Background: Academic productivity is a key component of advancement in academic medicine and development of expertise, however many new attendings lack the knowledge and experience to publish a paper. For example, a multi–institutional survey of academic hospitalists revealed that half of academic hospitalists have not produced an abstract, poster or first–author paper. The importance of [...]

Background: Unprofessional behaviors undermine the hospital learning environment and patient care quality.A prior needs assessment of residents and hospitalists regarding lapses in professionalism was utilized to identify clinical scenarios which increased during internship at our 3 institutions (blocking admissions, disparaging the ED or PCP for missed findings, and misrepresenting a test as urgent). Purpose: To [...]

Background: Starting a new job with a hospitalist group can be stressful and exhausting as new hires adapt to changes in processes, workloads, and institutional culture. Surveys have indicated high hospitalist attrition rates between 13–22% per year, with 26% of hospitalists planning to remain in their current job for less than two years. While private [...]

Background: Recognition of poor value in US healthcare is leading to reform of the hospital payment system. Effective physician leadership will be crucial for the potential gains from aligning incentives to be translated into improved value. Despite the central role physician’s play, traditional residency training neglects essential skills that physician leaders need in the new [...]

Background: Medical hospitalists typically manage hospitalized patients. However hospital medicine is evolving to meet the changing demands of hospitals and communities. A recent innovation, surgical co–management is now part of the standard repertoire of most medical hospitalist groups. We describe a further hospitalist innovation where a medical hospitalist physician assistant with advanced surgical training provides [...]

Background: Observation services are provided for clinical conditions that do not meet inpatient admission criteria but require a period of observation for evaluation and treatment. Dedicated observation units can serve this purpose and are found in 18.8% of emergency departments. While these units have traditionally been managed by emergency room physicians, there is an increasing [...]

Background: The advent of hospitalists has greatly improved the afterhours care in the hospital. A majority of the care planning happens when the hospitalists round in the daytime and the afterhours care is limited to ‘putting out fires’ and admitting new patients. Increasing focus on the patient flow, length of stay, and reducing costs demand [...]

Case Presentation: A 73–year–old man presented with symptom of locked jaw for one day. On further enquiry, he reported that he suffered an injury to the right leg after stepping on a rusty steel object one week ago. Even though he was seen at a nearby health facility for the wound, no tetanus shot was [...]

Case Presentation: We report a case of a 43–year–old African American female with a 30 years history of tobacco use who presented with complaints of severe retrosternal chest pain for 4 hours associated with mild non–productive cough. The pain radiate to upper back and both arm. She denied shortness of breath, palipitation, dizziness, nausea or [...]

Case Presentation: An 89–year–old man with past medical history of hypothyroidism, coronary artery disease, and atrial fibrillation on warfarin, is sent from his primary care physician for two week history of new onset diarrhea. The patient had four to five watery bowel movements daily with some vague right upper quadrant pain, nausea and vomiting. An [...]