Hospital medicine

5,188 articles · Since 2004

Articles, page 75

Being superhuman in the most human circumstance

May 14, 2017May 14, 2017

As we enter into the hospital each day, our goal is giving patients the best care we can provide. We get a list of patients that we will take care of each day, and as we get that list, we…

As we enter into the hospital each day, our goal is giving patients the best care we can provide. We get a list of patients that we will take care of each day, and as we get that list, we start thinking about what we should monitor in terms of their physical exam, lab results, and vital signs to ensure that their hospital course runs smoothly for the day. However, …

Physician voices

8 traits of excellent hospital doctors

Molly Harrod, PhD & Sanjay Saint, MD

May 11, 2017May 11, 2017

A good relationship between a patient and his or her physician is the cornerstone of superb medical care. That relationship is important when you know the doctor well. It may be even more important when you don’t, say when you…

Growing competition for new customers is inspiring American hospitals to focus on providing

…

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8 traits of excellent hospital doctors

Physician voices

Nurses make me a better doctor

Neha Sharma, DO

May 11, 2017May 11, 2017

It was a case that every physician dreads. I took a deep breath, mustered up some courage and walked towards my patient’s room. When I entered, I saw an apprehensive and anxious family who was patiently waiting for some answers. The mother was sitting at bedside with eyes closed, hands clung to a rosary and lips whispering a prayer. The patient’s sister was standing by the window, looking out with …

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Nurses make me a better doctor

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Health policy

The Joint Commission surveys matter more than we think

Tracy Cardin, ACNP

May 9, 2017May 9, 20173

Recently, the online version of JAMA published an original investigation entitled "Patient Mortality During Unannounced Accreditation Surveys at US Hospitals." The purpose of this investigation was to determine the effect of heightened vigilance during unannounced accreditation surveys on safety and…

Recently, the online version of JAMA published an original investigation entitled “Patient Mortality During Unannounced Accreditation Surveys at US Hospitals.” The purpose of this investigation was to determine the effect of heightened vigilance during unannounced accreditation surveys on safety and quality of inpatient care. The authors found that there was a significant reduction in mortality in patients admitted during the week of surveys by The Joint Commission. The change was …

Health policy

Are nonprofit hospitals a fairy tale?

Niran S. Al-Agba, MD

May 8, 2017May 8, 201725

Nonprofit hospitals have higher profit margins than most for-profit hospitals after accounting for their tax obligations. 3900 (62 percent) of U.S. Hospitals are nonprofit and therefore tax-exempt — they pay no property tax, no federal or state income tax and no sales tax. An article published in Health Affairs found seven of the nation’s 10 most profitable hospitals were of the nonprofit variety, each earning …

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Are nonprofit hospitals a fairy tale?

Physician finance

Other jobs have strict rules on hours worked. So should doctors.

Cory Fawcett, MD

May 3, 2017May 3, 201711

There has been much talk over the years about resident work hours. How long is a safe shift? With safety being considered for both the patient and the resident. But no one ever discusses attending work hours. If putting in a 24-hour shift is bad for a resident, isn’t it bad for an attending as well? When I was working in critical access hospitals, I usually was on call for …

Health policy

Facility fees are ruining quality care

Niran S. Al-Agba, MD

May 1, 2017May 1, 20175

The Affordable Care Act Medicaid expansion resulted in unanticipated negative consequences for many patients and physicians in rural, underserved or medically isolated communities across America. Consolidation of health care entities was financially incentivized by the ACA, and slowly my beloved…

In a beautiful community on the Olympic Peninsula, just north of where I live and practice, it happened again; another private …

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Facility fees are ruining quality care

Physician voices

A patient thought she knew who the real doctor was. She was wrong.

Dana Corriel, MD

April 30, 2017Apr 30, 20174

The setting: an inpatient unit in the Bronx, circa 2005. I was a resident (and hence was likely disheveled, groggy or exhibiting some other outward display of exhaustion) of the internal medicine program at Albert Einstein University Medical Center/Moses Division,…

The setting: an inpatient unit in the Bronx, circa 2005.

I was a resident (and hence was likely disheveled, groggy or exhibiting some other outward display of exhaustion) of the internal medicine program at Albert Einstein University Medical Center/Moses Division, aka Montefiore. The fact that the program was considered “malignant” by those in my industry — mainly due to the strict nature of the training program — likely strengthens the possibility …

Physician voices

The fundamental cause of surprise medical bills and how to fix it

Ezriel Edward Kornel, MD

April 17, 2017Apr 17, 20173

It’s no secret that health care is an unbelievably complex subject. One of the most complex issues facing the health care system is that of surprise medical bills. Surprise medical bills happen when: Patients receive emergency care by an out-of-network…

Patients receive emergency care by an out-of-network provider (one not included in their insurance plan);
Patients are unaware that one or more of the providers of their non-emergent care were out-of-network; and
Patients choose out-of-network care without

…

Physician voices

8 secrets to landing a locum tenens job

Brandy Collier-Pearson

April 16, 2017Apr 16, 2017

In the market for a locum tenens position? If you search online "How to book a locum assignment?" you'll likely find vague advice such as "Develop a relationship with a recruiter." Or "Do your homework when choosing an agency." Thanks,…

In the market for a locum tenens position? If you search online “How to book a locum assignment?” you’ll likely find vague advice such as “Develop a relationship with a recruiter.” Or “Do your homework when choosing an agency.” Thanks, Internet …

Having worked as a locum tenens recruiter for over 15 years, I have seen consistent trends in how the best clinicians are able to stand out and book jobs. …

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8 secrets to landing a locum tenens job

Physician voices

Please call me doctor: In defense of feminist medicine

Jenna T. Nakagawa, MD, MPH

April 14, 2017Apr 14, 20172

One stunning afternoon I walked into a patient’s room to discuss our plan, informing her that the nurse would come to draw blood. “You can draw my blood, Miss,” said the male family member sitting in a corner of the…

One stunning afternoon I walked into a patient’s room to discuss our plan, informing her that the nurse would come to draw blood.

“You can draw my blood, Miss,” said the male family member sitting in a corner of the room, as far from the patient as possible, his legs crossed, smirking, “We can go into the next room and lock the door.”

His smug grin brought back memories of older men …

Health policy

Hospital mergers don’t work

Niran S. Al-Agba, MD

April 14, 2017Apr 14, 201716

There is a growing body of evidence that hospital mergers lead to higher prices for consumers, employers, insurance and the government. It is imperative to educate patients and lawmakers as to how the consolidation of hospitals and medical practices raise costs, decrease access, eliminate jobs and, ultimately, reduce care quality as a result. Lawmakers should focus on this “first pillar” of cost control as they go back to the drawing …

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Hospital mergers don’t work

Conditions and diseases

What are the best uses of rehabilitation medicine in patients with cancer?

Val Jones, MD

April 5, 2017Apr 5, 2017

Rehabilitation medicine is one of the best-kept secrets in health care. Although the specialty is as old as America’s Civil War, few people are familiar with its history and purpose. Born out of compassion for wounded soldiers in desperate need of societal re-entry and meaningful employment, “physical reconstruction” programs were developed to provide everything from adaptive equipment to family training, labor alternatives and psychological support for veterans.

Physical medicine and rehabilitation …

Physician voices

What on call used to mean

Hans Duvefelt, MD

March 28, 2017Mar 28, 2017

“I was surprised when the emergency doctor at Cityside Hospital said he was going to call you to discuss my case," Farmer Carr said when I saw him today. “I figured you’d be asleep at that hour.” I smiled as…

“I was surprised when the emergency doctor at Cityside Hospital said he was going to call you to discuss my case,” Farmer Carr said when I saw him today. “I figured you’d be asleep at that hour.”

I smiled as I recalled the cell phone call that had come in at 9:30 the night I had sent him back to the hospital for a reassessment.

“No, I was sitting in my camping …

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What on call used to mean

Physician voices

How peer-to-peer review helps hospitals

Peter Pronovost, MD, PhD

March 25, 2017Mar 25, 2017

The moment that an accreditation team shows up unannounced can spike the pulse of even the most seasoned hospital executive. The next several days will amount to one big exam for the safety and quality of care, as surveyors meet with executives, managers and care teams, and watch first-hand as care is delivered. Make the wrong move or give a wrong answer, have them see rust on a ceiling sprinkler, …

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How peer-to-peer review helps hospitals

Physician voices

A tribute to the pharmacist

Taison Bell, MD

March 24, 2017Mar 24, 201720

Dear pharmacist, You just paged me and, I must admit, I’m not feeling excited to call back. I estimate that I probably get paged, called, texted or stopped in person by you exactly X·102 per day, where “X” is the…

Dear pharmacist,

You just paged me and, I must admit, I’m not feeling excited to call back. I estimate that I probably get paged, called, texted or stopped in person by you exactly X·102 per day, where “X” is the number of days I’ve been on service. Despite all of the interactions over the years, I have never stopped to really consider our relationship. Here are a few of our most …

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A tribute to the pharmacist

Physician voices

Death is a blessing in its right time and place

Uzma Khan, MD

March 24, 2017Mar 24, 20172

I am working hospitalist right now. On Friday, a man in his 80s was admitted with difficulty breathing. He had a complicated history, including a heart attack at age 35 with all the subsequent sequela of heart disease. He had an abnormal heart rhythm and was taking a blood thinner for stroke prevention. In addition, he had scarring of his lungs (cause unknown).

He was transferred to us from another hospital. …

Physician voices

In the hospital? Here are 7 things you must keep in mind.

Suneel Dhand, MD

March 22, 2017Mar 22, 20175

Being in a hospital is a scary and frightening time, and it’s easy for those of us at the frontlines — doctors and nurses — to forget that as we go about our busy work days. Patients are at a very low point in their lives and will remember everything about their hospital stay, including all their interactions, for a very long time.

As someone with a keen interest in improving …

Physician voices

Hospitals should quit alienating pregnant health care consumers

Poppy Daniels, MD

March 21, 2017Mar 21, 20177

When Barbara (name changed) recently underwent her fourth Cesarean section, she was appalled by the care she received during her recovery. Her catheter overflowed, and a CNA asked her to check her own incision. When the CNA asked if she was breastfeeding her baby, Barbara replied tearfully that she couldn’t lift her out the bassinette. Rooming-in is a great idea. Unless you’ve had a 36-hour labor or major abdominal surgery.

Pregnant …

Physician voices

Will telemedicine take your job?

#LifeofaMedStudent

March 18, 2017Mar 18, 20172

Telemedicine is often in the news and until recently I had only casually glossed over the latest articles. The details I paid little attention to, but the headlines I would remember. “Great for rural areas” I would read! “Extend physician…

As a nearly graduated anesthesia resident in a large city with an abundance of doctors, I didn’t think telemedicine would have …

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Will telemedicine take your job?

Hospital medicine

Articles, page 75

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