Background: Hospital medicine physicians may provide advantages in inpatient care compared with traditional ambulatory‐based primary care physicians (PCPs) because of hospitalists' greater focus and experience in inpatient care. However, hospitalists have disadvantages in inpatient care compared with traditional PCPs because PCPs generally have a more established relationship with the patient. Our prior research has shown […]

Case Presentation: The patient is a 58-year-old male with a past medical history of end-stage liver cirrhosis status post-liver transplantation in 1991 who was on tacrolimus (TAC) 1 mg twice a day. He was admitted for altered mental status, fever and respiratory distress. He was found to have bilateral pneumonia treated as community-acquired pneumonia. The […]

Case Presentation: Four years after kidney transplantation a 65 year-old woman with type 2 diabetes, hypertension, and no psychiatric history is referred to the hospital by her primary care physician to evaluate altered mental status. She was successfully maintained on tacrolimus with stable trough levels. During the preceding three months she had developed progressive symptoms […]

Case Presentation: A 61-year-old woman with a 9-month history of an asymptomatic parathyroid nodule presented to the hospital with three weeks of malaise, constipation, unsteady gait, and confusion. Over the three weeks, she described how difficult it was for her to concentrate and that on multiple occasions, while driving, she would “zone out” for minutes […]