October 17th, 2011 by Happy Hospitalist in Opinion, Research
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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*
September 12th, 2011 by Edwin Leap, M.D. in Health Policy, Opinion
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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*
