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FPHM: Open for Business


2010 could be called the year of recognition for hospitalists. For the hundreds of hospitalists who were inducted as fellows, senior fellows, or master fellows in April, it has already been a momentous year. For some of them—and others, too—their journey toward full recognition of their efforts in the hospital will continue by taking the inaugural Focused Practice in Hospital Medicine (FPHM) Maintenance of Certification (MOC) secure examination administered by the American Board of Internal Medicine (ABIM).

Registration opened for eligible candidates May 1.

The registration period ends Aug. 1.

The first exam is Oct. 25.

In order to qualify for the FPHM MOC program, candidates must submit attestations to ABIM—both from themselves and a supervisor—that demonstrate that the applicant “meets thresholds for internal medicine practice in the hospital setting and professional commitment to hospital medicine,” according to ABIM’s Q&A document about the program.

In addition to attestations, program entrants must have served as a hospitalist for at least three years and fulfill ABIM’s basic requirements for the MOC (see “FPHM Eligibility Requirements,” p. 10).

FPHM Eligibility Requirements

  • Current or previous ABIM certification in internal medicine;
  • Valid, unrestricted, medical license and confirmation of good standing in the local practice community;
  • Advanced Cardiac Life Support (ACLS) certification;
  • At least three years of unsupervised HM practice experience at the time of entry (formal fellowship training in HM fellowship program can be counted toward the three-year practice experience criteria); and
  • Attestation by the diplomate and a senior hospital officer that the diplomate meets thresholds for internal-medicine practice in the hospital setting and professional commitment to hospital medicine.

Source: American Board of Internal Medicine

Why Do It?

While HM has been gaining recognition in the healthcare arena for more than a decade, the FPHM MOC pathway is the first of its kind—and it represents the first time hospitalists will be recognized on an individual level by an independent evaluation organization like ABIM.

“This is a momentous opportunity at every level,” says SHM vice president of operations and general manager Todd Von Deak. “For the individual members, it provides a new kind of recognition of their expertise in a growing specialty. At a higher level, every applicant in the Hospital Medicine MOC program is helping to elevate the specialty among their peers and patients.”

For its part, SHM is helping to promote the program to its membership through informational e-mails to members and additional visibility on the website, www.hospitalmedicine. org.

“We are thrilled to introduce this program to our members,” Von Deak says. “We already have seen strong initial support for the program from SHM members, and we’re confident that even more will apply soon.”

Why Do It Now?

Participation in the first year of the FPHM program can influence the support the program receives in subsequent years, according to Von Deak. “A robust launch year is important to the success of a program like this,” he says. “SHM members can demonstrate to ABIM that this is a valuable program within the specialty by signing up soon. Strength in numbers is critical.”

Plus, hospitalists aren’t required to wait until their ABIM certification expires before registering for the FPHM program. While ABIM certification, which must be renewed every 10 years, is a prerequisite for the FPHM MOC, ABIM-certified hospitalists can register for the program at any time.

Hospitalists who don’t register soon will have to wait for more than 18 months before they can be recognized for their work by ABIM. Certificates for successful applicants in this year’s program will be distributed to hospitalists in early 2011.

For more details, visit, click the “Get Information by Specialty” box, then click the “Hospital Medicine, Focused Practice” section. TH­­­

Brendon Shank is a freelance writer based in Philadelphia.

Fellow in Hospital medicine Spotlight

Margaret Fang, MD, FHM

Dr. Fang is assistant professor in residence, division of hospital medicine, and medical director of the anticoagulation clinic at the University of California at San Francisco.

Undergraduate: Northwestern Univer-sity, Evanston, Ill.

Medical school: Feinberg School of Medicine, Northwestern University, Chicago.

Notable: A practicing hospitalist and SHM member since 2003, Dr. Fang was the co-chair and founding member of SHM’s Young Physicians Task Force in 2003. She has been an active member of SHM’s Scientific Abstracts Committee since 2004 and the Research Committee since 2009. She also has been an assistant editor for the Journal of Hospital Medicine since 2006.

FYI: Outside of the hospital, Dr. Fang has developed a strong interest in food and wine, “which is only natural living in the beautiful bay area of San Francisco,” she says. She recently read “The Omnivore’s Dilemma” by Michael Pollan, and has subscribed to Community Supported Agriculture (CSA) ever since. She enjoys being adventurous and creative with her recipes, using locally grown ingredients supplied by the CSA. She indulges her interests in both cooking and eating, “with a bigger emphasis on eating.”

Quotable: “As a hospitalist that is actively involved in clinical research and administration, I get the opportunity to try out a lot of different things and pursue my many interests. SHM tries to embrace all aspects of the hospitalist field, and I am a big advocate of promoting clinical research and quality-improvement projects in our field.”

Comanagement: Done Right, A Powerful Approach to Patient Care

SHM and a panel of experts are taking the concept of teamwork in the hospital to new levels by spearheading a movement that enables hospitalists and surgeons to comanage patient care.

In February, national leaders in medical management of surgical patients in the hospital convened to develop the first guidelines in this new and emerging practice. Soon, those providers will be putting their recommendations to the test.

SHM’s Co-Management Advisory Board, chaired by SHM board member Sylvia McKean, MD, SFHM, conducted a webinar to create consensus around the requirements of a comanagement program and to preview the demonstration project that will be implemented in late summer.

“Comanagement between hospitalist and surgeon is at the cutting edge of hospital medicine,” says Todd Von Deak, SHM vice president of operations and general manager. “There already are some great models for how to structure the relationships and processes necessary to provide the best care possible for surgical patients.”

The advisory board’s guidelines are posted on SHM’s website ( The resource room includes a white paper, a program building guide, and tips for documentation, coding, and billing. It also provides an outline of the demonstration project. The 11 steps to superior comanagement are:

  • Identifying comanagement program champions;
  • Consensus meeting(s);
  • Identifying patients appropriate for comanagement;
  • Determining roles and responsibilities of comanaging physicians and other stakeholders;
  • Identifying staffing models;
  • Developing service agreements or memos of understanding to clearly define program;
  • Developing communication guidelines/standards;
  • Addressing financial issues and considerations;
  • Developing key metrics;
  • Developing any necessary supporting documents; and
  • Considering the educational needs of referring services/physicians/ nursing units.

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