Hospital medicine

5,188 articles · Since 2004

Articles, page 148

A review of the latest stroke studies

December 23, 2009Dec 23, 20092

Originally published in HCPLive.com by Victor G. Dostrow, MD There are some recent developments in the world of stroke, which are interesting: The first manuscript is an evaluation of stroke risk and the "stroke belt" (North Carolina, South Carolina, Georgia,…

Originally published in HCPLive.com

by Victor G. Dostrow, MD

There are some recent developments in the world of stroke, which are interesting:

The first manuscript is an evaluation of stroke risk and the “stroke belt” (North Carolina, South Carolina, Georgia, Tennessee, Arkansas, Mississippi, or Alabama).

The authors evaluated stroke risk measured over three decade census intervals for persons aged 30 to 80, based on …

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A review of the latest stroke studies

Drugs and prescribing

How medication mistakes happen in the hospital

MedPage Today

December 22, 2009Dec 22, 20098

Originally published in MedPage Today by Katrina Woznicki, MedPage Today Contributing Writer Hospitalized patients were often clueless when asked about their medications, with almost all of them unable to name all their medications and many leaving out as many as…

Originally published in MedPage Today

by Katrina Woznicki, MedPage Today Contributing Writer

Hospitalized patients were often clueless when asked about their medications, with almost all of them unable to name all their medications and many leaving out as many as a half-dozen drugs they have been prescribed, according to a small survey of patients in a Colorado hospital.

Ninety-six percent of the …

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Health policy

Why doctors and hospitals oppose expanding Medicare

MedPage Today

December 15, 2009Dec 15, 20096

Originally published in MedPage Today by Emily P. Walker, MedPage Today Washington Correspondent The notion of a public health insurance plan appears to be evaporating from the Senate's healthcare reform bill, replaced in part with an expansion of Medicare --…

Originally published in MedPage Today

by Emily P. Walker, MedPage Today Washington Correspondent

The notion of a public health insurance plan appears to be evaporating from the Senate’s healthcare reform bill, replaced in part with an expansion of Medicare — an idea that’s meeting resistance from doctor and hospital associations.

A proposal to scrap the public plan to allow people as young …

Conditions and diseases

Some patients won’t accept a conservative approach to medical treatment

Michael Kirsch, MD

December 12, 2009Dec 12, 200912

by Michael Kirsch, MD Who says one person can’t make a difference? This past week, I personally set back health care reform. No, I wasn’t attending a ‘tea party’ or decrying Obamacare in a venomous letter to the editor. I…

by Michael Kirsch, MD

Who says one person can’t make a difference? This past week, I personally set back health care reform. No, I wasn’t attending a ‘tea party’ or decrying Obamacare in a venomous letter to the editor. I single-handedly bent the health care cost curve in the wrong direction. I performed an unnecessary medical test on a hospitalized patient, which exposed her to risk and cost the system money. …

Physician voices

Should health care workers go to jail for medical errors?

Robert Wachter, MD

December 11, 2009Dec 11, 200911

Two years ago, I wrote about the case of Julie Thao, the Wisconsin nurse sent to prison for a medication error. I argued then that – although Julie bypassed some safety rules – she most certainly did not deserve jail…

Along comes another case involving jail time for a medical mistake, this one featuring an Ohio pharmacist named Eric Cropp. I became aware of Eric’s case through the efforts of …

Health technology

How health IT can bankrupt healthcare

Alberto Borges, MD

December 8, 2009Dec 8, 20093

Originally published in HCPLive.com by Alberto Borges, MD For those interested in health information technology, there is now an excellent, new, powerful article about this topic entitled, "Can Cleveland Clinic Be a Model for Digital Medicine?" where they discuss how…

Originally published in HCPLive.com

by Alberto Borges, MD

For those interested in health information technology, there is now an excellent, new, powerful article about this topic entitled, “Can Cleveland Clinic Be a Model for Digital Medicine?” where they discuss how this hospital system has failed to recoup their $100 million investment to date.

Here is my take on the Cleveland Clinic story, beyond the …

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How health IT can bankrupt healthcare

Physician voices

The inpatient, outpatient divide in patient care today

Helen Kao, MD

December 7, 2009Dec 7, 20093

As the health reform debates continue, I am struck by the lack of attention to what seems to be a critical issue in poor health care delivery. With the technologizing of medicine (and more recently the hospitalist "movement"), delivery of…

As the health reform debates continue, I am struck by the lack of attention to what seems to be a critical issue in poor health care delivery.

With the technologizing of medicine (and more recently the hospitalist “movement”), delivery of health care has come to be centralized around acute care hospitals. Over time, patient care has been divided into acute inpatient care and ‘ambulatory’ outpatient care. While transitions of care, hospital-at-home, …

Health technology

iPhone radiology app to diagnose appendicitis

MedPage Today

December 2, 2009Dec 2, 2009

Originally published in MedPage Today by Kristina Fiore, MedPage Today Staff Writer For years, the pager and cell phone have summoned on-call radiologists to the emergency room. Now this leap in technology: an iPhone App that lets radiologists diagnose a…

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

For years, the pager and cell phone have summoned on-call radiologists to the emergency room. Now this leap in technology: an iPhone App that lets radiologists diagnose a patient remotely, wherever they may be.

Using a $20 iPhone application called OsiriX, radiologists made correct diagnoses of appendicitis in 124 of …

Medical education

Medical student needlestick injuries

MedPage Today

December 1, 2009Dec 1, 2009

Originally posted in MedPage Today by Kristina Fiore, MedPage Today Staff Writer Medical students are frequently stuck by needles, and few report their accidents, researchers say. In a survey, about 60% of surgery residents reported being stuck with a needle…

Originally posted in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Medical students are frequently stuck by needles, and few report their accidents, researchers say.

In a survey, about 60% of surgery residents reported being stuck with a needle while they were in medical school, Martin A. Makary, MD, MPH, of Johns Hopkins, and colleagues reported in the December issue of …

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Medical student needlestick injuries

Health technology

The billions spent on electronic health records, and why there’s no way to know if EHRs will save money

Glenn Laffel, MD, PhD

November 30, 2009Nov 30, 20096

Barack Obama is certain that electronic health records (EHRs) can improve the quality of care and the efficiency with which it is delivered. How certain? Certain enough to have bet billions on a program that pays providers to adopt and…

Of course there are many ways to improve quality and efficiency. The Pennsylvania Health Care Cost Containment Council (PHC4) for example, publishes outcomes data for the states’ 172 …

Physician voices

The joys of practicing rural emergency medicine

Edwin Leap, MD

November 25, 2009Nov 25, 20095

I practice in the rural, northwest corner of South Carolina, also known as “The Upstate.” It is a place of expansive lakes, white-water rivers and the mist covered foothills of the Blue Ridge Mountains. The area includes thousands of acres of Sumter National Forest. The natural beauty is breathtaking. Sumter National Forest and our various parks are laced with hiking trails, which are lined with unique plants and trees, some …

Conditions and diseases

What is the death toll for the H1N1 flu pandemic?

MedPage Today

November 23, 2009Nov 23, 2009

Originally published in MedPage Today by Michael Smith, MedPage Today North American Correspondent In the first six months of the H1N1 flu pandemic, 22 million Americans fell ill from the virus, the CDC now estimates. Of those, about 98,000 needed…

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

In the first six months of the H1N1 flu pandemic, 22 million Americans fell ill from the virus, the CDC now estimates.

Of those, about 98,000 needed inpatient care, and 3,900 died, according to Anne Schuchat, MD, director of the CDC’s National Center for Immunization and Respiratory Diseases.

The estimates …

Patient voices

Discharged from the hospital without answers; the death of Jane Q. Patient

Dan Walter

November 20, 2009Nov 20, 200961

We found out that her real name was Cindy Chapman, and that she died alone and afraid. Cindy was a paralegal, an activist and a fighter of lost causes who lived in Worcester, Massachusetts. She was part of an online…

We found out that her real name was Cindy Chapman, and that she died alone and afraid.

Cindy was a paralegal, an activist and a fighter of lost causes who lived in Worcester, Massachusetts. She was part of an online community called RATEMDs, where she had many soul mates. Her posts on health care were funny and cynical and wise. Her screen name was Jane Q. Patient.

My wife, Pam, was especially …

Patient voices

Are older nurses being forced out of the profession?

Colleen O'Leary, RN, MS

November 20, 2009Nov 20, 200913

Originally published in HCPLive.com by Colleen O'Leary, RN, MSN, AOCNS Last time I talked about how I had never really experienced the concept of nurses eating their young in action. However, I have seen the opposite begin to evolve. I…

Originally published in HCPLive.com

by Colleen O’Leary, RN, MSN, AOCNS

Last time I talked about how I had never really experienced the concept of nurses eating their young in action.

However, I have seen the opposite begin to evolve. I see this as a bigger issue in nursing these days. The “putting out to pasture” of seasoned, experienced nurses is happening more often …

Conditions and diseases

Can family doctors do safe first trimester abortions?

MedPage Today

November 18, 2009Nov 18, 2009

Originally published in MedPage Today by Chris Emery, MedPage Today Contributing Writer Complications from first trimester abortions performed by family practitioners are rare, and family doctors could help address abortion provider shortages across the U.S., a new study found. Among…

Originally published in MedPage Today

by Chris Emery, MedPage Today Contributing Writer

Complications from first trimester abortions performed by family practitioners are rare, and family doctors could help address abortion provider shortages across the U.S., a new study found.

Among more than 2,500 abortions performed by family physicians, abortion was successful without complications in 96.5% of patients using medications (95% CI 95.5% …

Conditions and diseases

Why doctors are doing so many unnecessary Pap smears

Matthew Mintz, MD

November 17, 2009Nov 17, 200912

The Wall Street Journal and other sources reported on a study from the Annals of Internal Medicine that showed that most US doctors don't know the guidelines of how often women should get a pap smear. More importantly, doctors were…

The Wall Street Journal and other sources reported on a study from the Annals of Internal Medicine that showed that most US doctors don’t know the guidelines of how often women should get a pap smear. More importantly, doctors were doing a lot of pap smears on women who didn’t need them. In all the talk about health care reform, reducing costs by eliminating unnecessary testing has been mentioned multiple …

Patient voices

Learn how to conduct a family meeting by using a structured approach

Alex Smith, MD

November 16, 2009Nov 16, 2009

On my last day of ward attending, I handed out an EKG that resembled the Dow Jones industrial average over the last 10 years (not pictured). The normal pattern of an EKG was completely disrupted: ST segments were markedly elevated, P waves were hidden, and beats were grouped in odd patterns. My medical team laughed and shook their heads.

I asked why.

A brave intern responded that he was completely at a …

Conditions and diseases

Medicine needs to get back to hands-on basics, rather than focusing on technology

Rahul K. Parikh, MD

November 14, 2009Nov 14, 200915

There is plenty to criticize in our bungling trek toward health reform. Leaders on the right, left and at 1600 Pennsylvania Avenue have sidestepped the crucial conversation of controlling the cost of care, in favor of partisan rhetoric about “death panels” and “rationing care.” Worse, the entire focus of reform has centered on spending billions of dollars on technology solutions that will only make marginal changes in the cost and …

Medical education

Surgeons don’t receive enough training when resident work-hours are capped

MedPage Today

November 13, 2009Nov 13, 20097

by Crystal Phend, MedPage Today Senior Staff Writer Limiting surgical residents' work hours has compromised both surgical education and patient safety, according to an analysis concluding that an 80-hour work week isn't enough. The maximum 80-work week imposed in the…

by Crystal Phend, MedPage Today Senior Staff Writer

Limiting surgical residents’ work hours has compromised both surgical education and patient safety, according to an analysis concluding that an 80-hour work week isn’t enough.

The maximum 80-work week imposed in the U.S. for residents is too little to provide mastery in surgery, Gretchen Purcell Jackson, MD, PhD, and John L. Tarpley, MD, …

Hospital medicine

Articles, page 148

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