Background: Hospitalists increasingly confront patient care and policy dilemmas due to financial incentives created by bundled payments, single payments that “bundle” acute and post-acute care for specific diagnoses. The most common and most successful bundled payment has been for total joint replacement, where cost savings have been achieved through discharging patients to home rather than [...]

Background: In surgical co-management (SCM), surgeons and hospitalists share responsibility of care of the surgical patients. In August 2012, we implemented SCM in Orthopedic and Neurosurgery services at our institution (Ann Surg 2016;264(2):275-282). This model is innovative because the same Internal Medicine hospitalists are dedicated year round to the same surgical service. After the first [...]

Case Presentation: A 66-year old woman with a history of obesity and hypertension presented with a right femoral neck fracture after a mechanical fall. She underwent a right total hip arthroplasty and the anesthesiologist reported transient intraoperative hypoxia during cement placement. In the recovery room, the patient was hypotensive, tachycardic and hypoxic requiring up to [...]

Background: Hospitalists increasingly confront patient care and policy dilemmas due to financial incentives created by bundled payments, single payments that “bundle” acute and post-acute care for specific diagnoses. The most common and most successful bundled payment has been for total joint replacement, where cost savings have been achieved through discharging patients to home rather than [...]