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The Hospitalist. 2008 September;2008(09):

September 1, 2008 | The Hospitalist

“We’ll take a list of top conditions relevant to our practice, to review as a working group and then take that to the rest of the group to decide how we’ll standardize care,” says Julia S. Wright, MD, director of hospital medicine and an associate professor of medicine at the University of Wisconsin School of Medicine and Public Health, Madison.

On top of setting up specific searches, many hospitalists use their institutions’ subscriptions to services such as:

UpToDate, the evidence-based, peer-reviewed electronic resource for doctors;
InfoPOEMs, Patient-Oriented Evidence that Matters from Essential Evidence Plus;
Epocrates and Micromedex, for drug-related information;
JournalWATCH;
The Medical Letter;
The Hospitalist’s “In the Literature” department; and
PubMed.

Physicians each have their favorite subscription services. Bill Stinnette, MD, a hospitalist for the Permanente Medical Group, Inc. at Kaiser Permanente San Rafael Medical Center in northern California, recommends MedPage Today daily headlines online as “an excellent source for breaking news and studies, with subspecialty areas, interactive features, FDA alerts, and CME.”

Kenneth Patrick, MD, hospitalist and ICU director of Chestnut Hill Hospital in Philadelphia, uses Medscape as his main online update method. After having completed a personalized profile of his interests, Dr. Patrick now receives e-mail links and general articles based on his criteria. “There’s no paper, it’s done at a convenient time and location, you don’t have to remember where you put that journal you were reading when you were interrupted, and there’s online CME credits,” he says.

Gatherings Become Informative Discussions

Despite enthusiasm about getting information electronically, many hospitalists continue to benefit from—and enjoy—good old-fashioned journal clubs. For example, the quarterly “Lunch and Learn” at the Hospital of St. Raphael in New Haven, Conn., developed by hospitalist Ilona Figura, MD, “has been a real hit,” says Steven Angelo, MD, director of hospitalist services there.

“On a rotating basis, each hospitalist presents an interesting case and leads our group in a discussion of the differential diagnosis, similar to what is done in the NEJM case presentations,” Dr. Angelo says. “At the end of the meeting, the presenter then provides the relevant points from the literature.”

Organization Tips

Now that you’re armed with several ways to retrieve information, how do you store and retain it? Below, a few tips from your peers:

1. Organize it in file folders on your computer. Most hospitalists we asked don’t use different e-mail addresses for electronic mailings, but instead separate e-mails by topic, body systems, or disease conditions. For example, Dr. Wright maintains a file on inpatient diabetes management. She also catalogs notes to keep track of what’s in each folder. “I’m a little bit compulsive,” she admits. “I love the learning, so I spend a lot of time with it.”

2. Discuss—even briefly—what you’ve learned. The hospitalists with whom Dr. Wright works are all sponges for knowledge; e-mail discussions within the group help them retain what they’ve read. Dr. Wright also posts on a board in the staff room any applicable data, such as updates in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial.

3. Retain hard copies of pertinent electronic information. When writing a specific paper, Dr. Horwitz prints out articles research-related articles and stores them in a file cabinet. Those are the only ones she prints. She downloads others electronically when she needs them. “I have a vague memory of which journal the ones I liked were in and then I just search again,” she says.

4. Ask a friend or peer. Some updates come simply by making an informal request. Remember Dr. Izakovic? He’s certainly not afraid to ask. “Let me know when your article is published,” he says with a laugh, “so I won’t leave it in a pile.”