A team of a dozen hospitalist experts has joined forces with The Hospitalist to provide our readers exclusive insights into the critical issues facing hospital medicine.
Team Hospitalist comprises a diverse array of hospital medicine talent by region, specialty, and experience. The team was selected late last year from a pool of more than two dozen candidates, and each member will serve a two-year term.
Team members will share their professional expertise on a regular basis within the pages of The Hospitalist and on our Web site (www.the-hospitalist.org) via blogs and discussion rooms. The team’s contributions will range from being tapped as sources for stories to sharing short accounts of their experiences relating to topics they are intimately familiar with.
Advancing the mission of hospital medicine is at the core of why team members say they desire to participate on this unique panel.
“Physicians practicing hospital medicine over the next couple of years must remember that providing excellent care to our patients remains our highest priority,” says Ken Patrick, MD, director of the intensive-care unit at Chestnut Hill Hospital in Philadelphia. “Being compassionate, empathetic, and communicating effectively to our patients, their families, and their primary care physicians can be exceedingly difficult in the stressful hospital environment. Having been trained in both primary care and critical care medicine and practiced hospital medicine for more than 25 years remind me just how vitally important this is for our profession.”
Nuts-and-bolts issues like funding, technology, research, and quality standards are uppermost on these experts’ minds.
Specializing in electronic medical technology and progressive scheduling, David J. Yu, MD, hopes to share his approaches to innovating hospital medicine. “Hospitalist programs will encounter more difficult problems … which will require medical directors to forego traditional and exhausted methods of practice,” says Dr. Yu, medical director of hospitalist services, Decatur Memorial Hospital, and clinical assistant professor, family and community medicine, Southern Illinois University, School of Medicine. “I hope to share my experiences in creating innovative approaches to scheduling and our creative use of electronic medical technology to advance the art of hospital medicine into the 21st century.”
The evolution of hospital medicine presents opportunities—and risks—says Rajeev Alexander, MD, lead hospitalist, Oregon Medical Group, Eugene, Ore.
“I enjoy the intellectual challenge hospitalist medicine presents, the range of pathologies and sorts of problems we’re asked about—everything from intensive care work to end-of-life care,” he says. “I would like to see hospitalist medicine evolve an identity along the lines of emergency medicine and/or anesthesia.” However, he fears hospitalists could be seen as, or become, either “physicians with a rapid turnover and without ties to the community who treat the position as a mere stepping stone before a higher-paying specialty fellowship, or ... overgrown house officers who, because of their status as employed physicians, are seen as fungible by hospital administrators.”
But the buck should stop with hospitalists when it comes to improving care quality, says Randy Ferrance, DC, MC, internal medicine and pediatrics medical director, Riverside Tappahannock Hospice, Riverside Tappahannock Hospital, Va.
“So many outside forces are working to constrain medicine in so many ways, I am hoping that we … can come together to so thoroughly and definitively improve the quality of our care that those outside agencies will feel comfortable stepping back and interfering less in how we practice,” says Dr. Ferrance.
When it comes to research, hospitalists could be in the driver’s seat, says R. Neal Axon, MD, assistant professor, medicine and pediatrics, Medical University of South Carolina, Charleston.
“The [National Institutes of Health] and the academic institutions who count on NIH funding have focused a great deal of publicity in recent years on ‘translational’ research that is supposed to move scientific discovery from the bench more expeditiously to the bedside,” Dr. Axon says. “Increasingly, hospitalists are the doctors at the bedside, and I see a huge opportunity for our specialty to both perform research and to set a relevant research agenda over the next several years.”
The bottom line is that hospitalists must focus on achieving three things, says Julia Wright, MD, associate clinical professor of medicine and director of hospital medicine, University of Wisconsin School of Medicine and Public Health, Madison. Her priorities are establishing hospital medicine as a specialty, creating uniform standards for hospitalists, and excelling in patient care and care-delivery systems. TH
Geoff Giordano is editor of The Hospitalist.