Palliative Care Resolutions for 2018
by Christian Sinclair (@ctsinclair)Happy New Year! As we look towards the future that is now 2018, many of us make promises which can be difficult to keep, but always with the purpose of working towards the best version of ourselves. (In a way it is kind of like a quality improvement project!) Often these resolutions are personal: exercise 5 times a week, eat more healthy, learn a new language, read more books, spend less time on my phone. Sometimes these resolutions reside in our professional spheres of influence. I thought it would be interesting to see what some hospice and palliative care colleagues are resolving to do...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 1, 2018 Category: Palliative Care Tags: meta sinclair Source Type: blogs
Collaboration with hospitalists, rather than competition, improves patient care
It’s been 21 years since Drs. Robert Wachter and Lee Goldman, in an article in the New England Journal of Medicine, first described a new delivery model called “hospitalists” – clinicians whose primary professional focus is the care of hospitalized patients. Since that time the healthcare system has seen rapid growth of hospitalist programs across a variety of specialties.
In the OB world, I have had the opportunity to observe the entire transition from both sides. In my opinion, the addition of a unit (OB emergency department, or OBED) where every patient presenting to labor and delivery for unscheduled care is ...
Source: Kevin, M.D. - Medical Weblog - January 1, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/charles-jaynes" rel="tag" > Charles Jaynes, MD < /a > Tags: Physician Hospital-Based Medicine Hospitalist OB/GYN Source Type: blogs
Do hospitalists improve patient outcomes? The answer isn ’t quite clear.
A study published recently in JAMA Internal Medicine looked at 650,651 Medicare patients hospitalized in 2013. It showed that when patients were cared for by their own outpatient physician, they had a slightly better outcome than when the patients were attended to by full-time hospital-based specialists who had not previously known them.
As an internal medicine physician who maintains hospital privileges, as well as caring for patients in an office setting, this study supports the type of medicine I have been trying to practice for the last 38 years. However, I am not naïve enough to believe it entirely.
In recent months,...
Source: Kevin, M.D. - Medical Weblog - December 26, 2017 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/steven-reznick" rel="tag" > Steven Reznick, MD < /a > Tags: Physician Hospital-Based Medicine Hospitalist Primary Care Source Type: blogs
Hospitalist “education” may have driven excessive narcotic use
(Source: Notes from Dr. RW)
Source: Notes from Dr. RW - December 19, 2017 Category: Internal Medicine Tags: hospital medicine pharmacology pseudoscience quality and safety Source Type: blogs
Do hospitalists really improve patient outcomes?
This study makes a compelling argument that longitudinal contact with patients may translate into different care patterns and outcomes (e.g., length of stay, discharge disposition, and even mortality). Importantly, this study was the first to distinguish between PCPs familiar with patients versus generalists without prior familiarity in the outpatient setting. However, the authors do acknowledge that, as with any observational study design, unmeasured confounders could contribute to the results, and they call for further research to understand the mechanisms by which PCPs may achieve better outcomes. Given that this pati...
Source: Kevin, M.D. - Medical Weblog - December 18, 2017 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/danielle-scheurer" rel="tag" > Danielle Scheurer, MD < /a > Tags: Physician Hospital-Based Medicine Hospitalist Source Type: blogs
LITFL Review 311
LITFL • Life in the Fast Lane Medical Blog
LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog
Welcome to the 311th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chunk of FOAM.
The Most Fair Dinkum Ripper Beauts of the Week
Do you have an ED spa at your shop? Invest in yourself and see the results as you flourish. O...
Source: Life in the Fast Lane - December 18, 2017 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: LITFL review LITFL R/V Source Type: blogs
BMJ study: Patients treated by older physicians (60 and older) had higher mortality vs. younger physicians (39 and younger)
FromBMJ:The researchers evaluated a 20% random sample of Medicare fee-for-service beneficiaries aged 65 and older admitted to hospital with a medical condition in 2011-14 and treated by hospitalist physicians.Main outcome measures 30 day mortality and readmissions and costs of care.The study included 700,000 admissions managed by 18,800 hospitalist physicians (median age 41).Patients ’ adjusted 30 day mortality rates were:- 10.8% for physicians younger than 40- 11.1% for physicians aged 40-49- 11.3% for physicians aged 50-59- 12.1% for physicians aged 60 and olderSee the figure here:http://www.bmj.com/content/bmj/357/bmj...
Source: Clinical Cases and Images - Blog - December 13, 2017 Category: Universities & Medical Training Tags: Age Geriatrics Physician Source Type: blogs
3 ways to fix end-of-life care
Anyone with even the slightest passing interest in health care, has heard the mind-blowing statistics. As a nation, we spend almost 3.5 trillion dollars on health care. To put that into perspective, that is more than the total GDP of every country in the world apart from China and Japan! Germany, next on the list, has an entire GDP of 3.4 trillion dollars. At 18 percent of the economy, we spend almost double the OECD GDP average percentage of other western nations. What’s more, our health care spending continues to spiral out of control, and will only realistically increase with newer expensive treatments against the bac...
Source: Kevin, M.D. - Medical Weblog - December 1, 2017 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/suneel-dhand" rel="tag" > Suneel Dhand, MD < /a > Tags: Physician Palliative Care Source Type: blogs
Hospitalists as housekeepers
(Source: Notes from Dr. RW)
Source: Notes from Dr. RW - November 27, 2017 Category: Internal Medicine Tags: hospital medicine Source Type: blogs
Hospitalists ’ enthusiasm for MOC: less than overwhelming
(Source: Notes from Dr. RW)
Source: Notes from Dr. RW - November 23, 2017 Category: Internal Medicine Tags: medical education Source Type: blogs
The doctor-patient relationship is everything
While doing my doctoral dissertation research at a clinic for kids with diabetes, I observed the attachment that some of them had to the physician faculty member who directed the clinic. I particularly remember one teenager who complained that this doctor “did not care” about her, as he sent “fake doctors” (residents) to take care of her, not coming himself. She was refusing to cooperate. When I suggested to the director that he visit her, he did so. He pulled up a chair by her bed and assured her that he did care about her and requested her cooperation with the residents, as a favor to him. She was...
Source: Kevin, M.D. - Medical Weblog - November 23, 2017 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/peggy-a-rothbaum" rel="tag" > Peggy A. Rothbaum, PhD < /a > Tags: Physician Practice Management Primary Care Source Type: blogs
Health Care Needs Its Rosa Parks Moment
BY SHANNON BROWNLEE
On Wednesday, October 25, 2017 I was at the inaugural Society for Participatory Medicine conference. It was a fantastic day and the ending keynote was the superb Shannon Brownlee. It was great to catch up with her and I’m grateful that she agreed to let THCB publish her speech. Settle back with a cup of coffee (or as it’s Thanksgiving, perhaps something stronger), and enjoy–Matthew Holt
George Burns once said, the secret to a good sermon is to have a good beginning and a good ending—and to have the two as close together as possible. I think the same is true of final keynotes after a...
Source: The Health Care Blog - November 22, 2017 Category: Consumer Health News Authors: Matthew Holt Tags: OP-ED Patients Physicians Lown Institute Overtreatment Right Choice Alliance Shannon Brownlee Society for Participatory Medicine Source Type: blogs
These are the biggest medical issues of 2017
Periodically we should reflect on what challenges face patients and physicians. Over the past few days, I have worked on a list of the issues that concern me the most. I welcome suggestions for expanding the list.
1. Diagnostic errors. All patient care requires that we make the proper diagnosis. Too often we make errors. A recent paper estimated that 30 percent of cellulitis admissions did not have cellulitis. A similar paper found almost the same estimate for community-acquired pneumonia admissions. The most common reason for successful malpractice claims is diagnostic errors. Have they increased? Members ...
Source: Kevin, M.D. - Medical Weblog - November 22, 2017 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/robert-centor" rel="tag" > Robert Centor, MD < /a > Tags: Physician Hospital-Based Medicine Primary Care Public Health & Policy Source Type: blogs
LITFL Review 307
LITFL • Life in the Fast Lane Medical Blog
LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog
Welcome to the 307th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chunk of FOAM.
The Most Fair Dinkum Ripper Beauts of the Week
Here’s a series of integrated Sepsis lectures from the Maryland CCProject. [SO]
Th...
Source: Life in the Fast Lane - November 19, 2017 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: LITFL review LITFL R/V Source Type: blogs
Instinct is Learned
Mr. Reynolds is a vivid 83 year old who lived alone at home. He walks everyday int he morning first thing before he has a small cup of coffee. His kids bought him an ipad and he uses it to browse the Washington Post, the Wall Street Journal, and the Pittsburgh Post Gazette while eating breakfast.
Every morning it’s the same breakfast…toast with honey and a small cup of yogurt. Then he’s ready to start the day, just when the rest of his neighbors are waking up.
Today however, he ate hist toast and his stomach grumbled, louder than usual. He thought to himself that he’d better get to the bathroom qu...
Source: Mr. Hassle's Long Underpants - November 10, 2017 Category: Emergency Medicine Authors: Doc Shazam Tags: Clinical Source Type: blogs
