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AMA: Unbeloved and Overvilified

AMA: Unbeloved and Overvilified

May 2, 2016 | No Comments

  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 | No Comments

    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 | No Comments

    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...

  • Here’s Why This Is The Best Study On Readmissions To Date
    Here’s Why This Is The Best Study On Readmissions To Date
    Mar 31, 2016 | Comments Off on Here’s Why This Is The Best Study On Readmissions To Date

      Love or hate readmission rates as an effective measure of institutional performance, the benchmark has become the coin of the realm for QI gurus, policy geeks, and stat crunchers.  As such, we see new journal releases every week–mostly data dives into large registries where the conclusions proffered are tentative at best.  Clinicians rarely get studies comprised of patient-level information whose...

  • One of our own gets the star treatment.  Big Time.
    One of our own gets the star treatment. Big Time.
    Mar 29, 2016 | Comments Off on One of our own gets the star treatment. Big Time.

      As is custom nowadays, if you read a profile about any prominent public servant, you finish the article and feel a tad icky. Sometimes, however, the stars line up, and a story renews our faith in who is doing ours, the people’s business in DC. In this case, it’s one of our own. Most of you know Patrick Conway,...

  • The Tale of The Black Knight: ABIM a Year in Review
    The Tale of The Black Knight: ABIM a Year in Review
    Mar 29, 2016 | Comments Off on The Tale of The Black Knight: ABIM a Year in Review

    I passed! Let me tell you I was nervous. Perhaps it isn’t the smartest thing in the world to announce publically on your blog  that you are up for recertification and preparing to sit for the secure examination. It was only after I did this that it occurred to me that it could be rather embarrassing if I didn’t pass....

  • Perioperative Care: Top of Mind & Topic for #Periop #JHMChat on April 4th
    Perioperative Care: Top of Mind & Topic for #Periop #JHMChat on April 4th
    Mar 28, 2016 | Comments Off on Perioperative Care: Top of Mind & Topic for #Periop #JHMChat on April 4th

    With great successes in hosting our first couple of Twitter chats over the last six months, we’re excited to bring you the third in our quarterly series, #JHMChat, where you ask Journal of Hospital Medicine (JHM) authors about their research and corresponding clinical implications for managing inpatient care. We invite you to join us for the next #JHMChat on Monday,...

  • Not So Involuntary: Hospitalists and Psych Holds
    Mar 24, 2016 | Comments Off on Not So Involuntary: Hospitalists and Psych Holds

    by Dr. Atashi Mandal MD He sat on the gurney, with averted eyes and contorted posture, as to avoid my encroaching examination. The usual jargon populated my assessment: psychomotor retardation, flat affect, poor vocalization… I glanced at his intake form and noted that he had been admitted to the emergency treatment unit for suicidal ideation, removed from a family with...

  • Widespread HM16 Coverage Dominates Latest SHM Media Highlights
    Mar 22, 2016 | Comments Off on Widespread HM16 Coverage Dominates Latest SHM Media Highlights

    Media Monitoring Report: March 3 – 17, 2016 Thanks to the tireless efforts of HM16 Course Director Dr. Melissa Mattison, the Annual Meeting Committee, volunteer speakers and SHM staff, Hospital Medicine 2016 featured the most robust course schedule to date and welcomed the largest number of attendees ever to attend an SHM meeting. This went hand-in-hand with extensive media coverage,...

  • Recidivism
    Recidivism
    Mar 21, 2016 | Comments Off on Recidivism

      You might wonder why “recidivism” in the subject line. In the context of readmissions, the word comes up often—and in particular, those who cycle from shelters to the street to the ER. Rinse. Repeat.  I focus on the Northeast, but my guess is your regional experience is like mine. You have noticed over the last two to three years,...

  • Heterogeneity of Interdisciplinary Rounds
    Heterogeneity of Interdisciplinary Rounds
    Mar 18, 2016 | Comments Off on Heterogeneity of Interdisciplinary Rounds

    I had the pleasure of interviewing Surekha Bhamidipati, a hospitalist in the Department of Medicine at Christiana Care Health System. She and her team sought to analyze the current literature on the structure and outcomes of interdisciplinary rounds among hospitalized medicine patients, to determine the composition and impact of such rounds in her recent Journal of Hospital Medicine (JHM) paper,...

  • Do Patients Really Prefer Hospitalists to Teaching Service?
    Mar 16, 2016 | Comments Off on Do Patients Really Prefer Hospitalists to Teaching Service?

    by Dr. Charlie M. Wray DO After diligently listening to the intern’s presentation and deciding on what our treatment plan would be for our patient, Mrs. Ramirez, my senior resident led our two interns, two medical students, and myself into her room. As we all methodically filed in, slowly gathering around the patient, I could see her anxiously sit up...

  • Approval of CMS Hospitalist Billing Code Tops Latest SHM Media Highlights
    Mar 4, 2016 | Comments Off on Approval of CMS Hospitalist Billing Code Tops Latest SHM Media Highlights

    Media Monitoring Report: February 18 – March 3, 2016 This edition of SHM Media Highlights features the introduction of a CMS billing code for hospitalists, potential approval of the pediatric hospitalist subspecialty, hospitalist and hospital medicine group spotlights, readmission penalties and more. SHM’s advocacy and public policy staff have been leading the way with the Public Policy Committee to push...

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