Background: Delays in the discharge of the hospital ward patients cause a backlog for new admissions from the Emergency Department, and transfers from the Intensive Care Units and telemetry units. This bottleneck unnecessarily increases overall resource utilization and also negatively impacts patient care and satisfaction. Therefore, our Internal Medicine Residency Program aimed through this quality [...]

Background: Unconscious bias within the U.S. health care system has been linked with disparities in the treatment of patients by age, gender, and race (1). While many factors contribute to these disparities, implicit bias may play a significant role. Stigmatizing language often reflects the implicit bias that healthcare providers possess toward patients (2). Recent research [...]

Background: Stigmatizing language in clinical notes can negatively impact physician attitudes, propagate bias, affect prescribing behaviors, and exacerbate healthcare disparities, yet remains prevalent even in the Open Notes era. Prior analyses of stigmatizing terms in clinical notes are limited by the lack of context in which terms are used and multiple meanings of certain words [...]

Background: Use of stigmatizing language in clinical note documentation is a recognized problem, but such notes may be viewed disparately and irregularly. Whether such language is also used in highly visible behavioral alerts (BAs), which are presented forcefully through push notifications and viewed repeatedly whenever a chart is opened, is unknown. Further, whether BAs with [...]

Background: Hematopoietic stem cell transplantation (HSCT) can be a life-saving and curative therapy in hematological malignancies. Pre-transplant evaluation for HSCT is a multidisciplinary process that can be complicated, time-consuming, and expensive for patients to navigate. The process requires coordination between several medical subspecialties including pulmonary, cardiology, and mental health, in addition to social workers and [...]

Background: Biases related to people with substance use disorder (SUD) actually increase during time spent in formal medical education, and continue into practice. Leading health professional education groups across medicine, nursing, pharmacy, and social work, including the Association of American Medical Colleges (AAMC), have recognized addressing substance use disorders including stigma and bias as a [...]

Case Presentation: A 73-year-old male with history of type 2 diabetes and one-month prior admission for acute renal failure in the setting of stage IV chronic kidney disease presented with symptomatic anemia found to have splenomegaly. A renal biopsy revealed features of membranoproliferative glomerulonephritis and necrotizing crescentic lesions with IgM kappa deposition, suspicious for cryoglobulinemic glomerulonephritis. Immunofixation [...]

Case Presentation: A 57-year-old man with depression and prior suicide attempts presented after being found unresponsive at home with empty bottles of doxepin, amitriptyline, and another unidentified pill bottle. In the ED, he had a GCS of 6, was intubated for airway protection and admitted to MICU. Sodium bicarbonate, fentanyl and propofol infusions were started [...]

Case Presentation: A 75 year old woman with past medical history of hypothyroidism presented with weakness and the sensation of “large folds of skin” on the bottom of her feet. Pertinent physical exam findings included conjunctival pallor, nonspecific diffuse abdominal tenderness, and hyperpigmented macules of the dorsal finger tips and soles, which were also new [...]

Case Presentation: 59 yo Caucasian male presented from an outside hospital (OSH) with primary complaint of “leg abscesses” of 1 wk duration. Patient was afebrile, vital signs stable and in no acute distress complaining of painful “leg abscesses.” PMHx significant for recurrent scrotal cellulitis for the past few years, but was improving when the leg [...]