Impact of Inpatient Consults by a Family Medicine Teaching Service

Objectives: Inpatient consult rates by family physicians significantly affect many aspects of medical care. Limited research has investigated the consultant rate by family medicine residents and their impact on length of stay (LOS) and direct cost. This study examines the inpatient consultant rate of family medicine residents. Methods: We conducted a retrospective electronic chart review of consults associated with hospitalizations on a...

Uterine Surrogacy is Morally Equivalent to Selling a Kidney

To the Editor: Uterine surrogacy is accepted in the United States, but it is illegal for an individual to financially benefit from donating a kidney to another person. Both provide the gift of life. For surrogacy, it is a newborn child; for transplantation it is longer life expectancy1 and an increased quality of...

Frequency, Timing, and Types of Medication Ordering Errors Made by Residents in the Electronic Medical Records Era

Objectives: To describe associations between resident level of training, timing of medication orders, and the types of inpatient medication ordering errors made by internal medicine residents. Methods: This study reviewed all inpatient medication orders placed by internal medicine residents at a tertiary care academic medical center from July 2011 to June 2015. Medication order errors were measured by pharmacists’ reporting of an error via...

Editor’s Response

We have elected to publish Dr McCartney’s Letter to the Editor, wherein he advocates for an open market for the sale of kidneys for transplantation, to again stimulate thought and discussion regarding the ethical nuances of organ...

Teaching to Teach: An Effective and Feasible Teaching Curriculum for Internal Medicine Interns

Objectives: New competency requirements from the Accreditation Council for Graduate Medical Education have prompted greater emphasis on developing residents’ teaching skills. Many residents make their first foray into teaching during internship, making it an important yet underrecognized opportunity to develop basic teaching skills. In addition, in the current graduate medical education climate, residents’ tasks are compressed into an even...

Stress Electrocardiography vs Radionuclide Myocardial Perfusion Imaging among Patients Admitted for Chest Pain: Comparison of Teaching and Nonteaching Hospital Services

Objectives: The American Board of Internal Medicine Foundation’s Choosing Wisely initiative has identified the routine use of stress cardiac imaging among lower-risk patients as an expensive test that should be questioned by both physicians and patients. The objectives of this study were to determine how often patients hospitalized for chest pain are assessed with stress electrocardiography (stress ECG) compared with radionuclide myocardial...

Physician Advance Care Planning Experiences and Beliefs by General Specialty Status and Sex

Objectives: Advance care planning (ACP) involvement could be substantially different by physician specialty or sex group, with implications for training and methods to increase ACP activities. The objective of this article is to compare primary care physicians (PCPs) and other specialty physicians and female compared with male physicians’ views and interactions surrounding ACP. Methods: This was a secondary analysis of an online anonymous...

Medical Student H&Ps: Do You Have to Observe Them All At Once?

Objectives: Direct observation of medical students’ history and physical examination (H&P) skills by attendings is essential in ensuring trainees’ competence. This study compared whether partial observations by multiple pediatric attendings across various clinical encounters versus a full observation by one attending affected students’ performance on the pediatric Objective Structured Clinical Examination (OSCE) and the Year 3 Clinical...

On “Women’s Health Curriculum for Medical Students”

To the Editor: We would like to sincerely thank Sattari et al for their insightful piece on developing a diverse women’s health elective for medical students.1 As future doctors studying in a time of change from paternalistic to patient-centered medicine, we believe it is important that we empower female patients into making educated decisions about their lives, other than just the gynecological and obstetric aspects of...

Differences in Medical Students’ Academic Performance between a Pass/Fail and Tiered Grading System

Objectives: Medical school implementation of a pass/fail grading system offers the opportunity for a reduction in student stress and anxiety and the creation of a less competitive environment, leading to an improvement in overall well-being. Some critics of a pass/fail system have raised concerns of a decrement in academic performance. The purpose of this research project was to determine whether medical students at the Medical College of...

Obesity and Weight-Biased Shaming in South Carolina: A Medical Student’s Perspective

To the Editor: The economic cost of obesity in South Carolina alone has been estimated by the Department of Health and Environmental Control to be >$8.5 billion/year and growing. As of August 2017, South Carolina was ranked 12th in the nation for adult obesity — 32.3% of the state’s population is obese; the number was 12.0% in the 1990s. The combined overweight and obesity rate of children aged 10 to 17 years is even higher than the adult...

Author’s Response

To the Editor: Kumar and Mathur eloquently highlight the importance of addressing not only the reproductive health of female patients but also preservation of their wellness and prevention of illness.1 Women’s health encompasses screening, diagnosis, and management of disease or conditions that are unique to or more common or serious in women; have distinct risk factors, causes, manifestations, or outcomes; or require different treatment or...

Do Teaching-Focused Medical Schools Perpetuate the Thinking That Black Faculty Should Not Be Researchers?

To the Editor: In attempts to address concerns about a physician shortage, there has been an increase in the number of US medical schools. Many of these schools are community based and have been created with a focus on teaching to increase the numbers of primary care physicians and a strong commitment to social mission.1 Some schools even have historically high black student and black faculty...

Religious Characteristics of Physicians Who Care for Underserved Populations or Work in Religiously Oriented Practices

Objectives: This study examined the relation between physicians’ religious characteristics and working for medically underserved populations or in religiously oriented practices. Methods: Secondary data analysis of 2009–2010 national survey of 896 primary care physicians (PCPs) and 312 psychiatrists. Predictors included physicians’ religious characteristics. Results: Adjusted response rates among eligible physicians were 63% (896 of...

Commentary on “Religious Characteristics of Physicians Who Care for Underserved Populations or Work in Religiously Oriented Practices”

In recent years, the common understanding has been that the United States is becoming increasingly less religious. Certainly as far as religious observance and active participation in organized faith communities is concerned, this is demonstrably the case. Paradoxically, however, attention to the role of religion and spirituality in how patients and caregivers cope with illness and make decisions about their care has increased. The rise of...

How Much Time Do Residents Spend on Inpatient Clinical Computing?

Objective: To evaluate the time that residents spend on clinical computing. Methods: Our electronic health record system was used to record clinical computing time. Residents were unaware that we were tracking their time. Prior studies have reported computing times by watching the users. We evaluated residents in internal medicine, general surgery, and emergency medicine. The postgraduate year 1 (PGY1) and PGY3 residents were evaluated in...

Hospitalist Infectious Disease Service in Academic Medical Centers: A Win-Win for Hospitalists and Fellows

In the last decade, inpatient care has changed dramatically at academic centers nationwide. In part this has been driven by resident work-hour restrictions, which have forced most teaching hospitals to develop and expand hospitalist services.1,2 Our institution initiated an inpatient hospitalist team, called the Collaborative Inpatient Medical Service, in 2000. The service has grown significantly since its inception, and in 2014 included 40...

Commentary on “Patient Beliefs and Preferences Regarding Surrogate Decision Makers”

In this issue of the Southern Medical Journal, Hunter and Walters report an ongoing problem with surrogate decision making in the absence of legally sufficient advance directives: the default choice as defined by state law may not be the patient’s preferred surrogate.1 This mismatch is particularly important because so few hospitalized patients (in this case, fewer than one-third) complete advance directives. Although the nature and weight of...

Patient Beliefs and Preferences Regarding Surrogate Decision Makers

Objectives: Many patients lose the capacity to make medical decisions because of severe illness or the effects of sedation or anesthesia. Most states in the United States designate the next of kin (NOK) as a default surrogate decision maker (SDM), but this may not always reflect patient preferences. Our objective was to determine how frequently the default SDM matched the patient’s preferred SDM, and whether patients knew who would serve as...

Team-Based Learning Activities for First-Year Medical Students: Perception of the Learners

Objectives: Team-based learning (TBL) is an active learning strategy that is used increasingly in medical education to promote critical thinking, knowledge application, teamwork, and collaboration. The aim of this study was to assess the students’ perspective on the utility of TBL compared with traditional lectures. Methods: We used a validated TBL student assessment instrument comprising three subscales studying accountability, preference...