Pearls4Peers (P4P): A “Learning by Sharing” Resource Dedicated to Hospital Medicine

Dear Peers,

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The ever-expanding medical knowledge base required to properly diagnose and manage the increasingly complex conditions of our hospitalized patients is often challenging and requires a healthy dose of daily humility.  Against this backdrop, it’s no surprise that, as Hospital Medicine physicians, we often have clinical questions revolving around the care of our patients.  Sometimes we find it difficult to find the answer, while other times we simply don’t have the time to look for it. Fortunately, we have our peers to count on for frequent exchange of knowledge and sharing of experience through face-to-face contact, by phone, by email, or texting.  Ideally, such informal or “curbside” exchanges should be brief, informative and contribute to the care of the patient.

As an internist who is also trained in infectious diseases and has been in practice for over 25 years, I became interested in these informal exchanges early in my career and realized their potential educational value not only to the clinician who asks the question but also the one to whom the question is directed, creating an opportunity for a bidirectional “learning by sharing” experience. Soon my interest in curbside exchanges turned into a serious hobby, resulting in the publication of a related book (Mosby’s Curbside Clinician, 1998), and couple of journal articles (JAMA 1996;275:145-7, and Clinical Infectious Diseases 1996;22:303-7).

You might say that P4P is only a natural digital age extension of my continued belief that informally-asked clinical questions in the care of hospitalized patients continue to have great educational value, particularly when answered in a clear and concise manner.  So why not share them with the Hospital Medicine community through a readily accessible resource?

Many questions in P4P relate to common clinical conditions while some may involve less common scenarios which I found quite fascinating and thought-provoking.  Regardless, all questions are based on real-life scenarios involving hospitalized patients, with the answers being brief and accompanied by 1-2 references.  I hope  that this format proves informative and useful, particularly to the busy clinician.

So click the sidebar in the right upper corner of the page and get started. As this project is truly a work in progress, your comments and suggestions on how it can serve you better are welcome. In the meantime, I hope that you find P4P worthy of a return visit soon!


Farrin A. Manian, MD, MPH, FACP, FIDSA, FSHE                                                                            Core educator faculty
Department of Medicine,
Massachusetts General Hospital,
Boston, MA
August 2016


Disclosures: The listed questions and answers are solely the responsibility of the author and do not necessarily represent the official views of Massachusetts General Hospital, Harvard Catalyst, Harvard University, its affiliate academic healthcare centers, or its contributors. Although every effort has been made to provide accurate information, the author is far from being perfect. The reader is urged to verify the content of the material with other sources as deemed appropriate and exercise clinical judgment in the interpretation and application of the information provided herein. No responsibility for an adverse outcome or guarantees for a favorable clinical result is assumed by the author.

3 thoughts on “Pearls4Peers (P4P): A “Learning by Sharing” Resource Dedicated to Hospital Medicine

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