shutterstock_147374198 I have spent 32 years working in hospitals and the last 16 running them.  Hospitals are created for the benefit of the community, a place where people go when they are acutely Ill, injured or have a complex condition that eludes quick diagnosis and treatment.  Hospitals historically provided primarily inpatient care and comprehensive diagnostic and treatment facilities for patients. It took a ...

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shutterstock_216800617 I was recently talking to a patient about having some extra help at home when she left the hospital with home nursing services. The elderly lady -- highly intelligent and fiercely independent -- politely declined with the reply: “No, I’m fine thanks Dr Dhand -- all they’ve done before is just come in with their computers, barely talk to me, enter ...

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shutterstock_100776622 Everyone likes to be recognized for a special achievement or accomplishment. Every career has special awards and commendations for everything. While there’s no reward that matches cold hard cash, many of these honorable mentions have no tangible value whatsoever. Pull into a fast food parking lot and you may see a parking space designated with a sign proclaiming, employee of the ...

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My 85-year-old patient was brought in from home. She was cachectic, contracted, minimally responsive to questions, covered in multiple decubitus ulcers on both hips, both knees, both shoulders, and her sacrum. She had polymicrobial sepsis-bacteremic with two different organisms. She was, in fact, dying. Despite her profoundly debilitated condition, her son, who cared for her at home wanted “everything” done. So she was placed on IV fluids, antibiotics, received an ...

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shutterstock_210331261 It's metoprolol. m-e-t-o-p-r-o-l-o-l The nurse on the other end of the phone sighs as she tolerates my tirade regarding pronunciation. They all know that I am particular about such things. For metoprolol is neither metoclopramide or metolazone, and the difference could be life altering. I live in a world of words. Trained in a language created to parse pertinent details. Dysarthria or dysphagia? Paroxysmal ...

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Inscribed on a plaque just below a statue of an eagle in front of my hospital is a famous quote from President Abraham Lincoln that begins, “To care for him who shall have borne the battle ...” It is the reason why the Veterans Affairs (VA) system exists. It is the reason why we VA physicians come to work each day. I am honored to care for our special patient population, ...

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There she lay: a 59-year old woman who had become increasingly disoriented and confused. Not only did she have an infection in her bloodstream, years of alcohol abuse had taken its toll on her liver, leaving her skin yellowed. “Welcome to the ICU,” I thought. In contrast to my previous clinical experience, I found this patient encounter unsettling. No conversation. No personality. No interaction. She was nothing more than a body in a bed punctured ...

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“Have you had any horrible problems with wait times?” shouted the reporter as he jogged towards the van pulling out of the parking lot. Leaning in so far that his head actually crossed the window’s threshold yet still audible from across the street, he continued “We’re looking for people who’ve had terrible experiences here!” So it was last week walking in to work at the Durham VA Medical Center. One year ago, ...

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shutterstock_191393468 A recent publication from the Mayo Clinic created a lot of buzz regarding the use of unmanned aerial vehicles (UAV), or drones, in medicine. However, in reality, most of the drones being used or tested in the U.S. are for things like aerial photography, small package delivery, and surveillance. While several corporations have been quick to expand existing applications ...

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If you are a doctor, nurse, patient, or just someone interested in patient safety, you should read a five-part story called "The Overdose: Harm in a Wired Hospital" excerpted from a book The Digital Doctor by Dr. Robert Wachter. Dr. Wachter and the hospital are to be commended for publicizing this incident so others may learn from it. The hospital staff, the patient, and his mother, also deserve credit for allowing their ...

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