Background: With the increasing use of diagnostic imaging modalities, incidental findings (IFs) are a common occurrence in hospitalized patients. They present a unique challenge to hospitalists treating patients admitted for chest pain because of the ever shorter hospital length of stay. Very few studies have focused on describing the characteristics of patient with IFs. A […]

Background: Despite a commitment to high-quality medical education, diagnostic errors continue to be pervasive. Clinical presentations with nonspecific symptoms and diagnoses with wide differentials are prone to diagnostic errors; dizziness may be the epitome of this conundrum. Dizziness is a common symptom, costly to assess, and frequently misdiagnosed. Diagnostic decisions have high stakes, given the […]

Case Presentation: A previously healthy 49‐year old woman presented for admission after a syncopal episode. She had a 4‐ month history of fever (104°F), sweats, rigors, 40‐pound weight loss, and abdominal pain associated with alternating diarrhea and constipation. Prior workup done at another hospital including pan cultures, HIV and hepatitis testing, upper and lower endoscopy, […]

Background: Rural areas are disproportionately affected by physician shortages, and small rural hospitals in particular struggle to staff acute medicine services 24/7. Telehospitalist models are emerging as an alternative to provide inpatient medicine services in rural settings. In a 2018 needs assessment of rural Veterans Health Administration (VHA) hospitals, 60% percent reported being short on […]

Case Presentation: A 74‐year‐old woman with a medical history of chronic obstructive pulmonary disease (COPD), hypertension, and paroxysmal atrial fibrillation presented to the preoperative clinic for optimization prior to her right hip replacement surgery. She had excellent functional capacity; however, this was limited lately because of increased hip pain. She denied any active cardiac symptoms […]

Background: Patients with complex medical problems are at high risk of readmission when transitioning from the hospital to home, especially when they reside in rural areas (as is the case within our VA Health Care System (HCS)). Innovative solutions are needed to improve access to post hospitalization follow up within our facility. We hypothesized that […]

Case Presentation: A 52‐year‐old Hispanic woman presented with bilious vomiting of 1 day's duration. It was associated with worsening headache and weight loss of one‐month duration. She denied other systemic symptoms. She was being managed for acquired immunodeficiency syndrome (AIDS) with highly active antiretroviral therapy (HAART) and was on atovaquone for PCP prophylaxis. Her CD4 […]

Background: Virtual care is becoming a fully realized modality of providing patient care (1, 2). In hospital medicine, the transition of care from inpatient to outpatient can be challenging to carry out efficiently and effectively while mitigating any preventable harm that may arise prior to a scheduled follow-up appointment with a primary care physician (PCP). […]