By  | April 28, 2015 |  0
My 85 year old patient was brought in from home.  She was cachectic, contracted, minimally responsive to questions, covered in multiple decubitus ulcers on both hips, both knees, both shoulders, and her sacrum.  She had polymicrobial sepsis-bacteremic with two different organisms. She was, in fact, dying. Despite her profoundly debilitated condition,  her son, who cared […]
By  | April 23, 2015 |  3
by Dr. Trina Dorrah MD, MPH In Part 1, we discussed the fact that providers are often resistant to change not because they fear change itself, but because they fear loss. In my work as a patient experience physician champion, I am constantly encouraging providers to change. At the Society of Hospital Medicine’s annual meeting […]
By  | April 22, 2015 |  2
by Regina Heyl DePietro I sat in the office of a staffer to a Manhattan congressman and waited for the right moment to tell my story about my mother’s experience with advanced directives. Dr. Celine Goetz, a hospitalist from Mount Sinai, and I had practiced our talk in a large atrium a floor below. Our […]
By  | April 21, 2015 |  1
by Dr. Trina Dorrah MD, MPH At the Society of Hospital Medicine’s 2015 conference, I had the privilege of hearing Dr. Peter Pronovost speak. He is a leader in the field of quality and safety, but the part of his talk that struck me the most was his advice on leading change. During his discussion […]
By  | April 20, 2015 |  4
I began to think about doctor fee carve outs in the context of global payments approximately five years ago.  At a meeting I attended where the subject came up, private conversations transpired between a group of us and folks in the know from CMS and the AHA.  We listened.  They talked. The discourse led me […]
By  | April 16, 2015 |  0
Most physicians recognize the JNC guideline for blood pressure management, or the ACCP thrombosis guideline for VTE.  Most would agree we use a handful of accepted benchmarks to manage a limited number of conditions.  For the rest, it’s the wild wild west. Try to develop consensus around delirium management or treatment of alcohol withdrawal, and […]