Canadian Hospitalist aggregator

ACP Hospitalist - Blog: On feedback and deliberate practice

Fri, 21 Aug 2015 06:00:00 -0700

Medical learners often complain that they receive inadequate feedback. Most programs develop solutions of “formal feedback” sessions. To that I say, “Bah, humbug”.

As a devotee of deliberate practice, I understand that formal feedback does not do the intended job.

ACP Hospitalist - Blog: We need to rethink professionalism

Thu, 20 Aug 2015 06:00:00 -0700

A new study in JAMA Pediatrics (free full text here) should make hospital epidemiologists and infection preventionists cringe. All physicians and advanced practice providers at Children's Hospital of Philadelphia were sent a survey on presenteeism.

ACP Hospitalist - Blog: 5 things that doctors learn from their patients

Tue, 18 Aug 2015 06:00:00 -0700

For all the talk about patient-centered care and a new health care paradigm, which is of course the right way forward, the doctor-patient relationship will always remain relatively one-sided because of the nature of the profession itself.

Essentially, patients come to doctors for help, and the knowledge transfer, advice and guidance flows in one main direction. But that doesn't mean that doctors, who are among the most highly educated professionals out there, aren't constantly learning and being inspired by their patients too.

ACP Hospitalist - Blog: On life support: the amount of clinical time doctors spend with patients

Tue, 11 Aug 2015 06:00:00 -0700

How much time do doctors actually spend with patients during a typical day?

The answer to this question should trouble any good and competent physician. It's been shrinking year by year, and has now reached a critically low level.

ACP Hospitalist - Blog: The attending physician's job as role model

Fri, 07 Aug 2015 06:00:00 -0700

After 35 years functioning as a ward attending, I have had many epiphanies. When I started, my concept of the ward attending physician's job consisted of providing pearls to the learners. My brilliant lists (differential diagnoses) had the ability to overwhelm the learners. They would bask in my reflected glory. I understood the job so poorly.

These are the main points that I believe are essential for our role. As Stephen Covey often quoted, “Begin with the end in mind.” What is the end of ward attending rounds?

ACP Hospitalist - Blog: The white coat debate continues on and on and on and on

Thu, 06 Aug 2015 06:00:00 -0700

I couldn't resist blogging in response to Eli Perencevich, MD's recent post regarding doctors' attire. I guess this debate continues on with some new warriors from the University of Michigan. They plan to do a bigger, worldwide study of patient preference for physician attire. We really do need another meaningless study on this topic, don't you think?

ACP Hospitalist - Blog: 5 simple ways we can give our patients a better experience

Tue, 04 Aug 2015 08:00:00 -0700

Being sick and hospitalized in a lonely and unfamiliar place is a terrifying time for our patients. It's an easy thing for doctors and nurses to forget as we go about our hectic days, when time goes by so quickly that we barely have time to stop and think. Whether you are practicing medicine in a large academic center or a small rural hospital, the feedback that patients give about their hospitalization is surprisingly similar.

SHM Clinical Blog: Pre-op fall assessment

Sat, 12 Oct 2013 18:28:36 -0700

This cohort found patients age >65 undergoing elective colorectal or cardiac surgery who had a history of falls in the past 6 months had significantly higher 30 day rates of complications, readmissions, and need for institutionalization. Asking about a history of falls pre-op may help assess post-op risk of adverse outcomes (abstract).

SHM Clinical Blog: Hypothermia not helpful in bacterial meningitis

Sat, 12 Oct 2013 18:20:32 -0700

This randomized trial found induced hypothermia was associated with higher mortality in patients with bacterial meningitis (compared to standard care) (abstract).

SHM Clinical Blog: Surgeon skill matters

Sat, 12 Oct 2013 18:12:02 -0700

This cohort of 20 surgeons were videotaped and rated on their skill performing laparoscopic gastric bypass surgery. Lower skill ratings were associated with significantly longer operations, rates of reoperations and readmissions, and higher rates of complications and mortality (abstract).