A few random observations from the Society of Hospital Medicine’s annual meeting in San Diego:There are about 1600 people here, most of whom I don’t know. How did this happen?People still seem pretty jazzed about their jobs and lives. The meeting has not lost its soul, nor its sense of wonderment or of family. That’s a very good thing, since these ...

Do you get as annoyed as I do about being pressured on your “Time of Discharge?” I just received my monthly report, and we’re in The Doghouse again: our average TOD – 3:28 pm – is hours after “check-out time.” But when did we turn into the Holiday Inn?Let’s start by appreciating where this comes from. Many hospitals, including mine, tend to run ...

Today my pals Peter Lindenauer and Andy Auerbach (and colleagues) published the largest hospitalist outcomes study to date, in the New England Journal of Medicine. It is a rigorous, important piece of work. Let me try to add a bit of context.First, the What’s What. Using the massive database of the Premier system (which Peter has mined to ...

In an article in this month’s Journal of the American College of Surgeons (with a companion cover piece in the ACS’s Bulletin), four of my surgical colleagues – and this internist, perhaps to add a “cognitive” spin – describe UCSF’s “surgical hospitalist” program. It is an impressive story.When Dr. John Maa and his friends speak of a “surgical ...

At my just-completed annual hospital medicine CME course, we held a fascinating session on the future of quality measurement, transparency, and pay for performance (P4P). The discussants – Andy Auerbach, Peter Lindenauer, and Kaveh Shojania – all emphasized the limits of process measurement, particularly noting the problems of unforeseen ...

Last week, another study was published (this one in the Archives of Internal Medicine) documenting a hospitalist efficiency advantage. Coming on the heels of more than 20 studies with similar results (see, for example, this and this), one might ask how much this study adds to our understanding of hospitalist care. The answer: more than you might ...