Medicolegal Issues

SHM’s Down with Digital


When hospitalist Robert Wachter, MD, FHM, started his HM blog almost two years ago, he didn’t anticipate that one of his blog entries would be about pop-music icon Britney Spears. Or that it would become his most popular, attracting nearly double the number of readers as his next-most-popular post.

Dr. Wachter—professor and chief of the division of hospital medicine at the University of California at San Francisco, a former SHM president, and author of the blog “Wachter’s World” (—attributes the popularity of that post partly to Spears, but also to the fact it touched on a topic that always sparks interest among hospitalists, other healthcare providers, and hospital executives: the relationship between doctors and nurses in a hospital setting. Dr. Wachter’s most-popular post used Spears’ hospitalization in early 2008 and the controversy surrounding care providers who sneaked a peek at her medical records to make a point about how physicians and nurses often are treated differently in a hospital setting.

I trust and hope that we can use the blog to help the professional status of our profession, as this ultimately will determine the choices we make, large and small.

—Robert Chang, MD, hospitalist, University of Michigan Medical Center, Ann Arbor

But that was just one story. In the first year alone, Dr. Wachter wrote 76 blog posts, each of which easily exceeded 1,000 words. During the first year of blogging, the average post was read more than 1,800 times and the Web site attracted nearly 140,000 views.

“This has been one of the most gratifying things I’ve done in my career,” Dr. Wachter says. “I’ve published hundreds of articles in journals, but something about this form has an immediacy and connection to the audience that feels very important.”

And he isn’t alone. Blogs and HM have experienced similar growth trajectories in recent years. Now they are coming together to help hospitalists understand the most pressing issues in the specialty and provide the best care to hospitalized patients.

Chapter Update

Rocky Mountain

The Rocky Mountain chapter hosted “Update in Hospital Medicine” Feb. 18-21 at the Beaver Run Resort in Breckenridge, Colo. The event featured SHM President Pat Cawley, MD, MBA, as the keynote speaker, along with nationally recognized HM leaders Greg Maynard, MD, MSc, professor of clinical medicine and chief of the division of hospital medicine at the University of San Diego at Irvine, and Sanjay Saint, MD, MPH, a hospitalist at the Ann Arbor VA Medical Center and University of Michigan Health System.

The event included fifteen presentations on various topics, such as “Management of Acute Congestive Heart Failure,” “Implementation of Evidence-Based Patient Safety and QI Initiatives,” and “The Hospitalist and Acute Ischemic Stroke.” Most of the speakers were from the HM faculty at the University of Colorado at Denver School of Medicine.

The four-day meeting served as the first of what is hoped to be an annual chapter meeting. The 70 attendees and 16 UC Denver faculty members represented 15 states; attendees included hospitalists, doctors of osteopathy, and physician assistants.

A Blog Primer

Blogs are Web sites that feature regular articles, or “posts.” The topic, length, and regularity of the posts are entirely at the discretion of the author, also known as the blogger. Some blogs are updated dozens of times a day; others, such as Wachter’s World, only feature new posts every week or so, but often with more depth and insight.

Although initially dismissed by many as outlets for trivial information, blogs are now recognized by experts in nearly every field as an important and cost-effective way to spark conversation and take positions on issues of the day.

Compared with more traditional media outlets, the ability to create dialogue is perhaps the most distinctive blog characteristic. Bloggers often invite readers to post or e-mail comments, creating interactivity between author and reader. In addition, many blogs automatically e-mail and distribute new blog posts to subscribers.

The “viral” aspect of blogs is a major contributor to their success. For instance, say Dr. Wachter writes a new blog post at 8:30 in the morning. Shortly thereafter, his readers will receive an automatically generated e-mail from the blog informing readers that Dr. Wachter has posted a new blog entry. When the reader visits the blog and reads the new post, they might think it could be of interest to a colleague, so they forward it to a colleague via e-mail. The colleague not only reads the article, but they also are impressed and post a comment for the rest of the blog’s readers to view.

SHM Blogs Advance the Specialty

The feedback loop of blogs isn’t limited to the on-screen world. That’s the lesson learned by clinical hospitalist Danielle Scheurer, MD, MSCR, SHM’s Web editor and director of General Medical Services at Brigham and Women’s Hospital in Boston.

As the author of SHM’s new clinical practice blog, “Hospital Medicine Quick Hits,” Dr. Scheurer knew the fledgling blog provided a valuable resource to busy clinicians, but she didn’t expect it to get back to her. She recalls that one day, “my blog was quoted to me by one of my house staff, who said, ‘I found this great hospital medicine blog today,’ and he didn’t realize I was the author.”

For the blog, Scheurer scours through 50 of the top medical journals for articles that are relevant to practicing clinical hospitalists. She posts concise overviews of the articles, along with links to the original research.

Popular HM Blogs

For hospitalists who have an interest in practice management, SHM offers another new blog, “The Hospitalist Leader.” It shares perspectives and ideas on the day-to-day interactions that hospitalists encounter and how best to administer a hospital practice. Four hospitalist co-authors—Robert Chang, MD, FHM, a hospitalist at the University of Michigan Medical Center in Ann Arbor; Rusty Holman, MD, FHM, chief operating officer of Brentwood, Tenn.-based Cogent Healthcare; John Nelson, MD, FHM, principal in Nelson/Flores Associates, a national hospitalist practice management consulting firm; and Robert Bessler, MD, FHM, a hospitalist with Sound Inpatient Physicians in Tacoma, Wash.—use many of their own experiences in the hospital as raw material for the blog.

Dr. Chang views the blog as another way to move HM forward: “I trust and hope that we can use the blog to help the professional status of our profession, as this ultimately will determine the choices we make, large and small,” he says.

click for large version

click for large version

What’s Next

If you’re attending HM09 this year, don’t be surprised if you see someone else in the crowd excitedly typing into an iPhone or BlackBerry. You just might find a new blog post on the session you just attended.

Gone are the old images of a blogger in slippers and pajamas stealthily typing on the computer in the basement. These days, posting at or during an event, on site and in real time, is standard practice for many bloggers. In fact, SHM made a concerted effort to invite the most influential bloggers in the industry to HM09.

And if the person typing away isn’t “live blogging,” he may be “tweeting,” or adding super-short updates to the popular Web site Twitter. For many bloggers, it’s a way of communicating instantaneously with their audiences; once they post a blog article, they “tweet”—or send out—the link to thousands of readers.

SHM has its own Twitter account—@SHMLive—and uses the account to keep interested hospitalists updated on new blog posts, society news, and other HM developments.

“Hospital medicine is constantly evolving,” says Heather Abdel-Salam, SHM’s public relations and marketing coordinator, “and so do our efforts t.o communicate the best practices in the specialty. Blogs, Twitter feeds, and other online outreach are a big part of how we promote hospital medicine and help it grow within the healthcare arena.” TH

Brendon Shank is a freelance writer based in Philadelphia.

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