Hospital medicine

5,188 articles · Since 2004

Articles, page 19

The weight of the pager

June 14, 2021Jun 14, 2021

I have heard from more than one retired anesthesiologist about becoming aware of the weight of the pager after it is relinquished. I imagine other physicians engaged in critical care, trauma (physical and emotional), other emergencies, and obstetrical care might have heard similar descriptions. Have I left anyone out? We do a pretty good job of negotiating chronic professional anxiety at a subacute level. In fact, we are so accustomed …

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The weight of the pager

Physician voices

The world should be more like a children’s hospital

Katharine Modisett, MD

June 10, 2021Jun 10, 2021

For 15 days, we lived at Children’s National Medical Center when our daughter Evelyn was diagnosed with leukemia. As a physician, I had felt like I had lived at the hospital before, but this was different. The first few days were a blur – long days followed by sleepless nights at home alternating with sleepless nights next to Evelyn’s hospital bed. My husband Kevin and I dressed in layers those …

Physician voices

How photography made me a better doctor

Moksha Patel, MD

June 5, 2021Jun 5, 2021

In my first year as an attending hospitalist, I personally discovered what Hippocrates realized millennia before, “Life is short and the art long.” Clinical reasoning is an intellectual labyrinth that can only be mastered with deliberate practice, introspection, and perseverance.…

However, I soon found that spending hours poring through manuscripts and cases was not only cumbersome, but often counterproductive. It dawned on me then that athletes faced a similar predicament, one …

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How photography made me a better doctor

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Patient satisfaction through a hospitalist lens [PODCAST]

The Podcast by KevinMD

June 4, 2021Jun 4, 2021

"In addition to leaking private information to an unauthorized individual who just happened to ask for Ms. Mann by name, Larry commanded Nigel to worsen this HIPAA violation. Given the tone of his command, Larry must have felt right proud…

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“In addition to leaking private information to an unauthorized individual who just happened to ask for Ms. Mann by name, Larry commanded Nigel to worsen this HIPAA violation. Given the tone of his command, Larry must have felt right proud of his informing an aggressive, unconfirmed querent. If so, perhaps he …

Physician voices

Here’s the secret to establishing a great physician reputation

Cory Fawcett, MD

May 24, 2021May 24, 2021

Summer marks a flood of young new attendings hitting hospitals all over the country. There will also be many doctors whose first contract is coming to an end, and they are moving to a new position. Both of these scenarios create an opportunity to make a first impression at a new job. The effects of that first impression will linger for years to come.

What lingering effects do you want to …

Health policy

A police shooting in a hospital forces a family to rethink American justice

Sarah Varney

May 23, 2021May 23, 2021

The beer bottle that cracked over Christian Pean’s head unleashed rivulets of blood that ran down his face and seeped into the soil in which Harold and Paloma Pean were growing their three boys. At the time, Christian was a confident high school student, a football player in the suburbs of McAllen, Texas, a border city at the state’s southern tip where teenage boys — Hispanic, Black, white — sung …

Health policy

This didn’t happen every day in a small town ER

Brian Alexander

May 14, 2021May 14, 2021

An excerpt from The Hospital: Life, Death, and Dollars in a Small American Town. Marc Tingle and his daughter, Summer, stood in a bathroom they were tearing apart over in Fayette in Fulton County. They had a problem: taking a…

An excerpt from The Hospital: Life, Death, and Dollars in a Small American Town.

Marc Tingle and his daughter, Summer, stood in a bathroom they were tearing apart over in Fayette in Fulton County. They had a problem: taking a cast-iron bathtub out of a room that had been built around the tub was a tactical nightmare. Breaking it made one helluva racket, but with just himself …

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Responding to the COVID pandemic: a lesson in coalescence [PODCAST]

The Podcast by KevinMD

May 7, 2021May 7, 2021

"When faced with an existential crisis, any organization, as large as a nation or as small as a marriage, will go one of two ways. Either it will bond together, coalesced in a common purpose, or it will collapse in…

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“When faced with an existential crisis, any organization, as large as a nation or as small as a marriage, will go one of two ways. Either it will bond together, coalesced in a common purpose, or it will collapse in a spasm of blame and shame. While our health care institutions …

Physician voices

Metric shock: the unintentional consequence of measuring

David M. Mitchell, MD, PhD

May 6, 2021May 6, 202110

Health care in U.S. hospitals is suffering from three under-recognized conditions that I will refer to as “Metris,” “Severe Metris” and “Metric Shock.” Metris occurs when a health system begins to focus more on achieving certain metrics than on improving…

Health care in U.S. hospitals is suffering from three under-recognized conditions that I will refer to as “Metris,” “Severe Metris” and “Metric Shock.”

Metris occurs when a health system begins to focus more on achieving certain metrics than on improving actual patient care. Severe metris occurs when pressured providers begin to base their clinical decisions on achieving a metric rather than on their best clinical judgment. And sadly, metric shock occurs …

Physician voices

A nurse is to a patient what a mother is to a child

Farhan S. Imran, MD

May 6, 2021May 6, 20212

I was on inpatient service and had already seen most of the patients on my list. I just had to see one more before I could call it a day and rush out just in time to take my daughter…

I was on inpatient service and had already seen most of the patients on my list. I just had to see one more before I could call it a day and rush out just in time to take my daughter to her tennis lesson. I reviewed the patient’s chart to find out that her cancer had spread to her spine, which had incapacitated her to the point that she could …

Physician voices

Bloated notes are a huge problem and a time suck

Craig Bowron, MD

May 4, 2021May 4, 20216

In a moment of caffeine-depleted delirium, I volunteered to head the creation of a “notes committee” for my 80-member hospitalist group. I placed myself on a 72-hour hold and quickly established a group consensus: "Bloated notes are a huge problem…

In a moment of caffeine-depleted delirium, I volunteered to head the creation of a “notes committee” for my 80-member hospitalist group.

I placed myself on a 72-hour hold and quickly established a group consensus: “Bloated notes are a huge problem and a time suck. I’m glad you [rather than me] are working on this. My notes are fine, though. It’s other people’s notes that are bad. Other people’s bad notes are …

Physician voices

By jeopardizing privacy, did this physician meet patient satisfaction goals?

Adedotun Adewusi, MD

April 30, 2021Apr 30, 20212

An excerpt from Under the Collar: Frank Conversations about Healing that Harms: Simply Speaking. Hospitalist Nigel admitted elderly Ms. Mann who had developed dehydration after several days of unrelenting nausea and vomiting. Respecting patients’ privacy, Nigel asked Ms. Mann to…

An excerpt from Under the Collar: Frank Conversations about Healing that Harms: Simply Speaking.

Hospitalist Nigel admitted elderly Ms. Mann who had developed dehydration after several days of unrelenting nausea and vomiting. Respecting patients’ privacy, Nigel asked Ms. Mann to name the individuals with whom the team could disclose her medical course and treatment. Ms. Mann designated only her son and daughter-in-law as her proxies. During her …

Patient voices

Medical facilities: Please keep your immune-deficient patients safe

Denise Reich

April 21, 2021Apr 21, 2021

“Go have a seat,” the receptionist at the imaging center told me, gesturing to the waiting room. It was a close, poorly ventilated space, and several of the chairs were already occupied. I turned back to the receptionist. ”I have…

”I have a primary immune deficiency,” I patiently explained. “I spoke to the scheduler about this. She said I could wait somewhere isolated.”

”This is what we have,” the receptionist said indifferently and turned to …

Physician voices

My 10 Commandments of a Servant Leader

Andy Lamb, MD

April 18, 2021Apr 18, 20213

I have seen great leadership and bad leadership. As a leader, I have also made my share of mistakes, and I am sure I will make more. When I do, I will immediately take ownership of it, learn from it, and do all I can not to make the same mistake. However, there will be times I may not recognize my failure, as can happen with any leader. This points …

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My 10 Commandments of a Servant Leader

The Podcast by KevinMD

In gratitude to our nation’s residents [PODCAST]

The Podcast by KevinMD

April 11, 2021Apr 11, 2021

"Most residents are young, often in their mid to late 20s, having spent years ensconced in libraries, research labs, and classrooms learning pathophysiology and pharmacology. Upon graduation from medical school, they are now drafted to the front lines of a…

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“Most residents are young, often in their mid to late 20s, having spent years ensconced in libraries, research labs, and classrooms learning pathophysiology and pharmacology. Upon graduation from medical school, they are now drafted to the front lines of a generational pandemic, working long hours, often in cities where they are …

The Podcast by KevinMD

We must address glaring disparities in treatment [PODCAST]

The Podcast by KevinMD

April 4, 2021Apr 4, 2021

"It is not enough to say we are anti-racist; we have to modify our systems to recognize that we have placed individuals of color at risk of poorer outcomes. Lack of insurance, lack of finances, or even the presence of…

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“It is not enough to say we are anti-racist; we have to modify our systems to recognize that we have placed individuals of color at risk of poorer outcomes. Lack of insurance, lack of finances, or even the presence of certain diagnoses may reflect less about the person and more about …

Physician voices

When it comes to medicine, what kind of practice makes perfect?

Salim Yaghi, MD

March 31, 2021Mar 31, 2021

The old saying that says “practice makes perfect” is a basic rule taught to every resident starting their training. The follow-up questions that pose themselves: Is it true? How much time does it need to become perfect? What type of…

Time was answered partially by the journalist Malcolm Gladwell and his famous 10,000 hours rule; if one dedicates 10,000 hours for a skill, one will become an expert. If you …

Physician voices

For the love of baseball and music: a Boston Hope Music story

Lisa Wong, MD & Ron Hirschberg, MD

March 28, 2021Mar 28, 2021

After entering Gate D at Fenway Park, John had his temperature taken and verified that he was symptom-free. As he rounded the corner, his friend heard him whisper through his mask, “I think this is real.” He was referring to the calming sounds of a string trio emanating from the concourse, next to the FIELD BOX 54-70 sign. Vaccine day was finally …

Physician voices

The rise and fall of Hahnemann University Hospital

Hyun Hee Heather Kim, MD

March 28, 2021Mar 28, 2021

In March, thousands of medical students received their residency match results. For most specialties, match rates for graduating U.S. MD seniors have typically remained above 90 percent. This almost certain job security is what allows most medical students to consider…

The individualist message is clear throughout medical school: Focus on yourself, your achievements, and hope for the best.

Absent from these …

Conditions and diseases

Doctor, am I going to make it?

Razia Jayman-Aristide, MD

March 22, 2021Mar 22, 2021

Never have I ever had to rely on my communication skills as much as I have as a physician in the pandemic of 2020. My eyes, however, were not taught those skills. There are pillars in medicine, communication guidelines, and lessons in empathy — all things we learn in our training. I can’t say that I had a strong foundation in communication skills as a medical student, but I learned …

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Doctor, am I going to make it?

Hospital medicine

Articles, page 19

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