Hospital medicine

5,188 articles · Since 2004

Articles, page 126

Overtreatment and the ethics of end of life care

March 1, 2012Mar 1, 201210

There was an exceptionally well-written piece published in the Washington Post recently. I presume a hospitalist wrote it, which magnifies its significance. In it, he describes the difficulties in caring for terminally ill patients. As I read it, it reminded…

There was an exceptionally well-written piece published in the Washington Post recently. I presume a hospitalist wrote it, which magnifies its significance. In it, he describes the difficulties in caring for terminally ill patients.

As I read it, it reminded me of a story my dad told me several years ago. His friend, I will call him Steve, was experiencing a great deal of stress because of his dad’s ailing …

Physician voices

Why the civil litigation system is unfair to physicians

Chris Rangel, MD

February 24, 2012Feb 24, 201234

It’s unclear how many non-legal persons actually understand how different civil trials are from criminal proceedings. Most people have heard that juries in criminal trials are told that they can only find a defendant guilty if their belief that the defendant is guilty is beyond a reasonable doubt. Federal courts define this term further as, “proof of such a convincing character that a reasonable person would not hesitate to act …

Physician voices

Understanding what patient centered care really means

Jordan Grumet, MD

February 21, 2012Feb 21, 20127

There was nothing the professor despised more then the syrup that oozed out of his partner's lips when dealing with patients. He often cringed as he walked by the examining room and imagined the hand holding that was taking place…

There was nothing the professor despised more then the syrup that oozed out of his partner’s lips when dealing with patients. He often cringed as he walked by the examining room and imagined the hand holding that was taking place behind closed doors.

Privately, they argued about the different approaches. One saw the world in terms of black and white, while the other was steeped in a foggy haze of gray. …

Real physician voices, twice a week

Free, and one click to unsubscribe.

Physician voices

Doctors cannot be expected to be financial engineers

Andrew Schutzbank, MD, MPH

February 20, 2012Feb 20, 20126

Peggy was in her early 70s and suffered from a terrible lung disease known as pulmonary hypertension. So bad in fact, that she had a pump infusing a medicine under her skin 24 hours a day to keep the blood supply to her lungs open. Once started, this medicine, treprostinil, was known to improve life in those with pulmonary hypertension. Unfortunately, like all continuous infusion medicines of this type, it …

Patient voices

Why patient engagement is reciprocal

Steve Wilkins, MPH

February 20, 2012Feb 20, 201221

It is said that "turn around is fair play." So if providers (physicians, hospitals and other health care professionals) expect patients to become more engaged in their own care, isn’t it fair for patients to expect their physicians to also…

It is said that “turn around is fair play.”

So if providers (physicians, hospitals and other health care professionals) expect patients to become more engaged in their own care, isn’t it fair for patients to expect their physicians to also get more involved in their care?

If you look closely at “proxy measures” for physician engagement, you will see that this is a legitimate if not equally important line of inquiry.

Hello? Hello? …

Read more…

Why patient engagement is reciprocal

Health policy

Why are labor and deliveries closing?

Vivian E. von Gruenigen, MD

February 18, 2012Feb 18, 201224

Labor and deliveries are slowly closing across the United States: California, Pennsylvania, and Ohio. In regional areas where there have been no closures, conversations in hospital boardrooms are probably questioning whether they should be. But why? Because of health care reform, increasing medical expenditures, hospitals are making less money due to reduced reimbursement, and because of the financial margin of obstetrics. To explain the complex answer further, we need to …

Read more…

Why are labor and deliveries closing?

Health policy

How patient satisfaction can kill

Kevin Pho, MD

February 14, 2012Feb 14, 201252

Patient satisfaction is all the rage. Medicare is beginning to tie patient satisfaction scores with hospital reimbursement, and doctors across the country are under pressure from administrative executives to raise patient satisfaction scores. High scores are even used by hospitals…

Patient satisfaction is all the rage.

Medicare is beginning to tie patient satisfaction scores with hospital reimbursement, and doctors across the country are under pressure from administrative executives to raise patient satisfaction scores.

High scores are even used by hospitals as a powerful marketing tool.

But, in the end, are patient satisfaction scores hurting patients?

I wrote about the issue previously, saying that patient …

Read more…

How patient satisfaction can kill

Patient voices

Good communication in health care is about listening

Rev. George Handzo

January 30, 2012Jan 30, 20127

A great deal of effort in the current health care environment is being put into improving communication - between patients and families and members of the health care team, among family members, and among members of the team. The case…

A great deal of effort in the current health care environment is being put into improving communication – between patients and families and members of the health care team, among family members, and among members of the team. The case can be made that good communication is at the heart of patient safety, cultural sensitivity, and the pillar of palliative care — aligning patient’s wishes and goals with treatment plans.

So …

Physician voices

Insider tips to surviving your hospital stay

Happy Hospitalist, MD

January 24, 2012Jan 24, 20123

Hospital stays can be traumatic for patients and their family members. I give you the top 10 ways to survive a hospital stay while maintaining your sanity. 10. Bring your own pillow. Trust me. 9. Bring a laptop computer or…

Hospital stays can be traumatic for patients and their family members. I give you the top 10 ways to survive a hospital stay while maintaining your sanity.

10. Bring your own pillow. Trust me.

9. Bring a laptop computer or request one from the hospital. Hospitals all have free wireless these days and many will actually provide you with a laptop if you just ask.

8. Bring an accurate and updated medication list …

Physician voices

Why the family meeting is important

Jeffrey Alderman, MD

January 24, 2012Jan 24, 20126

“Are you saying, doctor, that mom’s not getting better?” Eleanor asked. “I’m afraid so.” I replied. “Someone should have mentioned this to me before.” she said, before returning her gaze to my shoes. We were talking about Eleanor and Roger’s…

“Are you saying, doctor, that mom’s not getting better?” Eleanor asked.

“I’m afraid so.” I replied.

“Someone should have mentioned this to me before.” she said, before returning her gaze to my shoes.

We were talking about Eleanor and Roger’s mother, Bertha, who had been hospitalized in our intensive care unit for three weeks. Bertha, 67, had been admitted with an exacerbation of congestive heart failure. Despite everyone’s best efforts, she’d steadily grown …

Read more…

Why the family meeting is important

Physician voices

Paperwork causes unintended distractions for physicians and nurses

Christopher Chang, MD

January 21, 2012Jan 21, 201248

I admittedly snorted out loud when I read a New York Times article recently regarding increased physician distraction due to electronic devices, especially with the advent of the smartphone with its emails, text messages, calls, and other alerts that ping…

I admittedly snorted out loud when I read a New York Times article recently regarding increased physician distraction due to electronic devices, especially with the advent of the smartphone with its emails, text messages, calls, and other alerts that ping intermittently throughout a typical work day.

There is no question that electronic devices distract physicians as the article pointed out. But that’s like complaining about a leaky faucet when there’s a flooded basement …

Physician voices

The ambiguity of a hospital charge

Shilpa Iyer, MD

January 19, 2012Jan 19, 20124

It all started while out to dinner with a couple of my fellow Brigham/Massachusetts General Hospital OB/Gyn residents. We were discussing our favorite old TV shows and one fellow resident’s love of The Price Is Right with Bob Barker. After talking about the game show, a light bulb went off in my head and I thought, “Why can’t we play The Price is Right with hospital charges to our patients?”

With …

Read more…

The ambiguity of a hospital charge

Conditions and diseases

Why palliative care and hospice is the ultimate gift

Deb Discenza

January 19, 2012Jan 19, 201212

Dear Doctors: I am writing no less than 45 days after my mother died from a GI bleed from ovarian cancer. Not once did my mother's team of doctors mention palliative care. It was not until days and even hours…

Dear Doctors:

I am writing no less than 45 days after my mother died from a GI bleed from ovarian cancer. Not once did my mother’s team of doctors mention palliative care. It was not until days and even hours before her death that hospice was discussed and implemented. Our family was blindsided by this.

While no one likes to talk about the topic of death, it is important to remember that …

Health policy

How hospitals are gaining leverage over physicians

Richard Reece, MD

January 16, 2012Jan 16, 201233

Most hospital managers have never had the power to exert leverage over their most valuable resource, the physician, who, after all, admits the patients who make the hospital’s economic existence possible in the first place. So I wrote in introducing…

So I wrote in introducing a chapter in my first book in 1988. I hastened to add, however, at the close of that chapter, these admonishments:

1. The economic powers of the hospital is shifting from those …

Physician voices

How patients can remember their doctor’s name

Anthony Breu, MD

January 8, 2012Jan 8, 201215

“Do you remember my name?” Like a broken record, I repeat this question again and again as I make rounds in the hospital. My patients’ universal answer, given with furled eyebrows and an apologetic look is “uh, no, I don’t…

“Do you remember my name?”

Like a broken record, I repeat this question again and again as I make rounds in the hospital. My patients’ universal answer, given with furled eyebrows and an apologetic look is “uh, no, I don’t remember”.

My response: “Don’t worry. It’s Dr. Tony Breu, but call me Tony.” Theirs’ (again with furled brow, but also a smile): “Oh, okay.”

In a busy teaching hospital, it is not uncommon …

Physician voices

Why I miss practicing medicine

David Lee Scher, MD

January 8, 2012Jan 8, 20123

I recently left medical practice in order to pursue a career in mobile health technologies, for which I have had a passion for many years. I had wanted to become a physician since I was very young. The intellectual challenge…

What I will surely miss most are the priceless personal interactions I experienced on a …

Read more…

Why I miss practicing medicine

Physician voices

ACP: Making transitions better for patients

American College of Physicians & Fred Ralston Jr., MD

January 5, 2012Jan 5, 20125

A guest column by the American College of Physicians, exclusive to KevinMD.com. Many patients see multiple doctors and receive care in a variety of settings. Some patients receive care in more than one hospital. As an internist who is in…

A guest column by the American College of Physicians, exclusive to KevinMD.com.

Many patients see multiple doctors and receive care in a variety of settings. Some patients receive care in more than one hospital. As an internist who is in the process of transforming into a patient-centered medical home, I have been taking steps to help my patients when they see other physicians.

All physicians can recount instances when they saw …

Physician voices

Requiring doctors to give orders on patients they have not seen

Steven Reznick, MD

January 4, 2012Jan 4, 201219

To meet Federal patient satisfaction goals, our hospital administration is requiring community based physicians to give patient admission orders before we have a chance to see the patient. Patients who self-refer themselves to the emergency department, are evaluated by the emergency room staff, and who are determined to require admission must be admitted by their community physician within 20 minutes of receiving a call from the ER staff advising the …

Physician voices

What kind of shoes should you wear in the hospital?

Mary L. Brandt, MD

January 1, 2012Jan 1, 20123

I got home recently after a 14 hour day in the operating room with (predictably) a pair of really tired feet, which lead me to think about shoes, foot rubs, and the fact that no one ever talked to me…

What kind of shoes should you wear in the hospital?

There’s a lot of walking in the hospital, but there’s even more standing. Running shoes don’t provide …

Physician voices

The positive effects of palliative care on quality of life

Kohar Jones, MD

December 30, 2011Dec 30, 20116

“I’ve been a fighter all my life,” said my new patient, a middle aged man with thinning hair, a worried wife, and a dismal prognosis. He had worked all his life as a plumber with no health insurance. When he…

I was meeting him for the first time in the community health center where I work as a family physician, tending …

Hospital medicine

Articles, page 126

Real physician voices, twice a week

The Podcast

Latest episodes

Most popular

The Podcast

Latest episodes

Most popular