The world is atwitter over Twitter—the social networking utility that allows users to send immediate, 140-character text messages known as “tweets.” From then-presidential-nominee Barack Obama updating the masses on his campaign travels to actor Ashton Kutcher challenging the entire CNN news organization to a Twitter challenge (the former beat the latter by achieving 1 million Twitter followers first) to Britney Spears micro-blogging updates from her ever-so-fascinating life, Twitter is all the rage. The site describes its mission as allowing friends and family to stay connected through quick, frequent text answers to one question: “What are you doing?”
Not one to be left out, I thought I’d give it a shot. However, my tweeting ability is hamstrung by two serious insufficiencies: First, I’m a technology buffoon. Second, there’s no way I can keep my glorious insights to 140 characters.
So, with respect to the folks at Twitter, here’s a not-so-real-time chronicle of how I spent my time at HM09 in Chicago.
Us vs. Them?
The main session opened with a panel discussion about the future role of hospitalist leaders. The most poignant moment came when the panel of chief medical officers was asked how they viewed hospitalists. One recognized the tremendous potential hospitalists offer as the go-to resource for tackling important quality, efficiency, and process issues. This was countered by another participant warning that this potential can go untapped when HM group leaders function as “union stewards,” protecting hospitalists’ interests without a thought to the greater needs of the hospital. While recognizing advocacy as an important part of a group leader’s job, the message was clear: Too much advocacy can create an adversarial relationship that undermines our great potential. (That’s 769 characters.)
Laws Are Like Sausages: It’s Best Not to Watch Them Being Made
Mark Chassin, MD, MPP, MPH, president of The Joint Commission, discussed the quality revolution. He outlined the growing need and role of hospitalists in crossing the hospital quality chasm. He fired a cautionary shot across our bow by noting the increasing shortcomings of the public-private enterprise in improving healthcare quality. His clear concern is that if we don’t improve quality drastically, the government will step in and pass legislation—something that would most likely impact hospitals and hospitalists negatively. (532)
A highly informative physician roundtable tackled value-based purchasing. The Reporting Hospital Quality Data for Annual Payment Update, or RHQDAPU—pronounced “rack-da-poo”—is a voluntary (insofar as hospitals who don’t comply lose 2% of Medicare reimbursement) hospital reporting system for adherence to core measures. This program, widely viewed as the foundation for future hospital pay for performance, will be a budget-neutral process such that some hospitals will win while an equal number will lose. Up to 5% of hospital reimbursement could be at risk. Data is available at www.hospital compare.gov. Check out your hospital; your patients already are. (659)
The Eagle Has Landed
At the end of the first day I co-chaired the Academic/Research special-interest forum with David Meltzer, MD, PhD, of the University of Chicago. The group grappled with a number of questions, from struggles with QI work to finding ways to support research to the development of young academicians. One comment, from Kim Eagle, MD, a world-renowned cardiologist at the University of Michigan and SHM’s visiting professor, resonated with the group. Dr. Eagle sagely responded to a young physician having difficulty developing a research interest by stating research is not about research but about answering questions. In the current healthcare environment, there are more than enough questions to launch all of our academic careers. (734)