Hospitalists writing on KevinMD about inpatient medicine: the handoff between the ward and primary care, patient satisfaction scores, the electronic record as it is lived on rounds, the pandemic years that reshaped hospital medicine, and whether AI makes the hospitalist more or less necessary. Most of the archive dates from 2008 to 2020. Three maintained records draw on this archive: The electronic health record: what physicians say, in their own words, Medical errors: what physicians say, in their own words, and COVID-19: what physicians wrote as it happened.

Healthcare reform and the new role of hospitalists

Physician
April 30, 2010

by John Gever

With growing pressures on hospitals from the new healthcare reform law and from the stakeholder community to become more efficient and effective, administrators may find they already have the necessary expertise under their own roofs, a prominent hospitalist said.

“Some organizations with hospitalist programs need look no further than these programs to chart a course toward more effective physician-hospital integration,” wrote Robert M. Wachter, MD, of the University of …

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Healthcare reform and the new role of hospitalists

The inpatient, outpatient divide in patient care today

Physician
December 7, 2009

As the health reform debates continue, I am struck by the lack of attention to what seems to be a critical issue in poor health care delivery.

With the technologizing of medicine (and more recently the hospitalist “movement”), delivery of health care has come to be centralized around acute care hospitals. Over time, patient care has been divided into acute inpatient care and ‘ambulatory’ outpatient care. While transitions of care, hospital-at-home, …

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The inpatient, outpatient divide in patient care today

Learn how to conduct a family meeting by using a structured approach

Patient
November 16, 2009

On my last day of ward attending, I handed out an EKG that resembled the Dow Jones industrial average over the last 10 years (not pictured). The normal pattern of an EKG was completely disrupted: ST segments were markedly elevated, P waves were hidden, and beats were grouped in odd patterns. My medical team laughed and shook their heads.

I asked why.

A brave intern responded that he was completely at a …

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Learn how to conduct a family meeting by using a structured approach

Is incident reporting effective in reducing medical errors and increasing patient safety?

Health Policy
October 6, 2009

When the patient safety field began a decade ago with the publication of the IOM report on medical errors, one of its first thrusts was to import lessons from “safer” industries, particularly aviation. Most of these lessons – a focus on bad systems more than bad people, the importance of teamwork, the use of checklists, the value of simulation training – have served us well.

But one lesson from …

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Is incident reporting effective in reducing medical errors and increasing patient safety?

How hospitals should deal with disruptive physician behavior

Physician
September 20, 2009

by Mark N. Simon, MD

What can hospital medical staff leaders learn from University of Oregon football coach Chip Kelly? In the morning of September 4th, Kelly had an opportunity to review video tape from the conclusion of his team’s game with Boise State University the night before. What he saw was his senior running back LeGarrette Blount punch an opponent and then lose his cool with the fans …

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How hospitals should deal with disruptive physician behavior

How hospitalists can provide high quality patient care at the lowest possible cost

Physician
September 3, 2009

Much has been made of the superior performance – on both cost and quality – of integrated health care organizations like the Mayo and Geisinger Clinics. But since the defining characteristic of these standout systems is at least 50 years of integrated history, few believe that the rest of us – namely the docs and hospitals that provide the bulk of American health care – can quickly achieve such seamless …

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How hospitalists can provide high quality patient care at the lowest possible cost

Are relationships being lost in medicine, and are hospitalists partly responsible?

Physician
August 29, 2009

An emergency physician, like me, may be the worst possible person to discuss relationships with patients. I mean, one of the reasons I chose this specialty was that I didn’t want long-term relationships with my patients. I see, now, that God has a great sense of humor.

See, the county I landed in after residency is small enough that I do know many of my patients, and I do see them …

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Are relationships being lost in medicine, and are hospitalists partly responsible?

5 top medical comments, June 7th 2009

Health Policy
June 7, 2009

Here are some of the more interesting comments readers have left recently.

1. David Block on the ACP’s guest column, A practice model for increasing the appeal of General Internal Medicine:
Weinberger talks about the efficiency of Care. Our commentators talk about the efficiency of Consumption. Weinberger assumes the one-on-one of two individuals, known to each other, who together negotiate the terms of personhood. Medicine is “spiritus”; no wonder he became …

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5 top medical comments, June 7th 2009

ACP: A practice model for increasing the appeal of General Internal Medicine

Physician
June 1, 2009

The following is the first in a series of original guest columns by the American College of Physicians.

by Steven Weinberger, MD, FACP

Much is written and discussed these days about the importance of care coordination by a primary care physician, not only to facilitate patient-centered quality of care, but also to curb the unsustainable growth in the nation’s health care tab. Yet, we hear that the current shortage of …

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ACP: A practice model for increasing the appeal of General Internal Medicine

6 top medical comments, May 3rd, 2009

Medications
May 3, 2009

Here are some of the more interesting comments readers have left recently.

1. Carla Kakutani on the lack of primary care access in Massachusetts:
So we have a chicken and egg problem. Do we wait health care reform until we have revived US primary care, or is that even possible without health care reform to create the disruption needed to change our entrenched fee-for-service, procedure-happy payment …

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6 top medical comments, May 3rd, 2009

Most hospitalists are good, but some, like these ones, aren’t

Physician
April 1, 2009

It’s a well known phenomenon that hospitalists are taking over inpatient medicine.

And no wonder, the payment system strongly discourages newly minted doctors to practice outpatient medicine, and the demand that hospitals have for inpatient physicians is surging at an unprecedented rate.

It’s a good time to be a hospitalist, but, as this reader writes to me, that may lead to an increasingly variability in the quality …

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Most hospitalists are good, but some, like these ones, aren’t

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