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Hospital medicine

5,188 articles · Since 2004

Articles, page 83

Medical education

The stories of my medical school mentors

Popular shows like Gray’s Anatomy, ER, and House, MD have given the television watching public a good eyeful when it comes to the inner workings of medicine, hospitals, and emergency rooms. They have also shown us how the personalities of…

Popular shows like Gray’s Anatomy, ER, and House, MD have given the television watching public a good eyeful when it comes to the inner workings of medicine, hospitals, and emergency rooms. They have also shown us how the personalities of those who take up the stethoscope and reflex hammer run the gamut from the sweet, demure, tentative types to the sons of bitches who cut first and ask questions later.

I …

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The stories of my medical school mentors

Health policy

What John Stossel gets right, and wrong, about health care

15

I was saddened to hear that one of my favorite libertarians, the wonderful journalist John Stossel, has taken ill. True to form, however, he's taking it in stride (he nonchalantly quipped, "seems I have lung cancer"), and I want to…

I was saddened to hear that one of my favorite libertarians, the wonderful journalist John Stossel, has taken ill. True to form, however, he’s taking it in stride (he nonchalantly quipped, “seems I have lung cancer”), and I want to take this opportunity to wish him very well indeed. I enjoy his reporting and writing, and have learned a great deal from Mr. Stossel over the years.

But that doesn’t mean he’s always …

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What John Stossel gets right, and wrong, about health care

Physician voices

The time a 28-year-old MBA told a physician where to round first

132

The last couple of decades have seen a dramatic shift of power and clout away from individual physicians and towards administrators and the business side of health care. In many ways, physicians have nobody but themselves to blame collectively; because…

The last couple of decades have seen a dramatic shift of power and clout away from individual physicians and towards administrators and the business side of health care. In many ways, physicians have nobody but themselves to blame collectively; because for any large and respected group of people to surrender so much autonomy so quickly, a lack of strong leadership must always be a factor.

So many different reasons for this …

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The time a 28-year-old MBA told a physician where to round first

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Physician voices

Stories influence how I practice medicine. Here’s how.

3

My father was killed by an Islamic fundamentalist in Cairo, Egypt when he was just 47 years old. It was October 1993, exactly eight months following the first World Trade Center bombing. Terrorism was still a new word -- and…

My father was killed by an Islamic fundamentalist in Cairo, Egypt when he was just 47 years old.  It was October 1993, exactly eight months following the first World Trade Center bombing.  Terrorism was still a new word — and a new concept — to many Americans, and so my father’s death was featured prominently on the evening news and in the New York Times.

For over 22 years, this has …

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Stories influence how I practice medicine. Here’s how.

Physician voices

Should white coats be only worn by physicians?

43

Maybe it’s just me, and maybe this is a regional/local phenomenon, but I have noticed a sharp increase in the number of non-physicians who sport their white coats on a daily basis around the hospital. First, let me preface this…

Maybe it’s just me, and maybe this is a regional/local phenomenon, but I have noticed a sharp increase in the number of non-physicians who sport their white coats on a daily basis around the hospital.

First, let me preface this piece by saying I have absolutely nothing against any person who partakes in the care of patients; in fact, I commend all the helping hands that routinely dedicate themselves to health …

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Should white coats be only worn by physicians?

Physician voices

What would a patient’s dream doctor look like?

11

The practice of medicine has changed dramatically over the last couple of decades, with many of the changes unfortunately not so good for patients. It’s a well-known feeling among health care professionals, that among all the new elements of bureaucracy…

The practice of medicine has changed dramatically over the last couple of decades, with many of the changes unfortunately not so good for patients. It’s a well-known feeling among health care professionals, that among all the new elements of bureaucracy and information technology requirements and mandates, the one person who is often completely forgotten about is the patient. As someone who has worked up and down the east coast in …

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What would a patient’s dream doctor look like?

Physician voices

This is what true patient care is about

2

Heart of summer. Early August. All of Holland is on holiday. We are sitting in the flesh-colored morning light, in his back room, stuffed away behind the nurses’ station. He is sick as hell and just 32. I am sitting…

Heart of summer. Early August. All of Holland is on holiday. We are sitting in the flesh-colored morning light, in his back room, stuffed away behind the nurses’ station.

He is sick as hell and just 32. I am sitting next to his mother and his girlfriend. The intern and nurse are standing behind me, breathing carefully. He sits with his back to us, at his table. Visibly fighting for air. …

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This is what true patient care is about

Physician voices

Why Leapfrog stands behind Harlem Hospital

7

Despite the opinions expressed in column, "Here’s why you can’t believe 'top hospitals' lists," Harlem Hospital richly deserved the 2015 Top Hospital distinction it earned from our nonprofit, The Leapfrog Group. Our Top Hospitals committee sets the bar high, selecting…

Despite the opinions expressed in column, “Here’s why you can’t believe ‘top hospitals’ lists,” Harlem Hospital richly deserved the 2015 Top Hospital distinction it earned from our nonprofit, The Leapfrog Group.

Our Top Hospitals committee sets the bar high, selecting only hospitals that perform at or above the level we would want for ourselves and our families. We used data from the annual Leapfrog Hospital Survey, calculating which …

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Why Leapfrog stands behind Harlem Hospital

Medical education

Academic medical centers balance dollars with resident education

2

Medicine has a fraught relationship with money. Dealing as they do with matters of life and death, doctors are loath to assign a dollar value to human life, preferring to avoid the subject altogether and instead provide the care that…

Medicine has a fraught relationship with money. Dealing as they do with matters of life and death, doctors are loath to assign a dollar value to human life, preferring to avoid the subject altogether and instead provide the care that they deem appropriate no matter the cost. Insurance companies, on the other hand, make their business in rationing health dollars and have no such qualms: the consensus among them is …

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Academic medical centers balance dollars with resident education

Physician voices

To help some patients, we have to change our attitudes

8

Yesterday I caught myself doing something I had told myself I would never do, especially not in residency. I heard the medical student present the patient as a, “35-year-old male with a past medical history of poly substance abuse, noncompliance,…

Yesterday I caught myself doing something I had told myself I would never do, especially not in residency. I heard the medical student present the patient as a, “35-year-old male with a past medical history of poly substance abuse, noncompliance, and multiple stints in rehab,” and I caught myself rolling my eyes and writing drug seeker in my notes on the patient. This was not my last day practicing medicine …

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To help some patients, we have to change our attitudes

Physician voices

How to destroy a great ER: A step by step guide

25

I took a fantastic emergency medicine (EM) job when I finished residency. There was no question in my mind that it was the best job within a hundred mile radius, maybe more. When I first started, my expectations were met.…

I took a fantastic emergency medicine (EM) job when I finished residency.  There was no question in my mind that it was the best job within a hundred mile radius, maybe more.  When I first started, my expectations were met.  My group held a contract to staff a busy but well-staffed suburban emergency department, and had held that contract for almost 20 years when I signed.  The hospital was independent, …

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How to destroy a great ER: A step by step guide

Physician voices

Your anger towards doctors is misplaced

40

I learned that the 148-year-old community hospital that I did my residency at will be closing, and I am angry. Who am I angry at? Myself. Oh, and you. I’m angry at us because we as a country have turned…

I learned that the 148-year-old community hospital that I did my residency at will be closing, and I am angry. Who am I angry at? Myself. Oh, and you. I’m angry at us because we as a country have turned our backs on one another. And in the end, your relationship with your own doctor is in jeopardy.

Pawtucket, Rhode Island, home of Memorial Hospital, used to be a prosperous mill …

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Your anger towards doctors is misplaced

Physician voices

Here’s why you can’t believe “top hospitals” lists

6

At the end of 2015, The Leapfrog Group announced its annual list of America’s top hospitals for quality and safety; 98 hospitals receiving the honor. Unlike some other hospital rating schemes, Leapfrog’s does not factor in reputation. You won’t find…

At the end of 2015, The Leapfrog Group announced its annual list of America’s top hospitals for quality and safety; 98 hospitals receiving the honor.

Unlike some other hospital rating schemes, Leapfrog’s does not factor in reputation. You won’t find any of the usual suspects on Leapfrog’s list. Instead, Leapfrog uses surveys of hospitals and publicly available quality and safety data.

Leapfrog’s top 98 included 62 urban, 24 rural, and …

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Here’s why you can’t believe “top hospitals” lists

Physician voices

Dear health care administrator: Physicians are your friends

21

Dear health care administrator, I am writing to you in a spirit of cooperation, because the way health care works today, it is too complex a business to manage on the side while also taking care of patients. And I…

Dear health care administrator,

I am writing to you in a spirit of cooperation, because the way health care works today, it is too complex a business to manage on the side while also taking care of patients. And I hope you don’t have any illusions about medicine being so simple that non-physicians like yourself can manage patients’ health care without trained professionals who understand medical science and can adapt the …

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Dear health care administrator: Physicians are your friends

Physician voices

Who are the patients that stay in the hospital for a very long time?

I just finished reading a very delightful A Piece of My Mind essay in JAMA. JAMA is primarily a research journal, filled with new scientific or semi-scientific studies and comments on those, plus reviews of the literature and editorials on…

I just finished reading a very delightful A Piece of My Mind essay in JAMA.  JAMA is primarily a research journal, filled with new scientific or semi-scientific studies and comments on those, plus reviews of the literature and editorials on science or politics. There are also letters and announcements and educational sections for doctors or patients, even poems, but the part I like to read all the way through is …

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Who are the patients that stay in the hospital for a very long time?

Health policy

Inpatient vs. observation: We have created a monster of our own making

6

A few weeks ago I wrote a piece about my hero patient, a World War II veteran who landed on Normandy beach, and how he had been left in a difficult position by the whole observation versus inpatient situation while…

A few weeks ago I wrote a piece about my hero patient, a World War II veteran who landed on Normandy beach, and how he had been left in a difficult position by the whole observation versus inpatient situation while he was hospitalized.

My intention was to draw attention to these types of scenarios and how they cause intense anxiety and concern to our elderly. It’s a horrible …

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Inpatient vs. observation: We have created a monster of our own making

Medical education

The moments that define the type of physician we become

4

“Son, just let me die.” Those were the first words Mr. O. told me as I introduced myself. As a 75-year-old stage IV lung cancer patient with brain metastasis, Mr. O knew his time on this planet was limited --…

“Son, just let me die.”

Those were the first words Mr. O. told me as I introduced myself. As a 75-year-old stage IV lung cancer patient with brain metastasis, Mr. O knew his time on this planet was limited — the last place he wanted to be was in a hospital with a newly minted clinical student. Mr. O’s neighbor had found him unconscious on his porch earlier this morning, and …

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The moments that define the type of physician we become

Physician voices

Compassion on the inpatient oncology service

4

She had been admitted overnight: a previously healthy 62-year-old woman who had been blindsided by acute onset of abdominal bloating and pain 6 months prior. A flurry of tests showed she had pancreatic cancer, and that it was advanced. She…

asco-logo She had been admitted overnight: a previously healthy 62-year-old woman who had been blindsided by acute onset of abdominal bloating and pain 6 months prior. A flurry of tests showed she had pancreatic cancer, and that it was advanced. She had started chemotherapy, but the regimen was so toxic; she suffered from unrelenting nausea and fatigue to …

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Compassion on the inpatient oncology service

Physician voices

You can’t compare health care to the airline industry. Here’s why.

9

There’s been a lot of talk for quite some time in health care quality improvement circles about why health care can’t be as safe as airline travel. Some of the reasons behind asking this question are very valid, as there…

There’s been a lot of talk for quite some time in health care quality improvement circles about why health care can’t be as safe as airline travel. Some of the reasons behind asking this question are very valid, as there are many things health care can learn from the aviation industry. Others, however, are complete fallacy; because on so many levels, it’s like comparing apples to oranges.

Over recent weeks, I’ve …

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You can’t compare health care to the airline industry. Here’s why.

Physician voices

It’s time to instill a positive culture in medicine

9

This year marks 33 years of administrative positions in academic medicine. When I first started, I suspect I made many major mistakes. I learned through the time-tested school of hard knocks. As I reflect on my own career, and those…

This year marks 33 years of administrative positions in academic medicine.  When I first started, I suspect I made many major mistakes.  I learned through the time-tested school of hard knocks.  As I reflect on my own career, and those whom I have observed, I have come to believe the famous saying, “Culture eats strategy for breakfast.”

Look at ward attending physicians.  The same attendings have “good teams” every …

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It’s time to instill a positive culture in medicine

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