Hospital medicine

5,188 articles · Since 2004

Articles, page 36

What this medical student learned as a legal extern

August 9, 2019Aug 9, 201911

As a law student, I recently was a legal extern at a hospital this summer. It’s a crazy thought because when I started medical school back in Fall 2015, my bus would pass through the pick-up/drop off zone at the hospital every single day at 7:43 a.m. I always saw physicians with their long white coats and coffees in hand walking through the automatic sliding doors. I too saw patients …

Physician voices

White coats should no longer be worn by physicians

Frederick Gandolfo, MD

August 6, 2019Aug 6, 20196

Did you know that the traditional doctor’s white coat that you probably associate with your physician actually was a look that doctors “borrowed” from another profession? Back in the early days of doctoring, to add some perceived legitimacy to the title physician, the white coat look was adopted from our colleagues in the hard sciences who did actual experiments in the lab. If you recall, what we doctors call a “white …

Medical education

Who are the best educators for medical students?

Kunal Shetty

August 6, 2019Aug 6, 20192

I shared my assessment and plan with the preceptor as she walked into the room. She cut me off, “You think this patient needs surgery?” she smirked. “He has no idea what he is talking about, don’t mind him,” she whispered loudly to the patient. I kept quiet until the patient left, and my preceptor began writing her note. I pulled up a recent research article I had found prior …

Real physician voices, twice a week

Free, and one click to unsubscribe.

Conditions and diseases

Think of diagnostic excellence as playing smooth jazz

Robert Centor, MD

August 5, 2019Aug 5, 2019

When we think about clinical reasoning, most talks focus on diagnostic errors and the reasons for those errors. The legacy of Kahneman and Tversky focuses on errors and the many named mistakes we make. We focus on avoiding errors, but…

Gary Klein, the pioneer of naturalistic decision making, has focused more on the road to …

Conditions and diseases

A critical discussion is needed about planned death

Hope Wechkin, MD & Tom Schaaf, MD

August 4, 2019Aug 4, 2019

“Planned death.” When you put it like that, this can only mean one of two things: suicide or murder. For most of us in medicine, the very idea of “planned death” seems safely outside our purview. After all, the bulk…

“Planned death.”

When you put it like that, this can only mean one of two things: suicide or murder. For most of us in medicine, the very idea of “planned death” seems safely outside our purview. After all, the bulk of medicine is concerned with staving off death. And the very nature of death’s uncertain timing enables practitioners of everyday medicine to take refuge in its mystery.

When necessary, we prognosticate. But …

Physician voices

What The Big Sick says about our profession

Lindsay Ripley, MD

August 3, 2019Aug 3, 2019

"The Big Sick" is an intimidating name for a movie. I never know what to think when "sick" is used as a noun. Does it mean vomit? Are we referring to ailing people? Just as the name doesn't give you…

“The Big Sick” is an intimidating name for a movie. I never know what to think when “sick” is used as a noun. Does it mean vomit? Are we referring to ailing people? Just as the name doesn’t give you much insight, neither does the beginning of the film. It has nothing to do with illness. It’s about a Pakistani standup comedian/Uber driver who starts dating a white girl, but …

Physician voices

Roundsmanship: the skill you didn’t know you needed

Shannon Casey, PA-C

August 3, 2019Aug 3, 2019

"What's the most common missed fracture?" my supervising PA asked during my clinical rotation in the emergency department. "The second one," I answered confidently. It was the right answer, and I surprised him by knowing it. He had previously given…

“What’s the most common missed fracture?” my supervising PA asked during my clinical rotation in the emergency department. “The second one,” I answered confidently. It was the right answer, and I surprised him by knowing it. He had previously given a lecture to my class and had emphasized this clinical pearl in such a way that I knew it was one of his favorite trick questions.

Unfortunately, I didn’t always know …

Physician voices

When should physicians read the House of God?

Paul Sax, MD

August 2, 2019Aug 2, 20195

Many consider the novel the House of God, written by Samuel Shem (pen name for Stephen Bergman), to be a must-read for any physician or soon-to-be physician. A fictionalized account of his internship year, the book details how the accumulated stress, fatigue, and powerlessness of being a first-year doctor inexorably accumulates during that year — with sometimes hilarious, and but also disastrous, results.

The survival strategies of the interns in …

Physician voices

The entire medical education system needs sweeping change

Rachel Goossen, MD

August 2, 2019Aug 2, 20192

In May 2019, headlines of a study out of University of Michigan hit the lay media: “New Doctors’ DNA Ages 6 Times Faster Than Normal in First Year.” Using DNA samples submitted by medical residents across the country, the Intern Health Study measured telomere length before and after residents completed their intern years. Loss of telomere length has been associated with morbidity, mortality, and even depression. A …

Physician voices

Sometimes as physicians, we need to embrace death with open arms

Rosmy Jimmy, MD

August 1, 2019Aug 1, 2019

As a community of physicians, I'm sure we have heard the phrase, "I just want to get well, doc," from our patients. Have you ever wondered what does "get well" really mean to them? As a third-year internal medicine resident,…

As a community of physicians, I’m sure we have heard the phrase, “I just want to get well, doc,” from our patients. Have you ever wondered what does “get well” really mean to them?

As a third-year internal medicine resident, I had an unforgettable experience during my intensive care unit rotation. He was an elderly patient with HIV, stage 4 colon cancer with metastasis throughout the abdomen, who was being treated …

Health technology

5 steps to fix our EMR disaster

Shabbir Hossain, MD

August 1, 2019Aug 1, 2019

The EMR has become a focal point in the physician burnout discussion. Although I believe EMRs are a necessary evil, current iterations of them are just not good. Each click on a mouse is a prick on the many good souls that figuratively bleed until they are physically and mentally burned out. Scribes are not a solution either. That is just a workaround. EMRs are one of many things that …

Read more…

5 steps to fix our EMR disaster

Physician voices

How physicians become medical narcissists

Shannon Casey, PA-C

July 30, 2019Jul 30, 20195

It is no secret that health care providers shoulder a lot of responsibility. As a whole, they take this on with both competence and kindness. Sacrificially, they go above and beyond in order to provide patients with the highest of quality care. They juggle a multitude of professional and personal responsibilities in creative and admirable ways. Meanwhile, each health care provider learns to adopt a unique combination of coping mechanisms …

Health policy

Are pediatric hospitals ready to embrace value-based payment models?

Johanna Vidal Phelan, MD, MBA

July 30, 2019Jul 30, 2019

Although pediatric (children's) hospitals are not yet mandated (as are their general population counterparts) to participate in value-based contracts (VBCs), as competitive medical institutions they are very cognizant of the market changes toward value-based payment models while tirelessly seeking to…

Although pediatric (children’s) hospitals are not yet mandated (as are their general population counterparts) to participate in value-based contracts (VBCs), as competitive medical institutions they are very cognizant of the market changes toward value-based payment models while tirelessly seeking to increase value in pediatric health care delivery.

The push towards better alignment of payers and hospital systems continues to change the landscape of competitive health care. Children’s hospitals “are the backbone …

Physician voices

5 powerful words you can say to patients

Suneel Dhand, MD

July 28, 2019Jul 28, 20195

Our job as health care professionals is not just to diagnose our patients by applying our scientific knowledge and clinical skills, but also to be the “communicator-in-chief,” “listener-in-chief,” and “reassurer-in-chief.” Any doctor who doesn’t fully grasp this, is not doing…

Any doctor who doesn’t fully grasp this, is not doing the best job they can or being the best doctor they can be. I truly believe that over 90 percent of our everyday job as a physician involves being a good …

Physician voices

Medicine claims the life of a physician heroine

Cory Michael, MD

July 28, 2019Jul 28, 201914

Peg began internal medicine residency with altruistic goals. She didn’t want to become a specialist or seek personal financial wealth. She just wanted to help people. With a prior career related to her degrees in art history and sculpture, she had a unique way of truly embracing medicine as an art. Rarely spotted without a smile on her face despite long training hours in the hospital, she eagerly embraced taking …

Physician voices

When the standard of care is bad medicine

Myles Gart, MD

July 26, 2019Jul 26, 20192

For the last three decades, the numeric pain score has been the go-to assessment for acute pain in the hospital setting. Since this methodology was developed for research purposes to see if drug “A” had an effect on patient “A,”…

Let’s look at a simple example of a pain order set that is commonly used across the country. If a patient says …

Physician voices

The disaster at Hahnemann University Hospital

Karen S. Sibert, MD

July 26, 2019Jul 26, 201910

Though the news at first stayed local in Philadelphia and the northeast, it’s gaining traction nationwide. ZDoggMD is on it. Bernie Sanders held a rally. What happened? The venerable Hahnemann University Hospital, the main teaching hospital for Drexel University College…

Though the news at first stayed local in Philadelphia and the northeast, it’s gaining traction nationwide. ZDoggMD is on it. Bernie Sanders held a rally.

What happened? The venerable Hahnemann University Hospital, the main teaching hospital for Drexel University College of Medicine in Philadelphia, is bankrupt and will soon close its doors after more than 170 years as a safety-net hospital serving inner-city patients.

Why should we care? After all, there …

Physician voices

What health care can learn from the Boeing 737 Max tragedies

Cesar Padilla, MD

July 25, 2019Jul 25, 2019

The recent Boeing 737 airline crashes have left a scar on the American (and worldwide) psyche regarding air travel. Boeing, an iconic brand, prestigious in history and talent, neglected to update and formally educate pilots regarding an essential software update…

Recent audio between an American Airlines pilot and Boeing’s leadership offers some insight — and lessons — into this …

Physician voices

5 things I learned from being a “high-maintenance” patient

Dhaval Desai, MD

July 25, 2019Jul 25, 2019

Physicians and health care providers across the world are trained to treat disease processes and disease states. Often, this approach becomes technical. And while directed towards the patient, it paradoxically distances itself from the patient. The distance created between the patient and the physician through diagnostic and therapeutic approaches is related to the patient’s dissatisfaction with their medical journey.

Being sick and ill, whether it is a major or minor illness, …

Physician voices

Why we must embrace medical uncertainty

American College of Physicians & Philip A. Masters, MD

July 23, 2019Jul 23, 2019

A guest column by the American College of Physicians, exclusive to KevinMD.com. In the late 1800s, William Osler stated, “… if you want a profession in which everything is certain, you had better give up medicine.” He made this observation…

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

In the late 1800s, William Osler stated, “… if you want a profession in which everything is certain, you had better give up medicine.” He made this observation at a time when the science underlying health care was nascent, and little was understood about the effectiveness of treatments available for specific diseases, if they …

Read more…

Why we must embrace medical uncertainty

Hospital medicine

Articles, page 36

Real physician voices, twice a week

The Podcast

Latest episodes

Most popular

The Podcast

Latest episodes

Most popular