Hospital medicine

5,188 articles · Since 2004

Articles, page 130

Your consumer powers when choosing a hospital

August 26, 2011Aug 26, 201110

An excerpt from Doctor, Your Patient Will See You Now: Gaining the Upper Hand in Your Medical Care (Rowman & Littlefield). The casual attitude people demonstrate when choosing doctors incurs a steep price. Let's direct our attention to your consumer…

An excerpt from Doctor, Your Patient Will See You Now: Gaining the Upper Hand in Your Medical Care (Rowman & Littlefield).

The casual attitude people demonstrate when choosing doctors incurs a steep price. Let’s direct our attention to your consumer powers when choosing a hospital.

The imperative ‘caveat emptor’ (let the buyer beware) carries the most consequence when you purchase health care. When it comes to hiring a hospital’s services, it’s …

Patient voices

Top 10 musts for your hospital visit

Mitchell Brooks, MD

August 25, 2011Aug 25, 20114

Whether you are going to the hospital for an outpatient procedure or whether you will be admitted to the hospital for medical illness or surgical procedure, there are certain things you must know and certain things you must do in…

You must become informed about the terms and limits of your health insurance policy. See if the fees you are being

…

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Top 10 musts for your hospital visit

Patient voices

An ER specifically built for older patients

Brian Goldman, MD

August 24, 2011Aug 24, 20112

Seniors spend a lot of time at hospital ER's. Now, a small but growing number of hospitals in the US have built ER's especially for the aging patient - with wider hallways, motion detectors, hearing and visual aids. To me,…

Seniors spend a lot of time at hospital ER’s. Now, a small but growing number of hospitals in the US have built ER’s especially for the aging patient – with wider hallways, motion detectors, hearing and visual aids. To me, this is long overdue.

Older patients are avid consumers of emergency medical services. Older people make up a significant percentage of the total population of ER patients. A 2008 …

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Conditions and diseases

Navigating the path of contradictory medical opinions

Ralph Gordon, MD

August 24, 2011Aug 24, 2011

With the advancement in healthcare and technology we are able to greatly extend the life expectancy of the population. For the healthcare provider that means that more elderly patients and patients with multiple chronic medical conditions are being admitted to the hospital. Some “complex” patients require a multidisciplinary approach with the involvement of multiple consultants.

As a primary attending physician for the patient you often have to deal with contradictory …

Physician voices

An opportunity for hospitalists to improve patient care

Robert Centor, MD

August 18, 2011Aug 18, 20113

Some hospitalists are in denial. Some hospitalists have become methodologic critics. But all hospitalists should take the findings of the recent Annals of Internal Medicine article seriously. We should not argue about the article, but rather ask whether these findings…

Some hospitalists are in denial. Some hospitalists have become methodologic critics. But all hospitalists should take the findings of the recent Annals of Internal Medicine article seriously. We should not argue about the article, but rather ask whether these findings point out a weak point in our care of patients.

This article provides an opportunity, not a scolding:

In an accompanying editorial, two other researchers from the VA Medical Center in

…

Health technology

Why is the iPad be revolutionary for doctors and nurses?

Jared Sinclair, RN

August 13, 2011Aug 13, 20112

As a nurse, I spend a lot of time with other nurses. When they ask me to explain why I think the iPad is great, I respond with the following metaphor: imagine that you are a nurse who has been…

As a nurse, I spend a lot of time with other nurses. When they ask me to explain why I think the iPad is great, I respond with the following metaphor: imagine that you are a nurse who has been asked to design a new hospital from scratch. You are free to question every prior assumption, to throw out old ideas that no longer fit, to redesign everything according …

Medical education

Why work hour restrictions won’t improve patient safety

Kevin Pho, MD

August 11, 2011Aug 11, 20115

Darshak Sanghavi recently wrote an excellent piece in the New York Times summarizing the controversy over resident work hours. The topic has been discussed here frequently, with ramifications ranging from the fact that errors arising from patient handoffs negate any…

Darshak Sanghavi recently wrote an excellent piece in the New York Times summarizing the controversy over resident work hours.

The topic has been discussed here frequently, with ramifications ranging from the fact that errors arising from patient handoffs negate any benefit gained from restricting work hours, to surgeons not accumulating enough experience during their work hour-restricted training.

I’ve often …

Patient voices

What the death penalty has to do with medical errors

angienadia, MD

August 10, 2011Aug 10, 20115

A fascinating, beautifully-written article on a death penalty granted to a most likely innocent man, with interesting details on fire dynamics and the history of the judicial system pertaining to the death penalty. Reading about the system in place that…

Reading about the system in place that should prevent an innocent man from being wrongfully executed reminds me of the supposed system that prevents medical errors from occurring – both are imperfect, with innocent victims falling through …

Physician voices

Why you would want a younger doctor in the hospital

Maxwell S. Kennerly

August 10, 2011Aug 10, 20113

Recently, the American Journal of Medicine published a study with the unexpected conclusion that hospitalized patients were more likely to die or stay long in the care of an experienced physician than in the care of a recent graduate from…

Recently, the American Journal of Medicine published a study with the unexpected conclusion that hospitalized patients were more likely to die or stay long in the care of an experienced physician than in the care of a recent graduate from residency: “When doctors weren’t very busy, they kept patients in the hospital for roughly the same average time no matter how many years of experience they had. But when they did have a …

Physician voices

Why a neurologist turned down an interesting hospital case

Doctor Grumpy, MD

August 8, 2011Aug 8, 20115

Dr. Grumpy has lost his neurology mojo over time. Actually, I shouldn't say I've lost it, as much as it's been worn down by red tape. Yesterday I turned away a good hospital case, and told them to find someone…

Dr. Grumpy has lost his neurology mojo over time. Actually, I shouldn’t say I’ve lost it, as much as it’s been worn down by red tape.

Yesterday I turned away a good hospital case, and told them to find someone else. The patient was insured. The patient was interesting. Not some run of the mill chronic back pain case.

28-year old guy admitted for abdominal pain and weight loss. Large mass found (possibly lymphoma). …

Patient voices

There is no billing code for compassion

Paul Levy

August 7, 2011Aug 7, 201112

Back in 2009, Dr. Amy Ship gave a moving acceptance speech when she received the annual Compassionate Caregiver Award from the Schwartz Center. The most memorable tag line from the speech was, "There is no billing code for compassion." This…

Back in 2009, Dr. Amy Ship gave a moving acceptance speech when she received the annual Compassionate Caregiver Award from the Schwartz Center.

The most memorable tag line from the speech was, “There is no billing code for compassion.” This resonated with so many of us — patients and providers — in part because it set forth the proposition that compassionate care should be an inherent aspect …

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There is no billing code for compassion

Medical education

During the holidays, our goal should be to provide a holiday for our patients

Scrub, MD

August 6, 2011Aug 6, 2011

During Christmas holidays, many medical students, interns, and residents will not be celebrating the holidays with their families. Instead, they will be on call, or night shifts, or just long schedules, taking care of patients. For life and death, sickness…

For life and death, sickness and health, do not take holidays, and nor should our compassion for taking care of those who are in trying times. I recall working last year on Christmas Eve at …

Patient voices

Being a patient is an unforgettable form of medical education

Carolyn Thomas

August 6, 2011Aug 6, 201115

In his online essay, This Won’t Hurt A Bit, cardiologist Dr. Eric Van De Graaff tells his own story of being a hospital patient after surviving a motorcycle accident while he was in med school. His experiences as a patient will sound very familiar to heart patients, and the lessons he learned while on the other end of the stethoscope may very well have made him a far better doctor.

A …

Physician voices

Ingredients of a good team meeting in a medical setting

Donald Tex Bryant

August 5, 2011Aug 5, 20112

At Camden Community Hospital (a fictional hospital), Shana, a senior RN, is leading a team meeting to discuss standardizing the handoff of patients between shifts. She quickly looks over the team members, who are chatting among themselves, some not very quietly. “May I have your attention, please,” she says. Some stop talking and others keep on. She raps her hand on the table and now she has everyone’s attention. …

Physician voices

Hospitalist care is more expensive but don’t blame hospitalists

Kevin Pho, MD

August 3, 2011Aug 3, 20118

Hospitalists save money. Until the patient leaves the hospital, at least. A recent study from the Annals of Internal Medicine ignited debate over the cost effectiveness of hospitalists. Looking at Medicare patients from 2001 to 2006, researchers found that "those…

Hospitalists save money. Until the patient leaves the hospital, at least.

A recent study from the Annals of Internal Medicine ignited debate over the cost effectiveness of hospitalists. Looking at Medicare patients from 2001 to 2006, researchers found that “those who were followed by a primary care physician spent about half a day more at the hospital, costing Medicare …

Health policy

Why the debt ceiling deal is a horrific outcome for physicians

Kevin Pho, MD

August 2, 2011Aug 2, 201151

If you're a physician or hospital that relies on Medicare payments, grim times are ahead. Yes, even worse than the scheduled 29% payment cut that's scheduled to go into effect in 2013. Emergency physician Shadowfax calls the debt deal "a…

If you’re a physician or hospital that relies on Medicare payments, grim times are ahead. Yes, even worse than the scheduled 29% payment cut that’s scheduled to go into effect in 2013. Emergency physician Shadowfax calls the debt deal “a terrible deal for health care providers.”

Under the contentious debt ceiling agreement, significant cuts in Medicare dollars will be made. But …

Patient voices

Embracing different cultures in the service of the dying

Niamh van Meines, ANP-BC, EMT

July 30, 2011Jul 30, 20112

She was overwhelmed with grief when she walked into the room and saw her mother silently and peacefully dead in the hospital bed. Her death was expected, but as always, no-one is ever quite ready to let go. She started to wail loudly and speak directly to her deceased mother about the pain she was inflicting by dying.

She was compelled to hold her prayer beads and started to dance around …

Patient voices

What a hospital can do to be more comfortable for patients

Kathy Kastner

July 27, 2011Jul 27, 201110

Although filled to the brim with patients, hospitals were created to support doctors, not us patients. Historically, their organizational structure focused on doctors’ needs and doctors’ requirements. The concept of centering hospital care on patient needs and requirements is a…

How can a hospital switch from being provider-centered to patient-centered? Shifting such a complicated and cumbersome behemoth a full 180 degrees is a huge undertaking.

I believe it …

Physician voices

The secret in caring for the patient is to care for the patient

Jim deMaine, MD

July 24, 2011Jul 24, 201111

Erik's wife had warned him many times, "Stay off ladders dear, leave it to someone younger." Erik though was a pretty spry 72 years old and had been cleaning the gutters for many years. He had a sturdy 25 foot…

Erik’s wife had warned him many times, “Stay off ladders dear, leave it to someone younger.” Erik though was a pretty spry 72 years old and had been cleaning the gutters for many years. He had a sturdy 25 foot extension ladder, had years of experience as an athlete, and wasn’t about to slow down for no good reason.

It was an unusually bright crisp November day in Seattle, when Erik …

Physician voices

The benefits of successful patient self-management programs

Mark Novotny, MD

July 22, 2011Jul 22, 20112

The emerging literature on chronic disease management suggests that successful programs rely on patient self management skills. Having been in the primary care role for 20 years, that initially seemed self evident and a bit “so what?” to me, thinking…

However self-management skills refer to specific curricula of skills that can …

Hospital medicine

Articles, page 130

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