Sarah Hotovy

Reflection Day 3

I don’t want to cause my patients harm.

I fear that I’m going to cause my patients harm.

I don’t want to cause my patients harm.

I hope my patients know that I don’t want to cause them harm.

Reflection Day 2

One of the things that makes the practice of medicine both challenging and frightening is that “doing something” isn’t always in the patient’s best interest.

Not everyone with a fever needs a laboratory workup. Not everyone with an upper respiratory infection needs antibiotics. Not everyone with abdominal pain needs a CT scan.

Missed/delayed diagnoses can be devastating and life-threatening. What is tough to reconcile is that unnecessary workup and treatment can also lead to patient harm. Radiation exposure is not benign. “Shotgun” laboratory testing can lead to slight abnormalities that drive further testing and patient anxiety. Antibiotics, improperly given, cause resistance patterns and lead to side effects. Medical expenses bankrupt families.

While the goal of training and of practice is to continue to hone our skills as a physician to be able to more accurately determine whose story warrants further intervention and whose requires watchful waiting, it’s not black and… Continue reading

Reflection Day 1

It is amazing to think about the ways in which technology has propelled health care forward.  Twenty years ago, my family physician had a PalmPilot with this fancy new program called Epocrates–this was cutting edge technology. Today, we all walk around with mini-computers in our hands that not only give us access to the entirety of the medical literature, but also our patients’ records at our fingertips and also the score of the Packers’ game from last night so you know what kind of mood Mr. Miller in Room 32 will be in this morning.

I am excited to see how health information technology will continue to shape the care we provide our patients, detecting real-time opportunities to prevent adverse patient outcomes. While some dismiss algorithm-driving medicine as “cookbook,” I think it frees us to do what we as physicians are trained to do–synthesize data through a filter of… Continue reading

Pre-Arrival Reflection

“Anyone have any experiences they wanted to share with the group?” It was my first meeting working for the Accountable Care Organization and I was tasked with leading the meeting of the nurse care coordinators from the fifteen rural family medicine clinics that made up our ACO. I surveilled the room looking for a volunteer to speak, worried that no one had any updates on how hospital discharge phone calls were going.

“You will not believe it,” Marie, one of the care coordinators in a town of 25,000 in northeast Nebraska piped up. “I called a patient who was admitted for a heart failure exacerbation. We spent ten minutes reconciling his medication, and I found out he had been taking a quadruple dose of his beta-blocker. He couldn’t figure out why he was feeling so lightheaded and tired after he got out of the hospital and nearly fell. We were… Continue reading

AELPS 2022 Dates

- CMF Scholars (Week 1)*: 6/5/22 - 6/9/22
*Session exclusive to COPIC Medical Foundation Residents.
- Sorrel McElroy Scholars (Week 2): 6/12/22 - 6/16/22
- Bennathan Scholars (Week 3): 7/19/22 - 7/23/22
Apply Now