Troy Ahlstrom writes…

Assume one will question leadership’s motivation.  State your good intentions clearly and avoid allowing others to infer ill will.

Last month, we ruminated on the foundation of credible leadership, integrity.  This month, we survey how we get from that foundation to actually carrying out a program as an organization.  The all important intermediary step is demonstration of intent.  Our intentions or motives comprise the inseparable link between who we are and what we must accomplish as leaders of an organization. (more…)

Jack Percelay writes…

Do you get paid holiday time off as a hospitalist? Or are you told that everyday you are not working is time off, just like the kids who ask, “If there’s a Mothers’ Day and a Fathers’ Day, why isn’t there a Children’s Day?” and are told,  “Everyday is Children’s Day.”

As is true for most of my pediatric hospitalist colleagues, I am an employee of the hospital/Department of Pediatrics.  I am not an independent contractor, do not own my own group, nor am I employed by a larger Hospital Medicine company.  I love my work, work hard, and expect to work my fair share of nights and weekends.  I respect my general pediatrician colleagues, but prefer the inpatient setting to the outpatient setting.  (Guess I have too much ADD to treat it.)  I value their work, and value mine equally.   Their patient volume is higher with lower acuity.  My acuity is higher with lower volume.  In an ideal world, I would say that our work is of equal value and we should be equally compensated.

So, leaving out the night call and weekend call issues aside for now (I’d go crazy answering calls overnight or on the weekend in the middle of flu season), let’s examine the question of holidays. (more…)

Mike Radzienda writes…

In my fourteen years of medical practice, I had written a Do Not Resuscitate (DNR) order based on medical futility once. The patient was terminally ill, comatose, and without next of kin. The DNR order was by concurring physicians. It was not contested, and the patient ultimately died peacefully.

Last week, I wrote my second DNR order based on medical futility. This time was not so simple. (more…)

Rob Bessler writes…

I had the opportunity to meet with Senator Maria Cantwell (D) for Washington State. Senator Cantwell is on the senate finance committee and has had a strong voice in the Senate’s formation of their Healthcare bill.  The purpose of my meeting was to inform her about the role of hospitalists, our organizations focus in her state and express our support for meaningful reform that lowers cost and improves quality. I specifically offered up our help as the bills go through both the House and Senate as a resource.  I had a specific ask on page 220 of the Senate finance bill that stated (more…)

Public Policy Contributor Brad Flansbaum writes…

No, that is not my quote, but I did hear it from a guy sitting behind me at a recent conference on health reform.  There are no revelations in this statement, but in that sentiment, I found a kindred spirit.  Me.

The last 12 months of national health care debate have been fascinating.   The power plays by the major stakeholders, the expected and unexpected topics of focus by the press corps, the often unpredictable public polling numbers, and the messaging from the Whitehouse—sometimes highbrow, sometimes funny, sometimes disgusting—all better than reality TV in my book.  You just don’t know what will come next.  (more…)