Patient Experience

Do Patients Really Prefer Hospitalists to Teaching Service?

by Dr. Charlie M. Wray DO
by Dr. Charlie M. Wray DO After diligently listening to the intern’s presentation and deciding on what our treatment plan would be for our patient, Mrs. Ramirez, my senior resident led our two interns, two medical students, and myself into her room. As we all methodically filed in, slowly gathering around the patient, I could see her anxiously sit up in bed and look around at all the different faces, searching for one to focus on. As the intern reviewed the overnight labs and imaging with her, I stood there and imagined the confusion and overwhelming feelings she probably has every morning when a gaggle of doctors amass around her bed. I contrasted this experience with what would likely occur the following week when I would be back on service as a direct hospitalist, where instead of 6 different white-coated individuals to contend with, my patients would only have to…
Dr. Charlie M. Wray DO is currently a second year Hospitalist Research Fellow and Clinical Associate in the Section of Hospital Medicine at the University of Chicago. He completed medical school at Western University – College of Osteopathic Medicine and residency at Loma Linda University Medical Center prior to his fellowship. Dr. Wray’s research interests are focused on inpatient care transitions and care fragmentation in the hospital setting. Additionally, he has strong interests in medical education, with specific focus in evidence-based medicine, the implementation of value-based care, and how learners negotiate medical uncertainty. Following his fellowship, Dr. Wray will be joining the staff at the San Francisco VA Medical Center.

There Are a Million Stories in the Naked City

Hospital Allegory:  (Special thanks to Keiki Hinami). Three scientists are tromping through the wilds of a previously uncharted rain forest. They are captured by blood thirsty aborigines who scream and chant at them. The Chief approaches the first scientist as asks him, "Do you want death or do you want cheech?"  The natives whoop and holler.  The scientist, shaking in fear, has no idea what cheech is, but does not want to die, so fearfully chooses "cheech".  The aborigines yell and scream, yank out the scientist's eyeballs, slice open his abdomen, pull out his entrails until he crawls off moaning in agony into the jungle to die.  The second scientist is then approached. "Do you want death or do you want cheech?!"  The second scientist is in a state, saying convulsively over and over, "I don't want death; I don't want cheech!" The Chief demands an answer and the scientist,…

Star Wars: The Force Awakens. Hospitalist Edition

I have won as a father. [caption id="attachment_13770" align="aligncenter" width="300"] Source:[/caption] My daughters are enamored with Star Wars. It’s a simple victory to watch my children appreciate some of the same movies and music that I grew up loving. I can’t whip my nae nae or understand the obsession with Minecraft, but I will smile deeply when they hum Yellow Submarine, Piano Man, or cheer for Gene Wilder’s Willy Wonka (outclassed Depp’s version by 100 golden tickets). Their behavior will be short lived, and they will purposefully distance themselves from anything my wife and I enjoy in a few short years. For now, they are enjoying Darth Vader, Han Solo, and Leia as we all learn about Kylo Ren, Rey, and the latest droid BB-8. [caption id="attachment_13769" align="alignright" width="300"] Source:[/caption] Unless you’ve been living in a different galaxy, you know the 7th Star Wars movie is coming December…

CMS Just Paid for Advance Care Planning. But You’ll Still Make More Giving Injections.

I know the following may convey a lack of gratitude.  CMS funds a code, and by doing so, validates an activity for so long many in medicine have overlooked or dismissed.  Many specialists probably viewed end of life counseling as "stuff" those docs in the offices without the cherry finished cabinets dealt with.  You know. Trivial stuff.  Well, at least we can put that little contrivance to bed.  Amen. Cash is hard to come by these days and introducing a newly funded service risks cost overruns from overuse.  But if I had to guess how often practitioners will utilize these new E/Ms (99497 and 99498), my bet would be less than expected--and CMS can ease their fears that providers will back their Brink's truck in. (more…)

This Football Season, Watch out for This Teammate

Fall means football. Even in Florida where it’s still 90 degrees, we can pretend autumn has arrived, with football on the lawn as a rite of passage. Recently, I was in the front yard playing with my 2 daughters, 7 and 9 years old. We decided to play some 2 on 2, with myself as automatic quarterback, just like the good ole days of backyard football. (Although as a kid there were always fights on who would be QB. I often lost. One of the benefits of being a Dad, I just tell them I’m automatic QB and no one argues. “...because I said so.”) Shayna, the older one, and I drew up a play on her shirt, tracing it out with my finger, hidden from the eyes of the youngest, Lyla. We created some complicated play with a little razzle-dazzle, some goofy faces to distract the opponent, and then a…