July 2009


Hospital medicine around the world

The field is catching on in several countries outside the U.S., Canada and Europe. Although the health care systems and situations may differ, supporters’ reasons for wanting hospital medicine to flourish there are often the same, and the barriers are often similar, as well.

On the front lines of aortic dissection

A leading cardiologist explains why hospitalists are key to improving long-term outcomes.

Caring for the pregnant patient

Every hospitalist is likely to encounter a pregnant patient during his or her career and needs to be versed in the diagnosis and treatment of hypertension, preeclampsia, asthma, venous thromboembolism and diabetes.

Improving handoffs through better communication

Research has shown that speakers systematically overestimate how well their messages are understood by listeners, and assume a listener has all the same knowledge they do. Verbal updates and read-backs can help.

Accurate coding improves payments, quality ratings

Accurate coding has a significant impact not only on a hospital or practice’s finances but also on quality ratings, as Medicare’s new coding system increasingly is being used to profile hospitals and physicians.

Looking for a hospitalist? Be prepared, proactive

Kirk Mathews, CEO and co-founder of Inpatient Management Inc. of St. Louis, explains his cardinal rules of recruiting.

Start at the top to get to the bottom of a diagnosis

Our columnists explain the “top downâ€ï¿½ or “working forwardâ€ï¿½ approach.

Letter from the Editor

Hospital medicine is fairly well established in the U.S., Canada, and Europe, but in other countries the field is just getting started. These fledgling movements face familiar challenges, such as concerns about continuity of care, and unique obstacles, such as an income divide between physicians at public and private hospitals.

A leap forward

Life was fairly dull on Ganymede-13. I sat in my small bungalow on the edge of a vast forest of genetically engineered bamboo, looking at several foot-long segments of the plant.

Coding cardiac conditions: Beyond acute coronary syndrome

Acute coronary syndrome is a very popular diagnosis frequently documented when a patient presents to the hospital with chest pain thought to be cardiac in origin. For accurate coding, physicians should document unstable angina or acute myocardial infarction.

Measure of the month: Prevention of ventilator-associated pneumonia

In accordance with a law passed by Congress late in 2006, physicians and other eligible professionals are able to receive bonus payments of a percentage (increased to 2%) of their total allowed Medicare charges, subject to a cap, by submitting information for defined quality measures.

Test yourself: Acute kidney injury

The following cases and commentary, which address infectious diseases, are excerpted from ACP’s Medical Knowledge Self-Assessment Program (MKSAP14).

Journal Watch: Recent studies of note

Recent studies about early routine eptifibatide for ACS, predicting C. diff infections, and other topics.

In the News

Behavior changes trigger drop in MRSA rates, and more.