Public Policy

Hospitalists Have Opportunity to Transform Healthcare


 

“I’m going to the sun,” my TWO-and-a-half-year-old daughter confidently declared. She said it so casually, as if she was letting me know that she was going to the playground.

Thinking I could use this as a great parenting opportunity and push my toddler to think through her decisions, I replied in a concerned tone: “Sweetie, the sun is really, really hot. What are you going to do about that?”

She replied effortlessly, as if the solution had always been right there in front of me, and somehow I had failed to see it, “I’m going to wear a really, really big hat!”

Later that night, I was reflecting on the little exchange with my daughter. Why had I been so determined to point out to her that it was impossible to travel to the sun? After all, two is the age to dream and imagine. As we grow up, why do we stop believing that we can do anything, absolutely anything, we imagine?

Since I started working as a hospitalist in 2007, the state of healthcare has been in constant turmoil and distress. Everyone, from providers to policymakers to patients, has been critical about the current state of our healthcare system. Many are concerned with the future, too. In fact, headlines regularly describe healthcare as “deficient,” “error-prone,” “deadly,” “bankrupt,” or “wasteful.”

This is not the vision of the medical profession that I had when I was an idealistic medical student. I was filled with aspirations of curing the sick, alleviating suffering, and helping to make the world a better place.

Don’t get me wrong...I get it. Hospitals, hospitalists, and all forms of care providers have a long way to go before we provide the highest quality of care at a cost our nation and our patients can afford. But in the critical evaluation of the current state of healthcare, where is the positive beacon of hope?

We have a rare and unique opportunity to completely reinvent the system and redefine the practice of medicine—to transform it from how it is practiced to how it should be delivered: high quality, high value, patient-centered, yet population-focused.

When did we, providers of care, stop believing that we could do anything, absolutely anything, to improve the state of healthcare?

Over the past decade, numerous innovations have been introduced to address the deficiencies in our system. However, efforts to come together as a medical profession and address these issues systematically have been lacking. And new initiatives, such as the ABIM Foundation’s Choosing Wisely campaign, are still in the early stages of widespread acceptance and adoption.

We have come a long way from the witchcraft of early healers and the barber-surgeons of medieval times. Modern medicine comes from a tradition of discovering the germ theory, eradicating polio, sequencing the entire genome, and performing simultaneous multiple organ transplantation. Providers are more than healers of the individual patient; they are healers of populations. By advancing health, they have enabled societies to thrive, grow, discover, and innovate. We shoulder significant responsibility, and our impact has shaped the course of human history.

Despite the stated challenges in healthcare, I’d like to think this is our finest hour, our time to shine. We have a rare and unique opportunity to completely reinvent the system and redefine the practice of medicine—to transform it from how it is practiced to how it should be delivered: high quality, high value, patient-centered, yet population-focused. This goes beyond ensuring that every patient with acute myocardial infarction receives an aspirin or working to prevent surgical site infections. This opportunity affords us the possibility to deliver extraordinary care.

Can hospitalists bridge this gap and change the world? Absolutely!

Inherent in our work is continuous improvement, not solely the improvement of our specialty, but also of the services we help co-manage, the hospital-wide committees we sit on, and the C-suite conversations we partake in. And, unlike most of healthcare, we manage to do this, not in isolation, but in multidisciplinary teams of physicians, nurses, staff, and, most importantly, patients and families.

If we unleash the potential of our specialty, the possibilities are endless. Here are some examples from our own hospitalists and society:

  • Imagine the future of care with mentored implementation.

    SHM’s award-winning mentored implementation model has helped transform care in more than 300 hospitals through best practices in venous thromboembolism, readmissions, and care of diabetic patients.

  • Lead with the academy.

    The future of healthcare will belong to clinicians who can lead teams and make the case for real change. That’s one of the reasons that SHM’s Leadership Academy has been so successful: It is creating a cadre of more than 2,000 hospitalists who are armed with the confidence and know-how to envision the hospital of the future and manage hospital-based teams toward that vision.

  • Collaborate with HMX.

    If you’ve ever been to SHM’s annual meeting, you know that hospitalists are a collaborative bunch. In fact, it’s that tendency toward collaboration and problem solving that has led more than 2,300 hospitalists to participate in SHM’s new online community, Hospital Medicine Exchange (www.hmxchange.org). It’s unlike any other platform for hospital-based clinicians, and the conversations on HMX are helping hospitalists everywhere benefit from the experience of colleagues nationally.

  • Learn through the portal.

    Hospitalists can’t shape the future of healthcare without staying up to date, but the days of getting continuing medical education (CME) credit exclusively from conferences is over. SHM is helping hospitalists with its brand new eLearning Portal (www.shmlearningportal.org), which can be accessed on PCs, tablets, or mobile devices.

Expectation High

So, be bold! The sky is the limit. Continue to learn, collaborate, and lead. Most of all, never stop believing that you can create the future you imagine. After all, it was Albert Einstein who cleverly said, “Imagination is more important than knowledge.”

As for my daughter and I, well, I guess I’m going to start investing in really big hats.


Dr. Afsar is associate chief medical officer at UCLA Hospitals in Los Angeles. She is also assistant clinical professor and executive director of quality and safety in the Department of Medicine and Neurosurgery at UCLA Hospitals. She is an SHM board member. Contact her at nafsarmanesh@mednet.ucla.edu.

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