Laurence Wellikson, MD, SHM CEO, spelled out the challenges confronting hospital medicine.
“In a nation that spent $1.7 trillion on healthcare in 2003, or 15.3% of the nation’s GDP, with rising insurance premiums and out-of-pocket costs to consumers, hospitalists will be part of a systemic solution to controlling costs and providing high quality care,” says Dr. Wellikson.
He points out that hospitals are changing rapidly, requiring hospitalists to adapt to work environments in flux. The 20% annual turnover in nursing staffs, PCPs giving up inpatient care, subspecialists narrowing their hospital work, and overcrowded emergency departments all create both opportunities and challenges for hospitalists.
“Hospital medicine is growing rapidly and so are the demands on hospitalists,” adds Dr. Wellikson, who articulated SHM’s goal of helping hospitalists develop their leadership skills in a rapidly changing and complex field. He urges participants to transcend medicine’s “cult of uniqueness among individual doctors” and to lead teams that will reform hospitals internally and provide measurable improvements in patient care quality and reduce waste.
These trends are playing out in a healthcare system that’s forced to do more with less. Michael Guthrie, MD, MBA, executive in residence at the University of Colorado at Denver, points out that hospitalists must assume their CEOs and CFOs mindsets to understand the myriad challenges that arise from the swelling number of uninsured patients, the demands of aging baby boomers, malpractice liability, competition, rapid changes in technology, the need for new buildings, and the emphasis on patient satisfaction and safety. The rise of consumer-directed care resulting from employers shifting healthcare costs to employees has raised concerns about how “shopping around” among hospitals might affect clinical performance.
Dr. Guthrie stresses that value is in the eyes of the beholder and that the hospitalist’s work greatly affects other care team members’ satisfaction, relationships with other physicians, patient satisfaction and safety, and the hospital’s business interests.
“Hospitalists use their knowledge, ideas, skills, and expertise with process improvement to get things done with and through other people,” he explains. “When we understand what problems need to be solved and what our measures of success are we can have the rapture of accomplishment.”
Turmoil throughout the healthcare system and rapid growth of the hospitalist movement provided an apt backdrop for remarks Jack Silversin, DMD, DrPh, made in a session titled, “Leading and Managing Change.” Dr. Silversin is the president of Amicus Inc., a consultant firm based in Cambridge, Mass. He urges physicians to transcend their traditional roles as protectors of the status quo to become sponsors of change instead. Physicians as change agents publicly demonstrate their commitment to being leaders in several important ways.