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A New Direction


 

Listen to Bob Wachter, MD, MHM

JHM’s new editor-in-chief is a respected clinician-researcher at the University of California at San Francisco. Check out his CV, affiliations, and most significant published research.

Andrew Auerbach, MD, MPH, SFHM, is an associate professor at one of the most highly regarded academic medical centers in the country, and he is a nationally respected researcher whose work has been published in prominent scientific publications.

His peers believe both roles prepared him well for his newest endeavor: editor-in-chief of the Journal of Hospital Medicine. His five-year term begins in January.

Dr. Auerbach’s affiliation with the University of California at San Francisco (UCSF), where he also serves as director of research for the division of hospital medicine and associate director of the General Medicine Research Fellowship, lends instant legitimacy to the journal, editorial team members say. His research has focused on evaluation of care-delivery models and methods for improving the measurement of quality of care.

That background, medical publishing experts believe, gives Dr. Auerbach a foundation in scientific accuracy and reporting transparency that is integral to a new editor’s effort to expand a journal’s reach and increase the quality of work it publishes.

Dr. Auerbach intends to do both, continuing JHM’s growth and solidifying it as the go-to resource for hospitalists. “It is an incredibly good platform for hospitalists to publish their work,” he adds. “I want people to look back at the journal in five years and say it’s even better than it is now.”

As Dr. Auerbach prepares to take over as editor-in-chief, he is focusing his efforts on how to best build on the success the journal has enjoyed since its 2006 launch.

“JHM’s core values are to reflect the field of hospital medicine broadly, to provide a venue where the field’s current scholarly work can be published, and to provide a point of reference for where future scholarly work might be directed and published,” he says. “JHM has been very successful at the first two. I think there is an opportunity to be somewhat more strategic in providing the reference point for future research directions, largely through the input of the editorial team and by paying close attention to JHM readers.”

The Right Choice

An eight-person committee embarked on a five-month search to identify the ideal candidate to replace JHM ’s founding editor-in-chief, Mark Williams, MD, FACP, FHM. The intense process reflected the search committee’s goal that the new editor strengthen the journal and the society it represents, says committee member Harold C. Sox, MD, MACP, a noted internist and author who served as editor of Annals of Internal Medicine from 2001 to 2009.

“A journal published by a professional organization is far and away the most visible manifestation of the organization and its values and ambitions,” Dr. Sox says. “The appointment was anything but pro forma. It had to be the right choice.”

Committee members wanted to select a physician who had a strong scientific background, the judgment required to be a leader, and a desire to better position the journal as a source for first-rate articles in the competitive landscape of medical publishing, Dr. Sox says. They also searched for a candidate who had considerable experience writing for publication.

Listen to Bob Wachter, MD, MHM

Dr. Auerbach, who served as deputy editor of the Journal of General Internal Medicine from 2004 to 2007 and as a JHM reviewer, has been published in the New England Journal of Medicine, the Journal of the American Medical Association, Annals of Internal Medicine, and the Archives of Internal Medicine.

As editor of Annals, Dr. Sox shared responsibility for publishing two of Dr. Auerbach’s articles.

“I know something about how Dr. Auerbach thinks about science and about his own personal scientific standards—wanting to get it right, writing it in a way that people know exactly what happened, and interpreting the results in a way that will stand up over time, rather than trying to read too much into the results,” Dr. Sox says. “We also talked with some of the candidates about their strategy for trying to make the journal better, and I thought he showed himself to be very analytic and strategic in his thinking. I’m confident he’s going to move the journal forward.”

Dr. Auerbach believes his experience as a deputy editor and his mentoring role at UCSF, which requires him to provide constructive feedback on investigators’ papers, has prepared him for his new role.

“I have a good sense for how to approach the review process with the goal of getting a paper to the point where it can be accepted into a journal and, if not, have it leave the review process much better than it was when it arrived,” he says.

His research background also complements his new role, he says.

“Research is a way to take care of patients I never see and to disseminate things that are broadly applicable … that other people can look at and use to improve their healthcare delivery,” he says. “I see the journal as doing many of the same things.”

Strategies for Success

Dr. Auerbach, who has worked closely with Dr. Williams in recent months to ensure a smooth transition, says he does not intend to make substantial changes to the journal’s focus. But he is formulating strategies to make it more valuable and relevant to the hospitalists it serves.

Increasing the journal’s Impact Factor—currently 1.951, ranking it 40th out of 151 publications in its cohort—is one way to increase JHM ’s value, making it a destination for the highest-quality research, Dr. Auerbach says.

He also intends to solicit as many scholarly works as possible, employing “a marketing strategy and recruitment strategy all in one” to make sure JHM is on researchers’ short list of publications in which they consider submitting their work.

I’ve learned never to underestimate him. It’s an amazing characteristic, and it’s one that is very useful doing something like running a journal.


—Robert Wachter, MD, MHM, professor, associate chair, Department of Medicine, University of California at San Francisco, chief, division of hospital medicine, chief, medical service, UCSF Medical Center, former SHM president

He wants to take advantage of the growing number of hospitalists who are doing research and expand the journal’s reach beyond its traditional peer groups. “Are there intensive-care doctors, pulmonologists, cardiologists, or infectious-disease doctors who are doing work with hospitalists—or work that would align with hospital medicine—that could be published in JHM?” Dr. Auerbach asks, rhetorically.

He intends to empower members of his editorial team to serve as JHM ambassadors who promote the journal at professional meetings and encourage investigators who are pursuing interesting projects to submit their findings.

Dr. Auerbach expects to devise other content strategies in consultation with members of his editorial team. Certain aspects of content, such as case reports and scholarly reviews of conundrums in HM cases, could be enhanced, he says. Specific sections of the journal could be developed for effectiveness research or implementation research.

He also says he wants the journal to explore new content areas so that it appeals to readers who aren’t interested in randomized controlled trials.

He hopes to put the journal in the position to publish work supported by such new initiatives as the Patient-Centered Outcomes Research Institute and the Centers for Medicare & Medicaid Services’ Center for Medicare and Medicaid Innovation.

That might mean providing editorials or inviting papers that outline the importance of hospitalists’ involvement in those initiatives, then making sure the journal is opportunistic in reviewing and publishing high-quality work, he explains.

Andrew Auerbach, MD, MPH, SFHM

Age: 44

Academic rank: Associate professor of medicine, University of California at San Francisco’s Division of Hospital Medicine

Administrative titles at UCSF: Attending physician, Department of Medicine; director of research for division of hospital medicine; associate director of the General Medicine Research Fellowship; chair of the Clinical Content Governance Committee at UCSF Medical Center

Education: Bachelor’s degree in biochemistry from Bowdoin College, Brunswick, Maine (1988); medical degree from Dartmouth Medical School, Hanover, N.H. (1992); master’s of public health in clinical effectiveness from Harvard School of Public Health, Boston (1998)

Clinical training: Internship in internal medicine, Yale-New Haven Hospital, New Haven, Conn. (1992-1993); residency in internal medicine, Yale-New Haven Hospital, New Haven, Conn. (1993-1995); fellowship in general internal medicine, Beth Israel-Deaconess Medical Center, Boston (1996-1998)

Principal positions held: Attending physician at Moffitt-Long Hospitals in San Francisco (1998-present); clinical fellow at Beth Israel Deaconess Medical Center, Boston (1996-1998); emergency room physician at Milton Hospital, Milton, Mass. (1996-1998); physician and co-director of student health services at University of New Haven, New Haven, Conn. (1995-1996); hospitalist at Hospital of Saint Raphael, New Haven, Conn. (1995-1996); admitting officer at West Haven Veterans Administration Hospital, West Haven, Conn. (1994-1996)

Awards and honors: Western Society for Clinical Investigation, Investigator of the Year Award (2010); Orthopaedic Research Society Harris Award for Outstanding Research (2010); fellow, American College of Physicians (2009); James Rand Award for Outstanding Research Project (2008); Society of Hospital Medicine Young Investigator Award (2004)

Professional memberships: Association of Chiefs of General Internal Medicine, Society of Hospital Medicine, American Medical Association, American College of Physicians, Society of General Internal Medicine

Most Significant Co-Authored Publications

  • Rothberg M, Maselli J, Pekow P, Lindenauer P, Auerbach AD. Cost-effectiveness of changes in care at U.S. hospitals from 2000-2004. In press, Health Affairs.
  • Auerbach AD, Wachter RM, Cheng H, et al. Effects of a neurosurgery-hospitalist comanagement model on outcomes of patients with neurosurgical illnesses. In press, Arch Int Med.
  • Auerbach AD, Hilton JF, Maselli JM, Pekow P, Rothberg M, Lindenauer PK. Follow the crowd or shop for the best: How volume and care quality influence outcomes of cardiac surgery. Annals Int Med. 2009;150(10):696-704.
  • Auerbach AD, Landefeld CS, Shojania KS. The tension between needing to improve care and knowing how to do it. N Engl J Med. 2007;357(6):608-613.
  • Lindenauer PK, Pekow P, Rothberg M, Benjamin E, Auerbach AD. Outcomes of patients treated by hospitalists, general internists, and family physicians. N Engl J Med. 2007;357(25):2589-2600.

Bold New Direction

The JHM team, which partners SHM leaders and the journal’s publisher, Wiley-Blackwell Inc., is revisiting the journal’s press relations and editorial strategy (Wiley-Blackwell also publishes The Hospitalist). Discussions also are under way about whether to increase the journal’s publishing frequency, as well as how the journal can increase its digital footprint and take advantage of social media outlets to increase the usability and visibility of its offerings, Dr. Auerbach says.

“One side effect of JHM ’s growth has been growing constraints on space to publish excellent work,” he says. “Our team will focus a great deal on strategies to increase JHM ’s ability to review and publish the many outstanding papers submitted each year.”

Listen to Harold Sox, MD

Dr. Williams characterizes Dr. Auerbach’s appointment as “a software upgrade to JHM 2.0.”

Dr. Auerbach’s connection to the top-ranked division of hospital medicine in the country provides instant credibility to the journal, and his diverse contacts should help his efforts to solicit an increasing volume of high-quality submissions, Dr. Williams says.

His appointment also can reinvigorate members of the editorial team, motivating them to step out of their comfort zone and embrace the challenge of adapting to the rapidly changing world of hospital medicine.

“He’ll bring renewed enthusiasm,” says Dr. Williams, a former SHM president who is a professor and chief of the Division of Hospital Medicine at Northwestern University’s Feinberg School of Medicine in Chicago. “I firmly believe that’s essential for any growing enterprise. You need an infusion of new energy and fresh thinking.”

With Dr. Auerbach at the helm, JHM is well-positioned to attract well-done, systematic reviews while appealing to authors who are writing about such relevant topics as change management, collaboration, models of care, and transitional care, says deputy editor Brian Harte, MD, SFHM, chief operating officer of Hillcrest Hospital in Mayfield Heights, Ohio, and chairman of hospital medicine at The Cleveland Clinic.

“I hope people say under Dr. Auerbach’s tenure we continued to innovate and do things as an editorial group that other journals hadn’t thought of doing, were not nimble enough to do, or were not creative enough to do,” Dr. Harte says. “And that it was an incubator of novel and innovative and, ultimately, very effective ideas that took the journal into strategic directions that other journals weren’t bold enough to go in.”

Dr. Auerbach is more than capable of steering JHM in those new directions, according to his mentor, Robert Wachter, MD, MHM, professor and associate chairman of the Department of Medicine at the University of California at San Francisco, and chief of the division of hospital medicine and chief of medical service at UCSF Medical Center, former SHM president, and author of the blog Wachter’s World (www.wachtersworld.com).

Dr. Auerbach is a broad thinker who is capable of recognizing what issues are important to his field before they become obvious to others, a trait that will help him to use the journal to help chart the course for HM, Dr. Wachter says.

He also has the perfect personality for the job. “He is the most doggedly persistent person I’ve ever met,” Dr. Wachter says. “I’ve seen him go through setbacks that would have caused lesser mortals to give up their ideas.…He’s like a prizefighter. He sits in the corner for a little bit, has someone dab the wounds, and then comes back out again for the next round and swings a little bit harder.

“I’ve learned never to underestimate him. It’s an amazing characteristic, and it’s one that is very useful doing something like running a journal.”

Mark Leiser is a freelance writer based in New Jersey.

Key moments in JHM’s history

2005

February: The Society of Hospital Medicine signs an agreement with global publisher John Wiley & Sons Inc. to publish its new peer-reviewed medical journal, the Journal of Hospital Medicine.

March: SHM appoints Mark V. Williams, MD, FACP, FHM, as the journal’s first editor-in-chief.

2006

February: The inaugural issue of JHM is published. The Core Competencies in Hospital Medicine: A Framework for Curriculum Development is published as a supplement.

2007

May: JHM is selected for indexing and inclusion in the National Library of Medicine’s MEDLINE, a bibliographic database that today contains more than 18 million references to journal articles in life sciences, with a concentration in biomedicine.

2008

March: JHM is selected for impact factor tracking by Thompson’s Institute of Scientific Information services. The industry metric serves as a rough average of citations received by peer-reviewed journals.

2009

January: JHM changes its frequency from six to nine issues per year, a reflection of the increase in the volume of submissions and authors’ desire to publish in JHM.

June: Thomas Baudendistel, MD, FACP, is appointed the journal’s first continuing medical education (CME) editor. The first issue containing article-level CME credits is published in the October 2009 issue.

June: JHM receives a stronger-than-expected debut impact factor of 3.163, ranking it 21st out of 107 journals in the Medicine, General and Internal subject category.

2010

April: Pediatric Hospital Medicine Core Competencies are printed as an online-only supplement, also available as a print-on-demand book.

August: JHM follows the New England Journal of Medicine’s lead and implements a new conflict-of-interest policy requiring all authors to complete the International Committee of Medical Journal Editors (ICMJE) form and sign an “author contribution” form, which is published online with each article.

December: JHM’s online usage spikes 76% in 2010, as downloads of full-text articles near 100,000 per year (96,849).

May: SHM launches its publications app inclusive of JHM content.

2011

May: SHM appoints Andrew Auerbach, MD, MPH, SFHM, as the journal’s second editor-in-chief. His position commences in January 2012.

June: National media, including The New York Times, CNN, and The Wall Street Journal, reference popular JHM articles. One article, “Newly cleaned physician uniforms and infrequently washed white coats have similar rates of bacterial contamination after an 8-hour workday: A randomized controlled trial,” by Marisha Burden, Lilia Cervantes, Diane Weed, Angela Keniston, Connie S. Price, and Richard K. Albert, received significant and ongoing attention.

June: JHM’s third Impact Factor score is released—1.951, ranking it 40th out of 151 journals in the “Medicine, General and Internal” category.

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