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Hospital medicine

5,188 articles · Since 2004

Articles, page 76

Physician voices

How hospital executives wish their hospitalists would act

3

Recently, I wrote a letter to hospital executives, urging them to deliberately invest their own personal time and effort in fostering hospitalist well-being. I suggested several actions that leaders can take to enhance hospitalist job satisfaction and reduce the risk…

Recently, I wrote a letter to hospital executives, urging them to deliberately invest their own personal time and effort in fostering hospitalist well-being. I suggested several actions that leaders can take to enhance hospitalist job satisfaction and reduce the risk of burnout and turnover. Following the publication of that post, I heard from several hospital executives and was pleasantly surprised that they all responded positively to my message. Several execs …

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How hospital executives wish their hospitalists would act

Physician voices

What the Oscars can teach us about patient safety

Recently, one of the biggest mistakes ever observed on live television occurred when Warren Beatty and Faye Dunaway, presenters of the award, announced the wrong film as winner of the Academy Award for best picture. Not since Janet Jackson's costume…

Recently, one of the biggest mistakes ever observed on live television occurred when Warren Beatty and Faye Dunaway, presenters of the award, announced the wrong film as winner of the Academy Award for best picture.  Not since Janet Jackson’s costume malfunction has, live television caused such uproar.

How could this have happened?  How could it have been prevented?  Moreover, what can this error teach us about how we care for patients?

A …

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What the Oscars can teach us about patient safety

Physician voices

The great unspoken secret

2

Sometimes it feels like the great unspoken secret between doctors and nurses. The words that we dare not utter to patients and families. Perhaps it is our hope that we're wrong. Perhaps, we dread providing unwanted news. Perhaps, we don't…

Sometimes it feels like the great unspoken secret between doctors and nurses. The words that we dare not utter to patients and families. Perhaps it is our hope that we’re wrong. Perhaps, we dread providing unwanted news. Perhaps, we don’t want to face reality or extinguish our patients’ hope.

As a daughter, I felt that sense of sadness and dread, waiting to hear the news that would not be told. It was September …

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The great unspoken secret

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Medical education

The secret horrors of sleep-deprived doctors

117

Recently, the ACGME (Accreditation Council for Graduate Medical Education) made the reckless decision to increase work hours to 28-hour shifts for new doctors. Here are the catastrophic consequences of their decision. Here are actual quotes from physicians (de-identified with some…

Recently, the ACGME (Accreditation Council for Graduate Medical Education) made the reckless decision to increase work hours to 28-hour shifts for new doctors. Here are the catastrophic consequences of their decision. Here are actual quotes from physicians (de-identified with some patient details changed to protect confidentiality):

“I did my internship in internal medicine and residency in neurology before laws existed to regulate …

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The secret horrors of sleep-deprived doctors

Physician voices

Here’s how and why patients lose in our current system

2

It would never have gone down this way ten years ago when length of stay was all the buzz. The CT scan would have been done in the emergency department, and the patient would either have been discharged or admitted…

It would never have gone down this way ten years ago when length of stay was all the buzz. The CT scan would have been done in the emergency department, and the patient would either have been discharged or admitted for a quick observation stay. Bing, bang, boom. One, two, three.

Instead, the CT was pushed until morning. A resident saw the patient at midnight and then not a single practitioner …

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Here’s how and why patients lose in our current system

Physician voices

The top 3 questions hospital administrators ask

2

A few years ago, I was in a position where I was quickly going down the route of hospital administration. I thought it was interesting at first, but realized it wasn’t quite my cup of tea, at least in the…

A few years ago, I was in a position where I was quickly going down the route of hospital administration. I thought it was interesting at first, but realized it wasn’t quite my cup of tea, at least in the circumstances that I was exposed to. What I didn’t like about it was the feeling that I was losing touch with the front lines. And wherever my career takes me, …

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The top 3 questions hospital administrators ask

Physician voices

How religion influences the doctor-patient relationship

It was my turn to be on call during Christmas. I held the long list of patients signed out to me, and began my rounds early that morning in the hopes that I could be home in time to open…

It was my turn to be on call during Christmas. I held the long list of patients signed out to me, and began my rounds early that morning in the hopes that I could be home in time to open presents with my family that evening.

I went from room to room on the surgical floor, talking to patients. I knocked on one door and pushed it open. A white male …

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How religion influences the doctor-patient relationship

Physician voices

What’s the fix for the care disparity in corporate-owned health care?

2

“We must not allow a mineshaft gap!” famously spoken by George C. Scott as General Turgidson in Dr. Strangelove as the post-nuclear holocaust planning begins in earnest. For some reason, this quote goes through my mind as I sit through…

“We must not allow a mineshaft gap!” famously spoken by George C. Scott as General Turgidson in Dr. Strangelove as the post-nuclear holocaust planning begins in earnest. For some reason, this quote goes through my mind as I sit through meetings, assemblages and retreats that talk about the future state of medicine in a large gobble-gobble network that has aspirations to provide population health as an Accountable Care Organization to …

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What’s the fix for the care disparity in corporate-owned health care?

Physician voices

The importance of being present

An excerpt from Attending: Medicine, Mindfulness and Humanity. Sometimes a simple gesture and a few well-placed words can signal presence. One day on rounds in the hospital, as we walked into the room, Laura Hogan, a nurse-practitioner on our palliative…

An excerpt from Attending: Medicine, Mindfulness and Humanity.

Sometimes a simple gesture and a few well-placed words can signal presence. One day on rounds in the hospital, as we walked into the room, Laura Hogan, a nurse-practitioner on our palliative care team, said three words to the patient: “What beautiful flowers.” The patient looked at the flowers and smiled. The previous day the patient had had a biopsy …

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The importance of being present

Patient voices

How to ease your transition home from the hospital

A hospital stay is a right of passage for any patient, but the road to health is often a marathon and not a sprint. Discharge is an essential step in the patient journey, but it can be as exciting for…

A hospital stay is a right of passage for any patient, but the road to health is often a marathon and not a sprint. Discharge is an essential step in the patient journey, but it can be as exciting for a family as it is daunting. Families can prepare ahead and put all the right pieces in place in order for a “soft landing” home. Here are some of our …

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How to ease your transition home from the hospital

Physician voices

Place emotional harms on par with physical ones

8

Why would a well-respected, venerable health care organization adopt a soft and squishy approach -- tracking disrespect and other forms of emotional harm -- to monitor its performance? In 2007, Beth Israel Deaconess Medical Center (BIDMC), a 672-bed health system…

Why would a well-respected, venerable health care organization adopt a soft and squishy approach — tracking disrespect and other forms of emotional harm — to monitor its performance?

In 2007, Beth Israel Deaconess Medical Center (BIDMC), a 672-bed health system affiliated with Harvard Medical School, adopted the audacious aim of eliminating all preventable harm by January 1, 2012. According to Kenneth Sands, MD, chief quality officer of BIDMC, the organization has …

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Place emotional harms on par with physical ones

Physician voices

A victim of sexual harassment as a medical student

10

When I was a third-year medical student, I was a victim of sexual harassment. I had a patient (I no longer remember his name, so let's call him Mr. X) who was in his eighties and I had to do…

When I was a third-year medical student, I was a victim of sexual harassment.

I had a patient (I no longer remember his name, so let’s call him Mr. X) who was in his eighties and I had to do a rectal exam on him. I had been on the team taking care of Mr. X for a while, and I was fine doing the rectal exam and checking for blood …

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A victim of sexual harassment as a medical student

Physician voices

Making medical decisions without accountability 

9

A pediatrician decides a struggling teen with mental illness needs hospitalization to neutralize psychologic demons impacting their personal and social life. A workers’ compensation doctor requests a neck MRI in a powerline worker with growing right arm numbness and weakness…

A pediatrician decides a struggling teen with mental illness needs hospitalization to neutralize psychologic demons impacting their personal and social life.

A workers’ compensation doctor requests a neck MRI in a powerline worker with growing right arm numbness and weakness to search for potential paralyzing nerve impingement.

An orthopedist orders special testing to determine if an elder patient with right hip pain which limits walking and driving might need surgery to improve …

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Making medical decisions without accountability 

Physician voices

We need to start talking about what comes after physician burnout

21

I burned out, big and bad. I can see that now. My practice environment had become gradually untenable and every attempt I made to change it was blocked. My call schedule was inflexible and a lot more frequent than when…

I burned out, big and bad.  I can see that now.  My practice environment had become gradually untenable and every attempt I made to change it was blocked.  My call schedule was inflexible and a lot more frequent than when I started my job.  The hospitalists and ED kept sending me cases I didn’t feel qualified to manage, but as it was usually the middle of the night and I …

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We need to start talking about what comes after physician burnout

Medical education

Your doctors may be lying about how long they worked today

7

America’s resident physicians have strict limits on how many hours they can work in the hospital. Many break that limit and keep quiet about it. Others lie. Resident physicians are the doctors-in-training that millions of Americans come into contact with…

STAT_LogoAmerica’s resident physicians have strict limits on how many hours they can work in the hospital. Many break that limit and keep quiet about it. Others lie.

Resident physicians are the doctors-in-training that millions of Americans come into contact with at teaching hospitals across the country. We work for three to seven years (it depends on the medical specialty) …

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Your doctors may be lying about how long they worked today

Physician voices

Be careful of the labels we assign our patients

Reducing the essence of a human being to a single sentence is impossible, but in taking care of patients, we doctors do it all the time The one-liner attempts to summarize an individual and an illness into a single, typically…

Reducing the essence of a human being to a single sentence is impossible, but in taking care of patients, we doctors do it all the time

The one-liner attempts to summarize an individual and an illness into a single, typically run-on, sentence to expedite communication.  It is a thesis statement for your diagnosis. Word choice and omission are critical.  By the end of this thesis statement, your audience, in spite of …

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Be careful of the labels we assign our patients

Physician voices

A specter from the implementation and demise of the ACA

2

Danny rarely came to the clinic. He paid a sliding scale fee for the visit but this, in addition to the money he paid for his medicines, was already too much for him to afford. Now, in early November 2013,…

Danny rarely came to the clinic. He paid a sliding scale fee for the visit but this, in addition to the money he paid for his medicines, was already too much for him to afford. Now, in early November 2013, he had become concerned.

Danny had previously owned a jewelry boutique with his wife, Jacky. She made her own pieces and sold them in the store. Over time, the economy had …

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A specter from the implementation and demise of the ACA

Medical education

How to navigate the language barrier with patients

2

William Osler once said, “Listen to your patient; he is telling you the diagnosis.” Anybody who practices medicine knows that is easier said than done. The ability to take a skillful history takes years to develop. There are many nuances…

William Osler once said, “Listen to your patient; he is telling you the diagnosis.”  Anybody who practices medicine knows that is easier said than done. The ability to take a skillful history takes years to develop. There are many nuances in a medical history and physicians must know the right questions to ask. The next step is to avoid asking the wrong questions and the wrong wording of the right …

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How to navigate the language barrier with patients

Physician voices

Family visits: No one ever regrets coming too soon

3

Startled out of sleep, I reflexively reach for my beeping pager. For a split second, I lie poised between wakefulness and terror in the pitch-dark resident call room, not sure where I am or what happened. I resolve to sleep…

Startled out of sleep, I reflexively reach for my beeping pager. For a split second, I lie poised between wakefulness and terror in the pitch-dark resident call room, not sure where I am or what happened. I resolve to sleep with the lights on from now on.

I dial the call-back number.

“Pod A,” a caffeinated voice chirps. It’s Candice, one of the nurses.

“Hi. Amy here, returning a page,” I murmur.

“Oh hi, …

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Family visits: No one ever regrets coming too soon

Physician voices

Hospital color codes, and what they mean

Hospitals have lots of codes. The most famous one is Code Blue (medical emergency), but it turns out there are lots of color-based codes. This can be confusing, as the connection between the code colors and the situations they represent…

Hospitals have lots of codes. The most famous one is Code Blue (medical emergency), but it turns out there are lots of color-based codes. This can be confusing, as the connection between the code colors and the situations they represent are usually tenuous at best. Today we explore all of the types of codes, and shed some light these arcane medical euphemisms.

Code Blue

What it sounds like it means: Aggressively-scented cologne from Armani.

What it actually means: …

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Hospital color codes, and what they mean

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