About James Allen, MD

I am a Professor of Internal Medicine at the Ohio State University and the Medical Director of Ohio State University Hospital East

Penalizing Survival

There is one constant in regulations and policies… unintended consequences. Presently, Medicare seeks to improve quality of care delivered in hospitals by rewarding those hospitals that have lower mortality rates and lower 30-day readmissions. On the surface, this sounds like a great idea. But under the surface, are we penalizing hospitals that keep more patients […]

Kicking Hepatitis C Down The Road

Hepatitis C has exposed one of the larger cracks in American healthcare financing. In particular, the drug Harvoni (ledipasvir-sofosbuvir) has shown us the inherent conflict between private health insurance (commercial insurance companies) and public health insurance (Medicare, Medicaid, etc.). Hepatitis C is an enormous problem in the United States. There are about 2.7 million Americans […]

The Dialysis Blues

End-stage renal disease has been driving me crazy recently. When no one else will dialyze you, the hospital has to. There’s this thing called EMTALA law that requires us to treat you if you show up in our emergency department. Let me tell you about a few of our more exasperating patients that could fill […]

The Most Dangerous Procedure In Medicine

Alright, from the title of this post, I’m sure you are trying to guess what it is. Open heart surgery? A craniotomy? Separation of conjoined twins? Wrong. The most dangerous procedure in medicine is the hospital discharge. From the time a patient is admitted to the hospital, the medical resident or the hospitalist has one […]

The Documentation Game

Our hospital finished the last year with an inpatient mortality index of 0.54, a fantastic accomplishment. That means that we provide great care and we play the documentation game well. If the hospital mortality index is 1.0, that means that you had exactly the number of inpatient deaths that other hospitals have on average, after […]

Electronic Medical Record Translation Guide

For those of you who are new to electronic medical records, you will be learning a new language used by physicians who use electronic medical records. This quick guide will help you translate into English: When the physician says:        The physician means: @*#$(^*@                             Would you be so kind as to help me route this encounter? […]

Necktie, Vector Tie

If you know me, then you know that I usually don’t wear a tie at work. For most businessmen, a tie is a necessary fashion accessory to the male work wardrobe. For me, it is a device to transfer bacteria from one to another patient. Studies have shown that 50% of physician’s ties are contaminated […]

Guns, Guns, Guns

Yesterday, a man was shot a couple of miles from our hospital. Not an unusual event, people get shot every day in America’s large cities. Our hospital is not a designated trauma center but we still have gunshot victims dropped off at our front lobby by their friends – either they die in our ER or we […]

The Sports Page

Last week, we filmed one of Ohio State’s MedNet-21 webcasts, this one on Environmental Emergencies. One of the topics was hypothermia and one of the presenters, Dr. Nick Kman from OSU, made the comment that “a hypothermic patient is not dead until they are warm and dead”. That reminded me of when I was taught that […]

Reducing COPD Readmissions

On average, about 1 out of 5 patients admitted to the hospital with COPD in the U.S. get readmitted within 30 days. There is a wealth of medical literature analyzing COPD readmissions. For example, we know that patients at risk for readmission include: Patients without physician follow-up within 30 days of discharge African Americans Older […]