November 22nd, 2009 by Happy Hospitalist in Humor, True Stories
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When I initiate final hospital discharge planning, I am making a clinical judgment that the patient is safe to leave the monitored confines of the hospital system. Hospital discharge planning begins on the day of admission.
Good hospitalists are always thinking in their minds how to get the patient safely discharged in the quickest, safest and most efficient way possible.
Sometimes the patient wishes to leave against the medical advice of the physician. Sometimes they refuse to leave at the advice of the physician. And sometimes the physician and patient agree it’s time for the next level of care. Read more »
*This blog post was originally published at The Happy Hospitalist*
November 20th, 2009 by Happy Hospitalist in Better Health Network, True Stories
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Your child seems half dead to you, but you’re frozen with uncertainty. Are they just being whiny? Is that fever going to pass quickly? When do I know if my child needs an emergency assessment? When do I know if they need emergency medical care?
I recently got involved in just a situation with one of Mrs. Happy’s friends. She has a young child, about four years old who came down with a fever a week ago. The child has a history of asthma and a history of supraventricular tachycardia. The child was meandering along doing fine when one day his condition changed. Read more »
*This blog post was originally published at The Happy Hospitalist*
November 17th, 2009 by Happy Hospitalist in Better Health Network, News
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The physical scars will be nothing compared to the emotional scars that will haunt the children. I recently read that the effective acne treatment Accutane was pulled off the market this summer quietly ending access to an excellent and effective acne treatment for millions of self conscious teens and young adults. Accutane, or isotretinoin as it’s known, was used to treat severe nodular acne.
It turns out that Accutane was linked to inflammatory bowel disease, and other side effects resulting in thousands of lawsuits. It spent twenty five years on the market embroiled in controversy.
Approved by the Food & Drug Administration (FDA) in 1982, Accutane has been the subject of controversy for years. It first garnered attention in the late eighties for causing severe birth defects. It has also been known to cause psychiatric problems, and has been linked to hundreds of cases of suicide in the United States. Accutane has also been associated with problems of the liver, kidneys, central nervous system, and pancreas, as well as the cardiovascular, musculoskeletal and auto-immune systems.
Read more »
*This blog post was originally published at The Happy Hospitalist*
November 13th, 2009 by Happy Hospitalist in Better Health Network, Humor, Opinion
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What’s the deal with hospital stickers these days? I found this sticker laying around in Happy’s emergency department the other day. Should we be encouraging children to come to the emergency room and feeling happy and excited about the sticker they get? I’m not sure putting a happy robot on a sticker and proclaiming ones exciting visit to the emergency is the best public health policy. Perhaps we need to take a different course of action before another entire generation of citizens feel obliged to use the emergency department as their sole source of medical care. Perhaps instead of a hospital sticker, children in the emergency room would all get a saline injection in their shoulder. Now that’s the kind of memory you want kids to have of their emergency room visit. They should fear the hospital and do everything in their power to stay healthy as adults. Not feel giddy about happy robots on hospital stickers.
Do children get hospital stickers at your facility?
*This blog post was originally published at A Happy Hospitalist*
November 10th, 2009 by Happy Hospitalist in Better Health Network, Opinion
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When a patient decides they are leaving against medical advice what responsibility does the physician have to their care? When I was a resident in training, and even early on in my position as a hospitalist, I would get a call from the nurse that Mrs Smith was demanding to leave the hospital against medical advice. I would tell the nurse “Fine. Let her go. I’m not her father.” I would tell the nurse to discharge Mrs Smith with no medications and leave it up to them to find follow up.
I would suspect this is a prevalent attitude for many hospital and emergency based physicians. I’ve seen it over and over again. And I still see it today. Many doctors and nurses feel obliged to let grown men and women make poor decisions. However, being a grown man or woman able to make poor decisions is apparently not enough to keep a doctor for being sued and losing that lawsuit because a patient chose to make poor decisions. Read more »
*This blog post was originally published at A Happy Hospitalist*
