Annals for Hospitalists Inpatient Notes - Nonexpert Leadership—Can Hospitalists Turn the Tide of Aggressive End-of-Life Hospital Care?
Authors: Nauzley Christy Abedini
Journal: Annals of Internal Medicine (2018)

Web Exclusives18 December 2018Annals for Hospitalists Inpatient Notes - Nonexpert Leadership—Can Hospitalists Turn the Tide of Aggressive End-of-Life Hospital Care?Nauzley Christy Abedini, MDNauzley Christy Abedini, MDNational Clinician Scholars Program, Division of Hospital Medicine, University of Michigan, Ann Arbor, Michigan (N.C.A.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-3244 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Ms. S, a 61-year-old woman with refractory, progressive metastatic hepatocellular carcinoma, was admitted with acute liver failure. After hearing her diagnosis, she understood that she was approaching the end of her life. She expressed a desire to return home to her family, agreeing to stay in the hospital only if there was a meaningful intervention to be offered. The hepatology consult team requested a cadre of tests to investigate the cause of her progression. As the hospitalist overseeing her care, I attributed her presentation to the advanced cancer and felt certain that she would not improve with any intervention. Her ...References1. Institute of Medicine. Dying in America: Improving Quality and Honoring Individual Preferences Near End of Life. Washington, DC: National Academies Pr; 2015. Google Scholar2. Dzeng E, Dohan D, Curtis JR, Smith TJ, Colaianni A, Ritchie CS. Homing in on the social: system-level influences on overly aggressive treatments at the end of Life. J Pain Symptom Manage. 2018;55:282-289. [PMID: 28865869] CrossrefMedlineGoogle Scholar3. Bernacki RE, Block SD; American College of Physicians High Value Care Task Force. Communication about serious illness care goals: a review and synthesis of best practices. JAMA Intern Med. 2014;174:1994-2003. [PMID: 25330167] CrossrefMedlineGoogle Scholar4. Wallace WT, Creelman D. Leading people when they know more than you do. Harvard Business Review. 18 June 2015. Accessed at https://hbr.org/2015/06/leading-people-when-they-know-more-than-you-do on 21 August 2018. Google Scholar5. Weaver SJ. From teams of experts to mindful expert teams and multiteam systems [Editorial]. J Oncol Pract. 2016;12:976-9. [PMID: 27858549] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: National Clinician Scholars Program, Division of Hospital Medicine, University of Michigan, Ann Arbor, Michigan (N.C.A.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-3244.Corresponding Author: Nauzley Christy Abedini, MD, University of Michigan, Institute for Healthcare Policy and Innovation, North Campus Research Complex, 2800 Plymouth Road, Building 14, G100-23, Ann Arbor, MI 48109-2800; e-mail, [email protected]edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAnnals for Hospitalists - 18 December 2018 David H. Wesorick and Vineet Chopra Metrics 18 December 2018Volume 169, Issue 12Page: HO2-HO3KeywordsBiopsyEnd of life careGastroenterology and hepatologyHealth careHealth care policyHepatocellular carcinomaHospitalistsPulmonary hypertensionQuality of lifeReflexes ePublished: 18 December 2018 Issue Published: 18 December 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...