Background: Community-acquired pneumonia (CAP) is the most common infectious diagnosis necessitating adult hospitalization in the United States (US). Timely diagnosis of CAP is important to improve patient outcomes. However, overdiagnosis of CAP, or treatment of CAP despite inadequate signs or symptoms of CAP, may also pose a significant threat to patient safety. Potential harm of [...]

Background: Long-term central venous access devices (CVADs) are integral to cancer care provision. Despite the high prevalence of CVAD occlusion in children with cancer, strategies to prevent occlusive events are understudied. We aimed to test the safety and feasibility of conducting a randomized controlled trial (RCT) comparing heparinised saline, with normal saline (0.9% sodium chloride) [...]

Background: Confidentiality within adolescent medicine is imperative in establishing a trusting patient-physician relationship. In April 2021, the 21st Century Cures Act granted patients’ guardians immediate access to select patient electronic medical records. Whereas Pediatric Hospital Medicine (PHM) history and physical (H&P) notes are visible to guardians, adolescent sensitive notes (ASN) remain confidential. At our institution, [...]

Background: Hospitalist comanagement of surgical patients has become the standard of care for conditions such as hip fractures and has expanded widely to involve numerous surgical disciplines. While hospitalist comanagement has demonstrated improved patient outcomes, its impact on hospitalist satisfaction is unknown. The objective of this study was to evaluate the hospitalist experience and satisfaction [...]

Background: Medical training often lacks formal education on accurate documentation for billing and coding. Studies show residents are aware of their lack of knowledge and have a desire for more training[1-4]. Consequently, attending physicians lack confidence in billing and coding and also desire further education [5]. However, there is a paucity of studies on effective [...]

Background: Interhospital transfers are shown to be associated with increased length of stay (LOS), mortality, and discharge to facility.[1,2] Delirium has been associated with similar outcomes.[3] Our prior data showed that interhospital transfers had 1.91 times the risk of delirium when compared to ED admissions. We hypothesized that an interaction between admission source, namely interhospital [...]

Background: Although most cigarette smokers want to quit, current cessation therapies have limited effectiveness. Preventing relapse is limited by insufficient understanding of the neural pathways that are triggered during relapse. With recent advances in functional connectivity analysis, functional magnetic resonance imaging (fMRI) studies offer the ability to better neural functional connectivity during relapse. This study [...]

Background: Hospitalists—even at academic institutions—publish fewer papers than physicians in other specialties. In a 2021 study of the top 25 internal medicine residency programs, 51.4% of hospitalist faculty had zero publications and only 11.7% had been promoted beyond assistant professor (Sumarsano et al); by comparison, a 2014 study of academic cardiologists reported 28.2% were full [...]

Background: Joy in medicine for many hospitalists is centered around meaningful and rewarding interactions with their patients. Unfortunately, hospitalists commonly face challenging encounters with patients. Hospitalists may consider these encounters challenging when there is a mismatch between time available and time requested by the patient or family, delays of care which are due to system [...]

Background: Microaggressions are subtle, indirect words or actions that create hostility, communicate disrespect, or imply a sense of exclusion. Over time, these microaggressions can contribute to physician burn-out and negatively impact well-being. Although studies have found that a majority of physicians have been subjected to these deleterious comments by patients, many physicians have never received [...]