Hospital Hiring Is Not A Positive Prediction Rule

  When you follow the healthcare sector, you can depend on December being the time CMS and Health Affairs release cost growth estimates from the prior year.  All the papers give the news big time attention (see here). After looking at the charts annually, you inure to the trends.  It is like gas prices.  You just know when something breaks course, and you need to dig deeper.  2014 does not disappoint. My eyes always go right to the hospital sector: (more…)

Things to Know about Psychiatric Hospitals

by Dr. Cheryl Dodds
by Cheryl Dodds, MD I am a psychiatric hospitalist, and even though I started being called by that title only a year ago, I have been doing the job for 14 years. I care for psychiatric patients who are no longer safe in the community, either because they are suicidal, homicidal, psychotic or unable to care for themselves safely. When I call to send a patient to the ED or transfer to the inpatient medical service from my psychiatric hospital, the most common question I get is, “You can’t handle that where you are?” Unfortunately, I cannot. Here are some observations about psychiatric care, patients and hospitals to give you perspective on the care we deliver. Gaining Perspective: Psychiatric patients are still patients. When they present to an acute medical hospital to await a psychiatric hospitalization they are truly miserable and at a place where being alive no longer matters…
Dr. Cheryl Dodds is a graduate of the USC School of Medicine and Palmetto Health Residency in General Psychiatry and she completed a fellowship in Child and Adolescent Psychiatry. She has been in private practice and served as Medical Director for Three Rivers Behavioral Health in Columbia, SC for nine years as well as Program Director for an Adolescent DBT residential program and of a partial hospitalization program. Dr. Dodds currently serves as the Medical Director of the Behavioral Health Davidson Campus, which includes a 66 bed mood disorder hospital, for Carolinas HealthCare in Charlotte, NC. Her passions include mindful meditation, DBT and her husband, Doug, a pediatric hospitalist, who convinced her that she also deserves the title hospitalist.

Ten Random Thoughts

Recertification fast approaches--and the mind wanders when you burn out from studying.  Burke and I are in the thick of it, and blogging has been light.  But here are some singular observations to chew on to keep you in the game: (more…)

Super-Utilizers: Will they be buying or renting beds?

Costs in health care tend to concentrate in the domains of the few (think 80/20 rule).  As it goes for chronically ill community dwellers, the same applies to frequent flyers in the ER.  You may have heard of the term super-utilizers. Those individuals present week after week with innumerable complaints, sometimes pedestrian, sometimes critical--always finding themselves back on the ward for weeks at a time.  As expected, they have weak community support and comorbidities in need of TLC, often requiring services not available in their neighborhoods (mental health and substance abuse counseling come to mind). The local house of worship, community center, or corner bar have limits, and they only offer so much spiritual renewal or sustenance.  We all struggle to find a balance for these folks.  We see them a lot.  And thus, the ER becomes their second home. (more…)

Have we hit peak hospitalist?

I have detected something unusual.  Take a look at the cited quotes below and see if you can spot what I am referring to.  Both come from a national newspaper.  Here's the first: On arrival, Larson was put in a room and examined by a physician assistant. He didn’t stop at the admissions office because his information and treatment orders already had been placed into the hospital computer system. Larson was subsequently seen by an internal medicine hospitalist, an infectious-disease doctor and an orthopedic surgeon, who conferred regularly about his care over the next four days. He required 12 days of intravenous antibiotics after discharge; medical supplies were delivered within an hour of his arrival home. A nurse followed shortly to teach him how to administer the medication and give him a 24-hour phone number for a nurse and pharmacist. And here is the second: The hospitalist treating Albright told her that…