Hospital medicine

5,188 articles · Since 2004

Articles, page 46

3 lessons this physician learned from her patients

December 23, 2018Dec 23, 2018

I recently completed my internal medicine residency training. Three years, thousands of hours, thousands of patients, thousands of decisions. I certainly learned a lot from the past three years: everything from what “HFrEF” means and how to manage it, to treating recurrent C. difficile colitis, to how to share decision-making with patients about whether or not to start anticoagulation in atrial fibrillation. Despite the multitude of lessons I have learned from my co-residents, …

Physician voices

Why this physician doesn’t dress down when rounding on weekends

Suneel Dhand, MD

December 19, 2018Dec 19, 2018

I’ve always believed in looking the part as a physician. So much so that I even write about it! You may have read my piece that became widely circulated online, about why physicians should always dress to impress. The article generated quite a response, and I received a lot of interesting comments and emails. Of course, not all physicians are in a specialty where they can do …

Physician voices

How doctors can distinguish themselves in a data-driven world

Tara F. Bishop, MD, MPH

December 17, 2018Dec 17, 20183

When I was in medical school, I didn’t realize the potential data would have in health care. Back then I learned from 1000+ page hardcover textbooks and handwrote notes in paper medical records. Fast forward twenty years -- data and…

When I was in medical school, I didn’t realize the potential data would have in health care. Back then I learned from 1000+ page hardcover textbooks and handwrote notes in paper medical records.

Fast forward twenty years — data and analytics are at the forefront of health care. Other doctors and I now have electronic medical records in the majority of hospitals and medical offices; there are claims data warehouses, and …

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Medical education

Treating the patient’s body is not synonymous with treating the patient

Steven Zhang, MD

December 16, 2018Dec 16, 2018

We recently had a patient who arrived on our service in the intensive care unit after a complicated surgery. The surgery left him close to dying, and he was immediately put on life support and given heavy sedatives. Ventilators breathed…

Ventilators breathed for him. Special drugs kept his heart beating. A continuous pump acted as his kidneys, filtering out his body’s toxins and infusing the cleaned blood back into his veins anew.

He had …

Physician voices

The key to successful rounding

Robert Centor, MD

December 15, 2018Dec 15, 2018

A wonderful senior resident helped me understand the goal of rounding. Rounds should focus primarily on understanding the key problems and the diagnostic and therapeutic approaches to those problems. She suggested that some rounds spend too much time on “minutia” that the resident could handle, and not enough on understanding the big issues. According to her, rounds work best when we spend our time addressing the problems that the patient …

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The key to successful rounding

Medical education

The fight to save Howard University College of Medicine

Naveen Balakrishnan & Vicky Li

December 13, 2018Dec 13, 201810

Our country is at risk of losing an iconic institution that has played a pivotal role in the history of medical education. A school, which has produced some of the boldest pioneers in medicine, could lose accreditation upon the opening of a new hospital that will shunt away 40 percent of their current patients. Scores of our brightest potential medical students will be ripped away from the communities that desperately …

Conditions and diseases

The simplest treatment is sometimes the best

Naeem Rahman, MD

December 11, 2018Dec 11, 2018

“I am really uncomfortable and in pain,” said Elaine tearfully as I met her in the preoperative area for the first time. She had a very sad and difficult history, dealing with complications from childbirth nearly two years ago. She had developed a communication between her rectum and vagina, which allowed feces to come out vaginally. Despite multiple surgeries from reputable medical centers in NYC, the problem recurred. And she …

Health policy

The Wild West approach to PICU practice

Christopher Johnson, MD

December 10, 2018Dec 10, 20182

I spent my early and mid-career years working in a pediatric intensive care unit (PICU) at a large academic center. We did almost everything except for a few things esoteric at the time — small bowel transplants, a few kinds of experimental surgery. I’m now in my late career (but have no plans to quit anytime soon!) and work in a smaller PICU. I am frequently confronted with the issue …

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The Wild West approach to PICU practice

Physician voices

The millions of dollars hospitals spend for inspections

Steven Reznick, MD

December 10, 2018Dec 10, 201827

Two of my local hospitals just invested 3 to 4 million dollars in preparation for an inspection of the facilities by the Joint Commission. The cost of the inspection runs in the $10 million dollar range after the preparation costs. The inspection is a high-stress situation for the administration because if you fail, or lose your accreditation, the private insurers will void their contract with you and you won’t get …

Physician voices

3 common complaints patients have

Suneel Dhand, MD

December 7, 2018Dec 7, 20186

I enjoy talking to random people about their experiences with health care. As somebody who regularly travels all over the country, for both work and pleasure (I far prefer the latter), whenever I meet people in situations where you end up talking — be it on airplanes, a guided city tour, or at a social function — as soon as I say I’m a physician, the conversation invariably ends up …

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3 common complaints patients have

Physician voices

As doctors, our social capital is changing

Richard Plotzker, MD

December 5, 2018Dec 5, 201810

Retirement has gotten me edgy. Three months after departing, I had begun spending too much time horizontal, which I forced myself to remedy but then finding myself with nothing to do. Moreover, things have gotten more noticeably like Bowling Alone,…

Retirement has gotten me edgy. Three months after departing, I had begun spending too much time horizontal, which I forced myself to remedy but then finding myself with nothing to do.

Moreover, things have gotten more noticeably like Bowling Alone, an often-cited book by Robert Putnam published in 2000 that describes attrition of diverse communal activities over the previous 30 years. For physicians, our daily activities prevent us from working in …

Patient voices

Patients are not passengers

Christopher Noll, RN, MSN

December 5, 2018Dec 5, 20186

Health care safety efforts have long focused on improving the behavior of providers and improving the systems of care. A proven model of safety is in the airline industry. There are undoubtedly many parallels between airline safety and health care working toward common goals. This work should continue in both industries to ensure the safety of the people they serve.

The airline safety model, though, can only look at health care …

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Patients are not passengers

Physician voices

There’s no room for ego in health care

Suneel Dhand, MD

December 4, 2018Dec 4, 2018

I was recently seeing a rather complicated medical patient in the hospital. We were treating both a heart and kidney condition, and things were not going so well. To spare anyone non-medical who is reading this the scientific details of the bodily processes involved, we were essentially balancing hydrating, with the need to get rid of excess fluid. After seeing the patient, I spoke with the nurse, went over the …

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There’s no room for ego in health care

Physician voices

You must make a good first impression with patients

Andrea Lauffer, MD

December 4, 2018Dec 4, 2018

First impressions are critical. We are taught early in our careers that first impressions truly matter. Whether interviewing for medical school or a residency program, our goal is to make a positive first impression in hopes of making the cut…

These processes in our academic lives and careers are exhausting. As residencies and medical schools are becoming more competitive, the importance of first impressions …

Physician voices

Lead your health care organization toward a culture of sustainability

Isaac L. Wornom, MD

November 28, 2018Nov 28, 2018

On a recent vacation, I went out to eat at a small, out-of-the-way restaurant we always visit on our trips to the Outer Banks. There, I spotted a poster on the wall explaining why the cafe no longer uses plastic…

On a recent vacation, I went out to eat at a small, out-of-the-way restaurant we always visit on our trips to the Outer Banks.

There, I spotted a poster on the wall explaining why the cafe no longer uses plastic bags or plastic straws: to keep the material out of the ocean where it never really goes away.

Plastic bags, straws, eating utensils, plates, bowls, and cups are everywhere in hospitals these …

Physician voices

Advice from a “xennial” physician to aspiring physicians

Andrea Lauffer, MD

November 27, 2018Nov 27, 20184

I am considered a “xennial” physician. Not quite a millennial — but also not fitting into the generation of the respected preceptors I had in medical school and residency. I took my MCAT via paper and pencil. My mini boards during my clinical rotations were on paper and pencil. All of my licensing and board exams were computerized.

It was not an option to sit at home and log on to …

Medical education

A medical student as a patient. She thanks her support systems.

Natasha Abadilla

November 26, 2018Nov 26, 2018

Two weeks ago, while I was helping with an emergency medicine course that I’m a teaching assistant for, I started feeling extremely light-headed, and the chest tightness that I had dismissed as heartburn earlier that morning got worse. I was tended to by the emergency medicine doctor who I was teaching with, admitted to the ED with a resting pulse rate of 130 beats per minute, later admitted to the …

Health policy

Medicine: noble profession or big business?

David A. Guss, MD

November 24, 2018Nov 24, 201814

In 1976 I graduated from medical school and proudly joined the medical profession. Thirty-seven years later, I retired as an employee of the biggest business in the country. In 2016 the medical industry was responsible for 3.3 trillion dollars of expenditure, comprising 18 percent of the United States GDP. For perspective, there are only four countries with a GDP more than the amount spent on health care in the United …

Physician voices

The evolution of residents’ hours

Kevin Tolliver, MD, MBA

November 23, 2018Nov 23, 20185

It was the 24th hour of my call shift, and I was running on fumes. Despite my weariness, I could see the first rays of morning sunlight coming through the window in my patient’s room. It was then I knew I could make it to hour 30 (quitting time). It was grueling to keep going, but hitting the 30-hour mark only required me to keep my head down and do …

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The evolution of residents’ hours

Physician voices

3 reasons why we should care about the health care experience

Suneel Dhand, MD

November 21, 2018Nov 21, 20184

The health care experience is so much more than a buzzword to be talked about in administrative circles. Some physicians I encounter (a minority, but still enough) really scoff when they hear this term. Responses I’ve heard from doctors include: “Hospitals are not hotels!” or “If that means giving our patients as much Dilaudid as they want, then count me out!”

Aside from these sweeping statements being entirely silly, they are …

Hospital medicine

Articles, page 46

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