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2013: Did we pay more for inpatient care, or did we use more?

Nov 23, 2014 | No Comments

  The Health Care Cost Institute is not just another consulting firm or think tank.  They are a a non-partisan, non-profit clearinghouse for all things health care payment.  They obtain commercial and government data and generate reports on health spending direction. Their 2014 release analyzing 2013 commercial trends (think age 18-64 yo)  came out last week. The report has oodles of data...

  • Pareto’s Principle in Hospital Medicine
    Pareto’s Principle in Hospital Medicine
    Nov 19, 2014 | 1 Comment

    There are certain universal laws that appear to govern the broader workings of the world around us. For those of you unfamiliar with Pareto’s Principle, it’s a concept that was first applied in economics and then found to be a governing rule in a whole host of different arenas. It’s no understatement to say that understanding and acting upon this...

  • Century Old QI Lessons
    Century Old QI Lessons
    Nov 18, 2014 | 1 Comment

    Some days it seems like it would be easier to start from scratch. Maybe build your own hospital. That’s what Ernest Codman decided to do. Codman was born in Boston, graduating from Harvard Medical School in 1891. This was before the Flexner report fundamentally changed medical education in the US, and around the time medicine in America was starting to...

  • Do I look like a PGY?
    Nov 13, 2014 | 1 Comment

        Working as a hospitalist since our society’s founding, I have reaped insights and a dose of confidence those starting in our specialty lack.  I am not speaking just of clinical understanding. Hospital-based practitioners collaborate with colleagues from many specialties, and like us, each has its own identity. Surgery sees the world through their lens, as do we. Over time,...

  • Panic and Preparation
    Panic and Preparation
    Nov 12, 2014 | No Comments

    Things move fast in an outbreak – whether an outbreak of disease, panic, or both. A lot has happened since my last blog post. I wrote the last post just after Thomas Duncan became the first person to die of Ebola on U.S. soil, and nurse Nina Pham was infected while caring for him. In the past month, we have...

  • Throw Back Thursday: Hospital Food, Patient Satisfaction and Diabetes
    Nov 6, 2014 | 2 Comments

    Last year on June 24, 2013, Dr. Brad Flansbaum blogged about an article in Kaiser Health news about hospitals improving food options in order to increase their patient satisfaction scores. In light of November being Diabetes Awareness Month, I wanted to bring Brad’s post back into the spotlight. Patient nutrition is critically important for a patient’s recovery, and I’m especially...

  • Hospitalists: Missing Opportunities to Talk about Healthy Habits & Preventive Medicine?
    Hospitalists: Missing Opportunities to Talk about Healthy Habits & Preventive Medicine?
    Nov 4, 2014 | Comments Off

    As hospital doctors, we are extremely busy people. Our days whizz by, often without a moment to rest or take a deep breath. We are in “the zone” and rightly completely focused on getting our patients better and in a position where they can hopefully leave the hospital. We have chosen a specialty that is all about secondary level care,...

  • The Best Possible Day
    Oct 30, 2014 | Comments Off

    by Dr. Howard Epstein MD, FHM I have practiced medicine for more than 20 years now, and it still amazes me how poorly the health care system meets the needs of those nearing end of life. The chance to do better and help others do so led me to become a hospice and palliative medicine physician, start a hospital-based palliative...

  • 7-on/7-off Is Growing, but Will We Be Asked to Peel It back?
    7-on/7-off Is Growing, but Will We Be Asked to Peel It back?
    Oct 29, 2014 | Comments Off

    The new SHM/MGMA State of Hospital Medicine (SOHM) report has just been released and as always it is full of interesting nuggets about the way hospital medicine is practiced these days in our country. One fact/trend caught my eye. The number of 7-on/7-off scheduled programs is climbing. In the past two years, we have seen a rise from 41.9% in...

  • What’s going on?
    What’s going on?
    Oct 28, 2014 | 7 Comments

    I talk a lot with different physicians about integrating NP/PA providers into their practice.  I am frequently astonished by the level of reluctance, resistance and downright animosity from these physicians.  Many times a doctor will have a medical “horror story” with the NP/PA  playing  the  villain.  One bad encounter or event seems to  justify a complete rejection of the many...

  • THe AAFP just spent $20M over five years to promote family medicine…
    Oct 23, 2014 | Comments Off

    Think about that.  The equivalent move for SHM would be $2-3M to promote HM.  That’s a lot of dough. Organizations have tough choices.  Does SHM spend their money on research grants, exam recertification programs, services to members, advocacy in DC, or developing communications platforms (like the blog)?  You may not know it, but choices like these keep board leaders awake at...

  • A Day in the Life of a Young Hospitalist
    Oct 23, 2014 | Comments Off

    by Joshua Allen-Dicker, MD, MPH I am a young hospitalist who is 16 months into my role at an urban academic medical center. Unlike many of my more-senior colleagues who found their way to hospital medicine by circumstance, luck, or as a second-career path, I have been planning my career in hospital medicine since the beginning of my residency training....

  • Hospitalists Caught between a RAC and a Hard Place
    Oct 22, 2014 | Comments Off

    by Melinda J. Johnson, MD, FHM, FACP The observation status problem has continued to grow both larger and worse. My hospitalist colleagues and I are caring for patients in hospital beds in the exact same way as other patients in the hospital, but we are told that we must give them the designation called observation status.  CMS recognizes observation status...

  • Do hospital-based docs get sued more? Part II
    Do hospital-based docs get sued more? Part II
    Oct 21, 2014 | 2 Comments

      I left off last week’s post with a tease.  If you recall, I made note of the frequent mentions med mal gets in the lay and professional press, as well as the outsized influence the threat of getting sued has on physician psyches. Physician surveys, albeit with their biases, can tell us how we feel about medical torts.  However,...

  • Do hospital-based docs get sued more? Part I
    Oct 15, 2014 | 2 Comments

      If you want to get the hair on the necks of an audience full of docs to stand on end at a health reform lecture, utter the words salary or malpractice.  Without question, the two most galvanizing issues in our field, they hit hard because we feel their impact both in our professional and personal lives.  In addition, the outsized effects med mal has on our psyche cannot be overstated—especially by those whose...

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