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Occupy SHM


 

As a charter member of SHM, I have been paying my annual membership dues since the late 1990s. For those of you who are SHM members, I thank you. Our small group, which organized in the late 1990s, has grown to thousands. In addition to improving patient care, your SHM membership dues help hospitalists advocate for hospitalists and support the profession we call hospital medicine.

In addition to joining SHM, there are many other ways to support SHM and do your part to support the profession. As a longtime leader of the Boston SHM chapter, I encourage you to not only attend your local SHM chapter meetings, but also become involved in its operation. You might be surprised where your attendance and participation at local SHM chapter meetings lead you.

My friend Kathleen Finn, MD, and I first organized our “Boston Hospitalist Meetings” in the late 1990s, when we signed up as members of NAIP (National Association of Inpatient Physicians), which later became SHM. Our goal for meetings was pretty simple: We wanted a venue for Boston area hospitalists to share ideas and figure out what we were supposed to do as “hospitalists.” Our first meeting was held at Beth Israel Deaconess Medical Center, and we invited Win Whitcomb, MD, MHM, to speak. Win is a cofounder of NAIP and resided in central Massachusetts. Never could I have imagined back in the late 1990s that, in 2011, Kathleen and I would still be holding our quarterly meetings, nor could I imagine that I would become SHM’s president. I am proud of the part we played in shaping HM locally, regionally, and nationally.

Something else I am proud of is the fact that SHM members have a voice when it comes to electing its leaders. Today I received an email asking me to cast my vote for the SHM board of directors. Like me, some of you are members of other professional medical societies. Think about this: How many other organizations ask you for your vote when it comes to selecting its leaders? The board of directors set the direction for SHM and our profession. They not only choose the editors for our publications (The Hospitalist and Journal of Hospital Medicine) and the director of our annual meeting, but they also hire our CEO and elect our president. They make some decisions that seem pretty important to our organization and to our profession, don’t you think?

I liken the right to vote to getting a flu shot: Nobody seems to miss the flu shot until we hear there is a vaccine shortage. Then we are outraged there aren’t enough vaccines for everyone.

Here is where it gets a bit puzzling to me. Despite the size of our society (around 10,000 members), relatively few SHM members choose to exercise their right to vote.

I liken the right to vote to getting the flu shot: Nobody seems to miss the flu shot until we hear there is a vaccine shortage. Then we are outraged there aren’t enough vaccines for everyone. Let’s think about the alternative. What if SHM were to change the way it picks its leaders? Why not act like most other professional medical societies and do away with membership elections and ask existing leadership to hand-select the organization’s future leaders? “We know better who should be leading our organization!” Would we be surprised when people pick their own friends and colleagues to replace them on the board? That doesn’t sound “American,” does it? What if we were to ask congressmen to select their own members? As costly and cumbersome as our election process might be (think “hanging chads” in Florida), there is something comforting in knowing that I have a voice in electing my leaders.

The right to vote is a founding principle of our great nation, right? It is the reason why many of us and/or our ancestors came to the U.S. My maternal grandparents left China in the 1950s so they could live “free” in Hong Kong. My parents moved our family to the U.S. in the mid-1970s because of the anticipated “handover” of Hong Kong from Great Britain to China in 1997. Look back far enough in your family tree, and you likely will find similar stories.

Should we be concerned with the “as is” process and plod along with our annual SHM elections, even if voter turnout is low? Is there a problem with the status quo? Voter apathy is a bigger problem than we may realize. Low voter turnout creates the potential for any one group to insidiously wrest over the control of any organization’s agenda.

There are typically three or four board seats up for election annually. This means half the 12-person board could change every two years. One could easily imagine a scenario in which a special-interest group could elect directors with a like-minded agenda simply by generating increased voter turnout over two election cycles.

Sound crazy? Is this is Joe’s “Occupy SHM” conspiracy theory? I don’t think so. Take a look around and ask yourself why there are multiple professional societies that represent ED physicians or pulmonary/critical-care physicians. The list goes on and on when it comes to medical societies. With enough numbers, groups with their own interests can take over an organization and advance their own agenda. Overnight, we could see the hospitalist community splinter into multiple professional societies, each with its own agenda. This could happen to us. For example, we could have a society for academic hospitalists, another for community hospitalists, etc.

I think our patients and profession are better served long-term if there is one professional organization representing all hospitalists, whether you are a pediatrician, family physician, nurse practitioner, internist, etc., and whether you are self-employed, work for a management company, work for a hospital, etc.

The list of special-interest groups could go on and on. But it should be viewed as a strength, not a weakness, to preserve one professional society that represents all of hospital medicine’s interests. I am interested in your thoughts on how we can increase voter turnout for SHM’s board of director elections. Please email me at JosephLi@HospitalMedicine.org.

Dr. Li is president of SHM.

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