Medicolegal Issues

All Eyes on San Diego


 

SHM’s Annual Meeting highlights hospital medicine as a distinct field within internal medicine. Being able to, year after year, incorporate core clinical topics, evidence-based practice, quality-related content, and career development into three days is only possible because of the foundation laid from previous meetings over the past 10 years.

Expectations about the role of hospitalists have taken shape through recommendations from education summits and national experts on healthcare policy, and via publications like the Journal of Hospital Medicine and The Core Competencies in Hospital Medicine. The Annual Meeting Committee’s goal was to define a program that facilitates hospitalists in achieving that role.

San Diego skyline.

San Diego skyline.

The 2008 meeting April 3-5 in San Diego will feature:

  • National leaders in hospital medicine and healthcare;
  • Six precourses addressing timely and relevant topics; and
  • Seven tracks addressing clinical, operational, quality, academic, and pediatric issues.

Issues that have broad appeal and present challenges for hospitalists will be addressed in three widely anticipated keynotes:

Quality: Don Berwick, MD, MPP, FRCP, president and CEO, Institute for Healthcare Improvement (IHI) and architect of both the 100,000 Lives and 5 Million Lives campaigns;

The future of healthcare: Ian Morrison, PhD, president emeritus and health advisory panel chair, Institute for the Future, and an internationally known author on long-term forecasting with particular emphasis on healthcare;

Thriving in the face of comanagement, non-teaching services, transparency, and the reality of perpetual change: Robert Wachter, MD, professor and chief of the division of hospital medicine, associate chairman of the department of medicine, University of California, San Francisco.

Chapter Summaries

Connecticut

The opening presentation of the Sept. 26 meeting was given by chapter President Rachel Lovins, MD, director of the hospitalist program at Waterbury Hospital. The chapter discussed the need for guest speakers during the meeting, the amount of time allotted to speakers, and possible locations. Particular attention was paid to having speakers come from different hospitals to discuss policy, decision-making, protocols, and pathways. Matthew Katz, executive director of the Connecticut State Medical Society, spoke about his organization and the increasing role hospitalists play in providing inpatient care.

Southern Louisiana

The charter meeting of the Southern Louisiana Chapter took place Aug. 25 in Lafayette. The speaker was Leo Seoane, MD, associate program director of the internal medicine residency program at Ochsner Medical Center in New Orleans. Dr. Seoane spoke on methicillin-resistant staphylococcus aureus (MRSA) pneumonia in the inpatient setting. Later, the group discussed better cooperation between facilities during mass disasters, improved hospital-to-hospital transfers, and updates from the Joint Commission and the Centers for Medicare and Medicaid Services affecting inpatient medicine. Attendees laid the framework for what the chapter’s goals would be and determined that meeting locations would rotate between Lafayette and Baton-Rouge. Officers will be elected at the next meeting.

Western Massachusetts

The chapter met Aug. 28 in Springfield. The featured speaker was William McGee, MD, Baystate Critical Care Medicine in Springfield. Dr. McGee gave a lecture on MRSA pneumonia. Representatives of five hospitalist groups attended.

San Diego

The San Diego chapter met Oct. 10. Alpesh Amin, MD, lead hospitalist and chief of general internal medicine at the University of California, Irvine, updated the group on quality measures for congestive heart failure and acute myocardial infarction. Hospitalists from five local groups attended.

The future of hospital medicine: opportunities and challenges: A special plenary session presented by a panel of hospital medicine leaders who will share perspectives from:

  • The large hospitalist company;
  • The large hospital company as an employer;
  • The hospital CEO; and
  • The individual hospital employed/associated hospital medicine group.

The following program elements are only a few of the many highlights of “Hospital Medicine 2008”:

The Evidence-Based Rapid-Fire Track: This track was developed in response from last year’s attendees. It is designed to provide participants—new or old attendees, academic or community caregivers—with “rapid bursts” of content and to address specific questions framed by the committee, based on the highest level of medical evidence available.

Research, Innovations, and Clinical Vignettes (RIV) Competition: Building on a new feature from “Hospital Medicine 2007,” a nationally renowned professor will again tour the poster session and comment on the entries, meet with academic hospitalists, attend forums, and generally be a “visiting professor” for the duration of the meeting. Additionally, SHM’s RIV Committee, along with staff, are working on arrangements for junior faculty to interact with senior researchers during times that run concurrent with non-plenary sessions. Senior hospitalists with expertise in quality-improvement research will also provide individual feedback to authors at the poster sessions. Mini poster presentation sessions will provide a way for residents to highlight their work, and there will be new, separate receptions for the posters (April 3) and exhibits (April 4).

More networking: Networking provides a critical outlet to interact with senior hospitalists, find out what others are doing to advance their careers, and seek mentorship. In addition to the networking opportunities incorporated in the RIV Competition, other networking opportunities include the exhibits, President’s Luncheon and additional receptions, and two new special-interest forums on com-anagement and consultative medicine and international hospital medicine.

The Annual Meeting Committee sought improvements in developing and implementing this year’s program. Committee brainstorming sessions for this year’s meeting focused on:

  • Balancing what works with innovation;
  • Making the meeting more valuable to clinical educators and researchers, and more applicable to community hospitalists; and
  • Showing national leaders the extraordinary talent behind and work of SHM.

A key innovation was a successful “call for speakers.” Submissions were sought for three breakout sessions to create additional opportunity for members to play an active role in “Hospital Medicine 2008.” Based on submissions, sessions were added on the following topics:

  • “Prevention, Management, and Treatment of Acute Delirium”;
  • “Designing Compensation and Bonus Plans to Drive Desired Behavior”; and
  • “Acute Coronary Syndrome Trials and Tribulations.”

Changes for “Hospital Medicine 2008” reflect the volunteerism of many professionals and would not have been possible without the mentorship and expertise of seasoned veteran leaders in hospital medicine, as well as the feedback and participation of hospitalists providing daily inpatient care. As part of a continuous quality-improvement initiative, rules of engagement were developed so speakers would have useful information up front.

The success of the SHM Annual Meeting depends upon the participation and leadership of SHM members, staff, committees, and task forces, as well as the SHM Board. My thanks goes out to them all for their efforts in once again creating a top-flight program.

For more information on “Hospital Medicine 2008,” and to register, visit www.hospitalmedicine.org/hospitalmedicine2008.

SESSION HIGHLIGHTS

Precourses, April 3

  • “Inpatient Coding and Documentation: Getting Paid What You Deserve” (now a full day)
  • “Best Practices in Managing a Hospitalist Program”
  • “Hands on Training in HM Procedures” (new)
  • “Critical Care Medicine for the Practicing Hospitalist”
  • “High Impact Quality Improvement: How to Ensure a Successful Project”
  • “THE (Teaching Hospitalist Educators) Course: What Clinical Teachers in Hospital Medicine Need to Know” (new)

Evidence-Based Rapid Fire Track for Practicing Clinicians (new)

  • “Controversies in Critical Care”
  • “Clot Controversies: Prophylaxis and Treatment”
  • “Controversies in Transfusion Medicine”
  • “Common Endocrine Problems for the Hospitalist—What Is New?”
  • “Management of Anticoagulant-Related Bleeding Complications”
  • “Acute Renal Failure: Prevention, Diagnosis, Drugs”
  • “Peri-operative Cardiac Guidelines: What Is New?”
  • “Inpatient and Impatient Stroke Management”
  • “ACS Trials and Tribulations”
  • “New Practices in ACLS”

Special Forums

  • “Comanagement/Consultative Hospital Medicine (new)”
  • “Community-Based Hospitalists”
  • “Curriculum/Fellowship”
  • “Early-Career Hospitalists”
  • “Education”
  • “Family Practice Hospitalists”
  • “Geriatric Hospitalists”
  • “HMG Administrators”
  • “International Hospital Medicine” (new)
  • “Medical Directors/Leadership”
  • “Nurse Practitioners and Physician Assistants”
  • “Pediatric Hospitalists”
  • “Public Policy”
  • “Research”
  • “Rural Hospitalists”
  • “Women in Hospital Medicine”

Guilt By Association

SHM steps in when Massachusetts wrongly penalizes hospitalists

by Katie Stevenson

This past summer, several SHM members contacted us about a new health benefits program in Massachusetts called the Select and Save Plan.

The plan is part of the Massachusetts Group Insurance Commission’s (GIC) Clinical Performance Improvement (CPI) Initiative, which establishes differing copayments and benefits for state employees based on a statistical analysis of the physician’s practice patterns.

SHM learned hospitalists were unintentionally grouped with office-based primary care physicians (PCPs) and, therefore, unjustly penalized. The unfair analyses were lowering their ratings within the program and affecting benefits and copayments for their patients.

SHM Senior Vice President Joseph Miller contacted GIC staff to correct this. The GIC agreed to separate hospitalists from PCPs if the names of physicians practicing hospital medicine in Massachusetts could be acquired. Using hospital medicine group information from our membership database, SHM contacted hospital leaders asking them to supply the names of the hospitalists practicing within their facility, and spread the word about the CPI’s faulty analysis to encourage other leaders to submit their information.

As a result of this grass-roots campaign, more than 400 hospitalists and 30 hospitals were identified. The information was submitted to the GIC, and now hospitalists in Massachusetts are distinctly identified as separate from PCPs in their practice profiles.

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