Commentary on “Internal Medicine Hospitalists’ Perceived Barriers and Recommendations for Optimizing Secondary Prevention of Osteoporotic Hip Fractures”

Osteoporotic hip fractures are a public health concern in the United States. The potential sequelae of a hip fracture are far reaching and can lead to a state of chronic pain, functional dependence, diminished quality of life, increased cost burden, and premature death. A patient’s chance of a second...

Internal Medicine Hospitalists’ Perceived Barriers and Recommendations for Optimizing Secondary Prevention of Osteoporotic Hip Fractures

Objectives: Osteoporosis is a major public health concern affecting an estimated 10 million people in the United States. To the best of our knowledge, no qualitative study has explored barriers perceived by medicine hospitalists to secondary prevention of osteoporotic hip fractures. We aimed to describe these perceived barriers and...

Dramatic Reduction in 30-Day Readmissions Through High-Risk Screening and Two-Phase Interdisciplinary Care

Objectives: Thirty-day readmissions are common, serious, and costly. Most important, often they are preventable. The purpose of this quality improvement study was to evaluate an interdisciplinary, two-phase intervention to reduce 30-day readmissions among high-risk medical patients. One or two high-risk patients were selected each weekday by a hospitalist using...

Healthcare Utilization by Frail, Community-Dwelling Older Veterans: A 1-Year Follow-up Study

Objectives: Frailty is a prevalent clinical syndrome associated with a high risk of adverse health outcomes, including disability, morbidity, and mortality, that has become a major challenge for the healthcare system. The aim of this prospective study was to determine the level of healthcare utilization in prefrail and frail...

The “Hand-in” Project: Jump-starting Communication Between Inpatient and Outpatient Providers

Objectives: Communication between hospitalists and primary care providers (PCPs) upon discharge has been much discussed, but the transition from outpatient to inpatient has received less attention. We questioned whether a brief, standardized e-mail from the hospitalist to the PCP upon admission could facilitate information exchange, increase communication, elucidate PCP...

On “Direct to Physician Journal Marketing”

To the Editor: An interesting threefold (by my observation) phenomenon is under way in the medical publication field: an explosion of new journals around the world that are pure ‘‘pay to publish’’ (ie, Open Access) as the business model; direct-to-physician invitations to join the new journals’ editorial boards; and...

Commentary on “Impact of Consultation on Hospital Outcomes and Resource Utilization for Patients with Acute Congestive Heart Failure”

The rising cost of health care has been a problem in the United States for decades. As our population ages, healthcare costs continue to rise, becoming increasingly burdensome for our...

Impact of Consultation on Hospital Outcomes and Resource Utilization for Patients with Acute Congestive Heart Failure

Objectives: Consultation is an important tool for acquiring subspecialty support when managing patients with acute congestive heart failure (CHF). The effect of consultation on hospital outcomes and resource utilization in CHF is unknown. The objectives of our study were to determine the effect of consultation on outcomes in CHF...

Can Computers Be Made to Respect the Art of Medicine?

To the Editor: One of the common criticisms of the application of automated medical decision pathways is that although they may yield the correct answer in the case of straightforward clinical presentations, they fail to capture the nuances of more complex scenarios in which human clinical judgment and the...

Dissemination Approaches to Participating Primary Care Providers in a Quality Improvement Program Addressing Opioid Use in Central Appalachia

Objectives: Practice-based research networks (PBRNs) have been described as new clinical laboratories for primary care research and dissemination. PBRNs, however, have struggled to disseminate research results in a meaningful way to participating providers and clinics. Methods: The Central Appalachia Inter-Professional Pain Education Collaborative was developed to work with PBRN...

Physician Order Entry Clerical Support Improves Physician Satisfaction and Productivity

Objectives: To examine the impact of clerical support personnel for physician order entry on physician satisfaction, productivity, timeliness with electronic health record (EHR) documentation, and physician attitudes. Methods: All seven part-time physicians at an academic general internal medicine practice were included in this quasi-experimental (single group, pre- and postintervention)...

Hospital Readmissions from Patients’ Perspectives

Objectives: Healthcare expenditures in the United States have increased exponentially and hospital care accounts for one-third of these costs. Approximately 18% of hospitalized Medicare beneficiaries are being readmitted to the hospital within 30 days. Engaging patients in the discharge process can help better identify patients’ postdischarge needs and implement...

Standardized Physician-Administered Patient-Centered Discharge Protocol Improves Patients’ Comprehension

Objectives: Patients are 30% less likely to be readmitted or visit the emergency department if they have a clear understanding of their discharge instructions. A standardized approach to a hospital discharge plan has not been universally implemented, however. Our goal was to increase patients’ comprehension of discharge instructions by...

Will the “Fixes” Fall Flat? Prospects for Quality Measures and Payment Incentives to Control Healthcare Spending

Payment systems in the US healthcare system have rewarded physicians for services and attempted to control healthcare spending, with rewards and penalties based upon projected goals for future spending. The incorporation of quality goals and alternatives to fee-for-service was introduced to replace the previous system of rewards and penalties....

Commentary on “Will the ‘Fixes’ Fall Flat? Prospects for Quality Measures and Payment Incentives to Control Healthcare Spending”

In this issue of the Southern Medical Journal, Hauswald and Sklar et al explore the evolution of Medicare payment policies and the challenges faced by the quality-aligned payment incentives.1 After 50 years of various manipulations to a fee-for-service system, the Medicare Access and Children’s Health Insurance Program Reauthorization Act...

Association Between Energy Prices and US Hospital Patient Outcomes

Objective: To evaluate associations between changing energy prices and US hospital patient outcomes. Methods: Generalized estimating equations were used to analyze relationships between changes in energy prices and subsequent changes in hospital patient outcomes measures for the years 2008 through 2014. Patient outcomes measures included 30-day acute myocardial infarction,...

Self-Report Study of Predictors of Physician Wellness, Burnout, and Quality of Patient Care

Objective: The goal of this self-report study was to examine the relation of work variables, self-rated health and mental health status, and perceived social support to physician wellness, physician burnout, and quality of patient care. Methods: We administered a demographics questionnaire, the Physician Wellness Inventory, the Maslach Burnout Inventory,...

See ME Differently

Editor’s Note: In November 2016 at the Southern Medical Association’s (SMA) Annual Scientific Assembly, Randy Glick, SMA’s Executive Director, introduced the organization’s vision to “See ME Differently.” The following perspective details some of the shifts in the continuing medical education landscape and how the SMA is embracing the opportunities...

Effectiveness of Pharmacist and Physician Collaboration in the Treatment of Type 2 Diabetes Mellitus With Severe Insulin Resistance Using U-500 Insulin

Objectives: To evaluate the effectiveness of pharmacist–physician collaboration in the treatment of type 2 diabetes mellitus (DM) with severe insulin resistance, using 500 U/mL concentrated regular insulin (U-500) in a primary care clinic that is not staffed by an endocrinologist. Methods: A retrospective chart review was conducted searching for...

Interprofessional Precision Care: Coming Together to Improve Outcomes

With the implementation of the Patient Protection and Affordable Care Act (PL 111–148), historically inconspicuous components of healthcare systems have gained more salience as healthcare spending and reimbursement shifts from individual, fee-for-service to population-based, pay-for-performance. The paradigm is to improve the health of populations and positively enhance patients’ experience...