Being a part time hospitalist, I am frequently on overnight call in the hospital, spending the night admitting sick patients from the emergency room, or dealing with any calamities that happen on the medical floors. I would have to say the that the most dreaded events are: “Code blue” (this means a hospitalized patient in cardiac or respiratory arrest waiting to be resuscitated), followed closely by a nurse calling with: ...

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A few months ago marked the 20th anniversary of the launch of evidence based medicine (EBM). Now seems a good time for a retrospective. After twenty years what does EBM mean? Where has it taken us? What are the distortions and unintended consequences? You might be surprised. What I intend to do is start with a little of the history of EBM, talk about the essential notion as originally conceived by ...

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The sweat coalesced on my forehead.  I leaned forward to push the weight of my body into the wheel chair.  I was terrified.  Behind me strode the baffled parents with their arms full of coats and scarves.  The young boy shrunk into the chair and balanced his IV'ed arm on the rest, trying not to disrupt the tubing that had been so painfully inserted. I was lost. A week into my rotation as a volunteer ...

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Brought to you by MedPage Today. 1. Hospitalists Work Longer, Patients Stay Longer. Long work hours for hospitalists led to longer patient stays and unnecessary orders. 2. Automated BP Device Not Cutting It. An automated BP cuff billed as an in-office substitute for ambulatory monitoring may substantially underestimate pressures. 3. No Hike in Mass. Hospital Use Post Health Reform. Healthcare reform ...

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Locum tenens (literally "place holder") is professional work done to fill in where help is needed. It is what I have primarily been doing for the last year, and has been an interesting ride. When I decided to leave my practice related to losing a couple of partners and wanting to update my knowledge base and re-evaluate my career, I decided to do locum tenens work. I had always thought that ...

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Experiencing the revolving door of physicians in the hospital Complications from my cancer sent me to the hospital again recently. The news that I was in trouble came unexpectedly from my oncologist’s office Thanksgiving eve, following a routine blood test. “Your liver numbers are out of whack.” My response was “Really?” as if I’d been notified that my driver’s license had expired. I was diagnosed with a blocked bile duct and I ...

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This series is brought to you by MedPage Today. 1. Patients Suffer if Hospitalists Overworked. Many attending physicians said they feel overburdened to the point where it has a negative impact on patient assessments, satisfaction, and possibly safety outcomes. 2. Heart Disease, Cognitive Decline Linked in Women. Heart disease in older women tripled their likelihood of mild cognitive impairment. 3. Patients May Say Turn Off ...

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Dear hospitalists, we emergency physicians appreciate you Dear hospitalists, This is just a note to say that we, in emergency medicine, appreciate you.  Like all of us, you are stuck in an endless loop of unending residency.  Don’t worry, it isn’t an episode of The Twilight Zone.  It’s just your life.  No, it’s our life! As specialty after specialty withdraws from the practice of medicine, you, and all of us, ...

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Using the iPad Mini in the hospital: One doctors experience On my birthday several weeks ago, I was lucky to get an iPad Mini from my husband. I already have an iPad and have shared my experience. In fact, we gave all of our residents iPads (one of them contacted Steve Jobs and got a response), and documented an improvement in efficiency on the wards. ...

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The recipe for a great hospitalist program Internal medicine is the branch of medicine that deals with diseases of the internal organs in adults. It also involves dermatology, minor surgical procedures, general psychiatry and preventive care of well people. It is an excellent field, full of opportunities to think and feel and connect with people, mysteries to be solved and an endless variety of stuff to be learned. ...

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