5 ways to make a connection with previously unreachable patients
I sometimes joke that hospitalists are the medicine version of the mullet haircut; you know, all business in “the front” (i.e., the patient care area) and all party in “the back” (i.e., the work room). In “the back,” the usual scenario is to complain and moan about our frequent flyers, our drug seekers, our many unsaveable patients, the incredible situations (“He put a nail where?”), with good-natured but somewhat bitter truculence about sharing duties with house staff and general whining about hospital leadership.
Generally, as long as these semi-inappropriate conversations and remarks were kept “bac...
Source: Kevin, M.D. - Medical Weblog - June 1, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/tracy-cardin" rel="tag" > Tracy Cardin, ACNP < /a > Tags: Physician Hospitalist Source Type: blogs
How to give constructive criticism as a physician
Here are some questions that are still on my mind as I approach the tail end of my chief year. I’m thinking about the best ways to offer constructive feedback.
What is the best way to approach a struggling learner?
What is the best way to give guidance and feedback without being perceived as a tyrant or overbearing?
How can I maximize the potential of my team members and the trainees with whom I work, based on performance evaluations?
A senior colleague surely did not lie when he told me that his year as chief resident was “one of the best years of my life.” Our institute might be unique: I have an unrestricted me...
Source: Kevin, M.D. - Medical Weblog - May 26, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/joseph-cooper" rel="tag" > Joseph Cooper, MD < /a > Tags: Education Medical school Residency Source Type: blogs
Physicians have to stay in their lanes
I drive a fast car. Which if you know me, is quite uncharacteristic. I would say that it is one the few possessions that generally doesn’t reflect upon who I am. How I chose this car, the make, and model, are a long story not to be discussed here. But let’s just say that it has quite a kick.
These thoughts jostled through my mind this morning as I pulled into the hospital parking lot. A recent momentous decision, I surrendered my privileges at this hospital and started using the hospitalists. It had all become too hard. The inane compliance issues with the new EMR. The ER attendings admitting my patients withou...
Source: Kevin, M.D. - Medical Weblog - May 17, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/jordan-grumet" rel="tag" > Jordan Grumet, MD < /a > Tags: Physician Primary care Source Type: blogs
8 traits of excellent hospital doctors
A good relationship between a patient and his or her physician is the cornerstone of superb medical care. That relationship is important when you know the doctor well. It may be even more important when you don’t, say when you are in the hospital.
Growing competition for new customers is inspiring American hospitals to focus on providing a more positive patient experience — and hospitals expect their doctors to do their part.
We wanted to know what defines great physicians in the hospital setting (sometimes called attending physicians), both in terms of their interactions with patients and how they teach the next gener...
Source: Kevin, M.D. - Medical Weblog - May 11, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/sanjay-saint-and-molly-harrod" rel="tag" > Sanjay Saint, MD and Molly Harrod, PhD < /a > Tags: Physician Hospital Hospitalist Source Type: blogs
The Joint Commission surveys matter more than we think
Recently, the online version of JAMA published an original investigation entitled “Patient Mortality During Unannounced Accreditation Surveys at US Hospitals.” The purpose of this investigation was to determine the effect of heightened vigilance during unannounced accreditation surveys on safety and quality of inpatient care. The authors found that there was a significant reduction in mortality in patients admitted during the week of surveys by The Joint Commission. The change was more significant in major teaching hospitals, where mortality fell from 6.41 percent to 5.93 percent during survey weeks, a 5.9 per...
Source: Kevin, M.D. - Medical Weblog - May 9, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/tracy-cardin" rel="tag" > Tracy Cardin, ACNP < /a > Tags: Policy Hospital Hospitalist Source Type: blogs
Changing Lanes
I drive a fast car. Which if you know me, is quite uncharacteristic. I would say that it is one the few possessions that generally doesn't reflect upon who I am. How I chose this car, the make, and model, are a long story not to be discussed here. But let's just say that it has quite a kick.These thoughts jostled through my mind this morning as I pulled into the hospital parking lot. A recent momentous decision, I surrendered my privileges at this hospital and started using the hospitalists. It had all become too hard. The inane compliance issues with the new EMR. The ER attendings ...
Source: In My Humble Opinion - May 5, 2017 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
Changing Lanes
I drive a fast car. Which if you know me, is quite uncharacteristic. I would say that it is one the few possessions that generally doesn ' t reflect upon who I am. How I chose this car, the make, and model, are a long story not to be discussed here. But let ' s just say that it has quite a kick.These thoughts jostled through my mind this morning as I pulled into the hospital parking lot. A recent momentous decision, I surrendered my privileges at this hospital and started using the hospitalists. It had all become too hard. The inane compliance issues with the new EMR. The ER attendi...
Source: In My Humble Opinion - May 5, 2017 Category: Primary Care Authors: Jordan Grumet 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 - May 2, 2017 Category: Internal Medicine Tags: cardiovascular hospital medicine Source Type: blogs
What life is like for this retired physician
I have now been out of the active medicine for two years. I still have dreams about being a doctor and practice. I don’t think you can do the same thing day in and day out for 40 years and not have it be a part of who you are. I am still asked my opinion by friends and family about their health issues, and frankly, I find my fund of knowledge is slipping away. I did renew my license in the state of Florida that required 40 hours of continuing medical education. (I did mine mostly online.) I don’t know if I will renew it again in 2019.
Being on Medicare, I visit doctors — probably too often. I have become ...
Source: Kevin, M.D. - Medical Weblog - April 16, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/david-mokotoff" rel="tag" > David Mokotoff, MD < /a > Tags: Physician Primary care Source Type: blogs
Evidence-Based Health Reform
By MARGALIT GUR-ARIE
President Trump campaigned on making health care better, cheaper and available to all Americans, regardless of ability to pay. Once Mr. Trump was safely in the White House, the Republican thought leaders in Congress were quick to supply him with plans to repeal and replace Obamacare. Most were written in protest to President Obama’s policies and were never meant to be implemented.
When scrutinized by the rank and file of the Republican Party, it turned out that the Ryan/Price American Health Care Act was neither repealing enough for some, nor replacing enough for others.
The Democratic Party lost no...
Source: The Health Care Blog - March 26, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Death is a blessing in its right time and place
I am working hospitalist right now. On Friday, a man in his 80s was admitted with difficulty breathing. He had a complicated history, including a heart attack at age 35 with all the subsequent sequela of heart disease. He had an abnormal heart rhythm and was taking a blood thinner for stroke prevention. In addition, he had scarring of his lungs (cause unknown).
He was transferred to us from another hospital. He had shown up at the other hospital with a nosebleed (side effect of the blood thinner). In an attempt to stop the nosebleed, he was given blood and plasma transfusions. Nasal packing was placed. He subsequently ende...
Source: Kevin, M.D. - Medical Weblog - March 24, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/uzma-khan" rel="tag" > Uzma Khan, MD < /a > Tags: Physician Hospital Hospitalist Palliative care Source Type: blogs
Let primary care doctors practice more outpatient medicine
Long ago, before our hospital changed over to a nearly complete hospitalist model, the faculty at our internal medicine practice served as the attending of record for all of our own patients, as well as the patients of the residents we supervised, when those patients were admitted to the inpatient services across the street.
When we would arrive in the morning, we would look at the admission list, note that one or two of our patients had been admitted, and maybe one or two of some of our residents’ patients, and knew that our day would have the addition of rounding on those patients as well as our full schedule of ou...
Source: Kevin, M.D. - Medical Weblog - March 19, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/fred-n-pelzman" rel="tag" > Fred N. Pelzman, MD < /a > Tags: Physician Primary care Source Type: blogs
How hospital executives wish their hospitalists would act
Recently, I wrote a letter to hospital executives, urging them to deliberately invest their own personal time and effort in fostering hospitalist well-being. I suggested several actions that leaders can take to enhance hospitalist job satisfaction and reduce the risk of burnout and turnover. Following the publication of that post, I heard from several hospital executives and was pleasantly surprised that they all responded positively to my message. Several execs told me that they gained valuable new insights about their hospitalists’ challenges and needs, or that they planned to take action on one or more of my suggestio...
Source: Kevin, M.D. - Medical Weblog - March 17, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/leslie-flores" rel="tag" > Leslie Flores < /a > Tags: Physician Hospital Hospitalist Source Type: blogs
The great unspoken secret
Sometimes it feels like the great unspoken secret between doctors and nurses. The words that we dare not utter to patients and families. Perhaps it is our hope that we’re wrong. Perhaps, we dread providing unwanted news. Perhaps, we don’t want to face reality or extinguish our patients’ hope.
As a daughter, I felt that sense of sadness and dread, waiting to hear the news that would not be told. It was September of 1989, I was only 20 years old and just beginning my first year of medical school. It was less than a week from my first medical school examination, when my mother developed intractable nausea ...
Source: Kevin, M.D. - Medical Weblog - March 14, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/yvette-youssef" rel="tag" > Yvette Youssef, MD < /a > Tags: Physician Hospital Hospitalist Source Type: blogs
Who if not me will make my patients whole?
Having graduated from medical school in 2008 and internal medicine residency in 2011, I am a physician-child of the Affordable Care Act (ACA) era. The belief that “health care is a human right” ran deep through my upbringing and life experiences, but training during a period of such intense debate over health care reform reinforced this ideal. My professional identity developed interwoven with a compelling national conversation about access and improvement. Though the ACA has much to debate in the details, the dialogue of my medical coming-of-age was rooted in the quest for quality, sustainability, and equity.
I work...
Source: Kevin, M.D. - Medical Weblog - March 12, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/rebecca-jaffe" rel="tag" > Rebecca Jaffe, MD < /a > Tags: Policy Health reform Source Type: blogs
