Issue - Southern Medical Association


Where Joy May Find Us

Several of my colleagues have started to use a catchphrase to address a weariness that seems to be common among physicians these days: finding joy in practice. Although the concept of joy does not have roots in the social or psychological sciences, I think that most people would acknowledge having…

Invited Commentary

Commentary on “Where Joy May Find Us”

The capacity for joy is intrinsic to human nature, but physicians may not be finding it in their work like they once did. In a thought-provoking piece in this issue of the Southern Medical Journal, Timothy Daaleman reflects on joy in contemporary medical practice and asks whether we are looking…

Original Article

House Staff Participation in Patient Safety Reporting: Identification of Predominant Barriers and Implementation of a Pilot Program

Objectives: Patient safety event (PSE) reporting is a critical element for healthcare organizations that are striving for continuous quality improvement. Although resident physicians routinely provide the majority of direct patient care, the level of their participation in PSE reporting historically has been low. In addition, as part of the Accreditation…

Invited Commentary

Commentary on “House Staff Participation in Patient Safety Reporting: Identification of Predominant Barriers and Implementation of a Pilot Program”

In his book Outliers: The Story of Success, Malcolm Gladwell describes a dark period in the history of Korean Air, which had experienced more crashes than almost any other airline.1 After investigation it was found that in many of these crashes, the copilot/first officer had grave concerns before the crash…

Original Article

Examining Invasive Bedside Procedure Performance at an Academic Medical Center

Objectives: Explore the performance patterns of invasive bedside procedures at an academic medical center, evaluate whether patient characteristics predict referral, and examine procedure outcomes. Methods: This was a prospective, observational, and retrospective chart review of adults admitted to a general medicine service who had a paracentesis, thoracentesis, or lumbar puncture…

Invited Commentary

Commentary on “Examining Invasive Bedside Procedure Performance at an Academic Medical Center”

The decision to perform a procedure at the bedside or refer a patient to a radiologist rarely is based on the patient’s comorbidites and is largely discretionary.1 In this issue of the Southern Medical Journal, Kay and colleagues have shown that female patients and those with a higher body mass…

Original Article

Estimating the Net Career Income of a Geriatrician and a Nurse Practitioner: Still Want to Be a Doctor?

Objectives: With a continual shortage of geriatricians, adult-gerontology primary care nurse practitioners have assumed a greater role in the delivery of outpatient care for older adults. Given the long duration of physician training, the high cost of medical school, and the lower salaries compared with subspecialists, the financial advantage of…

Invited Commentary

Commentary on “Estimating the Net Career Income of a Geriatrician and a Nurse Practitioner: Still Want to Be a Doctor?”

In this issue of the Southern Medical Journal, Golden and colleagues use an economic model to compare the lifetime earnings of geriatricians, primary care physicians, and geriatric nurse practitioners; they then examine the effects of three policy interventions: forgiving medical student loans, shortening the duration of medical school and residency,…

Letter to the Editor

Pneumococcal Vaccine Eligibility Misconception

To the Editor: Oldfield and Stewart did an excellent job discussing 10 misconceptions regarding adult vaccination administration.1 Recommendation 4, ‘‘Both pneumococcal polysaccharide vaccine and pneumococcal conjugate vaccine are indicated in healthy adults older than 65 years,’’ however, contained some errors in the text and accompanying figure.

Author Response

Authors’ Response

To the Editor: We appreciate the clarifications provided in the letter by Dr Muncie. We apologize for the typographical errors in our figure. The current recommendations for immunoprophylaxis against pneumococcal disease are indeed confusing and changing frequently. Four different pneumococcal vaccines have been licensed since 1977 (only the two mentioned…

Original Article

When Should ED Physicians Use an HIE? Predicting Presence of Patient Data in an HIE

Objectives: Health information exchanges (HIEs) make possible the construction of databases to characterize patients as multisystem users (MSUs), those visiting emergency departments (EDs) of more than one hospital system within a region during a 1-year period. HIE data can inform an algorithm highlighting patients for whom information is more likely…


Incorporating Patient Satisfaction Metrics in Assessing Multidisciplinary Breast Cancer Care Quality: Erratum

In the article that appeared on pages 372-376 of the June 2015 issue, there is discordance between the text and Figure 1 in the reported outcomes for the metric ‘‘Comfort with Care Plan’’. Please see the corrected figure below that corresponds to the text

Original Article

Health Information Exchange in the ED: What Do ED Clinicians Think?

Objectives: Our regional health information exchange (HIE), known as Carolina eHealth Alliance (CeHA)-HIE, serves all major hospital systems in our region and is accessible to emergency department (ED) clinicians in those systems. We wanted to understand reasons for low CeHA-HIE utilization and explore options for improving it. Methods: We implemented…

Original Article

A Comprehensive View of Frequent Emergency Department Users Based on Data from a Regional HIE

Objectives: A small but significant number of patients make frequent emergency department (ED) visits to multiple EDs within a region. We have a unique health information exchange (HIE) that includes every ED encounter in all hospital systems in our region. Using our HIE we were able to characterize all frequent…