Hospitals aren’t the first businesses hurt when the economy sours, but they get hurt nonetheless, as an article in last week’s NY Times points out. But hospitalists have never lived through a massive downturn. What happens to them when the economy tanks? Let’s start with hospitals. Unlike new cars and Starbucks drinks – “discretionary” purchases ...

Rolling out a new “product” in a nasty economy is usually a formula for disaster. But last week we held the first-ever “Hospitalist Mini-College,” and it was an rousing success. The idea was this: hospitalists have lots of places to go to hear clinical lectures, and now a few options for leadership training and to learn “how to run a program.'' ...

Modern Physician just named Adam Singer, the founder of IPC-The Hospitalist Company, its first annual Physician Entrepreneur of the Year. Adam and I don’t always see eye to eye, but I want to congratulate him and highlight some of his contributions. When the hospitalist field launched in the mid-1990s, Adam was there – I recall seeing him at ...

As I mentioned in my last post, these should be the best of times for ''Infection Preventionists'' (formerly known as Infection Control Officers). After years of trying to get someone – anyone – to pay attention to their work, their day in the sun has finally arrived. But they are far from a joyful bunch. Why?In my talk to 4,000 members of the ...

A quick heads-up for those of you thinking about attending this year’s Management of the Hospitalized Patient (MHP) conference, October 23-25 in SF… we’re adding a hands-on, small group “Hospitalist Mini-College” pre-course. I think it will be tremendous. This will be our 12th Annual MHP conference (co-sponsored by the Society of Hospital ...

Of all the structural (how care is organized) “evidence-based markers of high quality care,” perhaps the most ironclad has been the involvement of critical care physicians in the care of ICU patients. That is, until now.In a sophisticated study in today’s Annals of Internal Medicine, Levy and colleagues mine a decade-old, 100-hospital, 123-ICU ...

Last week, Medicare added patient satisfaction data to its hospital reporting website. This is progress, but it raises an interesting question: should patient satisfaction scores be case-mix adjusted?The motivation to include patient satisfaction data comes from the Institute of Medicine’s inclusion of “patient-centeredness” as one key component ...

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 ...

In this month’s issue of the Joint Commission Journal of Quality and Patient Safety, I (with UCSF’s Adams Dudley and the American Hospital Association's Nancy Foster) tackle this provocative question. The answer may surprise you: yes (probably). The devil will be in the details.I hope you’ll have a chance to read the full article (the Joint ...