Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Academic medical centers are experiencing rapid clinical growth which has outpaced traditional teaching services. Learners such as medical students, advanced practice provider fellows, and residents may be placed onto direct care teaching services (i.e., inpatient services where attendings provide both direct care to patients and supervise learners) creating potential challenges for attending physicians due to clinical demands. ⋯ Direct care teaching services pose challenges given clinical workloads, time constraints for educational activities. Addressing these challenges may make these types of services more sustainable.
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Patients who reside in areas of high neighborhood disadvantage have poorer health outcomes; the mechanisms for this disparity are complex. We sought to determine if there was an association between neighborhood disadvantage and diagnostic error among a cohort of adult inpatients who experienced either an ICU transfer or in-hospital death. ⋯ In contrast to previous studies that found differences in hospital care based on socioeconomic status, we found no difference in diagnostic error rate between patients based on neighborhood disadvantage. Once a patient reaches the hospital, their risk of diagnostic error is not related to the neighborhood in which they live.
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Hospitalizations related to alcohol use disorder (AUD) are common. Yet, few patients receive pharmacotherapy consistent with guideline recommendations. ⋯ Hospitalization is an opportune time for change-naltrexone can promote the reduction or cessation of unhealthy alcohol consumption, as well as subsequent readmissions or progression of alcohol-related liver disease. Hospitalists should stop avoiding naltrexone in the treatment of AUD.