Background: Prior studies have found racial disparities in how patients are assessed for pain and prescribed opioids from emergency department and surgical settings. However, we do not know whether similar disparities exist among general medicine inpatients. We examined opioid prescriptions at discharge among adults admitted to the general medicine service at our medical center, with [...]

Background: Race and racism are social determinants of health resulting in marginalized groups often experiencing worse health outcomes. These racial differences are often due to physician bias as well as biased processes. To mitigate this, it is recommended that clinicians avoid reifying racial differences as biological differences. This study describes the use of racial identifiers [...]

Background: New internal medicine interns are expected to be familiar with bedside procedures such as paracentesis. Medical students frequently have inadequate dedicated time to learn bedside procedures and are taught in a fragmented manner. As a result, new interns lack familiarity with these procedures. As such, we assessed whether a comprehensive module for paracentesis would [...]

Background: Many hospitals do not have the means to supervise daily physical therapy (PT) for elderly inpatients. PT delivered in a group setting has the potential to allow hospitals to consolidate resources and extend PT services to more elderly patients within the hospital. However, little to no efforts have been made in implementing the delivery [...]

Background: The Institute of Medicine includes patient-centeredness as an essential component of high-quality patient care. One dimension of patient-centeredness is the need for physicians to provide clear communication to patients (1). The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey also measures physician communication skill.Patient perception of physician communication is complex. Visual aids [...]

Background: The 12-lead electrocardiogram (ECG) is an essential tool when evaluating patients with suspected cardiopulmonary disease and inaccurate ECG interpretation may result in adverse patient outcomes. The Alliance for Academic Internal Medicine stated that ECG interpretation should be a skill required for medical school transition to residency. Yet, prior research indicates graduating medical students correctly [...]

Background: New onset third degree or complete heart block (CHB) is a medical emergency and usually requires permanent pacemaker. CHB can be caused by cardiac ischemia or non-ischemic conditions such as infiltrative diseases or fibrosis. The purpose of this study was to analyze the clinical characteristics associated with ischemic versus non ischemic causes of complete [...]

Background: The American Board of Internal Medicine suggests residents participate in a minimum of five abdominal paracentesis (AP), central venous catheter (CVC) placements, and lumbar punctures to ensure “adequate knowledge and understanding” of procedures performed by practicing internists. Competency in these procedures is poorly defined and difficult to assess. To address the need for well-supervised, [...]

Background: In hospitalized patients with anemia, the AABB recommends that transfusion of red blood cells occur when a patient’s hemoglobin (Hb) drops below a restrictive transfusion threshold, either at 7 or 8g/dL1. These transfusion guidelines are the result of a growing body of clinical trial evidence showing that transfusion at lower or restrictive Hb thresholds [...]

Background: The Centers for Medicare & Medicaid Services (CMS) started penalizing hospitals with “excess” 30-day readmissions, as determined by observed-to-expected ratio, for patients discharged after treatment for an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). An understanding of modifiable determinants of 30-day readmission will likely help in developing interventions to reduce preventable AECOPD readmissions. [...]