Hospital-Based Medicine

Hospital secrets that patients don’t know

Physician
October 22, 2023

“America’s health care system is neither healthy, caring, nor a system.”
– Walter Cronkite

Hospitals, revered as places of healing and recovery, hold secrets and harbor mistakes that can take a heavy toll on patients. These hidden truths, often concealed behind the walls of health care institutions, come with dire consequences. Supported by alarming statistics and credible sources, this exploration unveils some of the most unsettling aspects of the health care system.

As …

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How to stay safe as a traveling physician

Physician
October 16, 2023

There was nothing unusual about my hotel in Anchorage, Alaska, when I checked in, but when I headed down to check out the laundry facilities and saw police swarming the lobby and parking lot, I knew it was time to move.

Thankfully, experiences like that have not been common during my time working as a locum tenens (physicians who work in temporary assignments to fill critical gaps in care) for over …

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Surgical procedures for inpatients: Addressing socioeconomic urgencies

Physician
September 20, 2023

Inpatients require surgical procedures, raising the question of whether these procedures should be scheduled as elective or emergent. Traditionally, surgeries were deemed emergencies solely when there were physical, psychological, or rarely, spiritual imperatives, necessitating immediate action to avert irrevocable harm to patients’ bodies, minds, and souls. Now, the debate centers on whether surgical procedures can be considered emergencies to mitigate socioeconomic risks. These risks could lead to profound and lasting …

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Challenges of prolonging hospital stays

Physician
September 11, 2023

In a recent article in the New England Journal of Medicine, a rheumatologist at a teaching hospital lamented about “hospital problems,” a phenomenon where patients are not allowed to stay in the hospital when they no longer have a medical necessity for hospital care, even though the physician may want to keep the patient longer to wait for test results or get prepped for a test. He proceeds to …

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The complexities of healing and faith

Conditions
September 10, 2023

As a physician, there are moments during the day when you must deliver a disheartening diagnosis to your patient: pancreatic cancer, ALS, leukemia, and unfortunately, the list goes on. The patient must face the harsh realities that are now placed before him/her. Those realities, at times, leave him with a very small window of hope for improvement. Sometimes, solutions cannot be found with the use of a scalpel, chemotherapy, or …

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The impact of certificate of need laws on rural health care

Policy
September 9, 2023

Rural communities have a problem. Their health care options continue to shrink, as medical facilities close or consolidate. The trend has accelerated in recent years, but Westfield Memorial Hospital in Western New York wants to expand.

The tiny facility on the shores of Lake Erie has four inpatient beds, and has plans to double its capacity to eight. The $700,000 project would not require an additional wing or any new floor …

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Continuous work coverage in health care: challenges and solutions

Physician
September 3, 2023

Two scourges of 24 x 7 x 365 coverage may be lost on-the-job sleep and soured on-the-job peace for workers, especially for health care workers.

Traditionally, attending physicians have had the privilege of call rooms while providing coverage for overnight health care services. The Accreditation Council for Graduate Medical Education expanded that privilege to resident physicians and fellow physicians. Now, it may be time to extend that privilege to advanced practitioners …

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Hospital as a river: Navigating uncertainty and empathy

Physician
September 1, 2023

The hospital is like a river. Patients float downstream into our care, stay in sight for a moment, and leave after we have done everything we can to help them. Regardless of why they arrive or how long they stay, every person in the hospital will always leave, whether for recovery, rehabilitation, transfer, or death. Meanwhile, the hospital staff guard the river banks, keeping watch over the steady flow of …

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Navigating the broken medical system: challenges faced by foreign medical graduates

Physician
August 25, 2023

As I sit here contemplating the beginning of this unsent letter, I find myself questioning its intended recipient and purpose. The truth is, I don’t have the answers just yet. Perhaps, by the end of these few paragraphs, some clarity will emerge.

When I left my home country to come to the United States, I envisioned hospitals here as being on par with what we would consider “first-world country” institutions. I …

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Patient complaints prompt hospital to reevaluate doctor’s bedside manner

Physician
August 18, 2023

Tom, a doctor friend, recently told me he was reprimanded by Michael, his hospital’s medical chief of staff, after two patients lodged complaints against him.

One instance involved a man whom Tom informed of a cancer recurrence. When the man cried, Tom put his hand on the man’s knee, attempting to comfort him. However, the man didn’t find it comforting. He said nothing to Tom but complained to administration, stating that …

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Teaching moments in medicine: Balancing autonomy and comfort

Physician
August 12, 2023

Late last year, I decided I needed to get my health checked up on. I went through the motions, trying to make an appointment with the doctor that was assigned to me. Nothing was available for months. I called every other day, asking about cancellations that would fit into my schedule for days I already had off. It was a pain and difficult as well to switch a single workday …

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A love letter to the doctor I was

Physician
August 8, 2023

I recently returned to the hospital where I had first worked as an attending. Everything felt different. It seemed darker and smaller, reminiscent of the feeling when you revisit your elementary school, and the water fountains appear almost touching the ground, making you feel like a giant.

I walked through the same door I had used countless times over ten years, yet it now seemed more like a portal. The floor, …

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Pain and laughter for a veteran patient

Physician
August 6, 2023

Mr. Sampson, a 70-year-old man with a history of diabetes, was referred to us by his primary care physician for nerve conduction studies. He had been experiencing increasing numbness in his right hand for the past year and had recently started having trouble playing his beloved guitar. As a Vietnam War veteran, he had a fascinating story to tell.

As I approached him in the waiting room, he greeted me with …

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Internship survival guide: Thriving on the night floor rotation

Physician
July 16, 2023

During my first week as an intern, a question weighed heavily on my mind: “How am I going to survive my night shift rotation?” Soon after, another question arose: “How can I make the most of my night shifts and continue to learn and grow?” I reached out to senior residents and faculty members to learn from their experiences and seek their advice.

I understand that you may have similar questions …

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The case for eliminating recertification by the ABIM

Physician
July 12, 2023

The American Board of Internal Medicine (ABIM) has long been responsible for setting standards and ensuring the competence of internal medicine practitioners. However, the practice of mandatory recertification has faced increasing scrutiny and debate within the medical community. This article explores some of the key reasons why eliminating recertification requirements imposed by the ABIM could have significant benefits for physicians and patient care.

Lack of evidence for improved patient outcomes

One of …

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What Lucille Ball and Einstein can teach us about overcoming burnout

Physician
July 10, 2023

In the demanding health care industry, physicians are frequently susceptible to burnout. The constant pressures, long hours, and emotional toll can be detrimental to one’s health. To support physicians on their path to wellness, we have compiled a collection of motivational quotes that can change their perspective and help them achieve their goals. In addition to these powerful quotes, we’ve included suggestions for cultivating growth and overcoming burnout. Discover the …

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The epidemic of narcissistic abuse in the medical field

Physician
July 7, 2023

I didn’t go through that to go through this.

“She doesn’t know how to work within a system,” said Snakeskin Shoes.

Narcissists grow and thrive in children’s hospitals. Their strategy is to inflict moral injury upon physicians by gaslighting and silencing those who speak up for patient safety or for themselves, while also controlling a false narrative about them.

Snakeskin Shoes, the former VP of marketing and communications, is a poster boy narcissist. …

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Stepping into the unknown: reflections of an intern on July 1st

Physician
July 6, 2023

I remember it like it was yesterday. Orientation had concluded, and it was showtime. Officially July 1st. It felt like all the cramming from the last few weeks was sitting astutely in my upper chest. My breathing was fairly shallow, and my brain was in an emotional fog, resembling a salad. Internal neon flash signs were going off every few seconds.

Many of these thoughts went like, “This is where they …

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Inspiring lessons from WWII veterans and the intensity of the medical field

Physician
July 2, 2023

On some of my night rotations during intern year, I found myself watching WWII documentaries and movies. The patients at the VA medical center had stuck with me with their stories and their attitudes. My experiences at the VA motivated me to learn more about my patients’ lives, who had served our country. As I watched some of these movies, I noticed parallels between my life and those of the …

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