Background: Moral distress, the inability to act in accordance with one’s ethical beliefs due to hierarchical or institutional constraints, has been associated with burnout and poorer well-being.  Significant moral distress amongst American physician trainees might occur when they feel obligated to provide treatments at the end of life that they believe to be futile or [...]

Background: One key factor cited in physician burnout discussion is the rigid block scheduling that has become ubiquitous for Hospital Medicine. For years, nursing has allowed self-scheduling to improve work life balance and abate burnout with good success per the literature. Recent commentary by leaders in Hospital Medicine has piqued the interest in further evaluation [...]

Background: Several studies attest the effectiveness of physician order set, also known as Power Plan (PP) in standardizing patient care and improving outcomes. In general, PP use is suboptimal. We hypothesized that PP use in patients admitted with Chronic Obstructive Pulmonary Disease (COPD) assists in  standardization and appropriateness of inpatient management. Methods: We conducted a [...]

Background: Patients often must wait several hours before being seen by an admitting attending physician. Protracted admit wait times are undeniably associated with delays in care, patient and family dissatisfaction, and very likely increased lengths of stay (LOS), morbidity, and mortality. For over 10 years at our tertiary care academic institution, advanced practice providers (APP) were responsible [...]

Background: Guiding health care delivery towards patient-centered value can be accelerated by reforming physician reimbursement. Recent legislation including the Medicare Access and CHIP Reauthorization Act (MACRA) and the Affordable Care Act have created frameworks for value-based health care payments. By the end of 2018, the United States Department of Health and Human Services aims to have [...]