Hospital medicine

5,188 articles · Since 2004

Articles, page 93

This is why physicians are burning out

March 21, 2015Mar 21, 201531

American physicians have had it. We are retiring early, cutting back, changing careers, and moping in to work in astounding numbers. The typical pep talks, whether given aloud by medical directors and administrators or consisting of internal dialog occurring in the physician’s mind, are not working anymore. “You have it better than most people.” “You are still making good money.” “Your …

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This is why physicians are burning out

Health policy

Patient experience builds brand equity

Jim Lahren

March 21, 2015Mar 21, 20155

Health care in the U.S. continues its radical transformation with the rollout and rapid adoption of high-deductible insurance plans. More than even value-based purchasing, this has the potential to reshape the health care landscape because it has awakened the health care consumer. In its 2014 Employer Health Benefits Survey, The Kaiser Family Foundation reported that 41 percent of all firms (32 percent of large employers, 61 percent of small …

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Patient experience builds brand equity

Health policy

Why you should help your local hospital improve

Tommy Prewitt, MD

March 20, 2015Mar 20, 20156

As we begin the journey to value-based health care, the relationships between a hospital and its medical staff are changing. For decades, these relationships were straightforward: doctors admitted patients to the hospital, performed procedures and delivered therapies, and at some…

Same with the doctors. The hospital would pretty much let us do what …

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The ethics and money in medicine

Danielle Ofri, MD, PhD

March 20, 2015Mar 20, 201515

In mid-January, a patient called me from her pharmacy, frantic. Her asthma inhalers came to $168 -- a sum that she hadn’t been prepared for. But she can’t live without those inhalers, so she withdrew cash from her meager savings…

In mid-January, a patient called me from her pharmacy, frantic. Her asthma inhalers came to $168 — a sum that she hadn’t been prepared for. But she can’t live without those inhalers, so she withdrew cash from her meager savings account and skipped her blood pressure pills for that month.

This is such a familiar story by now that it hardly makes …

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The ethics and money in medicine

Physician voices

Eulogy for the doctor

Michael Brant-Zawadzki, MD

March 17, 2015Mar 17, 20152

- Assaults Upon Medical Men. Journal of the American Medical Association, 1892 It’s happened again: A well-liked doctor is killed by his patient. Last year’s horrific death of a physician in our community, a valued colleague shot in his office…

No physician, however conscientious or careful, can tell what day or hour he may not be the object of some undeserved attack, malicious accusation, blackmail or suit for damages … “
– Assaults Upon Medical Men. Journal of the American Medical Association, 1892

It’s happened again: A well-liked doctor is killed by his patient. Last year’s horrific death of a physician in our community, a …

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Eulogy for the doctor

Health policy

Hospitals fight to charge you more

Tanya Feke, MD

March 17, 2015Mar 17, 201510

The Centers for Medicare and Medicaid Services (CMS) has put its foot down, this time on the side of patients. Many hospitals charge you more for the same outpatient tests you get in your doctor’s office. Sixty-six different services are…

Are the tests really all that different?

We are not talking about inpatient tests that happen when you are sick enough to be …

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Hospitals fight to charge you more

Physician voices

Using algorithms to beat down our physician colleagues

Luis Collar, MD

March 15, 2015Mar 15, 201547

An excerpt from A Quiet Death. Even as I lay perfectly still in the near-complete silence of my car, I could hear Dr. Tierney’s adenoidal voice in my mind. He always seized every opportunity to assure us that his diagnostic…

An excerpt from A Quiet Death.

Even as I lay perfectly still in the near-complete silence of my car, I could hear Dr. Tierney’s adenoidal voice in my mind. He always seized every opportunity to assure us that his diagnostic or therapeutic approach to patients was firmly supported by the literature. That, at least in the sense he intended it, was pure bullshit.

The medical literature had grown exponentially …

Physician voices

How corrosive cynicism is destroying professional relationships in medicine

Jeffrey Parks, MD

March 12, 2015Mar 12, 20154

One of the obligations of a medical or surgical specialist is to communicate with the referring primary care provider. This can take many forms: a phone call, texting via smartphone, email, messages sent via EMR, and dictated letters. The format is pretty standard no matter what medium is chosen. You thank the referring doc for the consult request, you give some brief background info about the patient in question, and …

Physician voices

5 things patients say that should make doctors sit up and listen

Suneel Dhand, MD

March 12, 2015Mar 12, 20153

In the busy world of hospital medicine, where doctors and nurses find themselves rushed off their feet for most of the day, time to sit down and actually listen to patients is at a premium. Every doctor knows that our primary focus has to be on the most important aspects of the history and clinical examination in order to get to …

Physician voices

Ease the transition to hospital medicine

Tracy Cardin, ACNP

March 11, 2015Mar 11, 20155

I came to hospital medicine from the land of pulmonary-critical care. I had spent ten years dealing with septic shock, respiratory failure, and acute renal failure. I had intubated, withdrawn life support, placed central lines, performed thoracenteses, and even placed a couple of chest tubes. I had changed tracheostomy tubes; I ran codes. In short I was a critical care bad ass. I thought I was hot stuff. But I …

Physician voices

It’s time to think about how we’re affecting patient morale

Val Jones, MD

March 10, 2015Mar 10, 20154

Many of the patients that I treat have brain injuries. Whether caused by a stroke, car accident, fall, or drug overdose, their rehab course has taught me one thing: nobody likes to be forced to do things against their will. Even the most devastated brains seem to remain dimly aware of their loss of independence and buck against it. Sadly, the hospital environment is designed for staff convenience, not patient …

Physician voices

An informed patient is a safer patient

American Society of Anesthesiologists & Fred E. Shapiro, DO

March 9, 2015Mar 9, 20154

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. The health care landscape is changing, and now more than ever we as physicians should be focused on quality of care and ensuring the safety of our patients.…

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

The health care landscape is changing, and now more than ever we as physicians should be focused on quality of care and ensuring the safety of our patients. Anesthesiology was the first medical specialty to champion patient safety as a specific focus. Over the past century, physician anesthesiologists have advanced patient safety through innovative research, science and technology advancements. …

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An informed patient is a safer patient

Physician voices

Pay doctors and nurses for the time they spend charting

Edwin Leap, MD

March 9, 2015Mar 9, 201543

I have a unique perspective as a physician. Having traveled to many hospitals in the past two years, working as a locums emergency physician, I can comment on a variety of issues with a reasonable amount of experience. One of…

One of those issues is EMR, or electronic medical records. I have spent plenty of time writing about this in the past, and I …

Medical education

An alcoholic patient, and his effect on a medical student

Cordelia Ross

March 6, 2015Mar 6, 20152

Once an alcoholic, always an alcoholic. This is one of the main tenets of Alcoholics Anonymous, and it serves to encourage its members to commit to absolute abstinence. It is also a belief, I have come to realize, held by…

Once an alcoholic, always an alcoholic.

This is one of the main tenets of Alcoholics Anonymous, and it serves to encourage its members to commit to absolute abstinence. It is also a belief, I have come to realize, held by the many medical residents I have encountered.

When an alcoholic patient is admitted to the hospital, it is no secret that he (or she) is an alcoholic. This is because it feels …

Health technology

EMR horror: Please choose one

Philip Green, MD

March 4, 2015Mar 4, 201514

The three words blink in front of me on the computer screen. Please choose one: Patient is- ☐Male ☐Female I click FEMALE. I watch as the auto-template feature fills in the paragraph for me based on my choices. Patient #879302045…

Please choose one:

The three words blink in front of me on the computer screen.

Please choose one:
Patient is-
☐Male ☐Female

I click FEMALE.

I watch as the auto-template feature fills in the paragraph for me based on my choices.

Patient #879302045

Patient is: 38-year-old female status post motor vehicle accident. Please acknowledge you have reviewed her allergies, medications, and past medical history.

I click YES.

Have you counseled her about smoking cessation?

I click NO.

A little, animated icon of a …

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EMR horror: Please choose one

Medical education

Dear patient: Apologies from your medical student

Jennifer Chevinsky, MD

March 4, 2015Mar 4, 201516

I am sorry that you are in the hospital. You are feeling ill. The noises are loud, people are walking in and out of rooms, and you aren’t sure of what to expect. You are probably nervous. This whole situation…

I am sorry that you are in the hospital. You are feeling ill. The noises are loud, people are walking in and out of rooms, and you aren’t sure of what to expect. You are probably nervous. This whole situation is a disturbance to your life. You would rather be at home — I can understand that. Few people want to …

Physician voices

A helping hand: Continuing improvement in hand hygiene

Daniel J. Castillo, MD, MBA

March 4, 2015Mar 4, 2015

Just because it’s simple doesn’t make it easy. Take a look at habits. Do you floss? We all know the advantages, and it doesn’t take a rocket scientist to do it. Yet only 28 percent of people say they floss…

Just because it’s simple doesn’t make it easy. Take a look at habits.

Do you floss? We all know the advantages, and it doesn’t take a rocket scientist to do it. Yet only 28 percent of people say they floss regularly. How about covering your mouth when you cough? Again, it’s not difficult, but we all know people who fail to grasp the concept.

Unfortunately, the same is true for hand-washing. It’s …

Health policy

Your ER group was just bought. What next?

Kyle Bray, MBA

March 3, 2015Mar 3, 2015

Hospital leaders who are successful managers today are successful because they manage change. The great hospitals leaders by now have become masters at it. But there’s a difference between change you can see coming (bundled payments, EHR implementations, declining reimbursements)…

That’s often what it feels like when a huge, publicly traded company acquires a smaller physicians group. It can feel like …

Health technology

How can we make the EMR note more legible? Here are some ideas.

Suneel Dhand, MD

March 2, 2015Mar 2, 20154

Despite the well-known rollout problems for hospitals and clinics across the nation, there are many palpable and welcome advantages to using electronic health records. Chief among these are the ability to access the chart from anywhere, rapidly search for information…

Despite the well-known rollout problems for hospitals and clinics across the nation, there are many palpable and welcome advantages to using electronic health records.

Chief among these are the ability to access the chart from anywhere, rapidly search for information needed, and reducing the centuries-old problem of illegible doctors’ handwriting. But with the good comes the bad, and in these still relatively early stages of health care information technology adoption — …

Conditions and diseases

4 things this doctor learned after his heart stopped beating

Chad Hayes, MD

February 26, 2015Feb 26, 20153

I sometimes think doctors forget what it’s like to be patients. But I’ve been there, and I know how frustrating and scary it can be. I remember one night, I was lying in a hospital bed, resting peacefully. I heard a noise and opened my eyes to a room full of chaos. Nurses everywhere. A crash cart. Someone holding paddles. I tried to speak, but couldn’t. …

Hospital medicine

Articles, page 93

Real physician voices, twice a week

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