Patient Care

Hospitalists Applaud Stress-Free CME Sessions, MOC Training at HM13


Recruitment is a major plank of Dr. Howell's presidential platform.

Former board member Joe Li (left) and SHM CEO Larry Wellikson.

Former board member Joe Li (left) and SHM CEO Larry Wellikson.

Brian Harte teaches in the ABIM Maintenance of Certification pre-course.

Brian Harte teaches in the ABIM Maintenance of Certification pre-course.

Thomas McIlraith (left) and Sameh Naseib received the first  SHM Leadership Certificates.

Thomas McIlraith (left) and Sameh Naseib received the first SHM Leadership Certificates.

Hospitalist Roman Cortez, MD, who helps run Inpatient Medical Service in Kailua, Hawaii, is up for recertification of his internal-medicine boards in 2015. So after attending—and loving—his first SHM annual meeting last year in San Diego, he couldn’t think of a better place to earn credits for the American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) than HM13 in National Harbor, Md.

“It’s more motivational to sit through a seminar than to do it on your own, obviously,” Dr. Cortez says. “It’s like going to the gym. Nobody wants to work out at home, but if you go to the gym, you’re more motivated because you look around and your peers are working out. It’s the same thing with your mind.”

Working on one’s mind and career development is a major aim of SHMa’s annual meeting. From credit-worthy CME pre-courses to the daylong MOC class to the newest class of Fellows, Senior Fellows, and Masters of Hospital Medicine, clinicians like Dr. Cortez can use the yearly gathering as a chance to benchmark their professional progress.

Dr. Cortez, one of three partners who launched their HM group about five years ago, says having tutors, a regimented curricula via the pre-course, and a packed room of like-minded physicians helps hospitalists who are looking for one-stop shopping rather than working on Practice Improvement Modules (PIMs) in a room at their hospital or at home while balancing domestic duties.

“It seems like SHM has streamlined it for us,” Dr. Cortez says.

Ethan Cumbler, MD, FACP, of the University of Colorado at Denver believes the MOC courses are working. Dr. Cumbler is faculty for the pre-course and says there has been a noticeable uptick in how comfortable physicians at the meeting are with quality-improvement (QI) terminology and concepts.

“I think that over the years, the audiences that we’re seeing are savvier as to the process,” he adds. “I remember the first year that the quality-improvement module went out, people were shocked.

“I see clear differences between now and where we were three, four years ago,” he says.

Moving forward, Dr. Cumbler believes that ABIM and the people who help compile PIMs and test questions have to continue to evolve with physicians.

“What we have to figure out how to do as teachers of the Maintenance of Certification modules is how to make this engaging, interesting, and relevant,” he says. And “the people who are writing these questions have to take those same considerations into account. If you are teaching things which are relevant and important, then smart people will learn them.”

New Recruits, New Paths

Larry Spratling, MD, chief medical officer at Banner Baywood Medical Center in Mesa, Ariz., expects to see even more changes to the career trajectory of hospitalists. A pulmonary-disease specialist by training, he believes that as the payment systems are reformed to reward the quality of treatment, many more hospitalists will find their careers outside the walls of institutions.

Theoretically, improved outcomes that reduce readmissions would equate to fewer overall patients, potentially requiring fewer hospitalists in the future. The recent proliferation of hospitalists in long-term acute-care hospitals (LTACs), rehabilitation centers, skilled-nursing facilities (SNFs), and other facilities likely will continue that trend, as HM practitioners adapt to the needs of what Dr. Spratling calls “hospital space in a new system.” Dr. Spratling goes as far as to wonder if the specialty’s skill set might even presage a new name, perhaps something like acute-care medical specialists.

“The acute-care management skills that they have in the hospital, we can use them in these other sites of care,” he adds. “They aren’t just limited to the hospital anymore.”

Another angle of career development is career inception, so newly minted by SHM president Eric Howell, MD, SFHM. In fact, Dr. Howell made recruitment of the next generation of hospitalists and HM leaders a major plank of his one-year term. Of the society’s 12,000 members, just 500 are medical students and house staff members. He’d like to triple that figure by HM14.

He believes that the same professional and personal factors that have swelled the specialty’s ranks to some 40,000 practitioners will appeal to younger physicians. On the clinical side, that includes a focus on QI at a time when health care is being pushed to be better and a chance to be a leader in the hospital of the future. On a positive note, Dr. Howell, chief of hospital medicine at Johns Hopkins Bayview Medical Center in Baltimore, says hospitalists continue to see their compensation rise along with good work-life balance.

“For our specialty to be just as powerful, and just as important, and thrive just as much in the next 16 years as it has in the past 16 years, we are going to need high-quality recruits—and a lot of them,” Dr. Howell says.

Richard Quinn is a freelance writer in New Jersey.

Mastering a Senior Field of Fellows

The annual crop of FHMs, SFHMs, and MHMs was inducted at HM13 with a twist. This year was the first time nonphysicians (nurse practitioners, physician assistants, and practice administrators) joined the fun. The first class of fellows (FHM) was introduced at SHM’s 2009 meeting in Chicago, with the initial cohort of senior fellows (SFHM) and masters (MHM) being honored the following year.

FHM: SHM has now inducted 822 fellows. Criteria to apply include spending at least five years as a practicing hospitalist and endorsements from two active society members.

SFHM: This level now numbers 318 physicians. Candidates must first be an FHM, and demonstrate experience in leadership, teamwork, and quality improvement.

MHM: This year’s class of three masters (Scott Flanders, MD, MHM; David Meltzer, MD, PhD, MHM; and Jeff Wiese, MD, MHM) brings to 13 the number of physicians who have reached the specialty’s highest designation. Hospitalists cannot nominate themselves but must have two letters submitted to a selection committee. Involvement in SHM is expected, with rare exception.

To apply for next year’s class, visit

—Richard Quinn

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