Hospital medicine has rapidly become one of the largest specialties in the United States. As the number of practicing hospital medicine doctors soars above the 30,000 mark and health care reform takes hold, the specialty finds itself at the forefront of American medicine. And for good reason. It is a young, dynamic, varied and flexible specialty that can be practiced in a number of different settings. Hospital medicine doctors are ...

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The discharge process has now been recognized as one of the most crucial points at which the actions of doctors and hospitals can have a huge impact on immediate health outcomes for our patients. At a time when 30-day readmission rates are still touching almost 20% for Medicare patients, there is an increasingly urgent need to focus on this transition of care point. Discharging a patient is, by its very ...

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Improving patient satisfaction and enhancing the hospital experience is all the buzz today in health care. Every hospital executive across the country is talking about it, and coming to terms with how their organization’s reimbursements will be directly tied to their performance in this area. A decade ago, none of us had ever heard of HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores, the core metric by which health ...

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Considering that hospital medicine has only really taken off as a specialty within the last several years, it’s amazing how far the specialty has come. The word “hospitalist” was first coined in 1996 when it was used in a New England Journal of Medicine article as a way of describing those internal medicine doctors who practiced inpatient medicine instead of primary care. Back then, hospital medicine was a strange new phenomenon. Fast-forward to today, ...

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I have been doing admitting shifts at a large hospital, as hospitalist. It is flu season, so volumes are large. Even people without the flu are sick. It often happens that way. And they are so very sick! The thing about the very sick patients I see is that they are generally what might be called medical "train wrecks." They are very sick because they have had interventions over the years ...

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Statistics show that about 1 in 5, or 20 percent of all Medicare patients are readmitted to hospital within 30 days of discharge. That’s a staggering number, not to mention all those patients that are readmitted frequently during the course of a year, but not necessarily within 30 days. The problem of frequent hospital readmissions is actually one that exists all over the world and not just in the United States. ...

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As my Division of Hospital Medicine has grown -- now to about 60 faculty -- I spend part of my time figuring out what direction we should go in. At times, the path is obvious. It didn’t take Wayne Gretzky to recognize that we needed expertise in healthcare IT a decade ago, or in cost reduction more recently. The story of how we became the nation’s leading program for “global health hospitalists” is ...

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A couple of weeks ago I took my car in for its regular servicing. I’ve always had excellent service at this dealership and have gotten used to some pretty high standards. But on this particular visit, I was about to receive a dose of new technology as well. After I pulled my car into the garage, I was immediately greeted by a welcoming and friendly customer service agent. She had ...

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The lack of access to primary care physicians is a well known problem impacting our healthcare system. The problem sends all sorts of negative ripples through the system, not the least of which is increasingly crowded emergency rooms packed with patients whose conditions could have been addressed earlier and cheaper had primary care been available. What is less talked about is the mixed reaction of primary care physicians to the kinds ...

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If Hattie had but one flaw, it was that she held her doctors in too high esteem. It was not unusual for an eighty-year-old woman of her culture to want to please her cardiologist. So when her blood pressure came up a little high, she was too embarrassed to admit that she had forgotten to pick up the Toprol and hadn't taken it in over a week. The cardiologist hemmed and ...

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