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A Year of Progress


 

It’s hard to believe eight years have gone by since I came to SHM. More than that, it is strange to think of a world without hospitalists. Hospital medicine is part of the fabric of healthcare; there’s no longer a debate over whether hospitalists are good or bad. Now, the talk is about how hospitalists can help solve so many of the ills that vex our healthcare system.

This year has been an extraordinary year even by SHM standards. Witness our progress in the following areas.

ABIM Progress

In a landmark and revolutionary decision, the American Board of Internal Medicine (ABIM) recommended proceeding with a recognition of focused practice (RFP) in hospital medicine as an option in its maintenance of certification (MOC).

This is the culmination of a strategy SHM laid out three years ago. SHM is working with ABIM to continue to make the MOC process meaningful to hospitalists as the ABIM recommendations wend their way through the American Board of Medical Specialties. SHM continues to reach out to the pediatric and family medicine boards so the RFP can be available to all hospitalists.

JHM Listed

In its first year of publication, the Journal of Hospital Medicine (JHM) has been included in PubMed, the National Institutes of Health online archive of life science journals. JHM now resides among other established journals, fielding a marked increased in submissions for publication.

In a landmark and revolutionary decision, the American Board of Internal Medicine recommended proceeding with a recognition of focused practice in hospital medicine as an option in its maintenance of certification. This is the culmination of a strategy SHM laid out three years ago.

Quality

SHM received its third consecutive grant from the John A. Hartford Foundation, this one for $1.4 million over three years to develop interventions to improve care transitions for older adults at discharge.

As part of our work to improve quality for our nation’s seniors, SHM is developing discharge-planning tools and implementation strategies to limit the voltage drop in care at discharge. Hartford’s support means funders see that hospitalists, with SHM support, improve quality at their hospitals. SHM has become a leader in discharge planning tools and is helping set standards for transitions of care.

To help give hospitalists tools and resources to effect change on the front lines, SHM continues to develop online resource rooms and unique strategies such as mentored implementation.

We also have several hospitalist leaders on key panels at the National Quality Forum (NQF). The American Medical Association’s Physician Consortium on Practice Improvement has asked SHM to take the lead in forming a coalition for setting transitions-of-care measurements.

When the Institute for Healthcare Improvement needed a physician group to join the announcement of its 5 Million Lives Campaign, it reached out to SHM. President Rusty Holman took the stage to support the initiative, which intends to protect 5 million patients from incidents of medical harm over the next two years.

Further, the Joint Commission on Accreditation of Healthcare Organ­izations asked SHM to co-sponsor its medication reconciliation workgroup. Lastly, SHM continues to get significant visibility for hospitalists with our leadership of the deep-vein thrombosis awareness coalition of more than 35 organizations.

Annual Meeting

In May, SHM took over the Gaylord Texan in Dallas with professional meeting staging that rivaled older, larger organizations. With banners, Jumbotrons, and devices projecting the SHM logo, we transformed the Gaylord into a “hospitalist city.” We treated the nearly 1,200 attendees to three superlative speakers:

  • David Brailer, MD, national coordinator for health information technology, United States Department of Health and Human Services;
  • Jonathan Perlin, MD, former undersecretary for health at the Veterans Health Administration and now chief medical officer and senior vice president of quality for Hospital Corporation of America in Nashville; and
  • Bob Wachter, MD, professor and chief of the division of hospital medicine at the University of California, San Francisco.

And, we had our largest poster session ever, with more than 200 submissions, and our largest exhibit hall. We plan to take it up a notch in San Diego in April.

Advocacy and Policy

Our presence in Washington, D.C., allows us to be active in Medicare payment reform. SHM leadership has met with senior staff at MedPAC, the organization that makes recommendations to the Centers for Medicare and Medicaid Services and Congress. MedPAC is interested in working with SHM as Medicare attempts to move away from paying for just visits and procedures and toward reimbursement strategies that drive performance and efficiency.

Current, Future Initiatives

In June, SHM forged a partnership with the Society of General Internal Medicine (SGIM) and the Association of Chiefs of General Internal Medicine to hold an academic summit to develop strategies for academic hospitalists to have a strong and sustainable career in teaching, training, and research in hospital medicine. When the Alliance for Academic Internal Medicine developed its proposal to redesign internal medicine training, SHM took the lead in crafting the hospitalist response.

In July, we joined the SGIM and American College of Physicians to hold a consensus conference on transitions of care. This coalition of more than 25 organizations produced a statement as the basis for future standards and measurements. Also in July, SHM worked with key leaders in emergency medicine and others to redefine the management and opportunities in observation units.

We held a multidisciplinary workforce summit in November to examine the challenges and solutions in growing hospital medicine from 20,000 to 40,000 or more physicians.

Diversity

While at times we may seem to focus more on internal-medicine-trained hospitalists, who make up more than 80% of the field, SHM continues to include hospitalists in family medicine and pediatrics, among other specialties. We also are home to nonphysician providers and physician assistants. We are working to support academic hospitalists, small groups, and multistate companies. In our toughest tightrope walk, SHM continues to be relevant and supportive of labor and management in hospital medicine.

Looking to 2008

The growth and influence of hospital medicine is relentless. Maybe 2008 is the year we will see hospitalists practicing in more than 3,000 hospitals or see the specialty grow to more than 25,000 hospitalists. One thing is for sure: SHM, with your suggestions, ideas, and energy, will be on the front lines with you, supporting and advocating a better healthcare system. TH

Dr. Wellikson is CEO of SHM.

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