Category: Hospital-Based Medicine

A police shooting in a hospital forces a family to rethink American justice

The beer bottle that cracked over Christian Pean’s head unleashed rivulets of blood that ran down his face and seeped into the soil in which Harold and Paloma Pean were growing their three boys. At the time, Christian was a confident high school studen…

This didn’t happen every day in a small town ER

An excerpt from The Hospital: Life, Death, and Dollars in a Small American Town. Marc Tingle and his daughter, Summer, stood in a bathroom they were tearing apart over in Fayette in Fulton County. They had a problem: taking a cast-iron bathtub out of a…

Responding to the COVID pandemic: a lesson in coalescence [PODCAST]

“When faced with an existential crisis, any organization, as large as a nation or as small as a marriage, will go one of two ways. Either it will bond together, coalesced in a common purpose, or it will collapse in a spasm of blame and shame. Whi…

Metric shock: the unintentional consequence of measuring

Health care in U.S. hospitals is suffering from three under-recognized conditions that I will refer to as “Metris,” “Severe Metris” and “Metric Shock.” Metris occurs when a health system begins to focus more on achieving certain metrics than on improvi…

A nurse is to a patient what a mother is to a child

I was on inpatient service and had already seen most of the patients on my list. I just had to see one more before I could call it a day and rush out just in time to take my daughter to her tennis lesson. I reviewed the patient’s chart to find out that…

Bloated notes are a huge problem and a time suck

In a moment of caffeine-depleted delirium, I volunteered to head the creation of a “notes committee” for my 80-member hospitalist group. I placed myself on a 72-hour hold and quickly established a group consensus: “Bloated notes are a huge proble…

By jeopardizing privacy, did this physician meet patient satisfaction goals?

An excerpt from Under the Collar: Frank Conversations about Healing that Harms: Simply Speaking. Hospitalist Nigel admitted elderly Ms. Mann who had developed dehydration after several days of unrelenting nausea and vomiting. Respecting patients’ priva…

Medical facilities: Please keep your immune-deficient patients safe

“Go have a seat,” the receptionist at the imaging center told me, gesturing to the waiting room. It was a close, poorly ventilated space, and several of the chairs were already occupied. I turned back to the receptionist. ”I have a primary immune defic…

My 10 Commandments of a Servant Leader

I have seen great leadership and bad leadership. As a leader, I have also made my share of mistakes, and I am sure I will make more. When I do, I will immediately take ownership of it, learn from it, and do all I can not to make the same mistake. Howev…

In gratitude to our nation’s residents [PODCAST]

“Most residents are young, often in their mid to late 20s, having spent years ensconced in libraries, research labs, and classrooms learning pathophysiology and pharmacology. Upon graduation from medical school, they are now drafted to the front …