Choosing Academic Medical Leaders

Choosing Academic Medical Leaders

I think that every search committee assembled for nominating academic medical center leaders should be required to watch the movie The Replacements before starting their search. In the movie, Gene Hackman is the coach of the Washington Sentinels, a fictitious professional football team. In the midst of a player’s strike, the team has been repopulated with […]

Leadership Means Listening

Leadership Means Listening

Whether you are a hospital medical director, an army major, a corporate CEO, or the President of the United States, you never have enough resources to do everything that you really want to do. Consequently, you can’t give everyone everything that they want. But you can listen and sometimes just listening is your most valuable […]

How To Be A Medical Malpractice Expert Witness

How To Be A Medical Malpractice Expert Witness

25 years ago, I got a call from an attorney representing a physician in an academic medical center in another state. The physician was being sued by the family of a patient who had died from a condition mimicking acute eosinophilic pneumonia, a disease that I had published some articles about, and the attorney asked […]

Deciphering The Medicare Hospital Star Rating System

Deciphering The Medicare Hospital Star Rating System

CMS just released its newest star ratings for U.S. hospitals. The ratings were supposed to come out last summer but there was a delay because of problems with the methodology Medicare was using. The rating system attempts to compare hospitals’ performance with common conditions. Hospitals are rated with 1 – 5 stars, with 5 stars […]

Interpreting The Cardiopulmonary Exercise Test

Interpreting The Cardiopulmonary Exercise Test

No test in pulmonary medicine is fraught with more confusion and mystery than the cardiopulmonary exercise test, or CPET. This is a test that reports a large number of physiologic measurements during exercise when the patient is asked to exercise to his or her maximum effort. On the one hand, there is a wealth of […]

Reducing Joint Replacement Surgery Infections

Reducing Joint Replacement Surgery Infections

Joint replacement surgeons are coveted by hospitals because they bring in lucrative elective inpatient surgeries that can improve the hospital’s financial margin. Furthermore, patients who have successful joint replacements are some of the happiest patients in the hospital and they will often improve the hospital’s patient satisfaction scores. However, a post-operative infection of the newly […]

Inpatient Palliative Medicine Services: Making The Right Economic Projections

Inpatient Palliative Medicine Services: Making The Right Economic Projections

The demand for inpatient palliative medicine services is very high and the supply of palliative medicine physicians is rather low. When considering bringing palliative medicine services to your hospital, the real value of palliative medicine is in what does not appear on the basic accounting pro forma. A robust palliative medicine service is a multidisciplinary […]

Timing Of Hip Fracture Surgery

Timing Of Hip Fracture Surgery

How we practice medicine in the United States is often dictated by quality metrics established by Medicare and The Joint Commission. Our hospitals often focus on monitoring these publicly reported metrics but there are others that deserve equal attention, even though they are not publicly reported. One of these is the time between when a […]

Dying To Reduce Hospital Readmissions

Dying To Reduce Hospital Readmissions

20% of people who get admitted to the hospital require readmission within 30 days of being discharged. Medicare has taken steps to reduce these readmissions, but the unintended consequence of these steps appears to be an increase in mortality rates. Readmissions are expensive and cost Medicare about $17 billion per year. Conventional dogma holds that […]