Gardens are not made by sitting in the shade.—Rudyard Kipling
For those of us who live in a climate where the vegetation dies in the winter, this is a great time of year. In the spring our plants and trees revive themselves and begin to give us color and aromas. We tend to our plants and add to our gardens with new flowers. We plant our seeds for vegetables and anxiously await the first fruit.
As I watched my garden blossoming this year, I was reminded of our Society. Perhaps, this is too poetic a comparison, but one that I think fits. No garden is pretty if it comprises all the same plant or grass or color. One of the most appealing things about a garden is its great variety. There are many variations of plants: grasses, flowers, trees, and groundcover. In a great garden, there may be many types of grass in many colors and shapes. There are flowers of various kinds. They all bloom at different times from spring to fall. Their colors range from white to the darkest blues and purples. Their fragrances are apparent in the morning or evening or at night. Some of them are phosphorescent. There are rocks and stones, water features, birds, and insects. Each part of the garden has a different role and yet together they create a peaceful and pleasing environment—a place we want to be. Without the many kinds of sites, smells, and sounds, a garden would not be interesting or pleasing to us.
Our organization is like a garden: We have many types of groups that make up the whole. For instance, we have groups of specialties. We are pediatricians. We are family medicine physicians. We are internists.
We have different professions. Our nurse practitioner and physician assistant members have a unique role. Their support of the organization and insights into patient care and care delivery give us all another perspective. In this complex age of pharmacology and polypharmacy, our pharmacy members assist us all in compiling a treatment plan for patients that helps them and does as little harm as possible. They educate us all about the many interactions and side effects of our medications.
We practice in different settings. Some of us see patients at the bedside in a community hospital. There we attempt to bring the best knowledge and skill we can to care for the individual. In addition, we bring our ideas and innovation to all the patients in our hospital by establishing new treatment plans and processes. We educate our nursing staffs and our fellow physicians. We educate our administrators about healthcare changes that can improve our community and our patients. We create liaisons with other specialists in the emergency department, the operating room, and in the ICU. Some of us practice at the bedside in a teaching setting. We care for patients with residents and medical students. We hope to bring to them a good example of empathy and care at the bedside as well as medical knowledge consistent with the best medical practice. Here, we also create liaisons with other specialists in the emergency department, the operating room, and in the ICU. By working in a multidisciplinary fashion, we hope to advance the care of all hospitalized patients.
We contribute by leading research and studies that discover new methods or new types of care. These results guide others at the bedside and in training. We have different interests. Thanks to this diversity we have individuals working on many topics to advance our specialty. Some individuals pursue public policy. They want to advance our field through the actions of the government and the national payers. The members’ focus on education has led to the core competency product, many wonderful national meetings, and active committee work. Those interested in research strive to produce a world-class journal, research opportunities, and a place for all hospitalists’ researchers. Quality and safety are important to our national healthcare. Our members have created resource rooms to disseminate information on these topics. Others, still, want to advance our field through the study of lifestyle and practice setting issues. Finally, we move toward recognition as a board certified specialty.
Regardless of how one looks at our SHM garden, we would be less of an organization without our variety and diversity. We continue to strive to meet the needs of and provide opportunities for all our members, regardless of their interests, practice setting, or discipline. We do not have a finished garden because gardens are always a work in progress, but we hope to continue to be the best place for all hospitalists to grow. TH
Dr. Gorman is the president of SHM.