In the April issue

This month's issue considers resident work hours, care at Indian Health Service hospitals, and readmissions.


Resident work hours have been getting shorter for decades. But a recent change from the Accreditation Council for Graduate Medical Education and new research on the impact of work-hour limits suggest that trend is about to change. Like residency programs, hospitalist services have also struggled to find the perfect balance between overworking clinicians and impairing continuity of care. This month's story gathers data and expert perspectives on the question of how long physicians' hospital shifts should be.

There have also been questions recently about the care provided by hospitals in the Indian Health Service. Our article describes some recent public failures of the service and how physicians and administrators are working to improve the care that these hospitals provide for Native Americans. It even offers some tips for how hospitalists outside the system can contribute to the improvement efforts.

Hospitalists are already on the front lines of efforts to reduce readmissions, of course. To review the impact of that work, an article looks at the effects so far of Medicare's Hospital Readmissions Reduction Program. Evidence of success includes significant drops in readmissions for targeted conditions, even in low-performing hospitals, but experts still have concerns about the program's fairness and potential long-term results.

On the clinical side, we delve into the seemingly endless debate over the risks and benefits of beta-blockers. The article reviews the latest data on use of the drugs, particularly in elderly hospitalized patients, and gathers expert advice on when and when not to prescribe them, based on diagnoses, patient preferences, and other factors. A related Test Yourself is included.

Finally, since you're reading this online, you've probably already noticed, but we're pleased to present our readers with redesigned websites for ACP Hospitalist and ACP Hospitalist Weekly. In addition to having an attractive interface, the new websites, which launched in mid-March, are mobile-friendly. Visit from your computer, tablet, or phone to check them out, and let us know what you think.

Sincerely,
Stacey Butterfield
Editor-in-Chief, ACP Hospitalist