Background: Mental illness is common among hospitalized patients and is associated with increased length of stay, higher costs, and worse clinical outcomes. Inpatient psychiatry consultations have traditionally held a reactive model, in which primary teams obtain consultation for patients that have developed active psychiatric symptoms. The reactive model has frequently led to missed opportunities to […]

Background: Mental illness is common among hospitalized patients and is associated with increased length of stay, higher costs, and worse clinical outcomes. Inpatient psychiatry consultations have traditionally held a reactive model, in which primary teams obtain consultation for patients that have developed active psychiatric symptoms. The reactive model has frequently led to missed opportunities to […]

Case Presentation: A 29‐year‐old man with type 1 diabetes of 10 years presented with abdominal pain for 2 days. The pain was located in the midepigastrium, was nonradiating, associated with nausea and bilious, nonbloody vomiting. No chest pain or shortness of breath was reported. He also complained of polyuria, polydipsia, and generalized weakness. The patient […]

Background: Acquired hyponatremia and hypernatremia are common in hospitalized patients and correcting dysnatremia may improve outcomes. Nephrology assistance with dysnatremia may help optimize management, but specialist resources are limited. Targeted Automatic e-Consultation (TACo), a model of selective e-consultation based on automated identification of patients from the electronic health record, has been applied for glycemic management […]

Case Presentation: The patient is a 50‐year‐old man with productive cough for 3 months, weight loss, and leg buckling with progressive thigh pain. He has a history of a ground‐level fall from a horse while working on a cattle farm 2 years prior to presentation. He relates he fell onto a tree, sustaining a puncture […]

Background: Procedures, both inpatient and outpatient, are an essential part of the training for family medicine residents. Several residency programs struggle to provide the minimum number of procedures for residents to develop competency and comfort with the said procedures. Hospitalists do offer increased experience with procedures, although more recently, hospitalists are also referring most procedures […]

Case Presentation: The patient was a 79‐year‐old male Jehovah's Witness who had been newly diagnosed with vasculitis and was near the end of life and requiring blood products. After 2 weeks of daily hemoptysis and severe dyspnea, this patient presented with acute blood loss anemia and in acute renal failure requiring intermittent hemodialysis. He was […]

Background: Medical Assistance in Dying (MAiD) was legalized in Canada in 2016. Health authorities across the country have grappled with how to ensure equitable access for patients. In Victoria, British Columbia, a small group of pioneering community physicians were responding to all community and hospital MAiD requests. The lack of a coordinated system, coupled with […]

Background: Point-of-care ultrasound (POCUS) is increasingly being used across medical specialties, improving diagnostic accuracy in numerous medical presentations and levels of acuity. Training in these skills is currently offered through major societies, but graduate medical POCUS training in internal medicine and family medicine is not common in US residencies. Therefore, we designed a two-week inpatient […]

Case Presentation: A 41‐year‐old man with insulin‐dependent diabetes and hepatitis C cirrhosis with multiple variceal bandings presented with progressive right‐sided weakness had been seen at an outside hospital 6 months prior to admission, where ring‐enhancing lesions in the left frontal lobe were noted on CT and MRI. CSF and serum analyses for toxoplasmosis and a […]