Hospital medicine

5,188 articles · Since 2004

Articles, page 116

The power of words in guiding patients toward recovery

April 12, 2013Apr 12, 20134

Just three words, a short phrase, heard from an ICU nurse that changed my friend’s well-being as she lay in an ICU bed. In fact, it is the only phrase my friend remembers from her entire hospital stay after having…

She was experiencing nausea, a sick feeling, and needing and wanting care, direction, and guidance from hospital staff. And three powerful words spoken from a …

Patient voices

Change the warfare metaphors when it comes to illness

Rob A. Ruff

April 12, 2013Apr 12, 20138

The metaphor we use, almost universally, to describe the experience of illness is that of warfare. Someone diagnosed with cancer is said to be “battling” cancer (as if the diagnosis itself implies a fight). Family members often say that their hospitalized loved one is a “fighter” who “will never give up” or surrender. Doctors refer to the most potent antibiotics as “big guns” that are prescribed to “kill the bugs” …

Physician voices

The patient experience can be dehumanizing

Joyce Ho, MD

April 12, 2013Apr 12, 20137

Being a clinical student is not a walk in the park. When we get together for “Reflections on Clerkship” days every two months in our small groups, students let the floodgates open about the hardships they have been facing on rotations. I am no exception. Transitioning to a strict schedule in the hierarchical world of academic medicine has been no small feat. In fact I was planning earlier this morning …

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Physician voices

Increasing the role of nurse practitioners in the inpatient setting

Gene Uzawa Dorio, MD

April 12, 2013Apr 12, 201360

We are fortunate in our country to have the best medical technology in the world. Unfortunately, delivery of this technology, reflected in a worldwide healthcare ranking of 37th, is a disservice to the American people and must be rectified especially…

As provisions of the Affordable Care Act are put in place, a daunting factor is the shortage of doctors who will be needed to provide this …

Physician voices

Quality healthcare isn’t just about clicks and lists

John Mandrola, MD

April 10, 2013Apr 10, 20132

My hospital has just weathered an impressive upswing in patient volume. The house was full for weeks. The experience highlights an important aspect about quality care–an obvious one that doesn’t always make headlines. What I notice when the hospital gets…

What I notice when the hospital gets full is that patients are sent to units that they don’t normally go to. For instance, at my hospital, like yours probably as well, there are numerous different types of heart …

Patient voices

Reviewing my cataract surgery: A casual disregard for patients

Trudy Lieberman

April 9, 2013Apr 9, 201344

At last it was time for my cataract surgery. Having had one eye surgery done by a different physician in another New York eye and ear specialty hospital a few months earlier, I knew what to look for and could make comparisons from a patient perspective. As I noted months ago on this blog, I really had no choice of hospitals. If I wanted my trusted doctor to …

Physician voices

How can doctors avoid killing or hurting people in their care?

Janice Boughton, MD

April 8, 2013Apr 8, 201315

Hospitals are very focused on avoiding harming patients lately. They have been moving in that direction for a long time, but with health care reform legislation, payments are on the line, which makes something that was a very good idea…

In the year 2000, the Institute of Medicine, a non-profit organization that monitors various aspects of medical care, reported that 44,000-98,000 people died each year due to medical …

Medical education

Our medical education system does not tolerate emotional cracks

Shara Yurkiewicz

April 5, 2013Apr 5, 20132

When we told the patient and his family that the mass in his lung was highly concerning for cancer, he didn’t say anything. His daughter asked about his symptoms. His son-in-law asked when and how he could get a definitive…

“I’m sorry for being so much trouble.” The tone was casually apologetic, …

Physician voices

Let patients be their own people inside the system of care

Zackary Berger, MD, PhD

April 5, 2013Apr 5, 20133

The more I try to help people in this field of mine, the more I realize that it doesn't take a village. It takes a huge industrialized city, all its wires and arteries humming with constant activity, just to try…

The more I try to help people in this field of mine, the more I realize that it doesn’t take a village. It takes a huge industrialized city, all its wires and arteries humming with constant activity, just to try and make one woman better. In this case, one smiling woman in her 50s, ethnicity I couldn’t figure and of dubious relevance, who came to our clinic seeking advice about …

Patient voices

A reminder to slow down and focus on the human being

Audrey Cortez, RN

April 4, 2013Apr 4, 20137

Years ago I worked as a registered nurse in a busy surgical pre-admission clinic, preparing patients who'd been scheduled for surgery for the upcoming operation and hospital experience. My workdays were packed with back-to-back, hour-long appointments. Whatever surgery the patient…

Years ago I worked as a registered nurse in a busy surgical pre-admission clinic, preparing patients who’d been scheduled for surgery for the upcoming operation and hospital experience.

My workdays were packed with back-to-back, hour-long appointments. Whatever surgery the patient was facing–oral, orthopedic or anything else–every interview followed the same format. I would greet the patient, who’d often bring along a family member, and quickly escort them both into my small …

Conditions and diseases

5 essential concepts to know about code status

Brian J. Secemsky, MD

April 3, 2013Apr 3, 20135

Full Code. Do not resuscitate. Do not intubate. Ask anyone without a personal or family history of a hospitalization on the implication of these terms and you’d likely get a blank stare in response. Unfortunately, this incomprehension often rings true…

Full Code. Do not resuscitate. Do not intubate.

Ask anyone without a personal or family history of a hospitalization on the implication of these terms and you’d likely get a blank stare in response.

Unfortunately, this incomprehension often rings true with those who need to know it most: the hospitalized patients themselves.

Many clinical reports (see here and here) have demonstrated that most physicians are not only inadequate in discussing code status with …

Physician voices

Is the era of patient centered care decidedly anti-physician?

Mona Kotecha, MD

April 2, 2013Apr 2, 201345

I’m lucky to practice in a national regional anesthesiology center, a hospital with five dedicated nerve block suites, each with the latest in ultrasound equipment, nurses trained in conscious sedation, regional anesthesiology colleagues and infrastructure to support regional practitioners. It seems like there is so much we can do for patients, but really, there is only so much a physician can do. We need a little help from the patient …

Health policy

The movement for medical price transparency is happening

G. Keith Smith, MD

April 1, 2013Apr 1, 201315

Years ago, I hired a carpenter to build a deck in my backyard. He showed up with a pencil behind his ear, a spiral notebook, and a tape measure. I told him what I was looking for, and he made…

Years ago, I hired a carpenter to build a deck in my backyard. He showed up with a pencil behind his ear, a spiral notebook, and a tape measure. I told him what I was looking for, and he made a few suggestions. After 15 minutes of measuring and taking notes, he handed me a piece of paper with how much it …

Conditions and diseases

CRE bacteria: The next superbug threat in your hospital

Daniel J. Morgan, MD

March 31, 2013Mar 31, 20135

A new CDC report is bringing a lot of attention to the emergence of drug-resistant bacteria in hospitals and long-term care centers across the country. Carbapenem-resistant Enterobacteriaceae, or CRE, strike critically-ill patients in nursing homes and intensive care units where…

Without being able to count on …

Physician voices

Doctors: It’s ok to shed the white coat and tie

Michael Edmond, MD, MPH

March 30, 2013Mar 30, 201311

Those of you who have followed our blog for the past few years probably know that one of my favorite topics in infection prevention is the role of clothing in transmission of pathogens. But I’m also fascinated by the sociologic aspects of clothing in medicine, which is usually framed around questions of professionalism (for example, is a doctor in a white coat more “professional” than a doctor …

Physician voices

Clinical pearls that you don’t learn during medical training

David Sack, MD

March 29, 2013Mar 29, 20136

Al Franken, the humorist-turned-senator, once published a book that was titled "Oh, the Things I Know!" Indeed, by the time we reach parenthood, it is truly amazing what we keep up there in that attic of a brain. Here is…

Al Franken, the humorist-turned-senator, once published a book that was titled “Oh, the Things I Know!” Indeed, by the time we reach parenthood, it is truly amazing what we keep up there in that attic of a brain.

Here is a brief selection of things about the practice of medicine that I have had to discover for myself or never quite figured out, including clinical pearls, aphorisms, dictums, platitudes, mysteries and …

Health policy

How a smart process helped Kaiser Permanente save lives

Chip Heath & Dan Heath

March 27, 2013Mar 27, 20132

The following is an exclusive excerpt adapted from #1 New York Times best selling authors Chip and Dan Heath’s new book Decisive: How to Make Better Choices in Life and Work, which was released on March 26, 2013. Click here…

The following is an exclusive excerpt adapted from #1 New York Times best selling authors Chip and Dan Heath’s new book Decisive: How to Make Better Choices in Life and Work, which was released on March 26, 2013. Click here to order.

One of the most fundamental problems of decision-making, according to psychologists, is that people get stuck in a “narrow frame”—they view their decision in an unduly limited …

Patient voices

I suddenly know why I’m here

Priscilla Mainardi, RN

March 26, 2013Mar 26, 20132

Tuesday morning, eight o'clock, and I have seven things to do. Check vitals, change a dressing, get a patient out of bed, send another to the operating room. Review lab results, give medications, start a blood transfusion. I have six…

Tuesday morning, eight o’clock, and I have seven things to do. Check vitals, change a dressing, get a patient out of bed, send another to the operating room. Review lab results, give medications, start a blood transfusion.

I have six patients, and they have an average of five morning medications each. I make three trips to the med room for supplies, two trips to the pantry for fresh water.

Mrs. Napoli has …

Read more…

I suddenly know why I’m here

Physician voices

Gender discrimination in medicine: The 5 miracles of Carol Warfield

Linda Brodsky, MD

March 25, 2013Mar 25, 20136

For those who haven’t been following, earlier this month, Dr. Carol Warfield, a Harvard doctor and chief of anesthesia at Beth Israel Deaconess Medical Center was awarded a settlement of $7 million dollars for gender discrimination. It was a massive…

But the large dollar figure is not the real story here. The real story is found in …

Patient voices

What can you say to the people who saved your mother’s life?

Pat Mastors

March 24, 2013Mar 24, 20137

My phone rang a few weeks ago, the morning of January 26th. It was my brother saying "Mom has cancer in her spine. I'm bringing her to the hospital this afternoon. They're operating Monday." I threw my stuff in my…

My phone rang a few weeks ago, the morning of January 26th. It was my brother saying “Mom has cancer in her spine. I’m bringing her to the hospital this afternoon. They’re operating Monday.”

I threw my stuff in my suitcase, jumped in the car and drove back home from the conference that moments before had seemed so important.

But before I left, I spoke at length with the orthopedist who’d delivered …

Hospital medicine

Articles, page 116

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