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Are Regulations Preventing Hospitalists From Reaching Their Full Potential?

How many patients should a hospitalist average on any given day?   What do you think?  The Hospitalist asked that question to hospitalists and  421 of them responded.  They were given responses in quintiles of 10 or fewer,  11-15, 16-20, 21-25, and more than 25 total patient encounters per day.

Go check out their results.  I’m not surprised.  But, as they say,  there is no right answer.  The right number is the number that brings WIN-WIN-WIN-WIN to the patient-doctor-hospital-insurance quadrangle.   WIN-WIN-WIN-WIN is possible.  It just takes a great understanding of removing the barriers to efficiency.  Efficiency and quality of care can move in the same direction.  They don’t have to be opposing forces.  You can be better and faster if given the tools, whether those tools are driven by IT support, systems process changes, communication enhancement, physical and structural hospital layout changes or documentation support tools.  There are many others. Read more »

*This blog post was originally published at The Happy Hospitalist*

The House-Call: Physician Laments The Passing Of The Good Old Days

Nostalgia for the house-call

Not too long ago, I made a house call. As a physician accustomed to working in the emergency department of a hospital, this was quite a change of pace. But it involved dear friends and their sick child, and it was a joy. We had spoken on the phone and I had some concerns about their infant, who was stricken with a high fever. When I went to their home I took only my stethoscope. That and my experience as a physician and parent of four.

When I walked through the door on Friday evening there were candles burning as dinner was prepared. There were no florescent lights. There was none of the chaos of a waiting room. No ambulances idled outside. No bloody, angry drunk screamed profanities. No one was stood by their exam room door, arms crossed in annoyance with waiting. It was a quiet place to be; and the child, on his worried mother’s hip, was quiet as well. He was in a place where he felt safe and was thus able to tolerate my poking and prodding.

I examined him and decided that he was not seriously ill. Because his mother had described him as lethargic when we spoke, I had been concerned that he might have meningitis. This was not actually the case. His parents and I were obviously relieved.

After he was dosed with ibuprofen and put to bed, I chatted a while with his mom and dad, then left for home. As I drove home I realized that Read more »

*This blog post was originally published at edwinleap.com*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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