Medicolegal Issues

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For a moment, put yourself in a hospital administrator’s shoes—more specifically, those of a hospital administrator who is looking to hire a handful of new hospitalists. You know the job duties you need to fill. You know what qualifications a candidate should have. You even know the hours you need covered.

But there remains one gaping hole in the job description: compensation.

This is about giving our members the best, most valuable information available. By enabling hospital medicine groups to make better decisions, this partnership will ultimately translate into better care for patients.

—Tex Landis, MD, FHM, SHM Practice Analysis Committee chairman

The question of how much to offer hospitalists who are in the market for a new job—and, conversely, how much they can demand—has bedeviled the specialty since its inception. And, as HM continues its exponential growth throughout the national healthcare landscape, the devil is in the details. How does an administrator or HM group leader take into account years of experience in compensation? Do nocturnists demand more or less? What about shift work?

That picture will get clearer in 2010, thanks to a new partnership between SHM and the Medical Group Management Association (MGMA). Together, the two groups are embarking on an ambitious new research project to provide hospital administrators and hospitalist practice leaders a comprehensive—and credible—set of data on hospitalist compensation and productivity. The data will be published in an annual report issued jointly by SHM and MGMA.

Nominate Yourself or a Colleague for SHM’s Board of Directors

Interested in becoming a leader in HM? Know someone who would be a great leader? SHM is seeking nominations for three open seats for the Board of Directors. These positions are three-year terms beginning in April 2010. Use this platform to help determine the course of this rapidly growing specialty. All nominations must include a one-page nomination letter, CV, and recent headshot. Submissions are due Oct. 30 to Joi Seabrooks at jseabrooks@hospitalmedicine.org. For full eligibility and nomination requirements, visit www.hospitalmedicine.org and click on “About SHM,” then “Election Information.”

If you have a question about the process, call 800-843-3360 or e-mail nominations@hospitalmedicine.org.

Previously, data available to hospitalists about the state of HM were researched and published by SHM every two years. The new partnership builds on the society’s original work by using questions similar to the SHM survey, but will add MGMA’s authority on such subjects and analytical firepower.

Big Changes

The SHM-MGMA partnership will provide two major improvements to HM and hospital administrators: the annual publication of results and MGMA’s stamp of approval to the research.

New data every year is a welcome change for David Friar, MD, president of Hospitalists of Northwest Michigan in Traverse City. “Things in hospital medicine continue to change very quickly. By the time new data is published, it’s already a few months old,” Dr. Friar says. “Doing the survey on the annual basis will be very useful to us.”

Credibility from an independent source, which MGMA has cultivated through nearly 80 years of organizational performance research, should go a long way when hospitalists are negotiating with hospital administrators. The original SHM-produced survey carried major weight within HM; this new collaborative survey will build on that success by expanding the survey’s credibility in hospitals across the country. Hospital administrators have been turning to MGMA data for other management metrics for years; now they will be able to use the same trusted source for decisions about their HM programs.

“When we negotiate with hospital administrators, we use the current data as a benchmark for comparison,” Dr. Friar says. “[Administrators] are much more familiar with MGMA. The marriage of the two should be very helpful.”

The combination also helps alleviate some confusion in the marketplace, which was the goal of both organizations, according to Crystal Taylor, MGMA’s assistant director for survey operations. “Our survey has been the gold standard for compensation but hasn’t had a high degree of detail around hospitalist-specific metrics,” Taylor says. “SHM’s research has always had more detail in this area because it was more specialized.”

Subtle Change

Although the research will be published in mid-2010, SHM members will notice changes long before then. In fact, many hospitalists already have taken advantage of the partnership, says Leslie Flores, MHA, the director of SHM’s Practice Management Institute.

“SHM and MGMA have already done a number of collaborative things,” she says. “We’ve presented a webinar together, and SHM is now offering MGMA books on its online store.”

In the near future, SHM and MGMA members can expect to hear from both organizations. MGMA has invited SHM to present at MGMA’s national conference, and MGMA will be presenting at HM09 in Washington, D.C., in April. For other SHM members, their first contact with MGMA will be through the survey, which will begin in January, according to Flores. SHM will issue e-mail invitations to group leaders to participate in the survey. The link in the e-mail will take members to MGMA’s data-gathering Web site. SHM and MGMA will present webinars and other educational tools to help practice administrators and others understand the new survey instrument.

Enthusiastic Partner

Like any other promising relationship, both parties are animated about the potential the partnership has for the future. MGMA hopes working with SHM brings them into a new and growing marketplace.

“The hospitalist market is new to us, which is another benefit of the relationship,” says Steve Hellebush, an MGMA vice president who is responsible for the association’s work with SHM. “By being able to interact with experts at SHM who really understand that segment of the healthcare industry, we’re learning more about it. As we learn more, we’ll find more opportunities.”

Both groups agree the joint project will better define the marketplace for hospitalist jobs and compensation. Those familiar with the challenges of administrating a hospitalist practice know that those changes will have a deep impact on healthcare.

“This is about giving our members the best, most valuable information available,” says Tex Landis, MD, FHM, chairman of SHM’s Practice Analysis Committee. “By enabling hospital medicine groups to make better decisions, this partnership will ultimately translate into better care for patients.”TH

Brandon Shank is a freelance writer based in Philadelphia.

Academic Hospitalist Academy Debuts in November

What: 2009 Academic Hospitalist Academy

When: Nov. 8-11

Where: Dolce Atlanta-Peachtree Conference Center, Peachtree, Ga.

More Info: CME credit is available through the University of Alabama; registration details are available at www.sgim.org.

New program designed to build better academic hospitalist practices

For academic hospitalist practice administrators and leaders, finding educational and professional development opportunities tailor-made for the unique needs of their junior faculty can be a challenge. A new academy from leaders in the field will address those needs in November.

In conjunction with the Society of General Internal Medicine (SGIM) and the Association of Chiefs of General Internal Medicine (ACGIM), SHM will present the first Academic Hospitalist Academy Nov. 8-11 in Peachtree, Ga. The four-day educational program is intended to empower academic hospitalists to take the best practices in the field back to their teaching hospitals.

“This is an unprecedented opportunity, not just for the individual academic hospitalist but for the leader of an academic hospitalist group who is working to build the confidence and experience of his or her staff,” says Jeff Glasheen, MD, FHM, physician editor of The Hospitalist and director of the hospital medicine program at the University of Colorado Denver.

The academy will cover a full range of practice-management skills and practical experience, including:

  • Teaching;
  • Scholarly research;
  • Career promotion;
  • Leadership;
  • Mentoring;
  • Business management; and
  • Quality improvement and patient safety.

Academic Hospitalist Academy registration is now open. For details, visit www.sgim.org.

Chapter Updates

Arizona

Arizona BRIAN ADDUCCI/ISTOCKPHOTO.COM

BRIAN ADDUCCI/ISTOCKPHOTO.COM

The Arizona chapter had a well-attended meeting Aug. 13 at Ruth’s Chris Steak House in Phoenix. Hospitalists, medical students, and several chief medical officers from local hospitals listened as chapter president Tochukwu S. Nwafor, MD, of Maricopa Medical Center in Phoenix, gave a lecture on VTE prophylaxis in the hospitalized patient. He discussed the pivotal role hospitalists provide in treating this medical condition and the leadership they can provide because of their accessibility and knowledge. The France Foundation sponsored the discussion.

After the lecture, VTE prevention strategies were discussed. The chapter agreed to continue such work on VTE in the future.

Chapter business was discussed after the lecture. Plans for the coming year include another weekend continuing medical education (CME) activity on pertinent hospitalist topics. The chapter also plans to continue its outreach to such outlying areas as Tucson and Flagstaff.

Northern Nevada

The Northern Nevada chapter met Aug. 18 at the Washow Grill in Reno. The 38 attendees represented four HM groups. Chapter president Phil Goodman provided an overview of SHM and its resources, meetings, fellowship, and membership costs. The chapter elected officers based on nominations submitted via e-mail and nominations at the chapter meeting. A written ballot was conducted, and the officers elected for 2009-2010 are:

  • President: Sukumar Gargya, MD, Renown Hospitalists;
  • VP Logistics/Secretary (president-elect): Levente Levai, MD, president, Sierra Hospitalists;
  • VP Membership: Lynda Malloy, director, NNMC EmCare;
  • VP Education: Nagesh Gullapalli, UNSOM Hospitalists; and
  • VP Projects: Jose Aguirre, president, Lake Tahoe Regional Hospitalists.

The next meeting is Nov. 3. The agenda includes a talk on “Difficult Decisions in Afib Management.” The chapter also plans to resume a journal club that aims to publish two to three times per year, starting in late November or early December.

Primary Piedmont Triad Chapter

The Primary Piedmont Triad SHM chapter had its first meeting June 23 at Wake Forest University Baptist Medical Center in Winston-Salem, N.C. The meeting was hosted by the Wake Forest Inpatient Physicians group of Wake Forest University Health Sciences and sponsored by Schering-Plough. The chapter had dissolved a few years ago, so this meeting was a “meet and greet.”

Ten hospitalists attended the meeting, which included the selection of new officers. There was no special presentation. The evening was spent socializing, reviewing survey results and deciding on a new vision for the chapter. The group was extremely enthusiastic and excited about the future of HM, even in the current economic climate and uncertainty surrounding healthcare reform. The chapter is planning to have quarterly meetings.

Southern Illinois

Southern Illinois STUARTB/ISTOCKPHOTO.COM

STUARTB/ISTOCKPHOTO.COM

The Southern Illinois chapter met July 23 at the Hilton Garden Inn in O’Fallon. The meeting was attended by 16 hospitalists from four HM groups. Theresa Murphy, a PharmD in neuro ICU at Barnes Jewish Hospital, presented on “Euvolemic and Hypervolemic Hyponatremia and AVP Antagonishm with Vapris.” The event was a success; attendees were pleased with the topics that were discussed.

Chicago

SHM’s Chicago chapter hosted a dinner July 29 at the Reel Club in Oakbrook, Ill. The speaker was Gary Shaer, MD, professor of medicine at Rush University. The topic for Dr. Shaer’s presentation was “Managing Patients with ACS in the Acute Setting: An Interventional Cardiologist’s Perspective.” The talk generated an excellent discussion. Various HM topics were debated, including healthcare reform and the hospitalist.

The chapter also welcomed new members and newly designated Fellows in Hospital Medicine. Attendees included hospitalists from Advocate Medical Group, Loyola Medical Center, Resurrection Hospitals, Northwestern Medical Center, and Signature Group.

The next chapter meeting will be in November; the date and location are to be announced. For more information about the Chicago chapter, contact Aziz Ansari, DO, FHM, at aansar1@lumc.edu, or Ana Nowell, MD, FHM, at ananowell@gmail.com.

Fellow in Hospital Medicine Spotlight

Eugene Chu, MD, FHM

Dr. Chu is the chief of the division of hospital medicine at the Denver Health and Hospital Authority, and is an associate professor of medicine at the University of Colorado School of Medicine.

Undergraduate Education: Stanford University, Palo Alto, Calif.

Medical School: Tufts University School of Medicine, Boston

Notable: Outstanding instructor, University of Colorado School of Medicine, 2001; co-author of Hospital Medicine Secrets (Elsevier, 2006); ACF Surge Capacity Hospital Discharge expert panel member.

SHM: Dr. Chu is an active member of SHM, serving as president of the Rocky Mountain chapter.

FYI: Outside the hospital, Dr. Chu enjoys spending time with his 3-year-old daughter, traveling, cycling, and training for triathlons.

For more information about the FHM designation, visit www.hospitalmedicine.org/fellows.

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