Letter from the Editor

We're thrilled to present you with our fourth annual Top Hospitalists issue, highlighting excellent work in the hospitalist community.

We're thrilled to present you with our fourth annual Top Hospitalists issue. As always, this issue was a collaborative effort, starting with our readers nominating the sharpest, most dedicated colleagues they know. Our editorial board then selected 10 nominees from the group whom they deemed truly outstanding, a difficult task given the impressive qualifications of all who were nominated. We hope that some of the physicians featured will be new to you, as one of our aims is to highlight excellent, underrecognized work in the hospitalist community. Whether community or academic hospitalists, leaders in quality improvement or teachers, the commitment of these men and women to their work is apparent and inspiring. We look forward to hearing your feedback on our choices, and hope you'll be moved to nominate your own candidate for 2012.

Also this month, we look at the tricky issue of whether and how to prescribe drug treatment for patients with delirium. Evidence on the matter is surprisingly thin, leaving hospitalists to sort out the best course for their patients. In our story, experts debate the usefulness of antipsychotics generally, as well as specific drugs within the class, and how treatment may differ for ICU patients compared to those on the general medicine ward.

Antipsychotics can also be considered for a different sort of circumstance: treating users of the designer drug known colloquially as “bath salts.” This mix of psychoactive chemicals including mephedrone (4-methylmethcathinone) and MDPV (3,4-methylenedioxypyrovalerone) is sending an increasing number of people to the hospital with symptoms like tachycardia, ischemia, peripheral neuropathy and delusions. In our Perspectives article, guest writer Andrea Porrovecchio, MD, ACP Member, describes how hospitalists can spot and treat those in the throes of this dangerous drug.

Our Q&A with Amir Qaseem, MD, PhD, FACP, director of clinical policy for ACP, delves into the College's new guidelines on assessment and use of venous thromboembolism prophylaxis, while our Success Story illustrates the rewards that can come when hospitalists are pushed beyond their clinical comfort zones. Meanwhile, our Coding Corner column clarifies the issue of whose documentation actually counts in the eyes of the Centers for Medicare and Medicaid Services.

We would love to hear your thoughts on our Top Hospitalists, or any other item in the magazine. Please email us.

Jessica Berthold
Editor, ACP Hospitalist