Duty hours have been the focus of a lot of research recently. If you are just joining this discussion, the iCOMPARE trial randomized 63 internal medicine residency programs to either flexible (interns could work more than 16 hours) or standard (interns…
Category: Hospital-Based Medicine
Don’t let patient care interfere with documentation
I’m being sarcastic, of course, but that’s often how it seems some days. Those are days when I’ve been busy at patients’ bedsides all day and then struggle to get my documentation done later, typically many hours later. I jot notes to myself as I go al…
How pneumatic tubes symbolizes our health system
About once or twice a day, everyone on our hospital’s computer network gets an emergency message that scrolls across the bottom of our screens, highlighted in the colors of danger and warning. They include things like a notification that a partic…
A parent shares health care lessons with my son as he begins medical school
Dear Alex, As you realize your destiny, I want to share the lessons I have learned in my 45 years on the front lines of health care. I am hoping they will serve you well on your journey. First and foremost, love what you do. Have fun with the people wh…
How better nutrition helps this physician get through the day
Take a stroll through any emergency department or hospital break room, and what do you see? Chips, pop, candy bars, and different flavors of junk food. Working in the trenches of medicine requires stamina and mental fortitude. Fueling the body and mind…
If you spend more than 80 percent of your day staring at a screen, you are no longer a doctor
The use of health care information technology has increased exponentially over the last five years, and as a frontline physician, I have seen this change at close quarters. In most of the hospitals I’ve worked in up and down the East Coast, it’s been i…
Scent of a hospital: a medical student’s perspective in a developing country
A little background before I set off: I study in a medical school in India whose attached public hospital is as busy as it can get. It serves its people absolutely free of cost and is often a refuge for the poor of the society. We often run out of res…
Should doctors take more responsibility for quality metrics?
How do you react when presented with your quality data? In my experience, physicians generally respond by: Ignoring the metrics Arguing about why the metrics are wrong Saying the metrics are stupid A lot of doctors refuse to participate in the process …
Never let your patients know you’re in a hurry
I was recently working in clinic on a Friday afternoon. I was on my last patient of the day, and it had been a particularly long clinic. I had big plans for the weekend and should have already finished. The gentleman entered the room, sat down, and we …
How hospitals drive up health costs
As voters fume about the high cost of health care, politicians have been targeting two well-deserved villains: pharmaceutical companies, whose prices have risen more than inflation, and insurers, who pay their executives millions in salaries while rais…
