As health care reform ramps up, so does discussion about how to cut medical costs without compromising quality. Medical testing has come under particular scrutiny as an area where costs can be scaled back through more judicious use. The challenge, however, is to reduce rote test ordering without making physicians feel vulnerable to oversight or mistakes. Our cover story looks at steps different hospitals have taken to reduce unnecessary testing intelligently, from teaching residents to reflexively question test orders to designing targeted computerized physician order entry systems that doctors actually heed (instead of ignoring).
Our coverage of the Society of Hospital Medicine's (SHM) annual meeting, Hospital Medicine 2011, begins with a wrap-up of the organization's latest salary and productivity survey. Learn why the Southern U.S. may seem, at first glance, to be the best place to get a hospitalist job from a financial standpoint, but may arguably be the worst. A second survey, meanwhile, revealed the salary and working conditions of nurse practitioners and physician assistants. Also in this section, we recap a session on how to identify patients at risk of hyperglycemia, transition them between glucose control regimens, and discharge them with a workable plan for home. We also provide a crash-course primer on the 21 drugs approved by the Food and Drug Administration in 2010, and summarize some expert tips on crafting a quality improvement project your hospital is likely to approve and support.
On a lighter note, editorial advisor Jamie Newman takes us back nearly 30 years to his first night of call, in homage to all the brand-new hospitalists embarking on their careers this month. Read how “Mayo Boy “ handled his first spinal tap.
Editor, ACP Hospitalist