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In The News

WORKFORCE
Could health reform produce a physician shortage?
Could the nation be facing a drastic physician shortage if health care reform passes? According to a recent survey, nearly one-third of 1,200 physicians said they would leave medicine if reform is implemented. Because the number of physician jobs is expected to grow by 22% this decade, any significant loss of physicians could lead to a workforce shortage. An article on the New England Journal of Medicine Career Center, however, notes that physician threats to drop out of medicine haven’t panned out in the past, most recently during the malpractice crisis.

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Posted on 03-12-2010 at 11:12 AM


MEDICATION ERRORS
Drug errors affect more than third of inpatients
More than one-third of patients encountered an error in the ordering of their medications, and 85% of those errors stemmed from information in patients’ medication histories. A study published on the Web site of the Journal of General Internal Medicine found that almost half of errors resulted from an omission, and that cardiovascular drug prescriptions contained an error about 29% of the time. Researchers concluded that if the errors had gone undetected, half could have required increased monitoring or intervention, and 11.7% were rated as potentially harmful.

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Posted on 03-11-2010 at 11:38 AM


ACID SUPPRESSION
Most inpatients receive ASTs unnecessarily
You’ve probably seen studies showing that acid suppression therapy is overused in the hospital, but new research gives details about what types of patients receive the drugs—and how many are discharged on ASTs. The study, which appeared in the March 2010 Southern Medical Journal, found that 73% of patients started on the drugs on admission were didn’t need the therapy. In many cases, physicians gave patients ASTs to prevent stress ulcers, but the patients were so low risk that the therapy was inappropriate. Researchers found that 69% of patients started inappropriately on ASTs were discharged on the therapy.

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Posted on 03-11-2010 at 11:38 AM


MEDICAL ECONOMICS
Senate blocks Medicare pay cuts until Oct. 1
In the continuing saga of the effort to block Medicare pay cuts for physicians, the Senate has passed a resolution that would hold off any cuts until Oct. 1. The House must approve a similar measure. The Senate recently blocked the cuts from taking place before the end of March. At the heart of the issue is the sustainable growth rate, which is supposed to link growth in Medicare spending to the gross domestic product.

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Posted on 03-11-2010 at 11:38 AM


WORKFORCE
Demand for locum tenens hospitalists spikes up
A Dallas-based recruiter that provides both permanent and locum staffing reports that the demand for locum tenens hospitalists in the last quarter of 2009 jumped 63% over the demand logged in 2008, making hospital medicine the No. 1 specialty assignment. In its December 2009 quarterly review, The Delta Companies claimed that 60% of both managed care organizations and hospitals in the U.S. either "directly employ or use hospitalists through a locum tenens agency."

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Posted on 03-10-2010 at 10:33 AM


PEDIATRIC INFECTIONS
What are the real clues to pediatric infections?
A review of more than 30 studies has ranked symptoms that are commonly viewed as signs of infections in children, and the results may surprise you. The study in the March 6 Lancet rated symptoms like cyanosis, rapid breathing, poor peripheral perfusion and petechial rash as strong predictors of infection, but found that symptoms like cough, vomiting and diarrhea were not particularly strong predictors. Researchers did, however, rank parental concern and clinical instinct as strong predictors of infection.

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Posted on 03-10-2010 at 10:33 AM


SEXUAL HEALING
More sex: cure for what ails you or sign of health?
In a classic chicken-and-egg study, University of Chicago researchers looked at U.S. interview data and found that men and women who self-reported excellent or very good health were both more sexually active and more interested in sex into middle and old age than those reporting only fair health. The study found that at age 30, men had 34.7 years of sexual active life expectancy and women had 30.7 years.

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Posted on 03-10-2010 at 10:33 AM


VAP PREVENTION
Can probiotics reduce VAP in the critically ill?
Probiotics have attracted a lot of attention lately, in part because antimicrobial resistance continues to grow, but are they effective? A meta-analysis of five previous trials in which patients received antibiotics found the answer is a definite “maybe.” The study, which appeared in last month’s New England Journal of medicine, found that the incidence of VAP was indeed lower among patients who received probiotics, but no differences were noted in mortality, ICU length of stay, and duration of mechanical ventilation. Researchers noted that were limitations to the study, including an inability to assess safety concerns of probiotics, particularly in patients with compromised immune systems.

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Posted on 03-09-2010 at 11:58 AM


PAIN MANAGEMENT
FDA to six makers of unapproved morphine: cease and desist
Now that the FDA has official approved an oral form of morphine, the agency is warning the manufacturers of unapproved forms of morphine sulfate that they have until the summer to exit that business. The FDA has quietly allowed the production of morphine sulfate by a handful of companies because until recently, there was no other product officially on the market. Now that it has officially approved an oral form of morphine, the FDA is warning companies that make unapproved forms of the drug to stop production by July 24. The agency has threatened to take actions including seizure and injunction to stop the production and distribution of unapproved morphine.

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Posted on 03-09-2010 at 11:58 AM


HOSPITAL ATTIRE
White coat: symbol of experience or hierarchy?
Is the doctor’s white coat a sign of experience or part of an antiquated dress code designed to reinforce a hierarchy? The February Journal of Hospital Medicine published a commentary on the issue, and the article’s author has more to say in an interview on the HealthLeaders Web site. Jeffrey H. Spiegel, MD, an otolaryngologist at Boston University School of Medicine, talks about the length of white coats as an indicator of status, the potential impact on patient care (a conduit for infections) and perceptions (white coat hypertension), and his own dress preference (tie and jacket).

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Posted on 03-09-2010 at 11:58 AM


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