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Family Matters
Published in John Launer, Reflective Practice in Medicine and Multi-Professional Healthcare, 2022
The purpose of this description isn’t to criticise any of the individual consultants I have seen at work. My focus here is on the wider culture of hospital medicine. This seems to dictate that it is very common indeed to speak about families (especially if this affects the length or cost of care) and sometimes to speak to families. Yet, there seems little recognition that family members should automatically be involved as partners in medical decision-making and care at the moment when it happens and whenever the patient might want this.
Health Workers
Published in Roger Cooter, John Pickstone, Medicine in the Twentieth Century, 2020
Firstly, some occupations have a pre-twentieth century history and to some degree may be seen to have ‘negotiated’ a relationship with modern medicine, within which they offer their services directly and autonomously to the public as separate practitioners in the market place. Examples here include pharmacists, dentists, podiatrists and optometrists (chiropodists and opthalmic opticians in UK terminology). These groups work relatively autonomously within carefully demarcated body sites or specific professional functions. Typically the vast majority of such practitioners work outside of hospital medicine, whether in solo or small group practices of their own, or as employees of major pharmaceutical and retail organizations.
The Big Canvas: Issues and Context
Published in John K. Crellin, A Social History of Medicines in the Twentieth Century, 2020
The process of selecting topics and themes for this book was challenged by the overwhelming amount of scientific and other literature on medicines and medicine taking, as well as by differing interpretations of the nature of change, and what influences it.78 Although this book constantly acknowledges that the nonmedical and medical factors shaping the use of medicines are commonly inseparable, space severely limits consideration of many direct and less direct or more subtle influences, as important as they are to the total picture. For instance, we omit detailed discussion on the development of medical education (especially on therapy) and on medical research, which can be key elements in a physician's choice of remedies for his or her patients. Hospital medicine, too, is hardly mentioned, though it has been a particular factor in the public validation of medicines, especially in the second half of the century, not only through hospitalbased research, but also through patients expecting or demanding, from their general or family physician, the same medicines as prescribed by hospital specialists. Nor do we consider the topic of vaccines and vaccination, which could also illustrate many issues raised in this book.79
“Ego massaging that helps”: a framework analysis study of internal medicine trainees’ interprofessional collaboration approaches
Published in Medical Education Online, 2023
Joanne Kerins, Samantha Eve Smith, Victoria Ruth Tallentire
Internal medicine training is a three-year training programme for doctors in the United Kingdom (UK) who wish to pursue a career in hospital medicine. Between August 2020 and March 2021, 124 internal medicine trainees participated in an interprofessional communication workshop in groups of six. The workshop, attended only by internal medicine trainees, was on the topic of interprofessional communication. It has been argued that education for collaboration should provide uni-professional opportunities which can address workplace structures, power and conflict, of which this workshop is an example [5]. Key learning objectives were to explore challenges of interprofessional interactions and collaboration approaches. The workshop was facilitated by two consultant physicians who aimed to create a safe space for trainee-led discussion. The discussion was guided by participants with trainees setting their own agenda at the start of the session. Trainees were asked to voice areas of difficulty regarding interprofessional interactions and a facilitator documented these on a paper flipchart. Thereafter, a free-flowing discussion followed this agenda. Facilitators used open questions to enquire about experiences and prompt reflection on the impact of challenges and the strategies that trainees have employed.
Post-discharge early assessment with remote video link (PEARL) initiative for patients discharged from hospital medicine services
Published in Hospital Practice, 2022
Sagar B. Dugani, Shangwe A. Kiliaki, Megan L. Nielsen, Trevor J. Coons, Karen M. Fischer, Riddhi S. Parikh, Sandeep R. Pagali, Anne Liwonjo, Darrell R. Schroeder, Ivana T. Croghan, M. Caroline Burton
The study sites were Mayo Clinic Hospital, Saint Marys Campus, Rochester, MN and Mayo Clinic Health System in Austin, MN (MCHS-AU). Mayo Clinic Hospital in Rochester, MN is a large academic hospital with 1,265 beds at two campuses–Saint Marys Campus and Rochester Methodist Hospital. In 2020, the hospital had 52,778 admissions, of which, 22% were managed by hospital medicine. The Division of Hospital Internal Medicine is comprised of approximately 50 physicians and 50 APPs. MCHS-AU has 82 beds and is part of MCHS, which is a network of 16 community hospitals in southern Minnesota, western Wisconsin, and northern Iowa. In 2020, MCHS-AU had 4,932 admissions, of which, 61% were managed by hospital medicine. At both sites, hospital medicine services provided care to adults hospitalized in general medical wards.
Successful recruitment and retention of academic physicians: hiring for longevity, productivity, and leadership in hospital medicine
Published in Hospital Practice, 2022
Richard M. Elias, Karen M. Fischer, Trevor Coons, Deanne Kashiwagi
It may seem counterintuitive that physician applicants to positions at an academic center would not prioritize academic promotion. Hospitalists have long filled a clinical workforce need in hospitals [3]. As such, hospital medicine programs have traditionally been built to support the clinical operations of hospitals and in many cases these roles have evolved into hospital leadership positions. This has led to development of groups that either are not designed, or do not have the resources, to support endeavors traditionally valued for academic promotion. Hospitalists more often identify themselves as clinician-educators or clinician-administrators than clinician-researchers. Activities that typically contribute to academic promotion, such as those undertaken by clinician-researchers, are not the same as those that contribute to job satisfaction for many hospital physicians.