Development of a Community Hospital Medicine Affiliated Inpatient Rotation for Family Medicine Residents - a Collaborative Success
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2022-05-02
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Abstract
Background
Hospitalists perform key roles as inpatient educators for family medicine residents. For the past decade, Duke University Family Medicine Residency Program had its inpatient family medicine resident rotation at non-Duke facilities.Objective
The authors describe the steps taken in 2020 to develop an inpatient Duke family medicine rotation at a North Carolina community hospital, Duke Regional Hospital, and provide outcomes data.Methods
Duke Family Medicine Residency and Duke Regional Hospital Medicine collaborated in addressing key issues to develop an inpatient rotation for family medicine residents. Performance metrics of patients cared for by both the family medicine inpatient resident team and internal medicine teams were compared. Resident satisfaction survey results were reviewed.Results
Retrospective cohort evaluation comparing the two inpatient services (internal medicine and family medicine) revealed the family medicine resident inpatient service performed comparatively in length of stay and 30-day readmission rates. Resident evaluation surveys of the family medicine inpatient rotation showed overall satisfaction with learning objectives.Conclusions
This new family medicine inpatient rotation has benefitted all parties. Key quality performance metrics such as LOS and readmissions are comparable to internal medicine, hospitalists have more teaching opportunities, and Duke family medicine has its residents training in a Duke-affiliated community hospital for their core inpatient rotation.Type
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Gallagher, David, Anthony Viera, William Bynum, Poonam Sharma, John Ragsdale, Jeffrey Eschbach and Lalit Verma (2022). Development of a Community Hospital Medicine Affiliated Inpatient Rotation for Family Medicine Residents - a Collaborative Success. Journal of Community Hospital Internal Medicine Perspectives, 12(3). pp. 5–12. 10.55729/2000-9666.1045 Retrieved from https://hdl.handle.net/10161/33447.
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Scholars@Duke
David Michael Gallagher
I am currently the Chief Medical Officer at Duke University Hospital. As CMO I am a member of the senior leadership team that positively impacts the strategies, goals, and objectives at our hospital. I also help support Duke Clinical Automated Laboratories in a clinical consultant role. I am a Professor of Medicine at Duke University. My faculty career track is as a Clinician Leader – Administrator with an emphasis on Clinical Practice Advancement. I have 25+ years of physician leadership experience with previous roles as Chief of Duke Hospital Medicine Programs and Associate CMO of Duke University Hospital. As a clinically active hospitalist, I actively teach learners as an attending physician for Duke Hospital General Medicine Teaching Services caring for patients at DUH and other venues. I am board certified by the American Board of Internal Medicine with a Focused Practice in Hospital Medicine, current in that board’s Maintenance of Certification Program, and have achieved the designation and recognition as a Senior Fellow in Hospital Medicine through the Society of Hospital Medicine. The themes of my scholarly output include readmissions reduction, venous thromboembolism risk in hospitalized older adults, physical activity in hospitalized older adults, mentorship programs for hospitalists, quality improvement teaching to residents, and hospitalist workflow improvements.
My Twitter handle is @DGallagherMD
Anthony Joseph Viera
My major area of research is cardiovascular disease prevention. I am particularly interested in improving detection and control of hypertension. Since assessment of blood pressure begins with measurement, my studies often include out-of-office BP measurement techniques including 24-hour ambulatory BP monitoring and home BP monitoring.
I am also interested in obesity prevention, and in another line of research am examining the effectiveness of food labeling policies (such as calorie-labeling) on people's food and physical activity decisions.
As a family physician, I enjoy providing full-scope primary care (acute care, chronic illness care, preventive services) to patients of all ages and from all walks of life.
William Edwards Bynum
Since arriving to Duke in October 2017, I have enjoyed a highly rewarding mix of patient care, teaching, and research. Prior to coming to Duke, I served seven years on active duty in the US Air Force, during which I served as faculty in the NCC Family Medicine Residency (Fort Belvoir, VA), deployed to Djibouti in support of regional operations, and served multiple congressional delegations as a traveling physician.
I currently have the privilege of 1) providing outpatient primary care to patients from the Durham region, 2) educating Duke family medicine residents, medical students, and physician assistant students, 3) serving as the Associate Program Director of the Duke Family Medicine Residency, and 4) researching self-conscious emotion (shame, guilt, & pride) in medical learners. In addition to ongoing empiric research, I have given numerous seminars, grand rounds, and workshops on shame in medical education, both here at Duke and in other organizations and national meetings. I am excited by Duke's commitment to building supportive, psychologically safe learning environments and very much look forward to contributing to these ongoing efforts.
Poonam Sharma
John William Ragsdale
I have worked at Duke Family Medicine since moving to the area in 2008, initially serving as Medical Director and later as Chief of Family Medicine and Vice Chair of Clinical Services since 2016. I have gained a great deal of personal satisfaction from being involved in patient care, particularly as my administrative roles have expanded. I continue to follow a panel of patients that I have been caring for for many years, along with a longstanding passion for gynecological procedural work, which I have maintained since completing my residency.
Since 2017, I have also collaborated with the Duke Cancer Center to improve care for cancer survivors, with a focus on patients with genitourinary cancers. That work has continued to expand to cover a broader array of cancer survivors and now occupies a larger piece of my clinical work. My interest lies in creating networks and systems that can better respond to and manage the complex and long-term needs of the growing population of cancer survivors.
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