over the world and not just in the United States. …

Physician voices

Doctors and patients: Always thank your nurses

Maria Yang, MD

January 6, 2014Jan 6, 20145

As I noted earlier, hospitals permit around-the-clock observation of patients. If you don’t need around-the-clock monitoring, you don’t need to be in the hospital. Who is doing this around-the-clock monitoring? Nurses. Therefore, whether you are a patient or a physician,…

As I noted earlier, hospitals permit around-the-clock observation of patients. If you don’t need around-the-clock monitoring, you don’t need to be in the hospital.

Who is doing this around-the-clock monitoring? Nurses.

Therefore, whether you are a patient or a physician, one of the best things you can do is get on the good side of the nurses.

If you are a patient, a nurse watches over …

Physician voices

My cancer shows how our world is ruled by love

Elana Miller, MD

January 6, 2014Jan 6, 20144

I recently wrote about how our world is ruled by love, and circumstances conspired to show me just how true that really is. Love is when I go to the ER at UCLA, where I work, for a cough and…

I recently wrote about how our world is ruled by love, and circumstances conspired to show me just how true that really is.

Love is when I go to the ER at UCLA, where I work, for a cough and feeling that “something isn’t right,” and even though my complaints are mild, I’m brought right in and treated respectfully.

Love is when the chest x-ray comes …

Health policy

We must rise up against the hospital-industrial complex

Gene Uzawa Dorio, MD

January 5, 2014Jan 5, 201430

In his farewell address to the nation on January 17, 1961, President Dwight D. Eisenhower warned the American people about the looming “military-industrial complex” which would sway public mindset and enhance money flow from government to the defense industry. This concept persists today with the practice re-adapted and launched against the health and welfare of the American people through the “hospital-industrial complex.”

Health care organizations like the California and American Hospital …

Health policy

When health care adopts best practices from other industries

Peter Pronovost, MD, PhD

January 4, 2014Jan 4, 2014

Last fall, the Armstrong Institute, along with our partners at the World Health Organization, had the privilege of hosting more than 200 clinicians, patient advocates, health care leaders and policy makers for our inaugural Forum on Emerging Topics in Patient…

The event featured presentations by international experts in a dozen different industries, including aviation safety expert Captain Chesley “Sully” Sullenberger, a former space shuttle commander and the …

Physician voices

The dynamics of global health in hospital medicine

Robert Wachter, MD

January 3, 2014Jan 3, 2014

As my Division of Hospital Medicine has grown -- now to about 60 faculty -- I spend part of my time figuring out what direction we should go in. At times, the path is obvious. It didn’t take Wayne Gretzky…

As my Division of Hospital Medicine has grown — now to about 60 faculty — I spend part of my time figuring out what direction we should go in. At times, the path is obvious. It didn’t take Wayne Gretzky to recognize that we needed expertise in healthcare IT a decade ago, or in cost reduction more recently.

The story of how we became the nation’s leading program for “global health hospitalists” is a very …

Physician voices

Alarm fatigue symbolizes the limits of technology

Shirie Leng, MD

January 2, 2014Jan 2, 20146

A few months ago while I was working in the interventional gastrointestinal unit I noticed something because it was driving me nuts. One of the monitors in the holding area that slaved to one of the procedure rooms was beeping.…

So I asked one of the nurses “can we turn that monitor off? No one is using procedure …

Physician voices

The consequences of zero tolerance: Why HIPAA is overkill

Michael Kirsch, MD

January 1, 2014Jan 1, 201443

Everyone is familiar with the acronym HIPAA, which is the 1996 edict called the Health Insurance Portability and Accountability Act. Isn’t that a smooth and melodious name? These are and regulations that are designed to protect your confidential protected medical…

Everyone is familiar with the acronym HIPAA, which is the 1996 edict called the Health Insurance Portability and Accountability Act. Isn’t that a smooth and melodious name?

These are and regulations that are designed to protect your confidential protected medical information. I support the mission. I don’t think that your medical records should be deliberately or inadvertently shared with those who are not lawfully permitted to view them.

Medical charts (remember when

…

Health policy

4 health stories that deserve more attention

Robert Pearl, MD

December 30, 2013Dec 30, 20134

The Affordable Care Act (ACA), sometimes called “Obamacare,” dominated health care media coverage this year. And rightly so. It is the most significant change in American medicine in more than half a century. But the legislation is just one aspect of a complex and highly fragmented system. It is also just the beginning (not the end) of the process to fix U.S. health …

Medical education

Why we persevere despite a poor prognosis

Andrew Ho, MD

December 29, 2013Dec 29, 20135

Last night, I responded to a code blue while working the night float at the hospital. The patient was a relatively young female who had just completed a coronary artery bypass procedure. Per training, I began compressing her chest to…

As I pushed, the incision reopened and blood began spewing everywhere. I could feel her ribs giving and cracking from the force …

Physician voices

The ethics of a blood test after a needlestick injury

Carwyn Hooper

December 29, 2013Dec 29, 20139

It was late on a Friday afternoon in November. I was a 21 year-old medical student diligently waiting for an opportunity to practice some medical procedures when a patient was admitted who was happy for a student to “have a go” at taking blood. Cue a bit of anxious excitement (clinical medicine was still new to me) before some inner steeling and a formal consent process. Then, in went the …

Physician voices

How scut work has changed for today’s generation of doctors

Kenneth Lin, MD

December 27, 2013Dec 27, 20135

When I was an acting medicine intern in Manhattan's Bellevue Hospital at the turn of the century, all employees who provided the hospital's "ancillary services" went home between the hours of 5pm and 8am. It was the job of the…

When I was an acting medicine intern in Manhattan’s Bellevue Hospital at the turn of the century, all employees who provided the hospital’s “ancillary services” went home between the hours of 5pm and 8am. It was the job of the on-call interns to fill in. If a patient needed a stat blood draw or IV line replacement in the middle of the night, his nurse paged the intern to do it. If …

Physician voices

5 universal problems hospitals need to solve

Suneel Dhand, MD

December 27, 2013Dec 27, 2013

As health reform sets in, hospitals are gearing up for many challenges. While some of these are new to the health industry, several are against the backdrop of old problems that have plagued us for decades. Speaking as a doctor who has worked in a number of different hospitals up and down the east coast, I would like to identify 5 of these that I believe are fairly universal.

1. Medication …

Physician voices

The challenges and rewards of rural medicine

Janice Boughton, MD

December 27, 2013Dec 27, 2013

Rural medicine, I guess, can be defined as health care that happens in places that aren't big cities or referral centers. The vast majority of the populated earth's crust that has any health care at all is served by rural…

Rural medicine, I guess, can be defined as health care that happens in places that aren’t big cities or referral centers. The vast majority of the populated earth’s crust that has any health care at all is served by rural practitioners. I have done a little bit of rural medicine in Haiti, in Mexico and now a bit more in South Sudan. I have also worked in a rural health …

Physician voices

These are the people who work in a hospital

Maria Yang, MD

December 26, 2013Dec 26, 20135

Who works at a hospital? (Again, just indulge me for now.) Doctors. If you’re a patient at a teaching hospital, this includes medical students (people in school to become doctors), interns and residents (people who have earned the title of…

Who works at a hospital? (Again, just indulge me for now.)

Doctors. If you’re a patient at a teaching hospital, this includes medical students (people in school to become doctors), interns and residents (people who have earned the title of “doctor”, but who are still learning their craft), and attendings (people who have completed their formal training as physicians). If you’re not at a teaching hospital, it’s less likely you’ll see medical …

Health technology

ICD-10 will lead to the perfect storm in health care

Edmund Billings, MD

December 22, 2013Dec 22, 20133

Let me concede from the outset that I lean toward the negative -- dire predictions, worst-case scenarios, a bit of doom and gloom, etc. But I ask you, oh gentle, patient reader, how could I not? Let’s go to the…

Let me concede from the outset that I lean toward the negative — dire predictions, worst-case scenarios, a bit of doom and gloom, etc.

But I ask you, oh gentle, patient reader, how could I not?

Let’s go to the satellite. You can see warm air from a low-pressure system (meaningful use stage 2, not changed dramatically by the one-year extension) collide with cool, dry air from a high-pressure area (the turmoil …

Hospital medicine

Articles, page 107

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