Letter from the editor

Most hospitalists comanage surgical patients as part of their day-to-day responsibilities, but the hows, whens and whys of a comanagement relationship can vary from hospital to hospital and even from physician to physician.


Most hospitalists comanage surgical patients as part of their day-to-day responsibilities, but the hows, whens and whys of a comanagement relationship can vary from hospital to hospital and even from physician to physician. Successful comanagement, experts say, involves defining hospitalists' and surgeons' roles from the very start. In our cover story, Stacey Butterfield examines the evidence for and against comanagement, some common pitfalls to avoid, and tips on making comanagement work for your group.

In 2006, Johns Hopkins Bayview Medical Center in Baltimore had some of the highest ambulance diversion hours in the region due to overcrowding and lack of beds. To address the problem, hospitalists and ED physicians teamed up for an active bed management initiative that put hospitalists in charge of monitoring and assigning available beds. Less than a year later, the ED's “red alert” hours (ambulance diversion due to lack of ICU beds in the hospital) had decreased by 27 percentage points, and ED throughput time had decreased by 98 minutes. For more specifics, read our latest Success Story.

This issue also features the next installment of Mindful Medicine, in which Jerome Groopman, FACP, and Pamela Hartzband, FACP, use readers' case studies to discuss the art of diagnosis. Read about a hospitalist who successfully diagnosed a Tylenol overdose by using deliberative thinking and keeping an open mind.

If you have a Success Story of your own, or a potential Mindful Medicine case that required a tricky diagnosis, we'd love to hear about it. Send us your experiences, or any other comments and questions.

Sincerely,
Jennifer Kearney-Strouse
Editor, ACP Hospitalist