Richard Quinn

A record 3,600 hospitalists swarmed the Mandalay Bay Resort and Casino for four days of education and networking that wrapped with the “father of HM,” Bob Wachter, MD, MHM, dressed as Elton John, warbling a hospitalist-centric version of Sir Elton’s chart topper, “Your Song,” to a packed ballroom.

“[HM14] is just intoxicating,” said hospitalist Kevin Gilroy, MD, of Greenville (S.C.) Health System. “And it ends with our daddy getting up there and lighting it up as Elton John. What other conference does that?”

LAS VEGAS—In perhaps the most tweeted line from HM14, keynote speaker Ian Morrison, PhD, compared the addictiveness of crack cocaine with physicians’ dedication to the fee-for-service payment system.

“It’s really hard to get off of it,” the national healthcare expert deadpanned to a packed ballroom at the Mandalay Bay Resort and Casino.

The zinger was one of the highlights of the annual meeting’s three plenary addresses, which alternately gave the record 3,600 hospitalists in attendance doses of sobriety about the difficulty of healthcare reform and comedy bits from Dr. Morrison and HM dean Robert Wachter, MD, MHM.

The keynote titled “Obamacare Is Here: What Does It Mean for You and Your Hospital?” featured a panel discussion among Centers for Medicare & Medicaid Services (CMS) chief medical officer Patrick Conway, MD, MSc, MHM, FAAP; executive director and CEO of the Medical University of South Carolina in Charleston and former SHM president Patrick Cawley, MD, MBA, MHM, FACP, FACHE; veteran healthcare executive Patrick Courneya, MD; and American Enterprise Institute resident fellow Scott Gottlieb, MD. The quartet—dubbed the Patricks and Scott by several emcees—followed their hour-long plenary with a question-and-answer session.

“I think this is ultimately going to hurt the financial standing of the hospital industry,” said Dr. Gottlieb, a newcomer to SHM’s annual meeting. “A lot of these hospitals that are taking on these capitated contracts, taking on risk, consolidating physicians, I think they’re going to get themselves into financial trouble in the next five years. That’s going to put pressure on the hospitalists.”

Dr. Cawley said that just a few years ago, his institution subsidized five medical groups. Now it’s 25. He has a simple message for hospitalists not committed to providing better care at lower costs: “You’re not going to be on my good side.”

Dr. Wachter told medical students and residents that he sees no end in sight to the unrelenting pressure to provide that high-quality, low-cost care, while also making sure patient satisfaction rises. And he’s more than OK with that.

“It’s important to recognize that the goal we’re being asked to achieve—to deliver high-quality, satisfying, evidence-based care without undue variations, where we’re not harming people and doing it at a cost that doesn’t bankrupt society—is unambiguously right,” he said. “It’s such an obviously right goal that what is odd is that this was not our goal until recently. So the fact that our field has taken this on as our mantra is very satisfying and completely appropriate.”

The keynote addresses also highlighted another satisfying result: Immediate past SHM President Eric Howell, MD, SFHM, reached the goal he set at 2013’s annual meeting to double the society’s number of student and housestaff members from 500 to 1,000.

 

Newly minted SHM President Burke Kealey, MD, SFHM, has a goal that is a bit more abstract: He wants hospitalists to look at improving healthcare affordability, patient health, and the patient experience—as a single goal.

“We put the energy and the effort of the moment behind the squeaky wheel,” said Dr. Kealey, medical director of hospital specialties at HealthPartners Medical Group in St. Paul, Minn. “What I would like us to do is all start thinking about all three at the same time, and with equal weight at all times. To me, this is the next evolution of the hospitalist.”

Dr. Kealey’s tack for his one-year term is borrowed from the Institute of Healthcare Improvement, whose “triple aim” initiative has the same goals. But Dr. Kealey believes that focusing on any of the three areas while giving short shrift to the others misses the point of bettering the overall healthcare system.

“To improve health, but then people can’t afford that healthcare, is a nonstarter,” he said. “To make things finally affordable, but then people stay away because it’s a bad experience, makes no sense, either. We must do it all together.”

And hospitalists are in the perfect position to do it, said Dr. Morrison, a founding partner of Strategic Health Perspectives, a forecasting service for the healthcare industry that includes joint venture partners Harris Interactive and the Harvard School of Public Health’s department of health policy and management. He sees hospitalist leaders as change agents, as the rigmarole of healthcare reform shakes out over the next few years.

Dr. Morrison, a native of Scotland whose delivery was half stand-up comic, half policy wonk (he introduced himself as Dr. Wachter’s Scottish caddy), said that while politicians and pundits dicker over how a generational shift in policies will be implemented, hospitalists will be the ones balancing that change with patients’ needs.

“This is the work of the future,” he said, “and it is not policy wonk work; it is clinical work. It is about the transformation of the delivery system. That is the central challenge of the future.

“We’ve got to integrate across the continuum of care, using all the innovation that both public and private sectors can deliver. This is not going to be determined by CMS, in my view, but by the kind of innovation that America is always good at.”

A record 3,600 hospitalists swarmed the Mandalay Bay Resort and Casino for four days of education and networking that wrapped with the “father of HM,” Bob Wachter, MD, MHM, dressed as Elton John, warbling a hospitalist-centric version of Sir Elton’s chart topper, “Your Song,” to a packed ballroom.

“[HM14] is just intoxicating,” said hospitalist Kevin Gilroy, MD, of Greenville (S.C.) Health System. “And it ends with our daddy getting up there and lighting it up as Elton John. What other conference does that?”

LAS VEGAS—In perhaps the most tweeted line from HM14, keynote speaker Ian Morrison, PhD, compared the addictiveness of crack cocaine with physicians’ dedication to the fee-for-service payment system.

“It’s really hard to get off of it,” the national healthcare expert deadpanned to a packed ballroom at the Mandalay Bay Resort and Casino.

The zinger was one of the highlights of the annual meeting’s three plenary addresses, which alternately gave the record 3,600 hospitalists in attendance doses of sobriety about the difficulty of healthcare reform and comedy bits from Dr. Morrison and HM dean Robert Wachter, MD, MHM.

The keynote titled “Obamacare Is Here: What Does It Mean for You and Your Hospital?” featured a panel discussion among Centers for Medicare & Medicaid Services (CMS) chief medical officer Patrick Conway, MD, MSc, MHM, FAAP; executive director and CEO of the Medical University of South Carolina in Charleston and former SHM president Patrick Cawley, MD, MBA, MHM, FACP, FACHE; veteran healthcare executive Patrick Courneya, MD; and American Enterprise Institute resident fellow Scott Gottlieb, MD. The quartet—dubbed the Patricks and Scott by several emcees—followed their hour-long plenary with a question-and-answer session.

“I think this is ultimately going to hurt the financial standing of the hospital industry,” said Dr. Gottlieb, a newcomer to SHM’s annual meeting. “A lot of these hospitals that are taking on these capitated contracts, taking on risk, consolidating physicians, I think they’re going to get themselves into financial trouble in the next five years. That’s going to put pressure on the hospitalists.”

Dr. Cawley said that just a few years ago, his institution subsidized five medical groups. Now it’s 25. He has a simple message for hospitalists not committed to providing better care at lower costs: “You’re not going to be on my good side.”

Dr. Wachter told medical students and residents that he sees no end in sight to the unrelenting pressure to provide that high-quality, low-cost care, while also making sure patient satisfaction rises. And he’s more than OK with that.

“It’s important to recognize that the goal we’re being asked to achieve—to deliver high-quality, satisfying, evidence-based care without undue variations, where we’re not harming people and doing it at a cost that doesn’t bankrupt society—is unambiguously right,” he said. “It’s such an obviously right goal that what is odd is that this was not our goal until recently. So the fact that our field has taken this on as our mantra is very satisfying and completely appropriate.”

The keynote addresses also highlighted another satisfying result: Immediate past SHM President Eric Howell, MD, SFHM, reached the goal he set at 2013’s annual meeting to double the society’s number of student and housestaff members from 500 to 1,000.

 

Newly minted SHM President Burke Kealey, MD, SFHM, has a goal that is a bit more abstract: He wants hospitalists to look at improving healthcare affordability, patient health, and the patient experience—as a single goal.

“We put the energy and the effort of the moment behind the squeaky wheel,” said Dr. Kealey, medical director of hospital specialties at HealthPartners Medical Group in St. Paul, Minn. “What I would like us to do is all start thinking about all three at the same time, and with equal weight at all times. To me, this is the next evolution of the hospitalist.”

Dr. Kealey’s tack for his one-year term is borrowed from the Institute of Healthcare Improvement, whose “triple aim” initiative has the same goals. But Dr. Kealey believes that focusing on any of the three areas while giving short shrift to the others misses the point of bettering the overall healthcare system.

“To improve health, but then people can’t afford that healthcare, is a nonstarter,” he said. “To make things finally affordable, but then people stay away because it’s a bad experience, makes no sense, either. We must do it all together.”

And hospitalists are in the perfect position to do it, said Dr. Morrison, a founding partner of Strategic Health Perspectives, a forecasting service for the healthcare industry that includes joint venture partners Harris Interactive and the Harvard School of Public Health’s department of health policy and management. He sees hospitalist leaders as change agents, as the rigmarole of healthcare reform shakes out over the next few years.

Dr. Morrison, a native of Scotland whose delivery was half stand-up comic, half policy wonk (he introduced himself as Dr. Wachter’s Scottish caddy), said that while politicians and pundits dicker over how a generational shift in policies will be implemented, hospitalists will be the ones balancing that change with patients’ needs.

“This is the work of the future,” he said, “and it is not policy wonk work; it is clinical work. It is about the transformation of the delivery system. That is the central challenge of the future.

“We’ve got to integrate across the continuum of care, using all the innovation that both public and private sectors can deliver. This is not going to be determined by CMS, in my view, but by the kind of innovation that America is always good at.”

A record 3,600 hospitalists swarmed the Mandalay Bay Resort and Casino for four days of education and networking that wrapped with the “father of HM,” Bob Wachter, MD, MHM, dressed as Elton John, warbling a hospitalist-centric version of Sir Elton’s chart topper, “Your Song,” to a packed ballroom.

“[HM14] is just intoxicating,” said hospitalist Kevin Gilroy, MD, of Greenville (S.C.) Health System. “And it ends with our daddy getting up there and lighting it up as Elton John. What other conference does that?”

LAS VEGAS—In perhaps the most tweeted line from HM14, keynote speaker Ian Morrison, PhD, compared the addictiveness of crack cocaine with physicians’ dedication to the fee-for-service payment system.

“It’s really hard to get off of it,” the national healthcare expert deadpanned to a packed ballroom at the Mandalay Bay Resort and Casino.

The zinger was one of the highlights of the annual meeting’s three plenary addresses, which alternately gave the record 3,600 hospitalists in attendance doses of sobriety about the difficulty of healthcare reform and comedy bits from Dr. Morrison and HM dean Robert Wachter, MD, MHM.

The keynote titled “Obamacare Is Here: What Does It Mean for You and Your Hospital?” featured a panel discussion among Centers for Medicare & Medicaid Services (CMS) chief medical officer Patrick Conway, MD, MSc, MHM, FAAP; executive director and CEO of the Medical University of South Carolina in Charleston and former SHM president Patrick Cawley, MD, MBA, MHM, FACP, FACHE; veteran healthcare executive Patrick Courneya, MD; and American Enterprise Institute resident fellow Scott Gottlieb, MD. The quartet—dubbed the Patricks and Scott by several emcees—followed their hour-long plenary with a question-and-answer session.

“I think this is ultimately going to hurt the financial standing of the hospital industry,” said Dr. Gottlieb, a newcomer to SHM’s annual meeting. “A lot of these hospitals that are taking on these capitated contracts, taking on risk, consolidating physicians, I think they’re going to get themselves into financial trouble in the next five years. That’s going to put pressure on the hospitalists.”

Dr. Cawley said that just a few years ago, his institution subsidized five medical groups. Now it’s 25. He has a simple message for hospitalists not committed to providing better care at lower costs: “You’re not going to be on my good side.”

Dr. Wachter told medical students and residents that he sees no end in sight to the unrelenting pressure to provide that high-quality, low-cost care, while also making sure patient satisfaction rises. And he’s more than OK with that.

“It’s important to recognize that the goal we’re being asked to achieve—to deliver high-quality, satisfying, evidence-based care without undue variations, where we’re not harming people and doing it at a cost that doesn’t bankrupt society—is unambiguously right,” he said. “It’s such an obviously right goal that what is odd is that this was not our goal until recently. So the fact that our field has taken this on as our mantra is very satisfying and completely appropriate.”

The keynote addresses also highlighted another satisfying result: Immediate past SHM President Eric Howell, MD, SFHM, reached the goal he set at 2013’s annual meeting to double the society’s number of student and housestaff members from 500 to 1,000.

 

Newly minted SHM President Burke Kealey, MD, SFHM, has a goal that is a bit more abstract: He wants hospitalists to look at improving healthcare affordability, patient health, and the patient experience—as a single goal.

“We put the energy and the effort of the moment behind the squeaky wheel,” said Dr. Kealey, medical director of hospital specialties at HealthPartners Medical Group in St. Paul, Minn. “What I would like us to do is all start thinking about all three at the same time, and with equal weight at all times. To me, this is the next evolution of the hospitalist.”

Dr. Kealey’s tack for his one-year term is borrowed from the Institute of Healthcare Improvement, whose “triple aim” initiative has the same goals. But Dr. Kealey believes that focusing on any of the three areas while giving short shrift to the others misses the point of bettering the overall healthcare system.

“To improve health, but then people can’t afford that healthcare, is a nonstarter,” he said. “To make things finally affordable, but then people stay away because it’s a bad experience, makes no sense, either. We must do it all together.”

And hospitalists are in the perfect position to do it, said Dr. Morrison, a founding partner of Strategic Health Perspectives, a forecasting service for the healthcare industry that includes joint venture partners Harris Interactive and the Harvard School of Public Health’s department of health policy and management. He sees hospitalist leaders as change agents, as the rigmarole of healthcare reform shakes out over the next few years.

Dr. Morrison, a native of Scotland whose delivery was half stand-up comic, half policy wonk (he introduced himself as Dr. Wachter’s Scottish caddy), said that while politicians and pundits dicker over how a generational shift in policies will be implemented, hospitalists will be the ones balancing that change with patients’ needs.

“This is the work of the future,” he said, “and it is not policy wonk work; it is clinical work. It is about the transformation of the delivery system. That is the central challenge of the future.

“We’ve got to integrate across the continuum of care, using all the innovation that both public and private sectors can deliver. This is not going to be determined by CMS, in my view, but by the kind of innovation that America is always good at.”

LAS VEGAS—If she said it once, Patience Reich, MD, SFHM, said it a half-dozen times during SHM’s annual meeting: “Let it go.”

“You can’t be Martha Stewart and a perfect doctor. Just let it go,” said Dr. Reich, associate professor of internal medicine and associate faculty for the Office of Women in Medicine and Science at the Wake Forest School of Medicine in Winston-Salem, N.C., told about 75 female hospitalists during a two-hour workshop focused on women’s issues at the Mandalay Bay Resort and Casino. “Even in 2014, there are trade-offs to be made.

“We judge ourselves too harshly. … We’re doing ourselves a disservice by saying we should be able to do it all. There are only so many hours in the day. Men don’t worry about these things. Just let it go.”

Dr. Reich and Rachel George, MD, MBA, CPE, SFHM, of Cogent Healthcare, have been moderating the workshop at SHM meetings for several years. They said the issues they encounter among hospitalists around the country, which are no different today than they were in years past, include gender bias, career advancement challenges, and the guilt some feel spending time away from their children or communicating with their stay-at-home husbands.

At HM14, workshop attendees searched for solutions to common struggles.

“Don’t pretend you can have it all,” Dr. George said. “It’s a myth ruining womankind. There’s nothing that says you have to be June Cleaver and Marcus Welby all rolled into one. We have to stop thinking that we have to do it.”

Dr. George told the workshop attendees that cooking and cleaning are so far down on her priority list that “they practically don’t exist.”

“It’s OK. My kids are happy and healthy,” she said. “It doesn’t matter if they come home to a dirty house or if they eat pizza. They’re going to survive. I think women put all that guilt on themselves. Some of it society does, but a lot of women put the guilt on themselves just because they don’t cook a three-course meal every night.”

Open Forum

The issues were much the same during a Special Interest Group attended by nearly 35 hospitalists and moderated by Melissa Mattison, MD, FACP, SFHM, of Beth Israel Deaconess Medical Center in Boston. Topics ranged from personal experiences with workplace discrimination to apprehension in pursuing leadership roles to “partner envy” and dealing with the “guilt” of being a working parent.

One hospitalist wondered how others dealt with harassment from patients. “I’m young, petite, and a minority,” she said. “I get ‘sweetie’ and ‘honey’ all the time from my patients.”

Another explained the difficulty of working full time while taking care of an elderly parent. Yet another admitted her desire for a role model, “as there are none in my area.”

“Men seem to have an innate drive to be the breadwinner,” one attendee said. “No matter how much help you have at home, it doesn’t take away the guilt I feel.”

Another said, “I think about all of these issues constantly.”

Dr. Mattison, a member of the annual meeting committee, left the 45-minute open forum with four action items:

• Increase the exposure of programming for issues related to work-life balance at annual meeting;
• Suggest keynote speakers who are not men;
• Create a toolkit for HM leaders and department of medicine leaders to help them understand work-life issues; and
• Create a community on the HMX portal to discuss work-life issues, “whether they are related to being a mother or father, juggling work and home, or whatever issues come up.”

 

The Key: Flex Schedules

Many physicians who choose a career in HM do it because of the work-life balance the specialty affords, and many of the challenges women hospitalists face at the local level revolve around the schedule. That’s how Zenobia JonesFoster, MD, MPH, a hospitalist at Wellstar Health in Atlanta, views it.

“I think it’s very facility-dependent. I think when we look for a job and decide where we want to go, we really need to understand the culture and how people advance within that culture,” said Dr. JonesFoster, who attended the women’s issues workshop. “The academic environment has a lot more deferred policy and bureaucracy versus a private institution, but you’re going to find that anywhere.”

A hospitalist for a little more than two years, Dr. JonesFoster has two young children, ages one and three, and works in a group with 30 full-time hospitalists and 10 nurse practitioners and physician assistants. Her husband is a businessman, so schedules and work-life balance are a major concern.

“If I was given a job opportunity Monday through Friday, regular work hours, there’s no way I would take it because of the flexibility of hospital medicine hours, with the seven-on seven-off schedule,” she said. “The time I have off, I get to just be a mom and not think about work. But when I’m at work, I love it.”

Dr. JonesFoster’s group has seen an increase in patient census recently and just went live with a new hospital-wide electronic health records system, which has opened up more shifts and moonlighting opportunities. Attending her first annual meeting, she was most interested in learning the pros and cons of leadership positions, because her health system “offers a lot of opportunity for advancement” and is “talking about adding a residency program.”

“Another thing I wanted to learn about was mentorship,” she said. “I wanted to meet women who have done this before, who have had children, who are working full-time trying to do a little bit of everything. I wanted to see how they did it and try and learn from their experiences.”

From all accounts, mission accomplished.

Richard Quinn is a freelance writer in New Jersey.

LAS VEGAS—If she said it once, Patience Reich, MD, SFHM, said it a half-dozen times during SHM’s annual meeting: “Let it go.”

“You can’t be Martha Stewart and a perfect doctor. Just let it go,” said Dr. Reich, associate professor of internal medicine and associate faculty for the Office of Women in Medicine and Science at the Wake Forest School of Medicine in Winston-Salem, N.C., told about 75 female hospitalists during a two-hour workshop focused on women’s issues at the Mandalay Bay Resort and Casino. “Even in 2014, there are trade-offs to be made.

“We judge ourselves too harshly. … We’re doing ourselves a disservice by saying we should be able to do it all. There are only so many hours in the day. Men don’t worry about these things. Just let it go.”

Dr. Reich and Rachel George, MD, MBA, CPE, SFHM, of Cogent Healthcare, have been moderating the workshop at SHM meetings for several years. They said the issues they encounter among hospitalists around the country, which are no different today than they were in years past, include gender bias, career advancement challenges, and the guilt some feel spending time away from their children or communicating with their stay-at-home husbands.

At HM14, workshop attendees searched for solutions to common struggles.

“Don’t pretend you can have it all,” Dr. George said. “It’s a myth ruining womankind. There’s nothing that says you have to be June Cleaver and Marcus Welby all rolled into one. We have to stop thinking that we have to do it.”

Dr. George told the workshop attendees that cooking and cleaning are so far down on her priority list that “they practically don’t exist.”

“It’s OK. My kids are happy and healthy,” she said. “It doesn’t matter if they come home to a dirty house or if they eat pizza. They’re going to survive. I think women put all that guilt on themselves. Some of it society does, but a lot of women put the guilt on themselves just because they don’t cook a three-course meal every night.”

Open Forum

The issues were much the same during a Special Interest Group attended by nearly 35 hospitalists and moderated by Melissa Mattison, MD, FACP, SFHM, of Beth Israel Deaconess Medical Center in Boston. Topics ranged from personal experiences with workplace discrimination to apprehension in pursuing leadership roles to “partner envy” and dealing with the “guilt” of being a working parent.

One hospitalist wondered how others dealt with harassment from patients. “I’m young, petite, and a minority,” she said. “I get ‘sweetie’ and ‘honey’ all the time from my patients.”

Another explained the difficulty of working full time while taking care of an elderly parent. Yet another admitted her desire for a role model, “as there are none in my area.”

“Men seem to have an innate drive to be the breadwinner,” one attendee said. “No matter how much help you have at home, it doesn’t take away the guilt I feel.”

Another said, “I think about all of these issues constantly.”

Dr. Mattison, a member of the annual meeting committee, left the 45-minute open forum with four action items:

• Increase the exposure of programming for issues related to work-life balance at annual meeting;
• Suggest keynote speakers who are not men;
• Create a toolkit for HM leaders and department of medicine leaders to help them understand work-life issues; and
• Create a community on the HMX portal to discuss work-life issues, “whether they are related to being a mother or father, juggling work and home, or whatever issues come up.”

 

The Key: Flex Schedules

Many physicians who choose a career in HM do it because of the work-life balance the specialty affords, and many of the challenges women hospitalists face at the local level revolve around the schedule. That’s how Zenobia JonesFoster, MD, MPH, a hospitalist at Wellstar Health in Atlanta, views it.

“I think it’s very facility-dependent. I think when we look for a job and decide where we want to go, we really need to understand the culture and how people advance within that culture,” said Dr. JonesFoster, who attended the women’s issues workshop. “The academic environment has a lot more deferred policy and bureaucracy versus a private institution, but you’re going to find that anywhere.”

A hospitalist for a little more than two years, Dr. JonesFoster has two young children, ages one and three, and works in a group with 30 full-time hospitalists and 10 nurse practitioners and physician assistants. Her husband is a businessman, so schedules and work-life balance are a major concern.

“If I was given a job opportunity Monday through Friday, regular work hours, there’s no way I would take it because of the flexibility of hospital medicine hours, with the seven-on seven-off schedule,” she said. “The time I have off, I get to just be a mom and not think about work. But when I’m at work, I love it.”

Dr. JonesFoster’s group has seen an increase in patient census recently and just went live with a new hospital-wide electronic health records system, which has opened up more shifts and moonlighting opportunities. Attending her first annual meeting, she was most interested in learning the pros and cons of leadership positions, because her health system “offers a lot of opportunity for advancement” and is “talking about adding a residency program.”

“Another thing I wanted to learn about was mentorship,” she said. “I wanted to meet women who have done this before, who have had children, who are working full-time trying to do a little bit of everything. I wanted to see how they did it and try and learn from their experiences.”

From all accounts, mission accomplished.

Richard Quinn is a freelance writer in New Jersey.

LAS VEGAS—If she said it once, Patience Reich, MD, SFHM, said it a half-dozen times during SHM’s annual meeting: “Let it go.”

“You can’t be Martha Stewart and a perfect doctor. Just let it go,” said Dr. Reich, associate professor of internal medicine and associate faculty for the Office of Women in Medicine and Science at the Wake Forest School of Medicine in Winston-Salem, N.C., told about 75 female hospitalists during a two-hour workshop focused on women’s issues at the Mandalay Bay Resort and Casino. “Even in 2014, there are trade-offs to be made.

“We judge ourselves too harshly. … We’re doing ourselves a disservice by saying we should be able to do it all. There are only so many hours in the day. Men don’t worry about these things. Just let it go.”

Dr. Reich and Rachel George, MD, MBA, CPE, SFHM, of Cogent Healthcare, have been moderating the workshop at SHM meetings for several years. They said the issues they encounter among hospitalists around the country, which are no different today than they were in years past, include gender bias, career advancement challenges, and the guilt some feel spending time away from their children or communicating with their stay-at-home husbands.

At HM14, workshop attendees searched for solutions to common struggles.

“Don’t pretend you can have it all,” Dr. George said. “It’s a myth ruining womankind. There’s nothing that says you have to be June Cleaver and Marcus Welby all rolled into one. We have to stop thinking that we have to do it.”

Dr. George told the workshop attendees that cooking and cleaning are so far down on her priority list that “they practically don’t exist.”

“It’s OK. My kids are happy and healthy,” she said. “It doesn’t matter if they come home to a dirty house or if they eat pizza. They’re going to survive. I think women put all that guilt on themselves. Some of it society does, but a lot of women put the guilt on themselves just because they don’t cook a three-course meal every night.”

Open Forum

The issues were much the same during a Special Interest Group attended by nearly 35 hospitalists and moderated by Melissa Mattison, MD, FACP, SFHM, of Beth Israel Deaconess Medical Center in Boston. Topics ranged from personal experiences with workplace discrimination to apprehension in pursuing leadership roles to “partner envy” and dealing with the “guilt” of being a working parent.

One hospitalist wondered how others dealt with harassment from patients. “I’m young, petite, and a minority,” she said. “I get ‘sweetie’ and ‘honey’ all the time from my patients.”

Another explained the difficulty of working full time while taking care of an elderly parent. Yet another admitted her desire for a role model, “as there are none in my area.”

“Men seem to have an innate drive to be the breadwinner,” one attendee said. “No matter how much help you have at home, it doesn’t take away the guilt I feel.”

Another said, “I think about all of these issues constantly.”

Dr. Mattison, a member of the annual meeting committee, left the 45-minute open forum with four action items:

• Increase the exposure of programming for issues related to work-life balance at annual meeting;
• Suggest keynote speakers who are not men;
• Create a toolkit for HM leaders and department of medicine leaders to help them understand work-life issues; and
• Create a community on the HMX portal to discuss work-life issues, “whether they are related to being a mother or father, juggling work and home, or whatever issues come up.”

 

The Key: Flex Schedules

Many physicians who choose a career in HM do it because of the work-life balance the specialty affords, and many of the challenges women hospitalists face at the local level revolve around the schedule. That’s how Zenobia JonesFoster, MD, MPH, a hospitalist at Wellstar Health in Atlanta, views it.

“I think it’s very facility-dependent. I think when we look for a job and decide where we want to go, we really need to understand the culture and how people advance within that culture,” said Dr. JonesFoster, who attended the women’s issues workshop. “The academic environment has a lot more deferred policy and bureaucracy versus a private institution, but you’re going to find that anywhere.”

A hospitalist for a little more than two years, Dr. JonesFoster has two young children, ages one and three, and works in a group with 30 full-time hospitalists and 10 nurse practitioners and physician assistants. Her husband is a businessman, so schedules and work-life balance are a major concern.

“If I was given a job opportunity Monday through Friday, regular work hours, there’s no way I would take it because of the flexibility of hospital medicine hours, with the seven-on seven-off schedule,” she said. “The time I have off, I get to just be a mom and not think about work. But when I’m at work, I love it.”

Dr. JonesFoster’s group has seen an increase in patient census recently and just went live with a new hospital-wide electronic health records system, which has opened up more shifts and moonlighting opportunities. Attending her first annual meeting, she was most interested in learning the pros and cons of leadership positions, because her health system “offers a lot of opportunity for advancement” and is “talking about adding a residency program.”

“Another thing I wanted to learn about was mentorship,” she said. “I wanted to meet women who have done this before, who have had children, who are working full-time trying to do a little bit of everything. I wanted to see how they did it and try and learn from their experiences.”

From all accounts, mission accomplished.

Richard Quinn is a freelance writer in New Jersey.

New research has found that hospital-onset Clostridium difficile infections increase length of stay (LOS), risk of in-hospital mortality, and hospital costs for inpatients with sepsis.

Authors of a new study titled, "The Impact of Hospital-onset Clostridium difficile Infection on Outcomes of Hospitalized Patients with Sepsis," report that after multivariate adjustment, in-hospital mortality rate was 24% for patients with sepsis who develop C. diff infections, versus 15% of inpatient controls, according to the paper that was published online in the Journal of Hospital Medicine earlier this month. Adjusted LOS among cases with C. diff was 5.1 days longer than controls (95% confidence interval: 4.4–5.8), and the median-adjusted cost increase was $4,916 (P<0.001).

"Big numbers, but I'm actually not surprised," says lead author Tara Lagu, MD, MPH, a hospitalist at the Center for Quality of Care Research at Baystate Medical Center in Springfield, Mass. "I know that it happens, because I see it all the time."

Dr. Lagu says that when a patient is on day four of five of a stay for sepsis and develops diarrhea, precautions and treatment will last a minimum of three days, which drives up LOS and cost of care.

In the report, Dr. Lagu did not compare the cost-effectiveness of C. diff prevention programs aimed at sepsis patients, but she's hopeful that is how physicians will use the data.

"I'm just suggesting that if, as a hospital, you're trying to figure out if your program is worth it, think about these numbers in terms of prevention,” she says. "If it looks like the cost is worth it, then you should keep doing what you're doing. If not, then maybe you should do something different if you're not preventing enough cases."

Visit our website for more information on preventing, managing C. diff infections.

 

 

New research has found that hospital-onset Clostridium difficile infections increase length of stay (LOS), risk of in-hospital mortality, and hospital costs for inpatients with sepsis.

Authors of a new study titled, "The Impact of Hospital-onset Clostridium difficile Infection on Outcomes of Hospitalized Patients with Sepsis," report that after multivariate adjustment, in-hospital mortality rate was 24% for patients with sepsis who develop C. diff infections, versus 15% of inpatient controls, according to the paper that was published online in the Journal of Hospital Medicine earlier this month. Adjusted LOS among cases with C. diff was 5.1 days longer than controls (95% confidence interval: 4.4–5.8), and the median-adjusted cost increase was $4,916 (P<0.001).

"Big numbers, but I'm actually not surprised," says lead author Tara Lagu, MD, MPH, a hospitalist at the Center for Quality of Care Research at Baystate Medical Center in Springfield, Mass. "I know that it happens, because I see it all the time."

Dr. Lagu says that when a patient is on day four of five of a stay for sepsis and develops diarrhea, precautions and treatment will last a minimum of three days, which drives up LOS and cost of care.

In the report, Dr. Lagu did not compare the cost-effectiveness of C. diff prevention programs aimed at sepsis patients, but she's hopeful that is how physicians will use the data.

"I'm just suggesting that if, as a hospital, you're trying to figure out if your program is worth it, think about these numbers in terms of prevention,” she says. "If it looks like the cost is worth it, then you should keep doing what you're doing. If not, then maybe you should do something different if you're not preventing enough cases."

Visit our website for more information on preventing, managing C. diff infections.

 

 

New research has found that hospital-onset Clostridium difficile infections increase length of stay (LOS), risk of in-hospital mortality, and hospital costs for inpatients with sepsis.

Authors of a new study titled, "The Impact of Hospital-onset Clostridium difficile Infection on Outcomes of Hospitalized Patients with Sepsis," report that after multivariate adjustment, in-hospital mortality rate was 24% for patients with sepsis who develop C. diff infections, versus 15% of inpatient controls, according to the paper that was published online in the Journal of Hospital Medicine earlier this month. Adjusted LOS among cases with C. diff was 5.1 days longer than controls (95% confidence interval: 4.4–5.8), and the median-adjusted cost increase was $4,916 (P<0.001).

"Big numbers, but I'm actually not surprised," says lead author Tara Lagu, MD, MPH, a hospitalist at the Center for Quality of Care Research at Baystate Medical Center in Springfield, Mass. "I know that it happens, because I see it all the time."

Dr. Lagu says that when a patient is on day four of five of a stay for sepsis and develops diarrhea, precautions and treatment will last a minimum of three days, which drives up LOS and cost of care.

In the report, Dr. Lagu did not compare the cost-effectiveness of C. diff prevention programs aimed at sepsis patients, but she's hopeful that is how physicians will use the data.

"I'm just suggesting that if, as a hospital, you're trying to figure out if your program is worth it, think about these numbers in terms of prevention,” she says. "If it looks like the cost is worth it, then you should keep doing what you're doing. If not, then maybe you should do something different if you're not preventing enough cases."

Visit our website for more information on preventing, managing C. diff infections.

 

 

Congress has once again delayed implementation of draconian Medicare cuts tied to the sustainable growth rate (SGR) formula, but this time, the vote by lawmakers to patch the ailing physician reimbursement program rather than scrap it also pushes back the pending debut of ICD-10.

And that's frustrating some hospitalists.

"For about 12 hours, I felt relief about the ICD-10 and then I just realized, it's still coming, presumably," says John Nelson, MD, MHM, a co-founder and past president of SHM and medical director of the hospitalist practice at Overlake Hospital in Bellevue, Wash. "[It's] like a patient who needs surgery and finds out it's canceled for the day and he'll have it tomorrow. Well, that's good for right now, but [he] still has to face this eventually."

The SGR extension through year's end means that physicians do not face a 24% cut to physician payments under Medicare. The delay in transitioning healthcare providers from the ICD-9 medical coding classification system to the more complicated ICD-10 could mean the upgraded system may not go into effect until at least Oct. 1, 2015. This comes after the Centers for Medicare & Medicaid Services already pushed back the original implementation date for ICD-10 by one year.

SHM Public Policy Committee member Joshua Lenchus, DO, RPh, SFHM, says he expects the majority of doctors to be content with the delay, particularly in light of some estimates that show only 20% or so of physicians "have actually initiated the ICD-10 transition," but that it's unfair to those health systems that have prepared.

"ICD-9 has a little more than 14,000 diagnostic codes and nearly 4,000 procedural codes. That is to be contrasted to ICD-10, which has more than 68,000 diagnostic codes...and over 72,000 procedural codes," Dr. Lenchus writes in an e-mail to The Hospitalist's eWire. "So, it is not surprising that many take solace in the delay."

"It's distressing and frustrating for hospitalists, but less disruptive than it might be for hospitals," Dr. Nelson says. "And, of course in some places, hospitalists may be the physician leads on ICD-10 efforts, so [they are] very much wrapped up in the problem of 'What do we do now?'"

 

Visit our website for more information about ICD-10.

 

 

Congress has once again delayed implementation of draconian Medicare cuts tied to the sustainable growth rate (SGR) formula, but this time, the vote by lawmakers to patch the ailing physician reimbursement program rather than scrap it also pushes back the pending debut of ICD-10.

And that's frustrating some hospitalists.

"For about 12 hours, I felt relief about the ICD-10 and then I just realized, it's still coming, presumably," says John Nelson, MD, MHM, a co-founder and past president of SHM and medical director of the hospitalist practice at Overlake Hospital in Bellevue, Wash. "[It's] like a patient who needs surgery and finds out it's canceled for the day and he'll have it tomorrow. Well, that's good for right now, but [he] still has to face this eventually."

The SGR extension through year's end means that physicians do not face a 24% cut to physician payments under Medicare. The delay in transitioning healthcare providers from the ICD-9 medical coding classification system to the more complicated ICD-10 could mean the upgraded system may not go into effect until at least Oct. 1, 2015. This comes after the Centers for Medicare & Medicaid Services already pushed back the original implementation date for ICD-10 by one year.

SHM Public Policy Committee member Joshua Lenchus, DO, RPh, SFHM, says he expects the majority of doctors to be content with the delay, particularly in light of some estimates that show only 20% or so of physicians "have actually initiated the ICD-10 transition," but that it's unfair to those health systems that have prepared.

"ICD-9 has a little more than 14,000 diagnostic codes and nearly 4,000 procedural codes. That is to be contrasted to ICD-10, which has more than 68,000 diagnostic codes...and over 72,000 procedural codes," Dr. Lenchus writes in an e-mail to The Hospitalist's eWire. "So, it is not surprising that many take solace in the delay."

"It's distressing and frustrating for hospitalists, but less disruptive than it might be for hospitals," Dr. Nelson says. "And, of course in some places, hospitalists may be the physician leads on ICD-10 efforts, so [they are] very much wrapped up in the problem of 'What do we do now?'"

 

Visit our website for more information about ICD-10.

 

 

Congress has once again delayed implementation of draconian Medicare cuts tied to the sustainable growth rate (SGR) formula, but this time, the vote by lawmakers to patch the ailing physician reimbursement program rather than scrap it also pushes back the pending debut of ICD-10.

And that's frustrating some hospitalists.

"For about 12 hours, I felt relief about the ICD-10 and then I just realized, it's still coming, presumably," says John Nelson, MD, MHM, a co-founder and past president of SHM and medical director of the hospitalist practice at Overlake Hospital in Bellevue, Wash. "[It's] like a patient who needs surgery and finds out it's canceled for the day and he'll have it tomorrow. Well, that's good for right now, but [he] still has to face this eventually."

The SGR extension through year's end means that physicians do not face a 24% cut to physician payments under Medicare. The delay in transitioning healthcare providers from the ICD-9 medical coding classification system to the more complicated ICD-10 could mean the upgraded system may not go into effect until at least Oct. 1, 2015. This comes after the Centers for Medicare & Medicaid Services already pushed back the original implementation date for ICD-10 by one year.

SHM Public Policy Committee member Joshua Lenchus, DO, RPh, SFHM, says he expects the majority of doctors to be content with the delay, particularly in light of some estimates that show only 20% or so of physicians "have actually initiated the ICD-10 transition," but that it's unfair to those health systems that have prepared.

"ICD-9 has a little more than 14,000 diagnostic codes and nearly 4,000 procedural codes. That is to be contrasted to ICD-10, which has more than 68,000 diagnostic codes...and over 72,000 procedural codes," Dr. Lenchus writes in an e-mail to The Hospitalist's eWire. "So, it is not surprising that many take solace in the delay."

"It's distressing and frustrating for hospitalists, but less disruptive than it might be for hospitals," Dr. Nelson says. "And, of course in some places, hospitalists may be the physician leads on ICD-10 efforts, so [they are] very much wrapped up in the problem of 'What do we do now?'"

 

Visit our website for more information about ICD-10.

 

 

Jairy Hunter III, MD, MBA, SFHM, was restless and wondering if office-based practice was the right career choice for him. He’d already worked as an ED tech during medical school, as an emergency physician for a few years after that, and as a family practitioner for a little more than five years.

Lucky for him, hospital medicine was taking root in his neck of the woods.

“Looking back, I realize that, at that point, I was interested in doing something different, and in becoming a leader in a new setting,” says Dr. Hunter, one of the newest members of Team Hospitalist, the volunteer editorial advisory group for The Hospitalist.

More than a decade later, Dr. Hunter is doing what he loves—acting as the “go-to guy” for coordination of care. He’s gravitated toward a career in leadership, serving 10 years as medical director of a hospitalist group in his native Charleston, S.C. and, since September 2012, as associate executive medical director for case management and care transitions at the Medical University of South Carolina (MUSC), also in Charleston. His titles include assistant professor in the department of family medicine at MUSC.

“We are the ‘details’ people,” he says. “The people who know how to get things done and maneuver efficiently through hospital systems.”

Question: What’s the biggest change you’ve seen in HM in your career?

Answer: Specialties like hospital medicine have become a sort of training ground for physicians in leadership. A lot of us were "thrust" into these positions, so to speak, with little background or training in how to be a leader. For example, I thought in order to be a physician leader, I had to work harder than everyone else, and I had to be the best doctor in the group. Let me tell you, most people will fail those tests almost every time! I think we are seeing many more hospitalists move into administrative roles along career paths like mine. It seems to be a natural fit, and I think that's very exciting.

Q: What do you dislike most about the job?

A: The disjointed scheduling patterns that many programs have in place. I feel too many programs think it’s too hard to create scheduling formats that foster longevity. I also dislike the fact that some hospitalists are on their way to somewhere else, such as fellowship or other careers. They don’t involve themselves in making the hospital better, improving the patient experience, or taking ownership of the job as a group member.

Q: What’s the best advice you ever received?

A: Say “yes” as often as possible. That’s also the best advice I received when I became a dad.

Q: Why is it important for group leaders to continue seeing patients?

A: To maintain the sense of shared experience and to sustain credibility amongst your hospitalist and medical staff colleagues. In addition, medicine is our calling. We should never be so far away from it as to lose touch with patients and what we do best.

Q: Outside of patient care, what are your career interests?

A: I’m very interested in physicians in leadership. I recently changed from a large, for-profit entity to an academic medical center, so I’ve increased the amount of teaching from basically zero to about 25% of my time. I found that I really enjoy interacting with young physicians. My current role has responsibility for a number of administrative projects—specifically, several dealing with readmissions, EHR implementation, and collaborating with our outpatient physician affiliates. I find the business side of medicine interesting and surprisingly exciting, in that we are now challenged with figuring out how to maintain and improve quality care and efficient patient flow, while economic constraints are a reality.

 

Q: What is your biggest professional challenge?

A: Finding avenues and opportunities for advancing my career in leadership. In the organization I formerly worked for, there were few opportunities for physicians to move upward. There was very little space for advancement. Earning an advanced degree, putting my CV out on the wire, and having the courage to break with an entity where I had worked for 15-plus years was a challenge.

Q: What is your biggest professional reward?

A: Learning under a number of mentors (physicians and non-physicians, clinical and business-oriented), working with over 100 hospitalists in my career, and being able to mentor them as well. Having been given an opportunity as an administrative leader and being trusted to create solutions and collaborate with a lot of groups in my current job, using my experience as a physician and my interest in the business of healthcare, has been extremely rewarding.

Q: What does it mean to be designated a Senior Fellow in Hospital Medicine?

A: I felt gratified to receive recognition for my career path and commitment to a vision that has developed into a thriving, essential force in medicine. Hopefully, I have contributed—and will continue to contribute—to that growth in some small way.

Q: When you aren’t working, what is important to you?

A: Family, photography, music, technology, and gadgets.

Q: Where do you see yourself in 10 years?

A: I currently am enjoying a new role and testing new responsibilities and opportunities for growth as they are presented. I’ve discovered an interest in teaching, both of perceptive young physicians and physicians-in-training. I have terrific mentors who continue to provide constructive feedback and guidance. I want to see where this leads. I find that I really enjoy mentoring and working with young people.

Q: If you weren’t a doctor, what would you be doing right now?

A: I’d either be a professional photographer or a writer—maybe a graphic designer.

Q: What’s the best book you’ve read recently?

A: Special Topics in Calamity Physics by Marisha Pessl. It is hilarious and witty and offers a unique writing style and unexpected turns. Richard Ford’s latest book, Canada. Anything by Ford is a “must."

Q: How many Apple products do you interface with in a given week?

A: About 20.

Q: What’s next in your iTunes queue?

A: Probably something by Matthew Sweet I have a threshold of about five minutes before I usually work my love for his music into a conversation.

---

Richard Quinn is a freelance writer in New Jersey.

Jairy Hunter III, MD, MBA, SFHM, was restless and wondering if office-based practice was the right career choice for him. He’d already worked as an ED tech during medical school, as an emergency physician for a few years after that, and as a family practitioner for a little more than five years.

Lucky for him, hospital medicine was taking root in his neck of the woods.

“Looking back, I realize that, at that point, I was interested in doing something different, and in becoming a leader in a new setting,” says Dr. Hunter, one of the newest members of Team Hospitalist, the volunteer editorial advisory group for The Hospitalist.

More than a decade later, Dr. Hunter is doing what he loves—acting as the “go-to guy” for coordination of care. He’s gravitated toward a career in leadership, serving 10 years as medical director of a hospitalist group in his native Charleston, S.C. and, since September 2012, as associate executive medical director for case management and care transitions at the Medical University of South Carolina (MUSC), also in Charleston. His titles include assistant professor in the department of family medicine at MUSC.

“We are the ‘details’ people,” he says. “The people who know how to get things done and maneuver efficiently through hospital systems.”

Question: What’s the biggest change you’ve seen in HM in your career?

Answer: Specialties like hospital medicine have become a sort of training ground for physicians in leadership. A lot of us were "thrust" into these positions, so to speak, with little background or training in how to be a leader. For example, I thought in order to be a physician leader, I had to work harder than everyone else, and I had to be the best doctor in the group. Let me tell you, most people will fail those tests almost every time! I think we are seeing many more hospitalists move into administrative roles along career paths like mine. It seems to be a natural fit, and I think that's very exciting.

Q: What do you dislike most about the job?

A: The disjointed scheduling patterns that many programs have in place. I feel too many programs think it’s too hard to create scheduling formats that foster longevity. I also dislike the fact that some hospitalists are on their way to somewhere else, such as fellowship or other careers. They don’t involve themselves in making the hospital better, improving the patient experience, or taking ownership of the job as a group member.

Q: What’s the best advice you ever received?

A: Say “yes” as often as possible. That’s also the best advice I received when I became a dad.

Q: Why is it important for group leaders to continue seeing patients?

A: To maintain the sense of shared experience and to sustain credibility amongst your hospitalist and medical staff colleagues. In addition, medicine is our calling. We should never be so far away from it as to lose touch with patients and what we do best.

Q: Outside of patient care, what are your career interests?

A: I’m very interested in physicians in leadership. I recently changed from a large, for-profit entity to an academic medical center, so I’ve increased the amount of teaching from basically zero to about 25% of my time. I found that I really enjoy interacting with young physicians. My current role has responsibility for a number of administrative projects—specifically, several dealing with readmissions, EHR implementation, and collaborating with our outpatient physician affiliates. I find the business side of medicine interesting and surprisingly exciting, in that we are now challenged with figuring out how to maintain and improve quality care and efficient patient flow, while economic constraints are a reality.

 

Q: What is your biggest professional challenge?

A: Finding avenues and opportunities for advancing my career in leadership. In the organization I formerly worked for, there were few opportunities for physicians to move upward. There was very little space for advancement. Earning an advanced degree, putting my CV out on the wire, and having the courage to break with an entity where I had worked for 15-plus years was a challenge.

Q: What is your biggest professional reward?

A: Learning under a number of mentors (physicians and non-physicians, clinical and business-oriented), working with over 100 hospitalists in my career, and being able to mentor them as well. Having been given an opportunity as an administrative leader and being trusted to create solutions and collaborate with a lot of groups in my current job, using my experience as a physician and my interest in the business of healthcare, has been extremely rewarding.

Q: What does it mean to be designated a Senior Fellow in Hospital Medicine?

A: I felt gratified to receive recognition for my career path and commitment to a vision that has developed into a thriving, essential force in medicine. Hopefully, I have contributed—and will continue to contribute—to that growth in some small way.

Q: When you aren’t working, what is important to you?

A: Family, photography, music, technology, and gadgets.

Q: Where do you see yourself in 10 years?

A: I currently am enjoying a new role and testing new responsibilities and opportunities for growth as they are presented. I’ve discovered an interest in teaching, both of perceptive young physicians and physicians-in-training. I have terrific mentors who continue to provide constructive feedback and guidance. I want to see where this leads. I find that I really enjoy mentoring and working with young people.

Q: If you weren’t a doctor, what would you be doing right now?

A: I’d either be a professional photographer or a writer—maybe a graphic designer.

Q: What’s the best book you’ve read recently?

A: Special Topics in Calamity Physics by Marisha Pessl. It is hilarious and witty and offers a unique writing style and unexpected turns. Richard Ford’s latest book, Canada. Anything by Ford is a “must."

Q: How many Apple products do you interface with in a given week?

A: About 20.

Q: What’s next in your iTunes queue?

A: Probably something by Matthew Sweet I have a threshold of about five minutes before I usually work my love for his music into a conversation.

---

Richard Quinn is a freelance writer in New Jersey.

Jairy Hunter III, MD, MBA, SFHM, was restless and wondering if office-based practice was the right career choice for him. He’d already worked as an ED tech during medical school, as an emergency physician for a few years after that, and as a family practitioner for a little more than five years.

Lucky for him, hospital medicine was taking root in his neck of the woods.

“Looking back, I realize that, at that point, I was interested in doing something different, and in becoming a leader in a new setting,” says Dr. Hunter, one of the newest members of Team Hospitalist, the volunteer editorial advisory group for The Hospitalist.

More than a decade later, Dr. Hunter is doing what he loves—acting as the “go-to guy” for coordination of care. He’s gravitated toward a career in leadership, serving 10 years as medical director of a hospitalist group in his native Charleston, S.C. and, since September 2012, as associate executive medical director for case management and care transitions at the Medical University of South Carolina (MUSC), also in Charleston. His titles include assistant professor in the department of family medicine at MUSC.

“We are the ‘details’ people,” he says. “The people who know how to get things done and maneuver efficiently through hospital systems.”

Question: What’s the biggest change you’ve seen in HM in your career?

Answer: Specialties like hospital medicine have become a sort of training ground for physicians in leadership. A lot of us were "thrust" into these positions, so to speak, with little background or training in how to be a leader. For example, I thought in order to be a physician leader, I had to work harder than everyone else, and I had to be the best doctor in the group. Let me tell you, most people will fail those tests almost every time! I think we are seeing many more hospitalists move into administrative roles along career paths like mine. It seems to be a natural fit, and I think that's very exciting.

Q: What do you dislike most about the job?

A: The disjointed scheduling patterns that many programs have in place. I feel too many programs think it’s too hard to create scheduling formats that foster longevity. I also dislike the fact that some hospitalists are on their way to somewhere else, such as fellowship or other careers. They don’t involve themselves in making the hospital better, improving the patient experience, or taking ownership of the job as a group member.

Q: What’s the best advice you ever received?

A: Say “yes” as often as possible. That’s also the best advice I received when I became a dad.

Q: Why is it important for group leaders to continue seeing patients?

A: To maintain the sense of shared experience and to sustain credibility amongst your hospitalist and medical staff colleagues. In addition, medicine is our calling. We should never be so far away from it as to lose touch with patients and what we do best.

Q: Outside of patient care, what are your career interests?

A: I’m very interested in physicians in leadership. I recently changed from a large, for-profit entity to an academic medical center, so I’ve increased the amount of teaching from basically zero to about 25% of my time. I found that I really enjoy interacting with young physicians. My current role has responsibility for a number of administrative projects—specifically, several dealing with readmissions, EHR implementation, and collaborating with our outpatient physician affiliates. I find the business side of medicine interesting and surprisingly exciting, in that we are now challenged with figuring out how to maintain and improve quality care and efficient patient flow, while economic constraints are a reality.

 

Q: What is your biggest professional challenge?

A: Finding avenues and opportunities for advancing my career in leadership. In the organization I formerly worked for, there were few opportunities for physicians to move upward. There was very little space for advancement. Earning an advanced degree, putting my CV out on the wire, and having the courage to break with an entity where I had worked for 15-plus years was a challenge.

Q: What is your biggest professional reward?

A: Learning under a number of mentors (physicians and non-physicians, clinical and business-oriented), working with over 100 hospitalists in my career, and being able to mentor them as well. Having been given an opportunity as an administrative leader and being trusted to create solutions and collaborate with a lot of groups in my current job, using my experience as a physician and my interest in the business of healthcare, has been extremely rewarding.

Q: What does it mean to be designated a Senior Fellow in Hospital Medicine?

A: I felt gratified to receive recognition for my career path and commitment to a vision that has developed into a thriving, essential force in medicine. Hopefully, I have contributed—and will continue to contribute—to that growth in some small way.

Q: When you aren’t working, what is important to you?

A: Family, photography, music, technology, and gadgets.

Q: Where do you see yourself in 10 years?

A: I currently am enjoying a new role and testing new responsibilities and opportunities for growth as they are presented. I’ve discovered an interest in teaching, both of perceptive young physicians and physicians-in-training. I have terrific mentors who continue to provide constructive feedback and guidance. I want to see where this leads. I find that I really enjoy mentoring and working with young people.

Q: If you weren’t a doctor, what would you be doing right now?

A: I’d either be a professional photographer or a writer—maybe a graphic designer.

Q: What’s the best book you’ve read recently?

A: Special Topics in Calamity Physics by Marisha Pessl. It is hilarious and witty and offers a unique writing style and unexpected turns. Richard Ford’s latest book, Canada. Anything by Ford is a “must."

Q: How many Apple products do you interface with in a given week?

A: About 20.

Q: What’s next in your iTunes queue?

A: Probably something by Matthew Sweet I have a threshold of about five minutes before I usually work my love for his music into a conversation.

---

Richard Quinn is a freelance writer in New Jersey.

LAS VEGAS—Newly minted SHM President Burke Kealey, MD, SFHM, wants hospitalists to change how they look at health-care affordability, patient health, and the patient experience: He wants you to view them as one thing, not three. 

“We put the energy and the effort of the moment behind the squeaky wheel,” Dr. Kealey said in his inaugural address Wednesday at the Mandalay Bay Resort and Casino. “What I would like us to do is all start thinking about all three at the same time, and with equal weight at all times. To me, this is the next evolution of the hospitalist.”

Dr. Kealey, medical director of hospital specialties at HealthPartners Medical Group in St. Paul, Minn., borrowed the approach from the Institute of Healthcare Improvement, whose “Triple Aim” initiative has the same goals. In his address, he told HM14 attendees that to focus on any of the three areas while giving short shrift to the others misses the point of bettering the overall health-care system.

“To improve health, but then people can’t afford that health care, is a nonstarter,” he said. “To make things finally affordable, but then people stay away because it’s a bad experience, makes no sense, either. We must do it all together.”

Dr. Kealey, who replaces Eric Howell, MD, SFHM, as president for the next year, says that as value-based purchasing further connects cost of care to the quality of delivery, hospitalists who link health, experience, and affordability will have success.

“This movement goes beyond just improving scores,” he says. “It improves the health of our patients.”

LAS VEGAS—Newly minted SHM President Burke Kealey, MD, SFHM, wants hospitalists to change how they look at health-care affordability, patient health, and the patient experience: He wants you to view them as one thing, not three. 

“We put the energy and the effort of the moment behind the squeaky wheel,” Dr. Kealey said in his inaugural address Wednesday at the Mandalay Bay Resort and Casino. “What I would like us to do is all start thinking about all three at the same time, and with equal weight at all times. To me, this is the next evolution of the hospitalist.”

Dr. Kealey, medical director of hospital specialties at HealthPartners Medical Group in St. Paul, Minn., borrowed the approach from the Institute of Healthcare Improvement, whose “Triple Aim” initiative has the same goals. In his address, he told HM14 attendees that to focus on any of the three areas while giving short shrift to the others misses the point of bettering the overall health-care system.

“To improve health, but then people can’t afford that health care, is a nonstarter,” he said. “To make things finally affordable, but then people stay away because it’s a bad experience, makes no sense, either. We must do it all together.”

Dr. Kealey, who replaces Eric Howell, MD, SFHM, as president for the next year, says that as value-based purchasing further connects cost of care to the quality of delivery, hospitalists who link health, experience, and affordability will have success.

“This movement goes beyond just improving scores,” he says. “It improves the health of our patients.”

LAS VEGAS—Newly minted SHM President Burke Kealey, MD, SFHM, wants hospitalists to change how they look at health-care affordability, patient health, and the patient experience: He wants you to view them as one thing, not three. 

“We put the energy and the effort of the moment behind the squeaky wheel,” Dr. Kealey said in his inaugural address Wednesday at the Mandalay Bay Resort and Casino. “What I would like us to do is all start thinking about all three at the same time, and with equal weight at all times. To me, this is the next evolution of the hospitalist.”

Dr. Kealey, medical director of hospital specialties at HealthPartners Medical Group in St. Paul, Minn., borrowed the approach from the Institute of Healthcare Improvement, whose “Triple Aim” initiative has the same goals. In his address, he told HM14 attendees that to focus on any of the three areas while giving short shrift to the others misses the point of bettering the overall health-care system.

“To improve health, but then people can’t afford that health care, is a nonstarter,” he said. “To make things finally affordable, but then people stay away because it’s a bad experience, makes no sense, either. We must do it all together.”

Dr. Kealey, who replaces Eric Howell, MD, SFHM, as president for the next year, says that as value-based purchasing further connects cost of care to the quality of delivery, hospitalists who link health, experience, and affordability will have success.

“This movement goes beyond just improving scores,” he says. “It improves the health of our patients.”

LAS VEGAS—Hospitalist Jennifer Johnson, MD, knows exactly where she’ll be at noon today: sitting in a banquet chair listening to “the father of hospital medicine,” Bob Wachter, MD, MHM, give his annual meeting address.

When you work in technology, “you don’t get to listen to Bill Gates talk,” says Dr. Johnson, who practices at Aurora Medical Center in Grafton, Wis. “It’s one of the few times you get to be in the same room with and hear how the real people at the forefront are thinking. I think that’s very helpful.”

Dr. Johnson, who last heard Dr. Wachter speak at HM12 in San Diego, says she relishes his vision, which goes beyond what most hospitalists’ day-to-day duties encompass.

“No matter what your vocation is, it’s always good to be reminded what more you could do,” she says. “How better you could improve yourself. Instead of stagnating…there’s always a next level, a next step. He’s the guy who thinks that way.”

She’s not alone in that view. Dr. Wachter’s presentation has become a rite of SHM’s annual meeting and an unofficial wrap-up of the four-day convention. This year’s edition is titled “Ten Years of Wachter Keynote: And Now For Something Completely Different.”

Sunil Kartham, MD, a hospitalist at Altru Health System in Grand Forks, N.D., spoke with Dr. Wachter earlier this week, as he wasn’t sure he could stay long enough for the formal address. But whether it’s Dr. Wachter or any of the keynote speakers, Dr. Kartham enjoys hearing HM’s leaders give advice.

“When you’re individual physicians,” he says, “you don’t know what to expect in the future. When the leaders come and speak, they lay out a map for you…so you can prepare yourself.”

For his part, Dr. Wachter has been priming the crowd for his talk. Earlier this week, he tweeted about his talk: “last 6 min wil b highlight (or lowlite) of conf, posibly of my life.”

LAS VEGAS—Hospitalist Jennifer Johnson, MD, knows exactly where she’ll be at noon today: sitting in a banquet chair listening to “the father of hospital medicine,” Bob Wachter, MD, MHM, give his annual meeting address.

When you work in technology, “you don’t get to listen to Bill Gates talk,” says Dr. Johnson, who practices at Aurora Medical Center in Grafton, Wis. “It’s one of the few times you get to be in the same room with and hear how the real people at the forefront are thinking. I think that’s very helpful.”

Dr. Johnson, who last heard Dr. Wachter speak at HM12 in San Diego, says she relishes his vision, which goes beyond what most hospitalists’ day-to-day duties encompass.

“No matter what your vocation is, it’s always good to be reminded what more you could do,” she says. “How better you could improve yourself. Instead of stagnating…there’s always a next level, a next step. He’s the guy who thinks that way.”

She’s not alone in that view. Dr. Wachter’s presentation has become a rite of SHM’s annual meeting and an unofficial wrap-up of the four-day convention. This year’s edition is titled “Ten Years of Wachter Keynote: And Now For Something Completely Different.”

Sunil Kartham, MD, a hospitalist at Altru Health System in Grand Forks, N.D., spoke with Dr. Wachter earlier this week, as he wasn’t sure he could stay long enough for the formal address. But whether it’s Dr. Wachter or any of the keynote speakers, Dr. Kartham enjoys hearing HM’s leaders give advice.

“When you’re individual physicians,” he says, “you don’t know what to expect in the future. When the leaders come and speak, they lay out a map for you…so you can prepare yourself.”

For his part, Dr. Wachter has been priming the crowd for his talk. Earlier this week, he tweeted about his talk: “last 6 min wil b highlight (or lowlite) of conf, posibly of my life.”

LAS VEGAS—Hospitalist Jennifer Johnson, MD, knows exactly where she’ll be at noon today: sitting in a banquet chair listening to “the father of hospital medicine,” Bob Wachter, MD, MHM, give his annual meeting address.

When you work in technology, “you don’t get to listen to Bill Gates talk,” says Dr. Johnson, who practices at Aurora Medical Center in Grafton, Wis. “It’s one of the few times you get to be in the same room with and hear how the real people at the forefront are thinking. I think that’s very helpful.”

Dr. Johnson, who last heard Dr. Wachter speak at HM12 in San Diego, says she relishes his vision, which goes beyond what most hospitalists’ day-to-day duties encompass.

“No matter what your vocation is, it’s always good to be reminded what more you could do,” she says. “How better you could improve yourself. Instead of stagnating…there’s always a next level, a next step. He’s the guy who thinks that way.”

She’s not alone in that view. Dr. Wachter’s presentation has become a rite of SHM’s annual meeting and an unofficial wrap-up of the four-day convention. This year’s edition is titled “Ten Years of Wachter Keynote: And Now For Something Completely Different.”

Sunil Kartham, MD, a hospitalist at Altru Health System in Grand Forks, N.D., spoke with Dr. Wachter earlier this week, as he wasn’t sure he could stay long enough for the formal address. But whether it’s Dr. Wachter or any of the keynote speakers, Dr. Kartham enjoys hearing HM’s leaders give advice.

“When you’re individual physicians,” he says, “you don’t know what to expect in the future. When the leaders come and speak, they lay out a map for you…so you can prepare yourself.”

For his part, Dr. Wachter has been priming the crowd for his talk. Earlier this week, he tweeted about his talk: “last 6 min wil b highlight (or lowlite) of conf, posibly of my life.”

LAS VEGAS—For three hospitalists at SHM's annual meeting at the Mandalay Bay Resort and Casino, today will be a masterful day. Patrick Conway, MD, MSc, FAAP, MHM, Steven Pantilat, MD, MHM, and Jack Percelay, MD, MPH, MHM, will be designated Masters in Hospital Medicine (MHM), the growing cadre of hospitalists who have attained SHM’s highest rank. Sixteen hospitalists have attained the MHM designation. The 2014 designees will be honored on stage today during ceremonies that include the announcement of all of SHM’s new fellows and SHM’s Annual Awards of Excellence.

"If you look at the previous MHM recipients, you see the pantheon of hospital medicine—an incredible group of individuals committed to improving the healthcare system and the care of patients," Dr. Pantilat wrote in an email to The Hospitalist eWire. "This designation recognizes that there are people who have made tremendous contributions to the field, and to changing the way we care for patients."

Dr. Pantilat, who was also a member of the inaugural class of Senior Fellows in Hospital Medicine (SFHM), is a professor of medicine in the department of medicine at the University of California at San Francisco (UCSF). He’s the founding director of the UCSF Palliative Care Program and serves as director of its Leadership Center, which trains hospitalists nationwide about how to establish palliative-care services. He is also a former SHM board member and the first recipient of the SHM Excellence in Teaching Award.

"I've never been a master of anything and despite my increasing age, somehow still feel too young to be a master," Dr. Pantilat adds. "Being bestowed with this highest honor in hospital medicine definitely ranks at the top."

Dr. Conway is used to being honored, but he says he still is humbled by the designation. As a former chairman of SHM's Public Policy Committee and the current chief medical officer for the Centers for Medicare & Medicaid Services (CMS) and its deputy administrator for innovation and quality, Dr. Conway is well known—and lauded—for giving HM a voice in Washington, D.C. He views his MHM as the latest sign that his specialty continues to grow and spur positive change in health-care delivery.

"I think the designation demonstrates that hospital medicine is a maturing specialty with strong leaders," he wrote in an email. "In addition, when you look at the current and former masters…it is a stellar group of leaders who are not only advancing hospital medicine, but also changing the face of health care across our nation and improving our health system."

Dr. Percelay is so humbled that he brought his wife, daughter, and mother with him to celebrate the moment. He’s also particularly honored that he and Dr. Conway represent the field of pediatric HM, which he believes has grown tremendously in reputation over the course of his career.

"We've been able to build upon the successes of adult hospital medicine and nurture the inherent 'playing nice in the sandbox' attitude of pediatrics to grow the discipline and work force to the point it's at now where pediatric hospitalists are seen as the experts and innovators for high value pediatric inpatient care," he wrote in an email.

Dr. Percelay is a hospitalist in the pediatric ICU at Saint Barnabas Medical Center in Livingston, N.J., and teaches in the department of physician studies at Pace University of College of Health Professions in New York. He was the founding chairman for the American Academy of Pediatrics Section on Hospital Medicine, an SHM board member from 2005 to 2012, and an associate editor of the Journal of Hospital Medicine. He says attaining the rank of master ranks just behind “being my daughter's father" on his list of personal accomplishments.

 

"I've received scholarships in high school, college, and medical school, but those acknowledged at most four years of work," he writes. "This award recognizes 20-plus years of work practicing as a pediatric hospitalist in community settings, caring for children and their families, and contributing to the field as a whole."

LAS VEGAS—For three hospitalists at SHM's annual meeting at the Mandalay Bay Resort and Casino, today will be a masterful day. Patrick Conway, MD, MSc, FAAP, MHM, Steven Pantilat, MD, MHM, and Jack Percelay, MD, MPH, MHM, will be designated Masters in Hospital Medicine (MHM), the growing cadre of hospitalists who have attained SHM’s highest rank. Sixteen hospitalists have attained the MHM designation. The 2014 designees will be honored on stage today during ceremonies that include the announcement of all of SHM’s new fellows and SHM’s Annual Awards of Excellence.

"If you look at the previous MHM recipients, you see the pantheon of hospital medicine—an incredible group of individuals committed to improving the healthcare system and the care of patients," Dr. Pantilat wrote in an email to The Hospitalist eWire. "This designation recognizes that there are people who have made tremendous contributions to the field, and to changing the way we care for patients."

Dr. Pantilat, who was also a member of the inaugural class of Senior Fellows in Hospital Medicine (SFHM), is a professor of medicine in the department of medicine at the University of California at San Francisco (UCSF). He’s the founding director of the UCSF Palliative Care Program and serves as director of its Leadership Center, which trains hospitalists nationwide about how to establish palliative-care services. He is also a former SHM board member and the first recipient of the SHM Excellence in Teaching Award.

"I've never been a master of anything and despite my increasing age, somehow still feel too young to be a master," Dr. Pantilat adds. "Being bestowed with this highest honor in hospital medicine definitely ranks at the top."

Dr. Conway is used to being honored, but he says he still is humbled by the designation. As a former chairman of SHM's Public Policy Committee and the current chief medical officer for the Centers for Medicare & Medicaid Services (CMS) and its deputy administrator for innovation and quality, Dr. Conway is well known—and lauded—for giving HM a voice in Washington, D.C. He views his MHM as the latest sign that his specialty continues to grow and spur positive change in health-care delivery.

"I think the designation demonstrates that hospital medicine is a maturing specialty with strong leaders," he wrote in an email. "In addition, when you look at the current and former masters…it is a stellar group of leaders who are not only advancing hospital medicine, but also changing the face of health care across our nation and improving our health system."

Dr. Percelay is so humbled that he brought his wife, daughter, and mother with him to celebrate the moment. He’s also particularly honored that he and Dr. Conway represent the field of pediatric HM, which he believes has grown tremendously in reputation over the course of his career.

"We've been able to build upon the successes of adult hospital medicine and nurture the inherent 'playing nice in the sandbox' attitude of pediatrics to grow the discipline and work force to the point it's at now where pediatric hospitalists are seen as the experts and innovators for high value pediatric inpatient care," he wrote in an email.

Dr. Percelay is a hospitalist in the pediatric ICU at Saint Barnabas Medical Center in Livingston, N.J., and teaches in the department of physician studies at Pace University of College of Health Professions in New York. He was the founding chairman for the American Academy of Pediatrics Section on Hospital Medicine, an SHM board member from 2005 to 2012, and an associate editor of the Journal of Hospital Medicine. He says attaining the rank of master ranks just behind “being my daughter's father" on his list of personal accomplishments.

 

"I've received scholarships in high school, college, and medical school, but those acknowledged at most four years of work," he writes. "This award recognizes 20-plus years of work practicing as a pediatric hospitalist in community settings, caring for children and their families, and contributing to the field as a whole."

LAS VEGAS—For three hospitalists at SHM's annual meeting at the Mandalay Bay Resort and Casino, today will be a masterful day. Patrick Conway, MD, MSc, FAAP, MHM, Steven Pantilat, MD, MHM, and Jack Percelay, MD, MPH, MHM, will be designated Masters in Hospital Medicine (MHM), the growing cadre of hospitalists who have attained SHM’s highest rank. Sixteen hospitalists have attained the MHM designation. The 2014 designees will be honored on stage today during ceremonies that include the announcement of all of SHM’s new fellows and SHM’s Annual Awards of Excellence.

"If you look at the previous MHM recipients, you see the pantheon of hospital medicine—an incredible group of individuals committed to improving the healthcare system and the care of patients," Dr. Pantilat wrote in an email to The Hospitalist eWire. "This designation recognizes that there are people who have made tremendous contributions to the field, and to changing the way we care for patients."

Dr. Pantilat, who was also a member of the inaugural class of Senior Fellows in Hospital Medicine (SFHM), is a professor of medicine in the department of medicine at the University of California at San Francisco (UCSF). He’s the founding director of the UCSF Palliative Care Program and serves as director of its Leadership Center, which trains hospitalists nationwide about how to establish palliative-care services. He is also a former SHM board member and the first recipient of the SHM Excellence in Teaching Award.

"I've never been a master of anything and despite my increasing age, somehow still feel too young to be a master," Dr. Pantilat adds. "Being bestowed with this highest honor in hospital medicine definitely ranks at the top."

Dr. Conway is used to being honored, but he says he still is humbled by the designation. As a former chairman of SHM's Public Policy Committee and the current chief medical officer for the Centers for Medicare & Medicaid Services (CMS) and its deputy administrator for innovation and quality, Dr. Conway is well known—and lauded—for giving HM a voice in Washington, D.C. He views his MHM as the latest sign that his specialty continues to grow and spur positive change in health-care delivery.

"I think the designation demonstrates that hospital medicine is a maturing specialty with strong leaders," he wrote in an email. "In addition, when you look at the current and former masters…it is a stellar group of leaders who are not only advancing hospital medicine, but also changing the face of health care across our nation and improving our health system."

Dr. Percelay is so humbled that he brought his wife, daughter, and mother with him to celebrate the moment. He’s also particularly honored that he and Dr. Conway represent the field of pediatric HM, which he believes has grown tremendously in reputation over the course of his career.

"We've been able to build upon the successes of adult hospital medicine and nurture the inherent 'playing nice in the sandbox' attitude of pediatrics to grow the discipline and work force to the point it's at now where pediatric hospitalists are seen as the experts and innovators for high value pediatric inpatient care," he wrote in an email.

Dr. Percelay is a hospitalist in the pediatric ICU at Saint Barnabas Medical Center in Livingston, N.J., and teaches in the department of physician studies at Pace University of College of Health Professions in New York. He was the founding chairman for the American Academy of Pediatrics Section on Hospital Medicine, an SHM board member from 2005 to 2012, and an associate editor of the Journal of Hospital Medicine. He says attaining the rank of master ranks just behind “being my daughter's father" on his list of personal accomplishments.

 

"I've received scholarships in high school, college, and medical school, but those acknowledged at most four years of work," he writes. "This award recognizes 20-plus years of work practicing as a pediatric hospitalist in community settings, caring for children and their families, and contributing to the field as a whole."

LAS VEGAS—Hospitalists are poised to be industry leaders and change agents as the rigmarole of healthcare reform shakes out over the next few years, a keynote speaker told a standing-room-only crowd Tuesday at HM14.

Ian Morrison, PhD, a founding partner of Strategic Health Perspectives, a forecasting service for the health-care industry that includes joint-venture partners Harris Interactive and the Harvard School of Public Health’s department of health policy and management, says that while the Affordable Care Act struggled with the rollout of its health exchanges, the broader movement from fee-for-service payment structures to population-based has "turned the corner…and we ain’t going back."

"You, as a society, you, as a group, need to take the long view," Dr. Morrison told 3,500 hospitalists at the Mandalay Bay Resort and Casino. "You are going to be central to this transformation."

Morrison, a native of Scotland whose delivery is half stand-up comic, half policy wonk, says hospitalists will be on the front lines as health care shifts from local health systems to just 100 to 200 regional or super-regional systems.

And while politicians and pundits dicker over how a generational shift in policies will be implemented, hospitalists will be the ones balancing that change with patients' needs.

"This is the work of the future," Morrison says. "And it is not policy wonk work; it is clinical work. It is about the transformation of the delivery system. That is the central challenge of the future. We've got to integrate across the continuum of care, using all the innovation that both public and private sectors can deliver.

"This is not going to be determined by CMS, in my view, but by the kind of innovation that America is always good at."

LAS VEGAS—Hospitalists are poised to be industry leaders and change agents as the rigmarole of healthcare reform shakes out over the next few years, a keynote speaker told a standing-room-only crowd Tuesday at HM14.

Ian Morrison, PhD, a founding partner of Strategic Health Perspectives, a forecasting service for the health-care industry that includes joint-venture partners Harris Interactive and the Harvard School of Public Health’s department of health policy and management, says that while the Affordable Care Act struggled with the rollout of its health exchanges, the broader movement from fee-for-service payment structures to population-based has "turned the corner…and we ain’t going back."

"You, as a society, you, as a group, need to take the long view," Dr. Morrison told 3,500 hospitalists at the Mandalay Bay Resort and Casino. "You are going to be central to this transformation."

Morrison, a native of Scotland whose delivery is half stand-up comic, half policy wonk, says hospitalists will be on the front lines as health care shifts from local health systems to just 100 to 200 regional or super-regional systems.

And while politicians and pundits dicker over how a generational shift in policies will be implemented, hospitalists will be the ones balancing that change with patients' needs.

"This is the work of the future," Morrison says. "And it is not policy wonk work; it is clinical work. It is about the transformation of the delivery system. That is the central challenge of the future. We've got to integrate across the continuum of care, using all the innovation that both public and private sectors can deliver.

"This is not going to be determined by CMS, in my view, but by the kind of innovation that America is always good at."

LAS VEGAS—Hospitalists are poised to be industry leaders and change agents as the rigmarole of healthcare reform shakes out over the next few years, a keynote speaker told a standing-room-only crowd Tuesday at HM14.

Ian Morrison, PhD, a founding partner of Strategic Health Perspectives, a forecasting service for the health-care industry that includes joint-venture partners Harris Interactive and the Harvard School of Public Health’s department of health policy and management, says that while the Affordable Care Act struggled with the rollout of its health exchanges, the broader movement from fee-for-service payment structures to population-based has "turned the corner…and we ain’t going back."

"You, as a society, you, as a group, need to take the long view," Dr. Morrison told 3,500 hospitalists at the Mandalay Bay Resort and Casino. "You are going to be central to this transformation."

Morrison, a native of Scotland whose delivery is half stand-up comic, half policy wonk, says hospitalists will be on the front lines as health care shifts from local health systems to just 100 to 200 regional or super-regional systems.

And while politicians and pundits dicker over how a generational shift in policies will be implemented, hospitalists will be the ones balancing that change with patients' needs.

"This is the work of the future," Morrison says. "And it is not policy wonk work; it is clinical work. It is about the transformation of the delivery system. That is the central challenge of the future. We've got to integrate across the continuum of care, using all the innovation that both public and private sectors can deliver.

"This is not going to be determined by CMS, in my view, but by the kind of innovation that America is always good at."

LAS VEGAS—Hospitalist Michael Hoftiezer, MD, has been to pre-courses at annual meetings before HM14, but yesterday’s lineup offered a new option: “Cardiology: What Hospitalists Need to Know as Front-Line Providers.”

The eight-hour seminar was one of three new pre-courses at SHM’s annual meeting, along with “Efficient High-Value Evidence-Based Medicine for the Practicing Hospitalist” and “NP/PA Playbook for Hospital Medicine.” The offerings drew hundreds of hospitalists to the unofficial first day of HM14 at Mandalay Bay Resort and Casino.

“It’s nice to have an extra day of learning,” says Dr. Hoftiezer, who practices at Holy Family Memorial Medical Center in Manitowoc, Wis. And “it’s concentrated on one subject. It’s a good overview of a single subject, rather than bouncing around different things.” Course director Matthews Chacko, MD, of Johns Hopkins Hospital in Baltimore, says the time is right for hospitalists to devote a full-day pre-course focused on cardiology. “Cardiovascular disease is the most common reason we die,” he says.

“It’s something hospital-based practitioners see often. Providing a comprehensive but yet simplified overview of the way to manage some of these diseases with talks given by some of the leading experts in the field seemed very appropriate for this meeting.”

The course covered such topics as arrhythmia, heart failure, peripheral artery disease, and unstable myocardial infarction. Dr. Hoftiezer says he gleaned tips he can take back to his hospital—including the mechanisms of atrial fibrillation and when to measure rhythm versus rate—and that’s what made the pre-course valuable.

“The more relevant, the better,” he adds. “My favorite lectures are the ones that change something I do.”

LAS VEGAS—Hospitalist Michael Hoftiezer, MD, has been to pre-courses at annual meetings before HM14, but yesterday’s lineup offered a new option: “Cardiology: What Hospitalists Need to Know as Front-Line Providers.”

The eight-hour seminar was one of three new pre-courses at SHM’s annual meeting, along with “Efficient High-Value Evidence-Based Medicine for the Practicing Hospitalist” and “NP/PA Playbook for Hospital Medicine.” The offerings drew hundreds of hospitalists to the unofficial first day of HM14 at Mandalay Bay Resort and Casino.

“It’s nice to have an extra day of learning,” says Dr. Hoftiezer, who practices at Holy Family Memorial Medical Center in Manitowoc, Wis. And “it’s concentrated on one subject. It’s a good overview of a single subject, rather than bouncing around different things.” Course director Matthews Chacko, MD, of Johns Hopkins Hospital in Baltimore, says the time is right for hospitalists to devote a full-day pre-course focused on cardiology. “Cardiovascular disease is the most common reason we die,” he says.

“It’s something hospital-based practitioners see often. Providing a comprehensive but yet simplified overview of the way to manage some of these diseases with talks given by some of the leading experts in the field seemed very appropriate for this meeting.”

The course covered such topics as arrhythmia, heart failure, peripheral artery disease, and unstable myocardial infarction. Dr. Hoftiezer says he gleaned tips he can take back to his hospital—including the mechanisms of atrial fibrillation and when to measure rhythm versus rate—and that’s what made the pre-course valuable.

“The more relevant, the better,” he adds. “My favorite lectures are the ones that change something I do.”

LAS VEGAS—Hospitalist Michael Hoftiezer, MD, has been to pre-courses at annual meetings before HM14, but yesterday’s lineup offered a new option: “Cardiology: What Hospitalists Need to Know as Front-Line Providers.”

The eight-hour seminar was one of three new pre-courses at SHM’s annual meeting, along with “Efficient High-Value Evidence-Based Medicine for the Practicing Hospitalist” and “NP/PA Playbook for Hospital Medicine.” The offerings drew hundreds of hospitalists to the unofficial first day of HM14 at Mandalay Bay Resort and Casino.

“It’s nice to have an extra day of learning,” says Dr. Hoftiezer, who practices at Holy Family Memorial Medical Center in Manitowoc, Wis. And “it’s concentrated on one subject. It’s a good overview of a single subject, rather than bouncing around different things.” Course director Matthews Chacko, MD, of Johns Hopkins Hospital in Baltimore, says the time is right for hospitalists to devote a full-day pre-course focused on cardiology. “Cardiovascular disease is the most common reason we die,” he says.

“It’s something hospital-based practitioners see often. Providing a comprehensive but yet simplified overview of the way to manage some of these diseases with talks given by some of the leading experts in the field seemed very appropriate for this meeting.”

The course covered such topics as arrhythmia, heart failure, peripheral artery disease, and unstable myocardial infarction. Dr. Hoftiezer says he gleaned tips he can take back to his hospital—including the mechanisms of atrial fibrillation and when to measure rhythm versus rate—and that’s what made the pre-course valuable.

“The more relevant, the better,” he adds. “My favorite lectures are the ones that change something I do.”