PEMBlog

SEPTEMBER 20, 2023

The Choosing Wisely Pediatric Emergency Medicine Recommendations The Choosing Wisely Campaign Toolkit Expert Contributors Kelly Levasseur, DO Children’s Hospital of Michigan Detroit, MI, USA docklevasseur@gmail.com Jennifer Thull-Freedman, MD Alberta Children’s Hospital Calgary, Alberta, Canada Jennifer.Thull-Freedman@albertahealthservices.ca

Diagnosis 122

Diagnosis Diagnose Hospital Clinic 122

The Clinical Problem Solvers

APRIL 24, 2025

She is the Psychiatrist-in-Chief and Chair of the Department of Child and Adolescent Psychiatry and Behavioral Sciences at the Children’s Hospital of Philadelphia (CHOP). Additionally, he consults with federal agencies on mental health system design and practices. Dr.  2023 Apr;21(2):166-7. Brent DA, Goldstein TR, Benton TD.

Mental Health 52

Mental Health Community Hospital Appointment 52

Today's Hospitalist

MAY 9, 2025

OUR ENTIRE FIELD of hospital medicine grew out of the need to innovate to address the growing complexities of inpatient medicine. AI Implementation: key considerations Integrating new technology in a hospital requires careful planning and attention to detail. It is crucial to have seamless integration with the existing EHR system.

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Patient-Centered Telemedicine Clinic Electronics 52

Vascular Physician

FEBRUARY 14, 2024

Prior to the procedure, you will have a consultation and evaluation. Most patients can expect to recover in the hospital for 1-2 days after surgery. Be sure to follow your health care provider's recommendations for physical activity restrictions and gradually reintroduce normal activities.

Complication 52

Complication Appointment Diagnose Healthcare 52

Aspiring Minority Doctor

APRIL 18, 2021

There is also the option of electronic health record (EHR) training and support work where you would travel to various hospitals/clinics around the country and train individuals on how to use EMR systems. This would require relocating and I am not aware of how much it pays.

GP 52

GP Medical Student Insurance General Practitioner 52

GeriPal

MARCH 14, 2024

And then when you look long-term care facilities, more between that like 35 to 50%, and then much higher estimates in hospitalized older adults. Eric: And why is it more common in hospitalized adults? Nicole: Yeah, I think definitely delirium, but there are also a lot of medical conditions that can be specific to hospitalizations.

Hospital 124

Hospital IT Patient-Centered Individual 124

Tiny Physician

FEBRUARY 15, 2022

Without even forming an enquiry committee, he was suspended for a few days by the hospital administration in order to satisfy the public. Nevertheless, PG doctors have to work 80 to 100 hours a week without any holidays and this tiring schedule does affect their physical and mental health. patients show their frustration at doctors.

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Patient-Centered Government Referral Hospital 52

Vida Family Medicine

JUNE 28, 2024

Come prepared to your doctors’ appointment: Make sure you are scheduled for a problem visit, not a physical or check-up, so that you are scheduled appropriately in the correct time slot and there will not be confusion about billing. Here are my tips to make the most of the system we have, and how to avoid the snake-oil!

Patients 52

Patients Primary Care Appointment Diagnose 52

GeriPal

OCTOBER 13, 2022

Sonali: This seven versus 14 days for male UTI combines really well with the gram negative bacteriemia paper because sometimes we are faced with patients in the hospital which are disposition issue. So transmission of other drug resistant organisms and C difficile to other patients in the hospital reduces if you control.

Complication 97

Complication Patient-Centered IT Patients 97

PEMBlog

SEPTEMBER 24, 2024

He had easy work of breathing, and physical exam was only notable for decreased breath sounds over the left lower lobe. Pulmonology and surgery were consulted during his hospital stay, and he has since had a left lower lobectomy after healing from his pneumonia. On arrival, the patient was febrile to 38.3C.

Diagnosis 52

Diagnosis Diagnose Patients Asthma 52

PEMBlog

SEPTEMBER 13, 2023

A careful history and physical examination are ways that we as providers can “see what’s going on inside the head.” Occult trauma Any trauma that is not seen on your physical (e.g. This includes scarring abnormalities, bleeds, and tumors.

Patients 52

Patients Screening Illness Physicals 52

GeriPal

MAY 5, 2022

And one of the parts of that was actually doing physicals for the students and putting them in job placements. Including more hospital utilization or healthcare utilization, maybe cognitive impairment issues. My own work focuses on hospitalization and health utilization over time. I don’t see myself in that world.”

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IT Screening Hospital Clinic 102

PEMBlog

SEPTEMBER 6, 2023

Children requiring psychiatric consultation in the pediatric emergency Berg JS, Payne AS, Wayra T, Morrison S, Patel SJ. Routine laboratory testing does not need to be performed. Systematic change so that routine laboratory testing is not required by facilities accepting patients for inpatient psychiatric treatment. J Emerg Med.

Lab Testing 52

Lab Testing Medical Patients Mental Health 52

GeriPal

DECEMBER 2, 2022

He wrote a book titled “ Psychiatric consultation in long term care ” that has a strengths based approach to staging dementia (how cool is that). She directs UCSF MERI’s patient, family, and clinician support with classes and consultation on resiliency, well-being, and grief. Ab: As Judy said, how much time do you have? But we have to.

Community 101

Community IT Individual Patient-Centered 101

GeriPal

JUNE 8, 2023

When I’m on palliative care consults and attending in our hospice unit we have to counsel patients about deprescribing and de-intensifying diabetes medications. This hasn’t floated into our hospital systems yet, but at least in the real world, people are using these to make insulin dosing decisions without needing to poke their fingers.

Diabetes 73

Diabetes Management Patient-Centered Family 73

GeriPal

JUNE 12, 2025

The physics and mathematics that went into radiation therapy planning. Eric 04:49 Drew me to the field physics and math. I didn’t know where they existed within the hospital. Eric 07:04 You actually created things like a curriculum for hospital medicine fellows in radiation oncology. So you have the consultation.

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Patient-Centered Referral Patients IT 102

GeriPal

FEBRUARY 15, 2024

The insight started when Carmen, an orthopedic surgeon-researcher, and Katie, a physical therapist- researcher participated in ride-alongs with EMS providers to patient’s homes. So it’s just a wide-opening lens that most of us never really get to see if we’re on the hospital-based side. Carmen: Thank you.

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Community Transportation IT PCP 114

GeriPal

OCTOBER 26, 2023

Physical therapy had walked with him that day and noted improvement compared to previous walks, suggesting that he should be discharged to a skilled nursing facility for rehabilitation on discharge. At the end of the day, I lamented that physical, occupational, and speech therapists aren’t more tightly integrated with palliative care teams.

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Hospital Patient-Centered Patients IT 132

GeriPal

JANUARY 25, 2024

You can also listen to an audio interview with Alex and JAMA Deputy Editor Preeti Malani about this study and the other RCT of default palliative care for hospitalized older adults with noncancer serious illness published in the same issue. People had to be in the top 20th percentile of risk for being hospitalized or dying in the next year.

Patient-Centered 122

Patient-Centered Illness IT Patients 122

Plum Health

OCTOBER 11, 2024

Clinics are often smaller than hospitals and may focus on a specific type of care, such as general health check-ups, urgent care, vaccinations, or specialty services like physical therapy. Patients can receive consultations, diagnosis, and treatment without needing an overnight stay.

Clinic 52

Clinic Primary Care Doctor Primary Care Chronic Condition 52

GeriPal

JUNE 9, 2022

Palliative care, in contrast, saw explosive growth in US hospitals. And palliative care was as a program was just growing at Penn moving from just consult hospice to actually having a team when I was training. I have never myself called a palliative care consult as a trainee because we didn’t have one.

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Consulting Patient-Centered Diagnosis Referral 99

GeriPal

MARCH 28, 2024

Kate: It was done in 10 hospitals, 17 ICUs in Atrium Health down in North Carolina. Asking clinicians to document prognosis did not change the primary outcome of hospital length of stay or really any of the secondary outcomes, which I’ll get into. Also the same hospital system? That’s when they got enrolled.

Consulting 115

Consulting Patient-Centered IT Patients 115

Doctor On Demand

APRIL 28, 2025

Paramedics can provide life-saving treatment on the way to the hospital. Paramedics can provide immediate emergency interventions on the way to the hospital, including oxygen support and life-saving medications. A short-term sore throat may resolve on its own — monitor symptoms or consult a primary care doctor.

ER 52

ER Telehealth Primary Care Doctor Appointment 52

PEMBlog

JUNE 2, 2025

Recognizing Hypertensive Emergencies The end-organ dysfunction component of this diagnosis presents as particular symptoms, physical exam findings, or laboratory and imaging results.

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Hypertension Management Physicals Lab Testing 75

GeriPal

DECEMBER 8, 2022

As Thor notes, capturing patient stories has face validity as positively impacting the patients who share their stories and have them documented, and for the clinicians who get to truely and deeply know their patients in far greater depth than “what brought you to the hospital?” Within the VA it’s now at 70 VA hospitals.

Patient-Centered 115

Patient-Centered Illness Healthcare IT 115

GeriPal

JANUARY 30, 2025

In one corner, weighing in at decades of experience, well known for heavy hits of bedside assessments, strong patient-family relationships, and a knockout punch of interdisciplinary collaboration, we have in-person palliative care consults. Consultations versus telehealth. You get a consult if you get a consult.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

GeriPal

OCTOBER 10, 2024

Of note: these lessons apply to geriatrics, primary care, hospital medicine, critical care, cancer care, etc, etc. social worker, chaplain), everyone should be able to ask a question or two about spiritual concerns, social concerns, or physical concerns. In other words, in addition to being a specialist (e.g. But how about you!

Screening 119

Screening IT Family Families 119

GeriPal

DECEMBER 15, 2022

Been in the hospital four times, vented, been told the story to her family, she won’t live. So those questions we ask when we’re doing a palliative care consult. Within the VA it’s now at 70 VA hospitals. She was a heart failure patient. And here she was with me today. Thor: That’s correct, yeah.

IT 105

IT Patient-Centered Healthcare Illness 105

GeriPal

AUGUST 29, 2024

I mean, how do you negotiate that with the oncologist who is the one who consulted you, by the way, Eric, who does that go to? Your patients expect you to care for them, their mental well being, their physical well being. They’re asking you for a consultation. After a very long 1 hour consult, you’re exhausted.

Illness 132

Illness IT Family Families 132

GeriPal

APRIL 28, 2022

So for those listening to the podcast, this is a clown looking very sad and what looks like a hospital administrator. And the hospital administrator says, “No, the hospital definitely values your contributions to the interdisciplinary team. Did they ask for a consult?” ” Nathan: The clown is a surrogate.

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IT Hospital Patients Illness 145

PEMBlog

MARCH 27, 2024

Her name is Emily Groopman, and she’s a current resident at Children’s National Hospital. You won’t be able to diagnose them on history and physical alone. Therefore, in the ED, the goal is really to recognize the science and symptoms on history and physical exam that are suggestive of metabolic disease.

Consulting 59

Consulting Individual Family Families 59

GeriPal

MAY 8, 2025

Vincent’s Hospital in Melbourne, Australia. And I spent the past couple years just collecting data from several hundred early palliative care patients and did a network analysis, which basically just looks at the Correlations between different constructs, whether they’re physical, emotional, social or spiritual.

Illness 107

Illness IT Patient-Centered Patients 107

GeriPal

OCTOBER 12, 2023

I’m just wondering, how do we get surgeons, and maybe, how do we teach surgical trainees to move away from this fix-it mentality into the space of deliberation where deliberation is actually invited and prioritized in the surgical consultation? People think of the phases of a typical clinical consultation. ” Eric: Yeah.

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IT Family Families Patient-Centered 128

GeriPal

OCTOBER 20, 2022

Sonali: This seven versus 14 days for male UTI combines really well with the gram negative bacteriemia paper because sometimes we are faced with patients in the hospital which are disposition issue. So transmission of other drug resistant organisms and C difficile to other patients in the hospital reduces if you control.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

JUNE 15, 2023

” And Bing responded, I should ask about how AI can help identify patients who need palliative care and reduce hospitalizations, what are the benefits and challenges of using AI in decision-making, communication, palliative care, and how could AI support the quality of life and dignity of patients for those who are receiving palliative care?

IT 99

IT Patient-Centered Patients Healthcare 99

GeriPal

MARCH 10, 2022

On today’s podcast we dive into drivers of invasive procedures and hospitalizations in advanced dementia by talking to some pretty brilliant nursing and nurse practitioner researchers focused on dementia, geriatrics, and palliative care in nursing homes: Ruth Palan Lopez, Caroline Stephens, Joan Carpenter, and Lauren Hunt. Ruth: Thank you.

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Nurse Practitioner Hospital Family Families 60

Tiny Physician

MARCH 30, 2022

Archana Sharma committed suicide because of the harassment by the bystanders of the patient who died at her hospital. She was a post-graduate in Obstetrics and Gynaecology (the branch which covers pregnancy and the female reproductive system) and she had won various accolades during her student and consultant days.

Hospital 52

Hospital Government Patient-Centered Medical 52