RT Book, Section A1 Saunders, Milda A1 Alexander, G. Caleb A1 Siegler, Mark A2 McKean, Sylvia C. A2 Ross, John J. A2 Dressler, Daniel D. A2 Scheurer, Danielle B. SR Print(0) ID 1137625498 T1 Principles of Medical Ethics T2 Principles and Practice of Hospital Medicine, 2e YR 2017 FD 2017 PB McGraw-Hill Education PP New York, NY SN 9780071843133 LK accessmedicine.mhmedical.com/content.aspx?aid=1137625498 RD 2024/03/28 AB Hospitalists, like all physicians, must master not only the clinical but also the interpersonal and ethical dimensions of medical practice. Four features of Hospital Medicine generate particular ethical challenges for the practicing clinician. First, hospitalized patients often face urgent medical issues in the midst of uncertainty. Second, the patient and the hospitalist are usually strangers to one another, having met for the first time when the patient is admitted to the hospitalists’ service. Decisions about code status, end-of-life care, or aggressiveness of care, difficult under the best circumstances, become even more difficult because hospitalists do not have the continuity of care many outpatient physicians have with their patients. Third, despite laudable efforts by many hospitalists to communicate with primary care providers, the absence of long-standing relationships with patients increases the challenge of knowing and representing their wishes and best interests during the course of clinical care. Finally, hospitalists’ shift work also poses challenges to the communication and trust required for sound clinical decision making. Patients and family members may begin a conversation about the goals and plan of care with a hospitalist only to continue such a conversation with another covering physician.