Creating a network of hospitalists, both regionally and nationally, provides opportunities to gain protected time for research pursuits and recognition from one’s peers, Dr. Basaviah continues. “I think what we’ve done for clinician educators is to promote thinking proactively about your short-term and long-term career goals, including developing an area of expertise, before you take on commitments,” she says.
Input with Curricular Design
Dr. Amin’s role in education at his institution informed his active participation in SHM’s Education Committee, which he chaired for four years, and his role on the Core Competencies Task Force. He believes it is through such initiatives that hospitalists can become leaders in their institutions, participating in curriculum development as well as quality and performance improvement efforts.
“I don’t view myself as just working for the hospital or … for the School [of Medicine]. I view myself as working for the enterprise,” he says. As a result his hospitalist group has taken the lead in designing various residency inpatient curricula. “If you do it right, you could actually design curricula to educate residents about heart failure—teaching them about the pathophysiology and disease management—but then also teach them about core measures, outcomes, and systems-based practice in heart failure,” he says. “When all that comes together, I think you’re making some progress.”
Jeffrey G. Wiese, MD, vice chairman and director of the Internal Medicine Residency Program at Tulane University, New Orleans, is the leader of the SHM Task Force for Integrating Core Competencies into Residency Education. He points to the SHM Academic Task Force’s idea of developing an EVU, or educational value unit, that would define and compensate for amounts of time invested in educational pursuits. He would also like to see SHM take a role in developing standards and recommendations for promotion criteria. These are tools that academic hospitalists could use to “make their case” to medical schools’ residency programs about the value they offer to the institution.
Dr. Wiese is excited about train-the-trainer pre-courses now being designed for SHM’s 2008 annual meeting. These courses, he says, will train academic hospitalists to teach issues that are not only important to residency programs but “right up the alley of the hospitalist: namely, systems of care and practice-based learning.” In this way, he explains, academic hospitalists could have an “exponential effect” on furthering the profession.
Recruitment and Retention
Daniel D. Dressler, MD, MSc, director of hospital medicine at Emory University Hospital and assistant professor of medicine at Emory University School of Medicine in Atlanta, is “significantly concerned” about attracting academic hospitalists. The 60+ hospitalists in his group staff five community hospitals (two of which have teaching services) in addition to the system’s tertiary care center. At that hospital, he says, patient acuity is appreciably higher, which means hospitalists must spend more time caring for patients and relating to their family members—time that does not translate into more billable relative value units (RVUs). This type of work environment is definitely “a difficult sell” to potential new hires, he notes. “There is … a balance between patient care and teaching in an academic environment, and maintaining that ‘right balance’ is always a challenge.”
System changes to reward educational prep time, such as the EVU Dr. Wiese mentioned, may be one solution to achieving a patient care/teaching time balance, agrees Dr. Dressler. “I think it’s an excellent idea to have some sort of measure that you can utilize to help reward physicians for putting an emphasis on education—actually promoting and executing educational efforts,” he says. Emory’s program is piloting a mechanism that would objectively measure clinicians’ self-identified efforts to set educational standards. Rewards (e.g., financial recognition or awards for “best teacher” and so on) could be built into the effort, he says.