Not knowing what else to do after finishing my pediatric residency 15 years ago, I became a general pediatrician. Not knowing how to find a job halfway across the country and closer to home, I relied on a recruiter from a smallish town in South Dakota to woo me into private practice. Not knowing how to choose my future partners, I let them choose me. Despite my unbelievably naive approach to ...

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This past week was one of those weeks looming ahead of me that I was already dreading as I entered into it. I was to be working through another holiday and following a string of nights, and I would have a quick turnaround into a mid-shift. As a nocturnist by choice, I rarely work mornings or mid-shifts. I find the nights busy but also less intrusive — i.e., less administrative ...

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When you or a loved one is sick or injured, health care decisions are fundamentally a matter of trust.  You trust your physician will have the answers you need, because you know that, as a highly-trained medical professional, they’re qualified to make the best recommendation for each and every patient under their care. Physicians receive some of the most rigorous education and training of any profession. They spend the better part ...

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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 ...

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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 ...

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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 ...

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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 ...

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Alvin is a 42-year-old man who was never really given a chance. His parents both had severe alcohol use disorder. At age 12, his parents encouraged him to skip school to sell marijuana in order to fund their drinking. As his parents began using various illicit drugs, Alvin started selling larger amounts of marijuana to foot their bill. Eventually, marijuana was not ...

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I have a theory. There is a simple thing hospitalists can do that can enhance relationships with our patients, and even, I bet, improve patient satisfaction scores. The catch is it is not something you can do for yourself; you can only “pay it forward” for somebody else. We know patients who trust their physicians are more likely to follow recommendations, and that trust and confidence in physicians probably ...

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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 ...

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