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Superbugs, Medical Errors and Safety Rankings in Hospital Medicine News

May 30, 2016 | No Comments

SHM & Hospital Medicine in the News: May 12 – 26, 2016 This issue of SHM & Hospital Medicine in the News features: The first case of a superbug in the U.S. that is resistant to antibiotics of last resort Suggestions to reduce the number of medical error-related deaths in hospitals, including work performed by SHM member Peter Pronovost, MD,...

  • Reflections on Palliative Care: Clinging to Life
    May 26, 2016 | No Comments

    By Dr. Allison Schneider My first day on the Palliative Care service ended with me in a heap on my couch sobbing into my husband’s shoulder. That day I attended family meetings for two patients in their 40s dying of cancer and leaving young kids behind. I also sat at the bedside with the mother of a young man dying...

  • What Kind of Car Will A Specialist Be Driving in 2030?
    What Kind of Car Will A Specialist Be Driving in 2030?
    May 23, 2016 | No Comments

    (Something I sent along to my PGYs.  Thought you might enjoy.  And think about where hospitalists fit into all of this) A Porsche or a Prius? Have a look at the two figures below and see if you can spot the dilemma: See it? I knew that you could. Here’s the thing.  We have lived with an arrangement that reimburses...

  • Next Step in Sustainability: Re-Thinking How Hospitalists Organize Their Work
    May 19, 2016 | 5 Comments

    Do we really need another commentary on the shortcomings of the 7-on/7-off work schedule?  My colleague John Nelson has written and spoken about this extensively, most recently in his January 2016 column in The Hospitalist.  And while I’ve been planning to write this post for a while, Bob Wachter got the jump on me by famously declaring at his HM16...

  • Revamped MOC, Opioid Addiction Epidemic in Hospital Medicine News
    May 17, 2016 | No Comments

    This issue of SHM & Hospital Medicine in the News features: Details of the revamped maintenance of certification assessment program from the ABIM The opioid addiction epidemic, including the possibility of mandatory training for doctors who prescribe opioids and the epidemic’s effect on hospitalizations and hospital costs The rise of medical errors to the third leading cause of death in...

  • No Words Needed. A Pictorial On Why I Punt On Hospital Report Cards.
    No Words Needed. A Pictorial On Why I Punt On Hospital Report Cards.
    May 16, 2016 | Comments Off on No Words Needed. A Pictorial On Why I Punt On Hospital Report Cards.

      If I was in flyover country without a contact and needed emergency services how would I research the best hospital in a pinch?  If you read Consumer Reports or a major newspaper, of course, you would run to the nearest handy dandy hospital report card and pick out the facility with the A grade. Me?  Yeah, I would look, but...

  • Peak Performance: Messler’s Hospitalist Hierarchy of Needs
    May 12, 2016 | 3 Comments

    Your alarm goes off at 6am. You show up for work, with your list of about 13 patients. Your bedside nursing team greets you and everyone else by their first name. You have time to see everyone twice today, and sit in on two family meetings, while your colleague holds your pager. After rounds you report a medication error to...

  • Slow Down and Ask
    Slow Down and Ask
    May 10, 2016 | 3 Comments

    We all knew her time was limited; recurrent metastatic glioblastoma at the age of 26. Surrounded by her husband and parents at all times, rounding on her was becoming more difficult for the team to endure. Each day she had a new limitation. First it was her inability to swallow food, then liquids, then her own secretions. Then it was...

  • The ABIM Announces a New Plan and This Time It May Actually Mean Something
    The ABIM Announces a New Plan and This Time It May Actually Mean Something
    May 5, 2016 | 6 Comments

    This morning the American Board of Internal Medicine (ABIM) published on its website a press release about new testing options for MOC.  The statement is short on details, but promises substantial change. The plan, arising from the recommendations in last year’s Assessment 2020 Task Force report and created after gathering input from stakeholders and physicians, describes an alternative to the...

  • SHM & Hospital Medicine in the News: April 14 – 28, 2016
    May 3, 2016 | Comments Off on SHM & Hospital Medicine in the News: April 14 – 28, 2016

    SHM & Hospital Medicine in the News: April 14 – 28, 2016   This issue of SHM & Hospital Medicine in the News features: A Medscape feature on the growth and evolution of the hospital medicine specialty, including commentary from SHM leaders and data from the State of Hospital Medicine Report The increasing presence of psychiatric hospitalists on medical wards...

  • AMA: Unbeloved and Overvilified
    AMA: Unbeloved and Overvilified
    May 2, 2016 | 1 Comment

      CMS just released their proposed MACRA regs (Cliff Notes version), and as you could expect, every specialty society and interested party dug in and critiqued.  The rule runs a thousand pages and will have a substantial effect on the future of provider payment. In case, you have not heard. Each organization will cut their sections of interest out, parse...

  • A Link between Hospitalist Morale and Retention?
    A Link between Hospitalist Morale and Retention?
    Apr 21, 2016 | Comments Off on A Link between Hospitalist Morale and Retention?

    Many observers of our specialty tend to think of hospitalists as itinerant shift workers, many of whom have little emotional commitment to the organization that employs them and will quickly decide to leave for another job where the grass is greener.  Even my colleague John Nelson often describes hospitalists as preferring to “date” rather than “marry” their practice.  And more...

  • You’ll Receive High-Value Care…Or Your Money back?
    You’ll Receive High-Value Care…Or Your Money back?
    Apr 19, 2016 | Comments Off on You’ll Receive High-Value Care…Or Your Money back?

    As hospitals across the country increasingly focus on patient experience, one health system, as we’ve written about before here on The Hospital Leader, is really putting their money where their mouth is: they are offering patients direct refunds, no questions asked. An article in The Washington Post calls these refunds, “the most unexpected hospital billing development ever.” The article opens...

  • ABX Stewardship, Growth of PAs & End-of-Life Care in Hospital Medicine News
    Apr 18, 2016 | Comments Off on ABX Stewardship, Growth of PAs & End-of-Life Care in Hospital Medicine News

    This issue of SHM & Hospital Medicine in the News features: The potential for CMS to require hospitals to adhere to a formal antibiotic stewardship program in order to receive reimbursement from Medicare The impetus behind and implications of the significant growth of the physician assistant profession over the last five years SHM member Dr. Matthew Hindman on FOX Carolina...

  • I left a pharma-sponsored research project.  My reasons for doing so may be instructive.
    I left a pharma-sponsored research project. My reasons for doing so may be instructive.
    Apr 18, 2016 | Comments Off on I left a pharma-sponsored research project. My reasons for doing so may be instructive.

      Not long back, I departed a pharma-sponsored research project.  I based my decision to leave in something I occasioned over a decade ago.  I thought it was time to share the episode and the lessons learned given the attention being paid to physician conflict of interest nowadays (as well as the annual Open Payments review and dispute period approaching)....

  • Quality Improvement – The Role of Each Provider
    Apr 14, 2016 | Comments Off on Quality Improvement – The Role of Each Provider

    by Dr. Moises Auron MD, FAAP, FACP It is certain that since the seminal publication of the Institute of Medicine “To Err is Human,” physicians and society in general have pursued a legitimate effort to gain perspective and understand the incredibly complex system which is the healthcare system. The increased focus on the degree of quality of healthcare delivery has...

  • Finding Hope When There Is None
    Finding Hope When There Is None
    Apr 12, 2016 | 3 Comments

    Young and in pain, she came to us from another country for a repair of a fracture. It wasn’t repaired at home because of the complexity of the fracture. There was some question that it may be a pathologic fracture due to a cancer, but nothing definitive. There were two biopsies in-country. One that was equivocal, one that said it...

  • Lessons from a Sprinkled Donut: A Pastry Almost Took out Our Hospitalist Group
    Lessons from a Sprinkled Donut: A Pastry Almost Took out Our Hospitalist Group
    Apr 7, 2016 | Comments Off on Lessons from a Sprinkled Donut: A Pastry Almost Took out Our Hospitalist Group

    The doctors’ lounge. A place of collegiality, medical discussions, and food breaks. It’s a showcase for new doctors. During a lunchtime visit it can be a window into how well the medical staff interacts. Since many hospitals are removing their doctors’ lounges, the fact that my hospital provides 24/7 access to coffee and food seems a privileged perk, a disappearing commodity. Each morning our lounge...

  • Purge this Word Your Vocabulary. It’s Likely Harming Patients and Wasting Real Money.
    Purge this Word Your Vocabulary. It’s Likely Harming Patients and Wasting Real Money.
    Apr 5, 2016 | Comments Off on Purge this Word Your Vocabulary. It’s Likely Harming Patients and Wasting Real Money.

      A little something I sent to my residents–and I post it here as the issue has relevance to every clinician.  Also, a wise professor offered me something to contemplate.  As you read, consider whether this is a professionalism OR systems issue.  If the latter, are the behaviors in accord with the signals we give our trainees, nocturnists and shift...

  • Healthcare Policy, EHR Security and MOC Make Hospital Medicine News
    Apr 5, 2016 | Comments Off on Healthcare Policy, EHR Security and MOC Make Hospital Medicine News

    This issue of SHM & Hospital Medicine in the News features: A profile of hospitalist and SHM leader Dr. Patrick Conway in The New York Times, which explores how his experience as a hospitalist and commitment to improving patient care informs his decisions on healthcare policy. An update on the high-profile reproductive rights case, Whole Woman’s Health v Hellerstedt, including...

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