Archive for March 2015

The Porridge Is Just Right: Choosing Wisely®

by John B. Bulger, DO, MBA It began in the spring of 2012. A small sub-group of the Society of Hospital Medicine’s (SHM) Hospital Quality and Patient Safety Committee (HQPS) was given the task of coming up with five test and treatments that hospitalists overuse. The pediatric hospitalist community was already hard at work (and quite far ahead) on their list. An adult list was needed. It was early June and five were required by August. Starting prolifically with 160 candidates, a mix of opinion and science, leadership and rank and file, rigor and pragmatism cut the list to five – really six, but we couldn’t figure out a way to present one of them in the ABIM required negative (avoid or don’t do) syntax. From SHM board approval in August to the release in February of 2013, the lists waited out a Presidential election and other media cycles. Manuscripts…

Engaging Hospitalists: What Makes You Tick?

by Jerome Siy, MD, SFHM, CHIE It would be easy to deliver on the triple aim if all hospitalists had to do was run a checklist.  But, it’s pretty obvious that we need more than a checklist to be successful.  How many of us are graduated in the top 10% of our class, but can’t get a score above 70% on our HCAPS scores?  A checklist is something we should be familiar with.  It’s how we got through medical school, and how we passed our boards.  Are we passing in our hospital medicine practice? Don’t get me wrong.  The checklist helps. A gentle reminder to foam in and foam out, a cue to sit down before I begin a conversation with a vulnerable patient, or a nudge to lend a hand at the next ED to inpatient lean project are all important ways we can improve upon our hospitalist mission.  If…

Say What?!

by Dr. Amit Singh "Good morning Mr. Johnson*!” our chief resident bellowed as we all crowded around the bedside, a sea of endless short and long white coats. “I want to let you know we took a look at the X-ray this morning and it looks good. The angle looks sharp, no effusion!” We looked at Mr. Johnson and I saw his completely blank stare. His breakfast tray was not far from him as he was just about to start eating. The resident “examined” him, and in a matter of one minute, our whirlwind of a team was out of the room as fast as we had entered. As he watched us all, it was at that exact moment on my very first day of rounds, on my first clinical rotation as a medical student that I learned exactly how not to talk to patients. Whether it’s your best friend,…

Reminiscing about Match Day

Friday March 20th was the 2015 Match Day. A big moment for every doctor that in many ways determines not only our specialty and where we will practice, but in some ways sets our destiny with who we will marry and who our lifelong friends will be. I still remember my Match Day 42 years ago in 1973. There were some unique aspects to my 1973 match. First, I was president of the senior class at Temple Medical School and by tradition I worked with the dean to develop a plan to help my classmates who went unmatched to get internships. In this role I actually got a look at the match results a day ahead of the public announcements. In my class we had six or seven people who did not match. Two people because they only listed one hospital (What were they thinking?!) and another because he listed…

My Op-Ed in Today’s New York Times… and My New Book

This week feels like the coming out for my new book, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age. The NY Times ran my op-ed on health IT today (they chose the slightly sensationalist title, FYI). I’ve also started something of a book tour, with several talks and media interviews scheduled this week, including a sit down with Sanjay Gupta. (Note to my wonderful children: sorry, no Jon Stewart; at least, not yet). Since the Times piece does not allow for comments, let me invite any comments here. The op-ed is really a Cliff’s Notes version of the book, whose formal publication date is April 7th but which began shipping from Amazon last week. If anyone would like to comment on the book, I’d love to hear that, too. (Of course, reviews of the book on Amazon are much appreciated, particularly if you liked…