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Coat Tales

Dr. Cucina believes the technology is evolving toward a tablet device that will integrate more of the resource databases hospitalists need in their daily practice with other essential functions, such as lab results, billing, and communications with primary physicians—all in a user-friendly scale and format. In the meantime, there’s still a lot that has to be stuffed into pockets.

Some hospitalists also prefer to hold favorite reference resources, such as the pocket-sized Sanford Guide to Anti­microbial Therapy in their hands. That also involves tradeoffs, notes Michelle Pezzani, MD, hospitalist at El Camino Hospital in Mountain View, Calif.

Have Office, Will Travel

For Duane Spaulding, MD, FACP, president and executive contracting officer for Advantage Inpatient Medical Specialists, practicing at Penrose St. Francis Hospital in Colorado Springs, Colo., some of the “more interesting” things he routinely carries from floor to floor as a working hospitalist include the following items:

  • Small folding leather case containing fresh business cards for patients and families;
  • Yellow, 3-by-4-inch Post-It note pad with name embossed at the top to leave queries in the progress notes section of the chart for a consultant to review and respond to. He leaves “messages that are important but do not warrant an interrupting phone call and should not be part of the official/permanent medical record”;
  • High-quality Welch-Allyn penlight for full visualization of eyes, teeth, throat, skin lesions;
  • PDA securely in a pouch on his belt (he has “been doing so since 1998 and have never dropped it”). He uses it for quick medical reference, drug interaction programs, and consultants’ phone numbers;
  • Tiny stapler (“nothing is more frustrating than wasting time looking around each nurses’ station for this essential item”). He uses it to keep discharge forms from becoming separated;
  • Tiny single-hole puncher so prescriptions can be clipped into the chart;
  • Alter-proof prescription pad embossed with his name;
  • Rubberized “finger cot” for “my non-dominant hand’s thumb—allows my otherwise slippery fingers to whip through an old chart at a near-blurring pace looking for key information I need ASAP”; and
  • Small self-inking rubber stamper with his name and office phone number “to unquestionably identify my signature [not as a replacement for the signatures, which is illegal] on all progress notes and orders we sign.”—LB

“I tried carrying a book bag over my shoulder, but I felt like a school kid,” Dr. Pezzani relates. “I also noticed that the more reference books I had stuffed into my pockets, the less confidence other people seemed to have in me as a physician.” Not to mention that her pockets ripped open from the weight. She even developed a sore neck from her ergonomically unbalanced, overstuffed lab coat.

“Although I love being a hospitalist, it’s getting to the point where I feel disorganized because I have no real home base,” Dr. Pezzani laments. She finds her hospitalist group’s shared office—a converted labor-and-delivery room with no windows and three desktop computers for nine doctors—less than ideal. She spends as little time as possible there.

“My life would be easier if I didn’t have to carry my office in my pockets—my ink-stained pockets,” she says. “I can’t carry my laptop around with me because of the neck pain, so I asked the hospital to give me a locker closer to the middle of the building. It has also become a kind of science for me to transfer a few personal essentials into a little satchel with a string that I wear around my neck,” since a purse is not feasible.

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