Case Presentation: 19 month old female with a history of unspecified T- cell immunodeficiency presented with a 10 day history of cough, fatigue, and persistent fevers. The patient had just returned from Mexico and reportedly was diagnosed with influenza there. Previously the patient had been on Bactrim prophylaxis, but ran out of it while in [...]

Case Presentation: A previously healthy 4-year-old female born in Mexico was sent to the emergency department for elevated blood pressures noted at her routine outpatient clinic visit. On arrival, her blood pressure was 161/126. The patient reported polydipsia, polyuria, and weight loss. Her initial physical exam was unremarkable and her vitals were otherwise within normal [...]

Case Presentation: A 17 y.o. female with systemic lupus erythematosus (SLE) presented with several weeks of worsening migratory polyarthralgia, as well as sporadic fevers, night sweats, and chills. Prednisone was begun 3 weeks prior for a presumed SLE flare, given elevated anti double-stranded DNA (anti-dsDNA) and erythrocyte sedimentation rate (ESR) and hematuria, but provided no [...]

Case Presentation: A 12-year-old Caucasian male with no significant medical history presented with a 6-day history of bilateral leg pain following a soccer game. As an avid soccer player, he had experienced similar episodes over the past three years, managed previously as “growing pains” with NSAIDs and acetaminophen. However, this presentation raised concern for an [...]

Background: Communication is a vital aspect of a doctor-patient relationship in providing medical care. Despite extensive research and ACGME guidelines of interpersonal and communication skills, there is a lack of a formal curriculum that is designed to systematically teach resident physicians on creating and sustaining therapeutic relationships with patients and families. Some institutions have tried [...]

Background: Clinicians face substantial challenges in limiting life-prolonging interventions (e.g., ICU admission, life-sustaining treatments, invasive procedures) near the end of life, even when they judge these interventions to be non-beneficial [1-3]. The objective of our study was to empirically derive a descriptive framework of decision-making approaches used by clinicians to limit (i.e., withhold or withdraw) [...]

Background: Bedside nurses often communicate via alphanumeric (text) paging with hospitalists and other providers. To help the nurse and provider triage the urgency of these messages, our institution has implemented a tiered paging labeling system based on message priority, but the use of this labeling system and the concordance between provider perception and nurse perception [...]

Background: As cannabis is legalized/decriminalized in more US jurisdictions, and social norms and perceptions around use change, many products for psychoactive, recreational use, and purported medical uses are available in edible and supplement formats. Rates of unintentional ingestion of cannabis products among children and adolescents have been described in the literature, but there is no [...]

Background: Fewer than one in three patients can correctly name a physician on their inpatient care team. Despite the fact, factors associated with correctly naming a physician have not been adequately explored. This study evaluates whether physician behaviors and patient characteristics are associated with a patient’s ability to correctly name their hospitalist physician. Methods: We [...]

Background: The Institute of Medicine includes patient-centeredness as an essential component of high-quality patient care. One dimension of patient-centeredness is the need for physicians to provide clear communication to patients (1). The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey also measures physician communication skill.Patient perception of physician communication is complex. Visual aids [...]