Practice Management

PHM15: Management of Febrile Infants with Urinary Tract Infections

Dr. Pate and Dr. Engel presented a hot topic in pediatric hospital medicine, sparking fruitful conversation about current evidence, identified gaps, and controversies regarding the management of febrile infants with urinary tract infections. After the American Academy of Pediatrics published the updated clinical guideline in 2011, controversies about radioimaging, duration of treatment, and pursuit of… [Read More]

10 Tips for Hospitalists to Achieve an Effective Medical Consult

10 Tips for Hospitalists to Achieve an Effective Medical Consult

A medical consult is an amazing way to learn. Consultation challenges us to practice our best medicine while also exposing us to innovations in other specialties. It can forge new and productive relationships with physicians from all specialties. At its best, it is the purest of medicine or, as some put it, “medicine without the… [Read More]

The Difficulty of Predicting Physician Shortages

Much of the criticism directed at the IOM’s proposed revamping of federal GME funding stems from the idea that a graying population will place additional strains on a healthcare system that already is facing a significant doctor shortage. “Number one, they came out and said, ‘We don’t know that there’s a shortage of physicians and… [Read More]

New Expectations for Value-Based Healthcare

A new book by three leading hospital medicine advocates for maximizing efficiency and outcomes while managing costs and avoiding waste in healthcare—also known as value-based healthcare—offers a primer filled with practical advice for doctors and other clinicians.1 The hospitalist authors of Understanding Value-Based Healthcare, Christopher Moriates, MD, of the University of California-San Francisco, Vineet Arora,… [Read More]

Dr. Nelson

Tips for Hospitalists on Spending More of Their Time at the Top of Their License

Hospitalists spend too little time working at the top of their license. Put differently, I think a hospitalist often spends only about 1.5 to two hours in a 10- or 12-hour workday making use of the knowledge base and skills developed in training. (I wrote about this and referenced some hospitalist time-motion studies in my… [Read More]

Specialty Hospitalists May Be Coming to Your Hospital Soon

Nearly 20 years ago, Bob Wachter, MD, coined the term “hospitalist,” defining a new specialty caring for the hospitalized medical patient. Since that time, we’ve seen rapid growth in the numbers of physicians who identify themselves as hospitalists, dominated by training in internal medicine and, to a lesser extent, family practice and pediatrics. But, what… [Read More]

Hospitalists Choose Quality Metrics Most Important to Them

Hospitalists Choose Quality Metrics Most Important to Them

Fantasy sports, hospital medicine, and quality metrics. Those were the unique elements of an RIV poster presented by Noppon Setji, MD, medical director of the Duke University Medical Center’s hospital medicine program in Durham, N.C., at HM15. Dr. Setji, who participates in a fantasy football league for physicians, says he aimed to apply the approaches… [Read More]

PHM15: Challenging Diagnoses, Ethical Dilemmas in Pediatric Immigrant, Refugee Patient Cases

Presenters: Nichole Chandler MD, Suresh Nagappan MD MSPH, Angela Hartsell MD MPH, and Emily Hodnett MD This workshop focused on interactive cases to highlight healthcare issues specific to the population of refugee/immigrant children in the US. It was an interactive format with small groups to allow the participants to work through the diagnoses by discovery…. [Read More]

Small Bowel Block in Elderly Merits Full Hospitalization

NEW YORK (Reuters Health) – The “vast majority” of elderly patients admitted with small bowel obstruction (SBO) are hospitalized for more than two days, and the diagnosis alone should allow appropriate Medicare coverage, according to a new study. In a paper online July 1 in Annals of Surgery, Dr. Zara Cooper, of Brigham and Women’s… [Read More]

2-Midnight_Rule_430

CMS Proposes Changes to Two-Midnight Rule

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]