Like hand hygiene, getting workers to stay home when sick is an example of a horizontal infection prevention strategy. Horizontal strategies are multipotent (not aimed at a single pathogen), generally simple methods. While most humans inherently know that it's not a good idea to come to work with fever or diarrhea, many either can't or won't stay home and risk infecting co-workers, customers, or patients. One major reason for ...

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The ED is a hectic place. Sore throats. Heart attacks. Dog bites. Broken bones. Strokes. Major trauma. If you work in an ED, you see it all. And then some. Is it any wonder then, with the potential for literally thousands of medical and surgical problems to stumble through the doors of an ED, that hospitals and the bodies that accredit them demand strict, regimented, standard, reproducible emergency assessments and the ...

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Sexual health, though fundamentally important to every human being, is rarely discussed between patients and their healthcare providers. It’s an important conversation and one that requires doctors and patients to venture into less-than-comfortable territory. Who exactly should treat sexual health issues? Many assume that this should be the territory of a gynecologist for women or a urologist for men. But because we see our patients more frequently than any other doctors, general ...

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It’s painful enough to lose a patient. But I found it even more painful to try to console a family whom I’d never met. Depending on your point of view, the limited patient contact afforded the anesthesiologist is a disappointment or a perk of the specialty. Anesthesiologists are steadily branching out into other areas of perioperative care where lengthier patient/family contact is necessitated but the preop encounter with the anesthesiologist is ...

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Mind-Map This, apparently, is a map of my mind.  It’s a little shocking to find out that my mind looks like a sea creature, a bug, or perhaps a vegetable.  Actually, “Rob’s mind” and “vegetable” are often used in the same sentence. Someone suggested to me that I may benefit from mind mapping.  I don’t know how to describe it, but I think spatially; ...

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shutterstock_96835279 Let’s get one thing clear from the start: I love nurses. My grandmother was a nurse’s aide. My aunt is a nurse. My mother is a nurse. Nurses have been by my side for the most frightening and important experiences in my life (in the hospital and out). However, I’m not a nurse. I’m a doctor. And when someone calls me ...

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acp-logoA guest column by the American College of Physicians, exclusive to KevinMD.com. Over the past several years, I have had the honor of representing the American College of Physicians at scientific conferences and professional society meetings. In addition to hearing about the latest advances in internal medicine at these events, I learn what is on the minds of physicians in ...

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I couldn't really blame the social worker.  He was just doing his job.  The skilled nursing facility (SNF) connected to the hospital was full of flailing patients.  So he thought he would ask for a palliative care consult (after getting an okay from the primary team).  It was his third request of the day.  He spoke slowly as he tried to untangle the twisted path the patient had taken. "Dr. X ...

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When I visited Allan in the hospital yesterday, I told him to get up and stroll the hall. However, when I checked in on him this afternoon, the nurses informed me that he refused to get up, even to the chair.  When I asked why, Allan told me he could not walk.  I was concerned, but when I examined him, I found his vital signs were fine, he had no ...

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Do you find yourself spending too much time on things that have nothing to do with seeing patients, and then getting home later than you would like? Do you notice that for every 15 minutes you spend with a patient you spend way more than that messing around in the EMR and being distracted by things like prescription refills, test results and a hundred other forms of two bit clerical work ...

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