Wednesday, December 26, 2007

Top 10 issues in hospital medicine for 2007

It’s time again for a year-end wrap up of developments in the field of hospital medicine. What were the defining issues in 2007? Although there are more answers to that question than there are people reading this blog I have a top 10 list, one that reflects my own biases. As I prepare to present it here as a series of posts over the next few days I’m struck by how the list is evolving. Some of the issues (e.g. Natrecor) have gone into dormancy, perhaps to resurface in future top 10 lists. Others, such as quality and safety remain on the front burner with the skeptics still winning the day. Occasional issues (such as sepsis bundles) seem to have come full circle while still others (glycemic control) remain ever-moving targets.

Here are my top 10 lists for 2006 and 2005---

State of the hospitalist movement.
Surviving sepsis guidelines under fire.
Debates about ALI and ARDS put to rest.
Medication reconciliation.
Outsourcing of hospital services.
Perioperative medicine.
The new C diff.
ER crowding.
Enthusiasm versus skepticism on the quality movement and core measures.

Diagnosis of pulmonary embolism.
Inpatient glycemic control.
Quality and accountability.
Combining modalities in treatment of sepsis.
Controversies in hypercoagulability.
Emerging infections.
The Natrecor controversy.
State of the hospitalist movement.

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