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The Best Possible Day

Oct 30, 2014 | No Comments

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 | No Comments

    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 | 4 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 | No Comments

    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 | No Comments

    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 | No Comments

    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...

  • Ebola and “Unknown Unknowns”
    Ebola and “Unknown Unknowns”
    Oct 14, 2014 | 14 Comments

    I did not think I would ever quote Donald Rumsfeld in one of my blog posts, but some of the missed opportunities as well as the media and public panic surrounding the Ebola epidemic in West Africa have brought this quote to the forefront of my mind this past week. First, let me share my personal view of the Ebola...

  • Reactive Scheduling of Hospitalists: A viable alternative?
    Oct 7, 2014 | Comments Off

    By Sowmya Kanikkannan, MD, FACP, SFHM  My earliest memories of medicine take me back to dinner table conversations with my mother, who is a physician. She would share with us her daily stories, telling us about patients she took care of in her clinics and in the hospital. As an internist, she often found herself traveling between many locations. I...

  • Shunshine Act
    Oct 6, 2014 | Comments Off

    The Physician Payment Sunshine Act (PPSA) is intended to expose any financial relationships that could compromise a physician’s research integrity or patient care. In response to the PPSA, CMS created the “Open Payments” database, into which device-drug-supply manufacturers publicly report any financial transfers to physicians or teaching hospitals. This includes 3 types of payments: “general” payments, research payments, and physician...

  • Q: How do you call a pharmacist? A: “Waiter!”
    Oct 5, 2014 | Comments Off

      That was the old cardiology joke from a decade ago when job supply exceeded demand.  The field seemed to get its groove back—through both supplier-induced and demand factors—but do not hold your breath.  Workforce needs have only begun to get critical reappraisal and I would not rule out restaurant service for any specialty as health reform shakes out our...

  • Hound Dog Holiday
    Hound Dog Holiday
    Oct 2, 2014 | 1 Comment

    Why do we love “home?”  Why is home,  despite the worn sofa with the faint but persistent odor of hound dog and the kitchen table with the varnish worn off from gazillions of spilled glasses of milk the place of satisfaction and ease? I started thinking about this concept when recently given re-credentialing forms.  At my hospital, these forms were...

  • A Day in the Life of a Pediatric Hospitalist
    Sep 30, 2014 | Comments Off

    by Dr. Erin Stucky Fisher, MD, MHM I am a career pediatric hospitalist. Not one of my days is the same because as a hospitalist I have the opportunity to serve in numerous capacities within my hospital medicine group, my hospital and the fields of pediatrics and hospital medicine. I am one of the senior attendings on the pediatric hospital...

  • The Things We Say to Our Patients That We Should Be More Tactful about
    The Things We Say to Our Patients That We Should Be More Tactful about
    Sep 25, 2014 | Comments Off

    With the increased focus on patient satisfaction and improving the healthcare experience, how we communicate with our patients is becoming more important than ever. And it’s long overdue. From our patients’ perspectives, being sick is bad enough without feeling disrespected or having an inappropriate message communicated by those who are supposed to be caring for them. Yet every day in...

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