Advice from a “xennial” physician to aspiring physicians
I am considered a “xennial” physician. Not quite a millennial — but also not fitting into the generation of the respected preceptors I had in medical school and residency. I took my MCAT via paper and pencil. My mini boards during my clinical rotations were on paper and pencil. All of my licensing and board […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - November 27, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/andrea-lauffer" rel="tag" > Andrea Lauffer, MD < /a > Tags: Physician Hospital-Based Medicine Hospitalist Source Type: blogs
We are in danger of hospitals no longer being safe havens
On the outside, most American hospitals appear completely modernized. If resources are utilized correctly, they appear equipped for any disaster, any CMS audit and any surprise joint commission inspection that may come. The procedural appearance of hospitals seems robust and reflective to medicine in the 21st century. However, the framework for the daily function of […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - November 7, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/andrea-lauffer" rel="tag" > Andrea Lauffer, MD < /a > Tags: Physician Hospital-Based Medicine Hospitalist Source Type: blogs
Help hospitalized patients vote by requesting emergency ballots
Two years ago, when I was still in residency I happened to be on overnight call the day prior to election day. An associate program director of my residency program asked me if I wouldn’t mind being a doctor of record who evaluates whether I agree a patient is too sick to go to the […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - November 5, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/priya-joshi" rel="tag" > Priya Joshi < /a > Tags: Policy Hospital-Based Medicine Hospitalist Public Health & Washington Watch Source Type: blogs
This physician is a better hospitalist because of the time she spent in the clinic
Not knowing what else to do after finishing my pediatric residency 15 years ago, I became a general pediatrician. Not knowing how to find a job halfway across the country and closer to home, I relied on a recruiter from a smallish town in South Dakota to woo me into private practice. Not knowing how to choose my future partners, I let them choose me.
Despite my unbelievably naive approach to finding my first job as a physician, I think I was pretty lucky. I joined a physician-owned multi-specialty practice that had been founded by the father and uncle of one of the general surgeons. I joined two well-established pediatrici...
Source: Kevin, M.D. - Medical Weblog - October 16, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/lisa-sieczkowski" rel="tag" > Lisa Sieczkowski, MD < /a > Tags: Physician Hospital-Based Medicine Hospitalist Pediatrics Source Type: blogs
When doctors behave badly: a call for civility
A guest column by the American College of Physicians, exclusive to KevinMD.com.
It can be as blatant as a public argument between a hospitalist and emergency medicine physician about whether a patient requires admission. But most commonly it is more nuanced and subtle. Such as members of one speciality “bad-mouthing” another or a subspecialist criticizing a generalist for asking for a consult they don’t think is appropriate. Not to mention the day-to-day interactions we have with other health care professionals in which we ignore, disregard, disparage, or otherwise fail to appreciate the work they do in caring ...
Source: Kevin, M.D. - Medical Weblog - October 7, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/philip-a-masters" rel="tag" > Philip A. Masters, MD < /a > Tags: Physician American College of Physicians Hospital-Based Medicine Primary Care Source Type: blogs
I ’m thankful that medicine is a small world
This past week was one of those weeks looming ahead of me that I was already dreading as I entered into it. I was to be working through another holiday and following a string of nights, and I would have a quick turnaround into a mid-shift. As a nocturnist by choice, I rarely work mornings or mid-shifts. I find the nights busy but also less intrusive — i.e., less administrative personnel around which allows us to have a bit more freedom. We have our own ebb and flow at nights, usually extremely busy when we arrive, and it tends to slow as the night turns into morning and dawn. That being said, we don’t often get to ming...
Source: Kevin, M.D. - Medical Weblog - October 4, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/maria-perez-johnson" rel="tag" > Maria Perez-Johnson, DO < /a > Tags: Physician Hospital-Based Medicine Hospitalist Source Type: blogs
Periprocedural management of anticoagulation in non-valvular a fib: what the hospitalist needs to know
(Source: Notes from Dr. RW)
Source: Notes from Dr. RW - October 2, 2018 Category: Internal Medicine Tags: cardiovascular hematology hospital medicine Source Type: blogs
Expensive Hospitals: The Enemy Within
By ANISH KOKA MD
Everyone agrees that health care is bankrupting the nation. The prevailing winds have carried the argument that a system that pays per unit of health care delivered and thus favors volume over value is responsible. The problem, you see, was the doctors. They were just incentivized to do too much. This incontrovertible fact was the basis for changes in the healthcare system that favored hospital employment and have made the salaried physician the new normal. Yet, health care costs remain ascendant.
Why?
It turns out overutilization in the US healthcare system isn’t what its cracked up to be.
Figure 1...
Source: The Health Care Blog - October 1, 2018 Category: Consumer Health News Authors: anish_koka Tags: Finance Patients Physicians Anish Koka expensive health care finances health care finances Incentives Source Type: blogs
Signposting Teaching Moments: Get Credit for What You Already Do
Hospitals around the country are struggling to accommodate the increasing number of patients requiring acute inpatient care while physician staffing remains relatively stagnant. Every time the emergency department goes into divert mode, the natural question is: “Why can’t the residents just take more patients? Can resident duty hours and teaching time preservation just be waived for a little while?” For clinical educators, the census and complexity of an inpatient service has a major effect on the time available for teaching. We ultimately want to provide the best learning experience for our students and resid...
Source: Academic Medicine Blog - September 25, 2018 Category: Universities & Medical Training Authors: Guest Author Tags: Featured Guest Perspective clinical educators rounds teaching strategies Source Type: blogs
Why doctors can ’t take sick days
I learn all manner of interesting things from the information sheets posted on the walls of the employee bathrooms at my hospital. I learn, for example, about upcoming CME offerings for advance practice providers, how many seconds one has to scrub the hub of a central line, and what the new process is when nurses need to call in sick. They call a specific phone number and state that they cannot come to work. Done. Someone else’s problem now.
This is amazing to me, because there is no such construct in place for physicians when we are sick.
Every few months, my cell phone dings at a sickeningly early hour. My “hospi...
Source: Kevin, M.D. - Medical Weblog - September 21, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/lisa-sieczkowski" rel="tag" > Lisa Sieczkowski, MD < /a > Tags: Physician Hospital-Based Medicine Hospitalist Practice Management Source Type: blogs
Patients need an advocate at the bedside
Being a hospitalized patient is perhaps one of the most disempowering experiences an individual can face (besides being in war, or a prisoner). Patients face constant uncertainty; having no idea what time their physician will visit, when they will be taken for their tests, or who will suddenly interrupt them again with a demand – perhaps an early morning blood draw, or yet another round of interrogation and uncomfortable examination (by students, trainees, and consultants).
One would imagine that hospitals would feel like safe havens with good-hearted nurses, physicians, and other health care professionals nurturing ...
Source: Kevin, M.D. - Medical Weblog - September 14, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/varun-verma" rel="tag" > Varun Verma, MD < /a > Tags: Physician Hospital-Based Medicine Hospitalist Source Type: blogs
Medical office design matters
Fresh out of residency and having just turned 29 years old, I started my first job as a general pediatrician in Sioux Falls, South Dakota. One of the first official tasks of my new position involved picking out brand new office furniture for my private windowed office which was housed along the perimeter of the multi-specialty clinic I had joined. I went with a blond L-shaped desk and shelf unit and later framed my diplomas to match. I was given a set of pens with my name engraved on the wooden holder. And I was directly involved in the hiring process of my own clinic nurse.
Fast forward 15 years, and I am now a pediatric ...
Source: Kevin, M.D. - Medical Weblog - September 10, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/lisa-sieczkowski" rel="tag" > Lisa Sieczkowski, MD < /a > Tags: Physician Hospital-Based Medicine Pediatrics Practice Management Source Type: blogs
6 things wrong with hospital medicine
In 2002, when I began my first hospitalist job, I was a dyed-in-the-wool hospital medicine convert, convinced that the transfer of inpatient care to true specialists in hospital medicine (hospitalists) would dramatically improve the quality and efficiency of inpatient care, increase patient satisfaction and decrease costs.
By 2008, I had developed serious doubts, which prompted me to publish an editorial in the Journal of Hospital Medicine, entitled “The Expanding or Shrinking Universe of the Hospitalist” (2008) that attempted to raise a red flag of concern about hospitalists, in general, failing to become “hospital ...
Source: Kevin, M.D. - Medical Weblog - September 10, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/david-m-mitchell" rel="tag" > David M. Mitchell, MD, PhD < /a > Tags: Physician Hospital-Based Medicine Hospitalist Practice Management Source Type: blogs
It ’s time for hospitalists to be engaged with opioid use disorders
Alvin is a 42-year-old man who was never really given a chance. His parents both had severe alcohol use disorder. At age 12, his parents encouraged him to skip school to sell marijuana in order to fund their drinking. As his parents began using various illicit drugs, Alvin started selling larger amounts of marijuana to foot their bill. Eventually, marijuana was not profitable enough. Alvin, then 16 years old, turned to crack cocaine. A year later, he was arrested with enough drugs in his possession to justify a criminal charge for dealing.
Alvin spent the next 20 years in and out of prison. He had never been in a physical ...
Source: Kevin, M.D. - Medical Weblog - September 5, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/rich-bottner" rel="tag" > Rich Bottner, PA-C < /a > Tags: Conditions Hospital-Based Medicine Hospitalist Source Type: blogs
4 reasons why physicians will become extinct
Will physicians go extinct? Artificial intelligence, legislation, profit motives in the health care industry, and clever lobbying by non-physician providers may all contribute to our demise. However, I believe the existential threat to our profession stems from the ranks of physicians themselves.
1. Unwillingness to embrace activism
Pathologist and writer Rudolph Virchow once said: “The physician is the natural attorney of the poor.” Like most physicians, my goal is to provide evidence-based and compassionate care to my patients and be their chief advocate. As a hospitalist, I consider it my duty to fight to ensure tha...
Source: Kevin, M.D. - Medical Weblog - September 1, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/varun-verma" rel="tag" > Varun Verma, MD < /a > Tags: Policy Public Health & Washington Watch Source Type: blogs
