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Latest Posts

Hospital(ist) Food Service, Too?

What is a hospitalist and what kind of care does a hospitalist provide? It’s funny to read what people are writing these days about my professional role in patient care. It now appears hospitalists don’t manage medical issues anymore, but rather go through seven years of medical training to discuss the efficiency of the cafeteria food with their patients.

I read one article where the reader (obviously not a hospitalist) suggests that a hospitalist is a medical doctor who can do all the things normal doctors can, but instead of seeing patients all day, he makes rounds through the hospital, talking to patients to find out what can make their hospital stay better. And what kind of issues does the hospitalist deal with on their rounds? Why, the efficiency of the cafeteria food, of course.

I guess I was sleeping the day I was supposed to learn about the efficiency of hospital food in medical school. Maybe that means, after reviewing the SHM/MGMA 2010 hospitalist salary compensation report, I should request a pay cut because of my failure to provide cafeteria support. Or better yet, maybe I could make it up by asking security if I could provide takedown support on some code assists. Okay, I feel better about my role as a hospitalist.

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

A Clinic For Diarrhea And International “Travelers?”

Diarrhea ClinicI’m not sure what country this photo was snapped in, but the clinic owners were smart enough to help international travelers seek care for traveler’s diarrhea. There’s no beating around the bush on this one. If you’re in this waiting room staring at strangers, they’re all going to know why you’re there.

Diarrhea Clinic — that’s simple brilliance. That doctor needs to be hired by the ACP and SHM and ABIM to help us answer questions like ”What is an internist?” and “What is a hospitalist?” For these doctors, everyone knows exactly what he does — no questions necessary.

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

9 Tips To Improve Patient Satisfaction

Some interesting points were raised at a recent Society of Hospital Medicine (SHM) session by Winthrop Whitcomb and Nancy Mihevc on patient satisfaction. To improve satisfaction scores:

1. Review the patient’s chart before you go in the room. It makes a big difference if the patient perceives you know what’s going on without having to bury your face in a chart.

2. Patients are often confused about who they are supposed to see after discharge. This, of course, is a safety issue as well as one that affects patient satisfaction.

3. Sit down when you are visiting a patient. Patients are happiest when they perceive you’ve spent enough time with them, and they are more likely to perceive this if you are sitting than standing with your hand on the doorknob. Read more »

*This blog post was originally published at ACP Hospitalist*

Insurance Rules And Overprescribing Expensive Drugs

I have yet another example of how third party insurance rules obstruct efficient patient care. I was asked to see a patient with fibromyalgia who was asking about about the drug Lyrica she heard about on television (one example of how direct to consumer marketing increases health care expenses).  Lyrica is about the only medication approved by the FDA to treat fibromyalgia.  I don’t know if it really works or if it’s just an expensive placebo effect.

Maybe fibromyalgia is all in the head, and that’s why this medication works.  I don’t really care.  I know it’s FDA approved, which means it has more going for it than most pharmaceuticals used for off label purposes.  At least doctors who prescribe Lyrica for fibromyalgia aren’t going to get charged with homicide for prescribing medications for unapproved reasons. Read more »

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

What If Investment Advisers Managed Risk Like Physicians?

I have blogged extensively about why standard of care is an irresponsible measure of the threshold for determining negligence in medical care. Most recently, I blogged about it here and here. Imagine for a moment what capitalism would be like if your investment adviser was sued every time your investment value went down. Imagine what life would be like if they risked civil liability every time a bad outcome occurred. What if no laws were broken? What if an after the fact determination of negligence was based on a bad outcome?

Read more »

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

Latest Interviews

The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

If you can read this you need to download a more recent browser It is estimated that as many as million U.S. adults have ADHD Attention-Deficit Hyperactivity Disorder A recent research study publication-pending suggests that the economic burden of ADHD on America could be as high as billion annually. I…

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Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

If you can read this you need to download a more recent browser Today most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago President Obama signed his executive order directing the FDA to take steps to reduce drug shortages…

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Latest Book Reviews

Book Review: The First Step To Improve Health Care Is A Close Examination Of How It’s Delivered

My friend and former Chair of the CFAH Board of Trustees Doug Kamerow has written a book that I think you will like. Besides being a mensch and witty as heck Doug is a family doctor and a preventive medicine specialist. In his new book Dissecting American Health Care Commentaries…

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“Your Medical Mind” Explores Factors That Influence A Patient’s Medical Decisions

Recently I had a conversation with Shannon Brownlee the widely respected science journalist and acting director of the Health Policy Program at the New America Foundation about whether men should continue to have access to the PSA test for prostate cancer screening despite the overwhelming evidence that it extends few…

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Book Review: Food Truths, Food Lies

Food Truths Food Lies written by family physician Eric Marcotte M.D. may be the most refreshingly evidence-based diet book of the decade. You will not find a single mention of super-foods magical berries or supplement must-haves in the entire book. What you will find is the cold hard truth about…

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