Category: Hospital-Based Medicine

A case for resident activism

In 2019, residents organized coast-to-coast to protest low pay, unsafe working conditions, and insufficient benefits. Residents at the University of Washington and UCLA walked out of the hospital in reaction to stalled contract negotiations. Residents …

Is medicine a minefield of gender discrimination and abuse?

I am a 57-year-old female physician, and I remember an incident that involved a cardiologist on the other end of the phone, roughly fifteen years ago. I had recently started work as a hospitalist, and the cardiologist and I had never met. He clearly di…

Can empathy be taught, or is it innate?

In medical school, I was taught to sit down at eye-level when speaking to a patient, ask them how they’d prefer to be addressed, make sure to ask questions in an open-ended manner to allow patients to express themselves, and interject with &#8220…

Medical error disclosure programs: Old habits die hard

A radical change is emerging from within our health care system: Rather than deny or defend medical errors, some hospitals are acknowledging them upfront. This enlightened response has been gaining ground since 2001 when the University of Michigan Hosp…

Start a hospitalist program with these 6 steps

Just to give you my background, I manage a large hospitalist program for a busy downtown community hospital that is part of a large health system consisting of a total of 29 acute care hospitals in the same geographical area. One of the reasons why our…

System failure: We need a reboot to better handle intersectionality

In medical school, physicians learn how to diagnose and treat medical conditions. We learn about all the different presentations and revel in catching a complex or rare diagnosis. In essence, we learn to categorize disorders based on a cluster of sympt…

When physician leaders get acquired and squeezed

As a child, when I first read The Little Prince and saw the picture of the boa constrictor swallowing an elephant, I would often ponder what it felt like to be the elephant. Later in seventh-grade science class, when I learned of amoebae and how they s…

IT deficits are eating hospital profits. CEOs need to wake up.

I work for a hospital network with the world’s slowest computers.  I timed it: Last shift, it took me fifteen minutes to log on. The first computer obtained didn’t function at all.  It had been worked on the day before by information techno…

Should nurse practitioners complete medical residencies?

About three months ago, something awful happened. The oncology nurse practitioner (NP) whom I trained for the past two years in my subspecialty decided to seek employment elsewhere in order to have a more flexible work schedule. My team and I lamented …

A peek behind that 8-minute $300 doctor visit

If you or a loved one has ever been hospitalized, by day two or two of your hospital stay, you likely remember the doctor visiting you every day but not staying more than seven or eight minutes or 10 to 15 minutes max. It may have felt like he or she w…