I’ve always been fascinated with dystopian novels and zombie movies.  When the apocalypse comes, we stop sweating the small stuff.  Important tasks like sculpting our abs or finding the perfect area rug suddenly take a back seat to the new primary directive: survival. Nothing else matters. Healthcare workers have taken a similar survival first approach to COVID.  We’ve put aside our tiny tragedies and banded together to save our communities.  It’s ...

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I’m a proud member of our hospital’s Jewish All-Star team, which means I work every Christmas. One great thing about working Christmas is the hospital is never full. No one wants to be hospitalized on Christmas. If patients can go home, they do, sometimes even against medical advice. On top of that, there are no elective surgeries, chemotherapy admissions, or surprise calls from clinic. All is calm, if not bright. Of ...

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I previously suggested that transitioning from the traditional inpatient care model to the hospitalist model inadvertently motivated providers to hospitalize more patients, specifically borderline sick patients.  Our example was a 74-year-old woman with pneumonia whose path to admission met less resistance with a hospitalist at the helm. The question I posed at the end was this: model aside, should we admit that patient or not?  What’s best ...

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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 ...

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