“So wonderful to see you!”
This phrase was heard repeatedly all over the convention hall at the recent American College of Physicians annual meeting, Internal Medicine 2025. Held in New Orleans last April, the meeting welcomed attendees …
Internal Medicine 2025: inspiration at the annual meeting
I would not recognize her if she crossed before me on the street. I could not pick her out in a staff photo of her and her colleagues. I do not know the color of her hair or skin; I could not even guess if she is short or tall. But her voice—I know her voice. I could recognize that voice anywhere.
I first met Julie sometime before the COVID pandemic, …
The voice that saved lives: a doctor’s pandemic hero
We all know that life is in transition, and we all go through different changes during our careers, from personal to professional growth. We all strive for a reasonable life-work balance.
Early in my career, after completing my residency training, I was discouraged by many of my mentors from pursuing a hospitalist career. The common agreement at the time was that hospital medicine was the recipe for burnout, and a fellowship …
Thriving through transitions: lessons from a hospitalist’s journey
As hospitals everywhere have been using every health care provider available to them in response to COVID-19, the specialty of hospital medicine has shown itself to be uniquely suited for coordinating the effort, to be the front of the frontline responders. I suspect that many people don’t understand what “hospital medicine” is, even though it’s larger than almost any other …
Why COVID-19 is a threat to hospital medicine
It was a Thursday. It was supposed to be one of those “regular” evening shifts. Then, at 6:15 p.m., my first page went off: Bed 11, Mrs. R., Dr. H. needs to talk to you. The page came from the COVID section of the emergency department.
I immediately called back. It saddened me when I learned that our patient was a young woman health care worker in her early 50s. She …
The emotional side of being a doctor during the COVID-19 pandemic
Multiple times a week, I get messages asking some variation of, “How are you holding up?” I am neither an anesthesiologist, critical care, or ER physician, so I’m not three inches away from exposure while intubating patients with coronavirus. I am also not a nurse or respiratory therapist in a room dozen of times a day administering life-saving medications, performing vital assessments, or carefully managing the oxygen lifeline. I’m certainly …
Doctors, how are you holding up? You could answer in one of 5 ways.
About a year ago, I had an interesting encounter on my way back home to Texas after visiting my parents. I was casually chatting with an older female acquaintance as I got situated on the plane. She asked me what kind of medicine I practice. This woman is in medicine, not a physician, but knowledgeable about the varying specialties. I told her that I was an internist working as a …
I am a hospitalist and I love my job
Just to give you my background, I manage a large hospitalist program for a busy downtown community hospital that is part of a large health system consisting of a total of 29 acute care hospitals in the same geographical area.
One of the reasons why our team was hired recently to manage this hospitalist program was to change the existing work culture, which had resulted in poor team performance, low physician …
Start a hospitalist program with these 6 steps
What if I told you that, as your doctor, I’d rather listen to your memoir than to your lungs? Or that while I find the sound of a beating heart a marvel to behold, I’m more interested in hearing the jazz song that you wrote or talking about the words tattooed on your left wrist. What if …
This physician takes the time to be humbled and amazed by the stories patients share
“Happiness is when what you think, what you say and what you do are in harmony.”
– Mahatma Gandhi
Burnout among physicians is at an epidemic proportion. National data suggests that more than 50 percent of our workforce is burned out, and this trend has been across the board from physicians in training to practicing physicians. Some of the specialties are more affected than others. Repercussions of provider burnout on health care …
Fixing burnout among hospitalists is a leadership challenge
Why is your hospital always full? Actually, it’s more than full. You have twenty boarders in the ED. You turned your postop recovery unit into an overnight surge center. Every day administrators beg you to please, please discharge patients, if possible before 11 a.m. You’ve hired an army of case managers, dissected the discharge process, and held countless capacity management meetings, but you’re still bursting at the seams.
It wasn’t always …
Wonder why your hospital is full?
A lot has been spoken and written about clinical documentation already. In spite of that, many hospitals still struggle in getting the best out of their doctors when it comes to documentation quality. And although we can cite various reasons for this, we can all safely agree that the hospital EMR is the single biggest influence when outcomes to efficiency and quality of documentation — both in terms of compliance …
The 3 goals of clinical documentation
I was recently seeing a rather complicated medical patient in the hospital. We were treating both a heart and kidney condition, and things were not going so well. To spare anyone non-medical who is reading this the scientific details of the bodily processes involved, we were essentially balancing hydrating, with the need to get rid of excess fluid. After seeing the patient, I spoke with the nurse, went over the …
There’s no room for ego in health care
First impressions are critical. We are taught early in our careers that first impressions truly matter. Whether interviewing for medical school or a residency program, our goal is to make a positive first impression in hopes of making the cut at each checkpoint in our early careers.
These processes in our academic lives and careers are exhausting. As residencies and medical schools are becoming more competitive, the importance of first impressions …
You must make a good first impression with patients
The surgical team filed out of the patient’s room. I looked over my shoulder to see a shaken daughter holding the wrinkled hand of her quiet, elderly mother who lay in the bed. I shuddered as I thought of the surgery her body would endure the next day. I knew I needed to return to her room later in the day to find out more about her history. After rounds …
Quality over quantity in life and care
I learn all manner of interesting things from the information sheets posted on the walls of the employee bathrooms at my hospital. I learn, for example, about upcoming CME offerings for advance practice providers, how many seconds one has to scrub the hub of a central line, and what the new process is when nurses need to call in sick. They call a specific phone number and state that they …
Why doctors can’t take sick days
Being a hospitalized patient is perhaps one of the most disempowering experiences an individual can face (besides being in war, or a prisoner). Patients face constant uncertainty; having no idea what time their physician will visit, when they will be taken for their tests, or who will suddenly interrupt them again with a demand – perhaps an early morning blood draw, or yet another round of interrogation and uncomfortable examination …
Patients need an advocate at the bedside
In 2002, when I began my first hospitalist job, I was a dyed-in-the-wool hospital medicine convert, convinced that the transfer of inpatient care to true specialists in hospital medicine (hospitalists) would dramatically improve the quality and efficiency of inpatient care, increase patient satisfaction and decrease costs.
By 2008, I had developed serious doubts, which prompted me to publish an editorial in the Journal of Hospital Medicine, entitled “The Expanding or Shrinking …
6 things wrong with hospital medicine
For the last 8 years, I have worked as a locum tenens hospitalist. I began on this path when it was the least popular option upon graduation from residency.
I did countless hours of research trying to find accurate information about locum tenens companies, but never found anything written by physicians, only by the companies themselves. So, I stepped into this field blindfolded and learned the hard way. Since then, I have …
5 mistakes hospitalists should avoid when starting a locum tenens position
Hospitalists, doctors who only see patients in the hospital, almost always in a shift work model, are the fastest growing “specialty” in medicine, from nothing about 15 years ago to about 50,000 today. There were some studies that I won’t review much here that showed some benefits from hospitalists compared to “usual care” in highly controlled environments, outcomes such as a 0.4 per day decrease in length of stay with …
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