Hospital-Based Medicine
Creating a subspecialty track for experienced hospitalists
A formal clinical track should allow experienced hospitalists to function as inpatient subspecialists: a so-called “focused practice in inpatient subspecialty.” This proposal makes sense on multiple levels.
First, there is a shortage of inpatient subspecialists, particularly in small community settings. Hospitalists, qualified and certified as inpatient subspecialists, could fill this gap.
Second, the practice of hospital medicine is an ideal launching pad for a focused practice in an inpatient subspecialty. Hospitalists are …
Not all healers wear scrubs or lab coats: Paying homage to our modern-day Santa Claus
Terminology has changed over the years.
When I was in training (1996-2000), we were called physicians. Nurses were called nurses. Nurse practitioners (NPs) were called nurse practitioners. Physician assistants (PAs) were called physician assistants. Patient care assistants (PCAs) were called patient care assistants. And the suits were just that … the suits. They kept the lights on and the doors open. They didn’t provide any direct …
Photography made me a better doctor [PODCAST]
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Join us for an insightful discussion with Moksha Patel, an internal medicine physician, as we explore the fascinating parallels between clinical reasoning and photography. Moksha shares how principles like focus, zoom, and flash …
Catholic hospitals in America [PODCAST]
A mother’s harrowing hospital experience
An excerpt from NERVE: Surviving Medical Madness.
“There are moments which mark your life. Moments when you realize nothing will ever be the same and time is divided into two parts, before this and after this.”
— N. Kazan
It was a peaceful, uneventful drive—until it wasn’t. My husband and I flipped to the local news radio station and heard them discussing an extreme weather event just as we looked straight ahead …
Innovation doesn’t have to be flashy to make a big impact
Labor shortages have become a pressing concern across the health care sector, with the nurse staffing crisis looming large over hospitals and health systems nationwide.
A report from the Massachusetts Health Policy Commission illuminated the severity of the workforce challenges, revealing a doubling of vacancy rates for registered nurses in the state’s hospitals from 2019 to 2022. Despite concerted efforts, the problem persists, with health systems still resorting to costly pandemic …
Improving maternal health with integrated technology and coordinated decision-making
The U.S. infant mortality rate, children who die under one year of age, rose to its highest rate in two decades in 2022, up about 3 percent to 5.6 infant deaths per 1,000 live births.
At the same time, the nation’s neonatal mortality rate, infants who die in less than 28 days, increased by 3 percent from 3.49 to 3.58, and the post-neonatal mortality rate, infants who die between 28 days …
The voice that saved lives: a doctor’s pandemic hero
I would not recognize her if she crossed before me on the street. I could not pick her out in a staff photo of her and her colleagues. I do not know the color of her hair or skin; I could not even guess if she is short or tall. But her voice—I know her voice. I could recognize that voice anywhere.
I first met Julie sometime before the COVID pandemic, …
The curse of the excellent doctor
The reward for good work is always more work. The employer becomes dependent on the quality of work that you do because he knows that you, as a person, are a workaholic and perfectionist. You put your heart and soul into everything you do. No other employers can do the kind of work that you do. But don’t ever think that you would be appreciated for your hard work. You …
Hospital retaliation and my fight for patient rights
I found myself compelled into the complex world of health care advocacy under extraordinary circumstances last year when I went to my university administration to request a table to do a free speech petition because of a personal and troubling experience. My mother, a respected pediatric intensive care doctor, had been abruptly terminated from her workplace after she raised concerns about patient safety.
Throughout my studies as an undergraduate, I frequently …
Sepsis protocols coupled with rapid host response technologies are the key to improving patient outcomes
Patients come into the emergency department (ED) with symptoms, not diagnoses. That’s when time is of the essence. Clinicians must quickly triage patients and establish an appropriate care pathway to obtain the best possible outcome. Most patients entering the ED are time-sensitive, requiring clear protocols for care. However, even some of the deadliest conditions still lack the necessary data, tools, and standards to quickly diagnose and effectively treat patients.
Over the …
How to face our mistakes: Using the military’s after-action review to improve morbidity and mortality conferences
Nearly three decades ago, David Hilfiker, a family medicine physician in rural Minnesota, authored an essay in the New England Journal of Medicine titled “Facing our mistakes.” In the piece, he chronicles three major medical mistakes he made during his long career practicing medicine. Some of the mistakes are horrifying and others simply tragic, but he is brutally honest and forthcoming—displaying a frank self-reflection that is too frequently absent …
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From intern to witness: Working in a resource-limited health care system
A little anecdote
The year was 2022, and it marked the first month of my initial rotation at one of the largest tertiary care hospitals in Punjab, Pakistan. After having assisted with several procedures in the ENT operating room one morning, I found myself on call for the next 18 hours in the emergency department as the new intern.
As soon as the shift changed, a young boy landed in the ED …
Inside the heart of a hospital: love, loss, and resilience
“Airports have seen more sincere kisses than wedding halls and the walls of hospitals have heard more prayers than the walls of churches.” – Anonymous
It’s 1 a.m. in the night. I am on call duty, which starts at 8:30 a.m. in the morning and ends at 10 a.m. the next day. I finished entering the labs and doing my final tasks at approximately 12:30 a.m. Then I ordered some food …
Sham peer review epidemic: A doctor’s career destroyed
An excerpt from The Medical Matrix: One Physician’s Story Maneuvering the Minefields of Medicine.
It was a routine Monday morning in the middle of May 2011. I had custody of my boys that day, so I dropped them off at school and headed to work.
As soon as I got to work I received a phone call from the vice CEO of the hospital. Maria (name changed) was a short woman …
Discover the physician who made a village his family
I finished my residency training on June 30th, 2000, in a combined internal medicine and pediatrics residency program at Ohio State University and Columbus Children’s Hospital (before it was renamed Nationwide Children’s Hospital). One month later, I was slated to begin my first “adult” job as I joined a private family medicine practice in Southern Ohio – practicing traditional medicine (outpatient and inpatient care). There were no hospitalists back then …
Surviving my nephrectomy nightmare: the night I’ll never forget
My first post-op night after my nephrectomy was a mix of fantastical and almost devastating.
I woke up in the PACU after my surgery, extremely confused and disoriented. I felt like I was trapped inside a video game, desperately trying to escape.
Upon entering my new post-op room on a medical-surgical unit, it had that brand-new, hotel-like decor – shiny and pristine. The nurses, techs, and NPs greeted me with words of …
Clinicians and management at odds in health care
In a survey conducted by a University of Pennsylvania School of Nursing team led by Linda Aiken, PhD, RN, of 21,050 physicians and nurses at 60 hospitals, it was found that more than 40 percent of clinicians were not confident that hospital management would act to resolve problems that clinicians identify in patient care. Close to one-third of clinicians said their values were not aligned with those of their hospital’s …
How religious freedoms impact patient care
An excerpt from The Catholic Church and Its Hospitals: A Marriage Made in Heaven?
The ability of Catholic hospitals and physicians to withhold some medically accepted care from patients based on their own religious and moral beliefs is made possible by numerous protections of religious freedoms. However, patients look to their …
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Past Week
-
My wife’s story: How DEA and CDC guidelines destroyed our golden years
-
The hidden costs of the physician non-clinical career transition
-
The gastroenterologist shortage: Why supply is falling behind demand
-
Health care as a human right vs. commodity: Resolving the paradox
-
Why private equity is betting on employer DPC over retail
-
Why voicemail in outpatient care is failing patients and staff
-
Past 6 Months
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Physician on-call compensation: the unpaid labor driving burnout
-
How environmental justice and health disparities connect to climate change
-
Will AI replace primary care physicians?
-
A physician father on the Dobbs decision and reproductive rights
-
What is the minority tax in medicine?
-
Why the U.S. health care system is failing patients and physicians
-
Recent Posts
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When diagnosis becomes closure: the harm of stopping too soon
-
Celiac disease psychiatric symptoms: When anxiety is autoimmune
-
Prostate cancer screening limitations: Why PSA isn’t enough
-
From flight surgeon to investor: a doctor’s guide to financial freedom
-
Why perimenopause feels like losing yourself
-
The surgical safety checklist: Why silence is the real enemy
-
