• By Joshua LaBrin MD FACP SFHM, Kencee Graves MD, Karli Edholm MD FACP, Devin Horton MD, Katie Lappe MD. Division of General Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah
Clinical question: Does fecal microbiotia transplantation (FMT) effectively treat patients with recurrent Clostridium difficile infection (CDI)? Background: Patients with initial CDI have increased rates of recurrence (15%–30%), with variable success noted in treatment of recurrent disease. Increased interest in the use of FMT as a treatment strategy for CDI has led to various studies evaluating… [Read More]
The number of inpatient hospital-acquired complications (HACs) typically spikes in July, but hospitalists can be instrumental in reducing this annual uptick, according to the lead author of a study on the “July effect” in hospital admissions. Researcher Timothy Wen, MPH, a medical student at the Keck School of Medicine of University of Southern California in… [Read More]
Clinical question: Are there long-term benefits to more intensive glycemic control in patients with type 2 diabetes mellitus? Bottom line: After approximately 10 years of follow-up, this study found 1 fewer cardiovascular event per 116 person-years among a group of patients (97% men) randomized to receive tight glycemic control, but found no reduction in mortality…. [Read More]
On July 1, 2015, the Centers for Medicare and Medicaid Services (CMS) announced proposed changes to its controversial two-midnight rule. The changes afford physicians more flexibility to determine patient hospitalization status and place primary patient status auditing authority with Quality Improvement Organizations (QIO), rather than the unpopular Recovery Auditor Contractors (RACs). The original policy was… [Read More]
Clinical question: Is trimethoprim-sulfamethoxazole equivalent to vancomycin for the treatment of severe infections caused by methicillin-resistant Staphyloccus aureus? Bottom line: Trimethoprim-sulfamethoxazole (TMP-SMX) did not achieve noninferiority as compared with vancomycin for the treatment of severe methicillin-resistant Staphyloccus aureus (MRSA) infections in hospitalized patients, and it may lead to increased mortality in the subset of patients… [Read More]
Value-based healthcare has to start from the beginning of training to become foundational to medical practice. In this interview, Dr. Wade Iams, Dr. Christopher Moriates, and Dr. Vineet Arora, talk about getting value-based principles embedded in medical school curricula.
Edwin Lopez, PA-C, of St. Elizabeth Hospital in Enumclaw, Wash., offers his views on post-acute care in the U.S. health system, and how his work as a hospitalist has expanded to the nursing home across the street.