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"Stuff a Hospitalist Says"

April 2011

In the grand Today’s Hospitalist tradition of celebrating April Fools’ Day, I have again attempted to create a humorous blog. Building on the success of last year’s "You might be a hospitalist … ," I bring you "Stuff a Hospitalist Says," my spoof of the Twitter sensation and CBS sitcom, "$#*! My Dad Says."

Didn’t someone once say that laughter is the best medicine? Hopefully, this will deliver an effective dose.

But first, let me send out a big thanks to those who contributed to this bit of fun. It turns out that our morning sign-out is a treasure trove of hilarious "Stuff a Hospitalist Says," some of which is intentionally funny and some, well, not so much. But it all adds up to a nice spoonful of sugar that helps make a 12-hour day with a 7 a.m. start time go down a little easier.

With tongue firmly planted in cheek. I give you then "Stuff a Hospitalist Says":

● "Pulmonology states the hypoxia is due to a CHF exacerbation, Cardiology says it is due to a COPD flare, and I write, ‘Continue current management as per Pulm and Cards.’ "

● "A dose of IV Rocephin a day keeps case management at bay. A dose of IV steroids a day keeps an insurance denial away. An apple a day … well, it turns out to be fairly useless."

● "I have to respectfully disagree. Bringing up DNR when discussing your severely cognitively impaired 96-year-old bedbound grandmother makes me a realist, not a pessimist."

● "Sure, I chose to do this. Really, the fact that I didn’t match in a subspecialty fellowship is just a coincidence."

● "Burnout? Honestly, that’s ridiculous. I’m just edgy and incoherent after seven consecutive night shifts because of my lactose intolerance."

● "Call me the optimist who always sees the glass half full, but I believe being four doctors short-staffed just gives me more opportunities to demonstrate how dedicated I am to my job!"

● "In ‘The House of God,’ it was Age + BUN = Lasix dose. In ‘The House of the Hospitalist,’ it is RVUs * LOS/CMI = Job security."

● "When I was in medical school, I used to think surgeons were the only ones who didn’t use a stethoscope."

● "Show me a medical director who works as hard as the rest of us … No, really, can you show me that medical director?"

● "So, you mean I get to start admitting after the resident’s cap? Cool!"

● "When I joined, I was told no more than 18 patients a day. I just wish there wasn’t one small exception to that golden rule: when there are more than 18 patients a day to be seen."

● "A level 3 bill requires eight points of the physical exam. That’s why I never miss an opportunity to check the inguinal lymph nodes."

● "I am not going to solve health care woes. But something is wrong when some private docs believe a patient bouncing back with insurance is an annuity plan, while I spend half my day trying to figure out a way to keep him healthy enough to stay home."

● "And I am not done with bouncebacks because I think I have a solution for the pending, no-pay, 30-day CMS bounceback rule. With the Subway Sandwich card in mind, can’t we give patients a card that has 30 spots for them to mark their daily weight? Once they record all thirty days, their card is now good for a free trip back to the ER!"

● "I completed the discharge medication reconciliation list without a single error, all 31 medications. What could possibly go wrong?"

● "I just wish the CMS would make an observation/inpatient roulette wheel and place it in every ER. One spin and you get what you get. Lady Luck, show me the inpatient!"

● "Say I discharged a patient without an ACE or ARB despite the fact that their EF was less than 40% and their K and creatinine were both 7.2 and I didn’t bother to specifically document my reasoning. Isn’t it safe to assume it wasn’t just a fortunate coincidence?"

● "Our group’s sign-out process was helplessly defective. Nothing worked until we finally overhauled our process and came up with a perfectly efficient, errorless communication system. We no longer sign out."

● "Yes, yes, of course we should admit the patient. After all, you get paid for only the procedure, and that’s just wrong."

● "I love my job, I love my job! Well, I am pretty fond of my job. Taking care of acutely ill patients with relatively little paperwork, and perhaps making a positive impact on the future sustainability of health care in this country–not a bad gig, really. No, not bad at all. Just a little bad. Or medium bad. Relatively non-bad. Better than most. Or some. But not all. Cruise ship doctors might have it better. But then there’s the sunburn. And the food poisoning. And don’t forget the seasick and inebriated. Whose idea was it to combine all-you-can-eat and drink with ocean travel, anyway? Yep, despite myself, I really do love my job!"

Happy April Fools’ Day!