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Have we hit peak hospitalist?

May 28, 2015 | 2 Comments

I have detected something unusual.  Take a look at the cited quotes below and see if you can spot what I am referring to.  Both come from a national newspaper.  Here’s the first: On arrival, Larson was put in a room and examined by a physician assistant. He didn’t stop at the admissions office because his information and treatment orders already...

  • Improving Patient Satisfaction through Education, Feedback & Incentives
    Improving Patient Satisfaction through Education, Feedback & Incentives
    May 27, 2015 | No Comments

    Patient satisfaction survey performance is becoming increasingly important for hospitals, as the ratings are being used by payers in pay-for-performance programs more and more (including the CMS Value Based Purchasing program). CMS also recently released their “Five-Star Quality Rating System” for hospitals, which publicly grades hospitals on 1-5 stars based on their patient satisfaction scores. Unfortunately, there is little literature...

  • Could you be just a little sicker?
    Could you be just a little sicker?
    May 23, 2015 | No Comments

    I take a deep breath as I get ready to go see Mrs. H. I can predict after sign-out from the ER doc where this is likely to go. Mrs. H. is an 87 year-old woman who comes to the emergency room with weakness. She stumbled and fell to the floor but could not get up to reach the phone...

  • Keeping up with the ABIM
    Keeping up with the ABIM
    May 19, 2015 | 2 Comments

    You can recall some of the famous apologies and non-apologies of the recent past. Bill—“Even presidents have private lives.”  Kanye—“It starts with this… I’m sorry, Taylor.”  And in early February, we added this one.  Rich- “We got it wrong. We are sorry.” Now don’t get me wrong, apologies are good and a necessary first step toward healing and returning to...

  • Ten 2-Letter Words to Live by
    Ten 2-Letter Words to Live by
    May 14, 2015 | 2 Comments

    One of my favorite residency attendings recently passed away. A life cut too short. Dr. Leeper, an Emory pulmonologist, was a prime example of the academic triumvirate: an incredible researcher, clinician and educator. Although I spent only a few weeks with him as an intern, I frequently find myself sharing and using his words of wisdom. As the intern, resident...

  • Passion to Improve Pain Care
    May 12, 2015 | Comments Off

    by Dr. Solomon Liao Students and residents often ask me why I like my job so much and why I always walk around with a smile on my face when I’m on service. I respond that helping to relieve people’s pain is very rewarding. It provides instant gratification. The more challenging the case is, the more rewarding the result. Very...

  • Healthcare Costs: Now what are we supposed to do?
    May 7, 2015 | 2 Comments

    by Vineet Arora MD MAPP, Chris Moriates MD, and Neel Shah MD MPP By now we have heard the stories about unconscionable medical bills causing financial harms for patients. We have read about more Americans than ever before on high-deductible health insurance plans. Some of us even helped our parents navigate the deceptively simple-looking bronze, silver, and gold tiers of...

  • Be Skeptical When Your Hospital Expresses an Urge to Merge
    Be Skeptical When Your Hospital Expresses an Urge to Merge
    May 6, 2015 | 2 Comments

    Old myths die hard, and for years as hospitals continue to join forces in the name of efficiency, the refrain cited most often by individuals who steward their systems has not changed:  “do the deal and everybody wins.” Intuitively, when a facility joins a network or bigger hospital, one would expect administrative and clinical redundancy to lessen.  As a result,...

  • Mother Knows Best
    Mother Knows Best
    Apr 28, 2015 | Comments Off

    My 85 year old patient was brought in from home.  She was cachectic, contracted, minimally responsive to questions, covered in multiple decubitus ulcers on both hips, both knees, both shoulders, and her sacrum.  She had polymicrobial sepsis-bacteremic with two different organisms. She was, in fact, dying. Despite her profoundly debilitated condition,  her son, who cared for her at home wanted...

  • Do Providers Fear Change or Do They Fear Loss? Part 2
    Apr 23, 2015 | 3 Comments

    by Dr. Trina Dorrah MD, MPH In Part 1, we discussed the fact that providers are often resistant to change not because they fear change itself, but because they fear loss. In my work as a patient experience physician champion, I am constantly encouraging providers to change. At the Society of Hospital Medicine’s annual meeting in March, Dr. Peter Pronovost...

  • Getting on the Bus: Hospitalists on the Hill
    Apr 22, 2015 | 2 Comments

    by Regina Heyl DePietro I sat in the office of a staffer to a Manhattan congressman and waited for the right moment to tell my story about my mother’s experience with advanced directives. Dr. Celine Goetz, a hospitalist from Mount Sinai, and I had practiced our talk in a large atrium a floor below. Our morning meeting led by SHM...

  • Do Providers Fear Change or Do They Fear Loss? Part 1
    Apr 21, 2015 | 1 Comment

    by Dr. Trina Dorrah MD, MPH At the Society of Hospital Medicine’s 2015 conference, I had the privilege of hearing Dr. Peter Pronovost speak. He is a leader in the field of quality and safety, but the part of his talk that struck me the most was his advice on leading change. During his discussion on change strategies, he accurately...

  • Your Salary in A Bundled Fee World
    Apr 20, 2015 | 4 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 | Comments Off

    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 | 1 Comment

    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...

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