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Your Salary in A Bundled Fee World

Apr 20, 2015 | No Comments

I began to think about doctor fee carve outs in the context of global payments approximately five years ago.  At a meeting I attended where the subject came up, private conversations transpired between a group of us and folks in the know from CMS and the AHA.  We listened.  They talked. The discourse led me to two conclusions: one, as compensation...

  • Prioritizing Inpatient Geriatric Care Is NOT a Moon Shot.
    Prioritizing Inpatient Geriatric Care Is NOT a Moon Shot.
    Apr 16, 2015 | No Comments

    Most physicians recognize the JNC guideline for blood pressure management, or the ACCP thrombosis guideline for VTE.  Most would agree we use a handful of accepted benchmarks to manage a limited number of conditions.  For the rest, it’s the wild wild west. Try to develop consensus around delirium management or treatment of alcohol withdrawal, and you will likely find yourself...

  • Congratulations, Drs. Wachter, Conway and Murthy
    Apr 10, 2015 | No Comments

    Imagine for a minute that you’re Bob Wachter. Last week, you introduced your book to more than 3,000 hospitalists at Hospital Medicine 2015 on a Wednesday. Then, on Saturday, your photo is on the cover of Modern Healthcare and you find yourself at the top of the list of its top 50 most influential physician executives. His rise to thought...

  • Low Hanging Fruit
    Low Hanging Fruit
    Apr 9, 2015 | No Comments

    I just finished reading the soon to be published JHM article called “The highest utilizers of care: individualized care plans to coordinate care, improve health care service utilization, and reduce costs at an academic tertiary care center” by Mercer et al. Using a multidisciplinary team of volunteers including members from hospital medicine, ER, psychiatry, ambulatory care, social work, nursing and...

  • Medicare at 50: Fixing the Status Quo
    Medicare at 50: Fixing the Status Quo
    Apr 8, 2015 | No Comments

    Several years ago, I was talking with a hospitalized patient whose kidneys were failing about the difficulties she faced accessing care.  She was reluctant to see a primary care physician because she did not have insurance so preferred to wait until things got really bad.  During that hospital stay, I had to give her the bad news that she would...

  • Frequency and Clinical Relevance of Inconsistent Code Status Documentation
    Frequency and Clinical Relevance of Inconsistent Code Status Documentation
    Apr 7, 2015 | No Comments

    I had the pleasure of interviewing Adina Weinerman, a Hospitalist in the Division of General Internal Medicine at Sunnybrook Health Sciences Centre in Toronto, Canada, about her team’s recent publication in the Journal of Hospital Medicine (JHM) Frequency and Clinical Relevance of Inconsistent Code Status Documentation. This “point prevalence” study from 3 academic medical centers found that 65% of inpatients...

  • Refreshed, Re-energized and Ready for Another Year
    Refreshed, Re-energized and Ready for Another Year
    Apr 3, 2015 | Comments Off

    One of my favorite things about being a hospitalist is attending the annual SHM meeting. I look forward to making new friends, reconnecting with old colleagues, and learning about what’s happening across the country. With so many opportunities to connect and educational tracks to learn from, this year’s conference did not disappoint in the slightest. HM 2015 opened with a...

  • Congratulations, Hospital Medicine 2015 Research, Innovation and Vignette Winners!
    Congratulations, Hospital Medicine 2015 Research, Innovation and Vignette Winners!
    Apr 1, 2015 | Comments Off

    Congratulations to the winners of SHM’s 2015 poster session winners at Hospital Medicine 2015! This year, SHM received a record-breaking number of abstract submissions and selected. To see all of the accepted abstracts at Hospital Medicine 2015, visit Research Overall: Standardizing Attending Rounds to Improve the Patient Experience: A Cluster Randomized Controlled Trial Bradley Monash, MD; Nader Najafi, MD;...

  • The Porridge Is Just Right: Choosing Wisely®
    The Porridge Is Just Right: Choosing Wisely®
    Mar 26, 2015 | Comments Off

    by John B. Bulger, DO, MBA It began in the spring of 2012. A small sub-group of the Society of Hospital Medicine’s (SHM) Hospital Quality and Patient Safety Committee (HQPS) was given the task of coming up with five test and treatments that hospitalists overuse. The pediatric hospitalist community was already hard at work (and quite far ahead) on their...

  • Engaging Hospitalists: What Makes You Tick?
    Mar 25, 2015 | Comments Off

    by Jerome Siy, MD, SFHM, CHIE It would be easy to deliver on the triple aim if all hospitalists had to do was run a checklist.  But, it’s pretty obvious that we need more than a checklist to be successful.  How many of us are graduated in the top 10% of our class, but can’t get a score above 70%...

  • Say What?!
    Mar 24, 2015 | 4 Comments

    by Dr. Amit Singh “Good morning Mr. Johnson*!” our chief resident bellowed as we all crowded around the bedside, a sea of endless short and long white coats. “I want to let you know we took a look at the X-ray this morning and it looks good. The angle looks sharp, no effusion!” We looked at Mr. Johnson and I...

  • Reminiscing about Match Day
    Reminiscing about Match Day
    Mar 23, 2015 | Comments Off

    Friday March 20th was the 2015 Match Day. A big moment for every doctor that in many ways determines not only our specialty and where we will practice, but in some ways sets our destiny with who we will marry and who our lifelong friends will be. I still remember my Match Day 42 years ago in 1973. There were...

  • Thin-slicing Your Next Hospital Medicine Program
    Thin-slicing Your Next Hospital Medicine Program
    Mar 19, 2015 | 1 Comment

    As our specialty of hospital medicine continues its exponential expansion, so does the number of established programs to choose from. Without exaggeration, the job market in most areas of the country is pretty hot right now—and all of us know this from the avalanche of offers and job advertisements out there. Speaking as someone who has worked in several different...

  • Does This Learner Really Stink?
    Does This Learner Really Stink?
    Mar 17, 2015 | 4 Comments

    by Dr. Calvin Chou MD, PhD I recently finished service with a struggling intern. This intern (I’ll call her Mary) had “achieved” a reputation for being deficient in clinical reasoning, disorganized, argumentative, and unwilling to receive feedback. None of this had been communicated with me before I began work with her, but on rounds the very first day I noticed...

  • Saturday Night Shifts With Lifetime Caps.
    Mar 15, 2015 | 2 Comments

    A good idea, but not quite. A subject I hope to engage more in depth in the future concerns how career hospitalists age into our specialty.  As the healthcare system veers toward greater patient responsiveness, 24/7 access to caregivers will be a priority.  As physicians continue to offload their night and weekend work, hospitalists will pick up the slack.  It’s...

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