Background: In 2010, the Patient Protection and Affordable Care Act (ACA) aimed to enhance health insurance access through subsidies and Medicaid expansion. The expansion was not adopted by all states, leading to variable coverage. The Centers for Medicare & Medicaid Services (CMS) releases a 3-year running average of 30-day risk-standardized mortality rates for Medicare patients [...]

Background: Despite medical advancements for organic and structural diseases, effectively managing acute and chronic functional pain syndromes remains a daunting challenge for hospitalists. Standard inpatient treatments frequently fail to adequately control symptoms, often compelling hospitalists to shift from diagnostics to the contentious task of tapering opioids in patients with legitimate pain. This pivot can lead [...]

Background: In 2010, the Patient Protection and Affordable Care Act (ACA) aimed to enhance health insurance access through subsidies and Medicaid expansion. The expansion was not adopted by all states, leading to variable coverage. The Centers for Medicare & Medicaid Services (CMS) releases a 3-year running average of 30-day risk-standardized mortality rates for Medicare patients [...]

Background: Despite medical advancements for organic and structural diseases, effectively managing acute and chronic functional pain syndromes remains a daunting challenge for hospitalists. Standard inpatient treatments frequently fail to adequately control symptoms, often compelling hospitalists to shift from diagnostics to the contentious task of tapering opioids in patients with legitimate pain. This pivot can lead [...]

Background: The direct oral anticoagulants (DOACs) apixaban and rivaroxaban are increasingly prescribed due to convenient oral formulation without the need for routine laboratory monitoring and are now commonly regarded as first line anticoagulants in most cases of venous thromboembolism (VTE). However, the optimal choice of subsequent anticoagulant in instances of first line DOAC failure is [...]

Case Presentation: An 89-year-old man with coronary artery disease, hypertension, and osteoarthritis presented with acute-onset severe posterior neck pain, with no viral prodrome. The patient reported experiencing generalized weakness and associated headache, but denied any fevers, chills, cough, myalgia, joint pain, ulcers or rashes. Additionally, he did not report any photophobia, phonophobia, changes in vision, [...]

Case Presentation: A 23-year-old man with cystic fibrosis presented to the Emergency Department with a two-day history of gradual, persistent, right sided abdominal pain associated with dark, tarry stools. He was afebrile with unremarkable vital signs. Exam was notable for generalized abdominal tenderness most noticeable in the right lower quadrant and a normal rectal exam. [...]

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: The lack of competent teaching faculty is a major limitation to the expansion of point-of-care ultrasound (POCUS) in the field of inpatient and outpatient medicine despite the availability of approved training programs. Programmatic research demonstrates that participants have increased knowledge, skill and confidence immediately after a course. Currently there is insufficient data on long [...]