Robert Harrington Jr., MD, SFHM

When the American Board of Internal Medicine (ABIM) announced changes to its Maintenance of Certification (MOC) process in early 2014, the response was overwhelmingly negative. Individual physicians and medical societies criticized ABIM for adding significant time and expense to MOC, and loudly challenged the program’s effectiveness, relevance, and value.

After months of backlash, ABIM issued an apology in February and rolled back or delayed some of the MOC changes. In a letter to diplomates, ABIM President and Chief Executive Officer Richard J. Baron, MD, acknowledged that some of the criticism of ABIM was legitimate and that “some believe ABIM has turned a deaf ear to practicing physicians.” He said, “We got it wrong and sincerely apologize. We are sorry.”

Despite ABIM’s apology, the conversation about MOC continues to rage—and for good reason.

Though the medical community needs a formal process like MOC to ensure that physicians at all stages of their careers are knowledgeable, qualified, and capable of handling their patients’ care, it’s not clear that the current MOC process delivers those outcomes. I’m certain there are individuals who, over the course of seven or 10 years, complete their training modules, pass an exam, and still do not practice according to the most current, evidence-based guidelines. Just because we know the information needed to pass an exam doesn’t mean we actively use that knowledge to deliver quality care to patients.

To bridge this gap, certifying organizations like ABIM and the American Board of Family Medicine (ABFM) should consider how to better integrate the MOC process into physicians’ daily practice of medicine, so that actual patient care and outcomes are used to determine whether or not an individual is recertified.

Done well, this integration would solve multiple problems.

New Approach Required

Instead of measuring our test-taking ability, it would tie certification directly to how we care for patients: weighing whether or not we use current, evidence-based practices to achieve optimal outcomes. It also would address the problem of testing physicians’ knowledge on topics that fall outside their normal scope of practice. For example, as I have focused my career in hospital medicine, I no longer practice in pediatrics or OB/GYN, but those topics are still included in my family medicine board examination. When I was recertified in 2013, I spent a lot more time preparing for that section of the exam than for the areas in which I practice daily.

In fact, a better-integrated MOC process could help reduce the significant investment of time and money associated with recertification. Not only do most physicians need to take time off from practicing to prepare for the exam, but we also must bear the direct costs of the test itself, along with the necessary test preparation materials.

According to a study released in July by the University of California at San Francisco and Stanford University, ABIM’s latest MOC requirements will cost individual physicians more than $23,600 over 10 years, with the costs in some subspecialties exceeding $40,000. Of those costs, $9 out of every $10 is associated with the demand the process makes on a physician’s time. In announcing the study, the lead author said, “We estimate that ABIM MOC will cost 33.7 million physician-hours over 10 years. Efforts to reform MOC and lower its costs should focus on making the most efficient use of physician time.”

A Simple SPARK

Until MOC is reformed, physicians seeking recertification have no option but to continue under the current process. To help members with test preparation, SHM has launched SPARK, an online tool to prepare physicians for the ABIM/ABFM Focused Practice in Hospital Medicine (FPHM) exam. It is available to SHM members at a significant discount. SPARK features 175 vignette-style, single best answer, multiple-choice questions, complete with answers, cohort comparison, discussion, references, and quizzing capabilities. This first edition targets gaps in other available tools like palliative care, ethics and decision-making, patient safety, peri-operative care, consultative co-management, quality, cost, and clinical reasoning.

The first iteration of SPARK has launched. From here, we will expand SPARK to include preparation materials for the remainder of the family medicine/internal medicine sections of the MOC exam. As the only FPHM MOC preparation tool created by hospitalists for hospitalists, we believe SPARK provides an effective and more affordable alternative to the test preparation tools offered directly through ABIM and ABFM.

Although the concept of MOC is a valid one, the process should be improved to ensure that physicians maintain the knowledge necessary to deliver high quality care. As we work toward further reforms, we hope SPARK will ease the preparation process for our members.

When the American Board of Internal Medicine (ABIM) announced changes to its Maintenance of Certification (MOC) process in early 2014, the response was overwhelmingly negative. Individual physicians and medical societies criticized ABIM for adding significant time and expense to MOC, and loudly challenged the program’s effectiveness, relevance, and value.

After months of backlash, ABIM issued an apology in February and rolled back or delayed some of the MOC changes. In a letter to diplomates, ABIM President and Chief Executive Officer Richard J. Baron, MD, acknowledged that some of the criticism of ABIM was legitimate and that “some believe ABIM has turned a deaf ear to practicing physicians.” He said, “We got it wrong and sincerely apologize. We are sorry.”

Despite ABIM’s apology, the conversation about MOC continues to rage—and for good reason.

Though the medical community needs a formal process like MOC to ensure that physicians at all stages of their careers are knowledgeable, qualified, and capable of handling their patients’ care, it’s not clear that the current MOC process delivers those outcomes. I’m certain there are individuals who, over the course of seven or 10 years, complete their training modules, pass an exam, and still do not practice according to the most current, evidence-based guidelines. Just because we know the information needed to pass an exam doesn’t mean we actively use that knowledge to deliver quality care to patients.

To bridge this gap, certifying organizations like ABIM and the American Board of Family Medicine (ABFM) should consider how to better integrate the MOC process into physicians’ daily practice of medicine, so that actual patient care and outcomes are used to determine whether or not an individual is recertified.

Done well, this integration would solve multiple problems.

New Approach Required

Instead of measuring our test-taking ability, it would tie certification directly to how we care for patients: weighing whether or not we use current, evidence-based practices to achieve optimal outcomes. It also would address the problem of testing physicians’ knowledge on topics that fall outside their normal scope of practice. For example, as I have focused my career in hospital medicine, I no longer practice in pediatrics or OB/GYN, but those topics are still included in my family medicine board examination. When I was recertified in 2013, I spent a lot more time preparing for that section of the exam than for the areas in which I practice daily.

In fact, a better-integrated MOC process could help reduce the significant investment of time and money associated with recertification. Not only do most physicians need to take time off from practicing to prepare for the exam, but we also must bear the direct costs of the test itself, along with the necessary test preparation materials.

According to a study released in July by the University of California at San Francisco and Stanford University, ABIM’s latest MOC requirements will cost individual physicians more than $23,600 over 10 years, with the costs in some subspecialties exceeding $40,000. Of those costs, $9 out of every $10 is associated with the demand the process makes on a physician’s time. In announcing the study, the lead author said, “We estimate that ABIM MOC will cost 33.7 million physician-hours over 10 years. Efforts to reform MOC and lower its costs should focus on making the most efficient use of physician time.”

A Simple SPARK

Until MOC is reformed, physicians seeking recertification have no option but to continue under the current process. To help members with test preparation, SHM has launched SPARK, an online tool to prepare physicians for the ABIM/ABFM Focused Practice in Hospital Medicine (FPHM) exam. It is available to SHM members at a significant discount. SPARK features 175 vignette-style, single best answer, multiple-choice questions, complete with answers, cohort comparison, discussion, references, and quizzing capabilities. This first edition targets gaps in other available tools like palliative care, ethics and decision-making, patient safety, peri-operative care, consultative co-management, quality, cost, and clinical reasoning.

The first iteration of SPARK has launched. From here, we will expand SPARK to include preparation materials for the remainder of the family medicine/internal medicine sections of the MOC exam. As the only FPHM MOC preparation tool created by hospitalists for hospitalists, we believe SPARK provides an effective and more affordable alternative to the test preparation tools offered directly through ABIM and ABFM.

Although the concept of MOC is a valid one, the process should be improved to ensure that physicians maintain the knowledge necessary to deliver high quality care. As we work toward further reforms, we hope SPARK will ease the preparation process for our members.

When the American Board of Internal Medicine (ABIM) announced changes to its Maintenance of Certification (MOC) process in early 2014, the response was overwhelmingly negative. Individual physicians and medical societies criticized ABIM for adding significant time and expense to MOC, and loudly challenged the program’s effectiveness, relevance, and value.

After months of backlash, ABIM issued an apology in February and rolled back or delayed some of the MOC changes. In a letter to diplomates, ABIM President and Chief Executive Officer Richard J. Baron, MD, acknowledged that some of the criticism of ABIM was legitimate and that “some believe ABIM has turned a deaf ear to practicing physicians.” He said, “We got it wrong and sincerely apologize. We are sorry.”

Despite ABIM’s apology, the conversation about MOC continues to rage—and for good reason.

Though the medical community needs a formal process like MOC to ensure that physicians at all stages of their careers are knowledgeable, qualified, and capable of handling their patients’ care, it’s not clear that the current MOC process delivers those outcomes. I’m certain there are individuals who, over the course of seven or 10 years, complete their training modules, pass an exam, and still do not practice according to the most current, evidence-based guidelines. Just because we know the information needed to pass an exam doesn’t mean we actively use that knowledge to deliver quality care to patients.

To bridge this gap, certifying organizations like ABIM and the American Board of Family Medicine (ABFM) should consider how to better integrate the MOC process into physicians’ daily practice of medicine, so that actual patient care and outcomes are used to determine whether or not an individual is recertified.

Done well, this integration would solve multiple problems.

New Approach Required

Instead of measuring our test-taking ability, it would tie certification directly to how we care for patients: weighing whether or not we use current, evidence-based practices to achieve optimal outcomes. It also would address the problem of testing physicians’ knowledge on topics that fall outside their normal scope of practice. For example, as I have focused my career in hospital medicine, I no longer practice in pediatrics or OB/GYN, but those topics are still included in my family medicine board examination. When I was recertified in 2013, I spent a lot more time preparing for that section of the exam than for the areas in which I practice daily.

In fact, a better-integrated MOC process could help reduce the significant investment of time and money associated with recertification. Not only do most physicians need to take time off from practicing to prepare for the exam, but we also must bear the direct costs of the test itself, along with the necessary test preparation materials.

According to a study released in July by the University of California at San Francisco and Stanford University, ABIM’s latest MOC requirements will cost individual physicians more than $23,600 over 10 years, with the costs in some subspecialties exceeding $40,000. Of those costs, $9 out of every $10 is associated with the demand the process makes on a physician’s time. In announcing the study, the lead author said, “We estimate that ABIM MOC will cost 33.7 million physician-hours over 10 years. Efforts to reform MOC and lower its costs should focus on making the most efficient use of physician time.”

A Simple SPARK

Until MOC is reformed, physicians seeking recertification have no option but to continue under the current process. To help members with test preparation, SHM has launched SPARK, an online tool to prepare physicians for the ABIM/ABFM Focused Practice in Hospital Medicine (FPHM) exam. It is available to SHM members at a significant discount. SPARK features 175 vignette-style, single best answer, multiple-choice questions, complete with answers, cohort comparison, discussion, references, and quizzing capabilities. This first edition targets gaps in other available tools like palliative care, ethics and decision-making, patient safety, peri-operative care, consultative co-management, quality, cost, and clinical reasoning.

The first iteration of SPARK has launched. From here, we will expand SPARK to include preparation materials for the remainder of the family medicine/internal medicine sections of the MOC exam. As the only FPHM MOC preparation tool created by hospitalists for hospitalists, we believe SPARK provides an effective and more affordable alternative to the test preparation tools offered directly through ABIM and ABFM.

Although the concept of MOC is a valid one, the process should be improved to ensure that physicians maintain the knowledge necessary to deliver high quality care. As we work toward further reforms, we hope SPARK will ease the preparation process for our members.

It’s that time of year again. Across the country, thousands of students are starting medical school. And in just a short time—it goes faster than you think—they’ll be faced with the decision of what specialty they want to pursue.

To make that decision, these students will have to consider a variety of factors beyond their personal interests, including the training, compensation, lifestyle, and career path associated with each specialty.

When I was in medical school, hospital medicine wasn’t a career option—our field didn’t even exist. I remember going through the decision process like it was yesterday. The first two years, as you know, provide little exposure to the true day-to-day challenges and lifestyle of any of the potential choices. That time comes in the third and fourth years, and many students are forced to make a decision after experiencing only a few of the myriad possibilities.

My personal experience with this process was quite a wandering path. I began medical school with tunnel vision around becoming an orthopedic surgeon. I struggled through the first two years of physiology and embryology and the like, eager to get my hands on the “tools” of a real surgeon.

Gradually, I moved away from that plan as I witnessed firsthand how grueling the residency training was and how it personally impacted those residents I knew and their families. I was briefly tempted by a vascular surgery attending who offered to take me under his wing, but I soon came to my senses.

I then gravitated toward specialties that were less technical and more intellectual. After a very enjoyable third-year pediatrics rotation, I could clearly see myself taking care of “little people.” Internal medicine challenged me with the most interesting of clinical conundrums, and I began to see myself solving great mysteries. Family medicine gave me a nice mix of both, and that is where I eventually settled. Having the option of hospital medicine would certainly have made the choice more difficult for me. The attraction would have been, and frankly, still is, the combination of caring for the patient and the system simultaneously.

A Career Choice

Today, hospital medicine is medicine’s fastest growing field. Unfortunately, many young physicians don’t think about hospital medicine when planning their careers. It’s often considered a brief stop between residency and a fellowship—a way to make some money and pay back medical school loans before continuing toward a career in a specialty like cardiology, gastroenterology, or hematology.

That’s why SHM has been making a concerted effort to increase awareness among medical school students about the benefits of a career in hospital medicine. We have launched several programs geared specifically to medical students and residents.

For example, SHM has built a “Future of Hospital Medicine” website for students and residents, filled with information about what it’s like to have a career in hospital medicine. Plus, we now offer free membership dues and electronic access to our publications for medical students who want to join SHM.

SHM launched the “Future of Hospital Medicine” (FOHM) campaign in 2013 under then-President Dr. Eric Howell’s leadership. Since then:

• Student membership has increased 217%;
• Resident/fellow membership has increased by 97%;
• We’ve conducted five “FOHM” live events in Philadelphia, New York, Baltimore, and Chicago (twice) and will be hosting another event in Los Angeles this fall; and
• We offer more focused student and resident content at HM15, as well as the largest attendance to date for both groups.

We also recently developed the Society of Hospital Medicine Student Hospitalist Scholar Grant program. Through the program, eligible students can receive a $5,000 summer stipend for scholarly work on a project related to patient safety/quality improvement or other areas relevant to the field of hospital medicine. The program also provides up to $1,500 in travel-related reimbursement for the student attending the SHM annual meeting.

This year, the grant program’s first, three students are participating in summer research on topics that include post-hospital syndrome and physiologic alarm responses. You can follow their progress on the SHM blog. Eventually, we expect the program to grow to 10 grantees every summer.

Awareness Is Key

We hope efforts like these will help raise awareness and interest in hospital medicine and SHM among medical students and young physicians. Although our field is relatively young, it’s full of opportunities for building a rewarding, lasting career.

Hospital medicine is so much more than a medical pit stop. As we know at SHM, it’s a specialty in which young physicians can launch and build a sustainable career.

If you are a career hospitalist, I ask you to help spread the word. And, if you are a student contemplating your future, I invite you to visit us and learn more. I know you will not be disappointed.

It’s that time of year again. Across the country, thousands of students are starting medical school. And in just a short time—it goes faster than you think—they’ll be faced with the decision of what specialty they want to pursue.

To make that decision, these students will have to consider a variety of factors beyond their personal interests, including the training, compensation, lifestyle, and career path associated with each specialty.

When I was in medical school, hospital medicine wasn’t a career option—our field didn’t even exist. I remember going through the decision process like it was yesterday. The first two years, as you know, provide little exposure to the true day-to-day challenges and lifestyle of any of the potential choices. That time comes in the third and fourth years, and many students are forced to make a decision after experiencing only a few of the myriad possibilities.

My personal experience with this process was quite a wandering path. I began medical school with tunnel vision around becoming an orthopedic surgeon. I struggled through the first two years of physiology and embryology and the like, eager to get my hands on the “tools” of a real surgeon.

Gradually, I moved away from that plan as I witnessed firsthand how grueling the residency training was and how it personally impacted those residents I knew and their families. I was briefly tempted by a vascular surgery attending who offered to take me under his wing, but I soon came to my senses.

I then gravitated toward specialties that were less technical and more intellectual. After a very enjoyable third-year pediatrics rotation, I could clearly see myself taking care of “little people.” Internal medicine challenged me with the most interesting of clinical conundrums, and I began to see myself solving great mysteries. Family medicine gave me a nice mix of both, and that is where I eventually settled. Having the option of hospital medicine would certainly have made the choice more difficult for me. The attraction would have been, and frankly, still is, the combination of caring for the patient and the system simultaneously.

A Career Choice

Today, hospital medicine is medicine’s fastest growing field. Unfortunately, many young physicians don’t think about hospital medicine when planning their careers. It’s often considered a brief stop between residency and a fellowship—a way to make some money and pay back medical school loans before continuing toward a career in a specialty like cardiology, gastroenterology, or hematology.

That’s why SHM has been making a concerted effort to increase awareness among medical school students about the benefits of a career in hospital medicine. We have launched several programs geared specifically to medical students and residents.

For example, SHM has built a “Future of Hospital Medicine” website for students and residents, filled with information about what it’s like to have a career in hospital medicine. Plus, we now offer free membership dues and electronic access to our publications for medical students who want to join SHM.

SHM launched the “Future of Hospital Medicine” (FOHM) campaign in 2013 under then-President Dr. Eric Howell’s leadership. Since then:

• Student membership has increased 217%;
• Resident/fellow membership has increased by 97%;
• We’ve conducted five “FOHM” live events in Philadelphia, New York, Baltimore, and Chicago (twice) and will be hosting another event in Los Angeles this fall; and
• We offer more focused student and resident content at HM15, as well as the largest attendance to date for both groups.

We also recently developed the Society of Hospital Medicine Student Hospitalist Scholar Grant program. Through the program, eligible students can receive a $5,000 summer stipend for scholarly work on a project related to patient safety/quality improvement or other areas relevant to the field of hospital medicine. The program also provides up to $1,500 in travel-related reimbursement for the student attending the SHM annual meeting.

This year, the grant program’s first, three students are participating in summer research on topics that include post-hospital syndrome and physiologic alarm responses. You can follow their progress on the SHM blog. Eventually, we expect the program to grow to 10 grantees every summer.

Awareness Is Key

We hope efforts like these will help raise awareness and interest in hospital medicine and SHM among medical students and young physicians. Although our field is relatively young, it’s full of opportunities for building a rewarding, lasting career.

Hospital medicine is so much more than a medical pit stop. As we know at SHM, it’s a specialty in which young physicians can launch and build a sustainable career.

If you are a career hospitalist, I ask you to help spread the word. And, if you are a student contemplating your future, I invite you to visit us and learn more. I know you will not be disappointed.

It’s that time of year again. Across the country, thousands of students are starting medical school. And in just a short time—it goes faster than you think—they’ll be faced with the decision of what specialty they want to pursue.

To make that decision, these students will have to consider a variety of factors beyond their personal interests, including the training, compensation, lifestyle, and career path associated with each specialty.

When I was in medical school, hospital medicine wasn’t a career option—our field didn’t even exist. I remember going through the decision process like it was yesterday. The first two years, as you know, provide little exposure to the true day-to-day challenges and lifestyle of any of the potential choices. That time comes in the third and fourth years, and many students are forced to make a decision after experiencing only a few of the myriad possibilities.

My personal experience with this process was quite a wandering path. I began medical school with tunnel vision around becoming an orthopedic surgeon. I struggled through the first two years of physiology and embryology and the like, eager to get my hands on the “tools” of a real surgeon.

Gradually, I moved away from that plan as I witnessed firsthand how grueling the residency training was and how it personally impacted those residents I knew and their families. I was briefly tempted by a vascular surgery attending who offered to take me under his wing, but I soon came to my senses.

I then gravitated toward specialties that were less technical and more intellectual. After a very enjoyable third-year pediatrics rotation, I could clearly see myself taking care of “little people.” Internal medicine challenged me with the most interesting of clinical conundrums, and I began to see myself solving great mysteries. Family medicine gave me a nice mix of both, and that is where I eventually settled. Having the option of hospital medicine would certainly have made the choice more difficult for me. The attraction would have been, and frankly, still is, the combination of caring for the patient and the system simultaneously.

A Career Choice

Today, hospital medicine is medicine’s fastest growing field. Unfortunately, many young physicians don’t think about hospital medicine when planning their careers. It’s often considered a brief stop between residency and a fellowship—a way to make some money and pay back medical school loans before continuing toward a career in a specialty like cardiology, gastroenterology, or hematology.

That’s why SHM has been making a concerted effort to increase awareness among medical school students about the benefits of a career in hospital medicine. We have launched several programs geared specifically to medical students and residents.

For example, SHM has built a “Future of Hospital Medicine” website for students and residents, filled with information about what it’s like to have a career in hospital medicine. Plus, we now offer free membership dues and electronic access to our publications for medical students who want to join SHM.

SHM launched the “Future of Hospital Medicine” (FOHM) campaign in 2013 under then-President Dr. Eric Howell’s leadership. Since then:

• Student membership has increased 217%;
• Resident/fellow membership has increased by 97%;
• We’ve conducted five “FOHM” live events in Philadelphia, New York, Baltimore, and Chicago (twice) and will be hosting another event in Los Angeles this fall; and
• We offer more focused student and resident content at HM15, as well as the largest attendance to date for both groups.

We also recently developed the Society of Hospital Medicine Student Hospitalist Scholar Grant program. Through the program, eligible students can receive a $5,000 summer stipend for scholarly work on a project related to patient safety/quality improvement or other areas relevant to the field of hospital medicine. The program also provides up to $1,500 in travel-related reimbursement for the student attending the SHM annual meeting.

This year, the grant program’s first, three students are participating in summer research on topics that include post-hospital syndrome and physiologic alarm responses. You can follow their progress on the SHM blog. Eventually, we expect the program to grow to 10 grantees every summer.

Awareness Is Key

We hope efforts like these will help raise awareness and interest in hospital medicine and SHM among medical students and young physicians. Although our field is relatively young, it’s full of opportunities for building a rewarding, lasting career.

Hospital medicine is so much more than a medical pit stop. As we know at SHM, it’s a specialty in which young physicians can launch and build a sustainable career.

If you are a career hospitalist, I ask you to help spread the word. And, if you are a student contemplating your future, I invite you to visit us and learn more. I know you will not be disappointed.

My path to the SHM presidency has been a long and winding one. After paying back some student loans courtesy of the U.S. Air Force, I joined a busy traditional family medicine practice. Routinely, we would have a census of 20-25 patients in our local community hospital on any given day, and we shared the hospital duties as the “hospital doc” for a week at a time. I truly enjoyed the hospital-based portion of my practice, and this eventually led me to start and build a hospitalist program at our small community hospital. I’ve been a hospitalist ever since and have never looked back.

My story is similar to the experiences of thousands of hospitalists across the country today. Many physicians who entered medical school with the intention of working in an office-based or traditional practice have been drawn into the fast-growing hospital medicine field—where they’ve happily stayed.

Today, according to our best estimates, there are more than 44,000 hospitalists practicing in the U.S. Most have come to the specialty from the internal medicine field, but that is rapidly changing. As the first hospitalist trained in family medicine to serve as SHM president, I couldn’t be more excited or encouraged by the increasing diversity in the types of healthcare practitioners who call themselves hospitalists.

A Changing Profession

Today’s hospitalists come from diverse training environments. In addition to internal medicine, hospitalists are trained in family medicine, pediatrics, intensive care, obstetrics and gynecology, surgery, orthopedics, neurology, oncology, and a variety of other specialties and subspecialties. The specialty hospitalist movement has grown on the back of the same forces that gave a dramatic push to the hospitalist movement over the past 15 years—in-house provider availability, the need for greater inpatient efficiency, the aging physician workforce, and the enormous difficulty of staying competent in both an ambulatory and inpatient setting, just to name a few. Needless to say, it’s become a well-established dynamic with evidence pointing to its long-term benefits for both patients and healthcare delivery systems.

In addition, as demand for hospitalist services continues to grow, hospitals and hospital medicine groups are increasingly adding nurse practitioners (NPs), physician assistants (PAs), and other advanced practice providers to their ranks. According to the 2014 State of Hospital Medicine Report, the use of NPs and PAs in hospital medicine programs serving adults has risen nearly 12% since 2012. Today, more than 65% of hospital medicine groups employ NPs or PAs.

Within SHM, we’re seeing these changes begin to play out in our membership makeup, as well. Though the vast majority of our 14,000 members are internal medicine physicians, more than 10% are hospitalists trained in family medicine (HTFMs), 3% are trained in pediatrics, and 3% are internal medicine/pediatrics. Our fastest growing segments are family medicine and NPs/PAs.

Strength in Diversity

The expansion of the hospitalist field to include so many different kinds of providers is beneficial to both SHM and the broader profession.

On a macro level, the increasing diversity of the field has the potential to improve care for hospitalized patients. For example, when more hospital providers are based within the facility, there’s an opportunity for providers to develop improved relationships and communication, which leads to better patient handoffs and expedited care across the inpatient care continuum. Studies have shown that hospitalist practices have a positive impact on patient lengths of stay, readmission rates, and patient satisfaction scores.

Among our peers in healthcare, this diversity opens up opportunities for even more physicians and clinicians to work as hospitalists and improve care delivery in America’s hospitals. For instance, the American Academy of Family Physicians (AAFP) and SHM recently endorsed the growing contribution of hospitalists trained in family medicine. Together, our two organizations stated that “the opportunity to participate as a hospitalist should be granted to all physicians commensurate with their documented training and/or experience, demonstrated abilities and current competencies.”

SHM is stronger when we can draw upon a membership of varying types of training, opinions, and expertise in developing initiatives and educational programs in support of our mission to promote exceptional care for hospitalized patients. Diverse membership also provides an additional level of authority to our organization and is one of the reasons we are often invited to Washington, D.C., to testify in front of Congress about various medical topics. Because we represent many constituencies among physicians and maintain close working relationships with clinical and business leaders throughout the hospital, we can provide unique insight into healthcare reform, quality initiatives, and other issues shaping the healthcare industry today.

Expanding Membership

Although we are seeing the increasing diversity in the hospital medicine field play out in SHM membership, many specialty hospitalists, advanced practice providers, and even family medicine and pediatric physicians don’t yet consider SHM a professional “home.” And our membership ranks represent only a fraction of the hospitalists practicing across the country.

One of the goals for my presidency is to help spread the word that SHM isn’t just for internal medicine hospitalists—though they certainly make up a majority of our membership and we owe them a debt of gratitude for getting us to where we are today—but for all providers involved in the hospital-based care of patients. We are an organization that truly represents all of the professionals across the continuum of hospital-based medicine. We can be a valuable professional resource for the growing number of physicians, advanced practice providers, administrators, and other care providers who choose to focus their careers on the care of hospitalized patients.

Looking Ahead

Though I happened into the hospital medicine field by chance, making my career in the field was no accident. I’m proud to work in a specialty that is so uniquely positioned to enhance the care and experience for hospitalized patients. I’m excited to see so many providers from various fields of medicine choosing hospital-based practice.

I hope the trend will continue and that our organization will have the opportunity to welcome many of them in the months ahead.

My path to the SHM presidency has been a long and winding one. After paying back some student loans courtesy of the U.S. Air Force, I joined a busy traditional family medicine practice. Routinely, we would have a census of 20-25 patients in our local community hospital on any given day, and we shared the hospital duties as the “hospital doc” for a week at a time. I truly enjoyed the hospital-based portion of my practice, and this eventually led me to start and build a hospitalist program at our small community hospital. I’ve been a hospitalist ever since and have never looked back.

My story is similar to the experiences of thousands of hospitalists across the country today. Many physicians who entered medical school with the intention of working in an office-based or traditional practice have been drawn into the fast-growing hospital medicine field—where they’ve happily stayed.

Today, according to our best estimates, there are more than 44,000 hospitalists practicing in the U.S. Most have come to the specialty from the internal medicine field, but that is rapidly changing. As the first hospitalist trained in family medicine to serve as SHM president, I couldn’t be more excited or encouraged by the increasing diversity in the types of healthcare practitioners who call themselves hospitalists.

A Changing Profession

Today’s hospitalists come from diverse training environments. In addition to internal medicine, hospitalists are trained in family medicine, pediatrics, intensive care, obstetrics and gynecology, surgery, orthopedics, neurology, oncology, and a variety of other specialties and subspecialties. The specialty hospitalist movement has grown on the back of the same forces that gave a dramatic push to the hospitalist movement over the past 15 years—in-house provider availability, the need for greater inpatient efficiency, the aging physician workforce, and the enormous difficulty of staying competent in both an ambulatory and inpatient setting, just to name a few. Needless to say, it’s become a well-established dynamic with evidence pointing to its long-term benefits for both patients and healthcare delivery systems.

In addition, as demand for hospitalist services continues to grow, hospitals and hospital medicine groups are increasingly adding nurse practitioners (NPs), physician assistants (PAs), and other advanced practice providers to their ranks. According to the 2014 State of Hospital Medicine Report, the use of NPs and PAs in hospital medicine programs serving adults has risen nearly 12% since 2012. Today, more than 65% of hospital medicine groups employ NPs or PAs.

Within SHM, we’re seeing these changes begin to play out in our membership makeup, as well. Though the vast majority of our 14,000 members are internal medicine physicians, more than 10% are hospitalists trained in family medicine (HTFMs), 3% are trained in pediatrics, and 3% are internal medicine/pediatrics. Our fastest growing segments are family medicine and NPs/PAs.

Strength in Diversity

The expansion of the hospitalist field to include so many different kinds of providers is beneficial to both SHM and the broader profession.

On a macro level, the increasing diversity of the field has the potential to improve care for hospitalized patients. For example, when more hospital providers are based within the facility, there’s an opportunity for providers to develop improved relationships and communication, which leads to better patient handoffs and expedited care across the inpatient care continuum. Studies have shown that hospitalist practices have a positive impact on patient lengths of stay, readmission rates, and patient satisfaction scores.

Among our peers in healthcare, this diversity opens up opportunities for even more physicians and clinicians to work as hospitalists and improve care delivery in America’s hospitals. For instance, the American Academy of Family Physicians (AAFP) and SHM recently endorsed the growing contribution of hospitalists trained in family medicine. Together, our two organizations stated that “the opportunity to participate as a hospitalist should be granted to all physicians commensurate with their documented training and/or experience, demonstrated abilities and current competencies.”

SHM is stronger when we can draw upon a membership of varying types of training, opinions, and expertise in developing initiatives and educational programs in support of our mission to promote exceptional care for hospitalized patients. Diverse membership also provides an additional level of authority to our organization and is one of the reasons we are often invited to Washington, D.C., to testify in front of Congress about various medical topics. Because we represent many constituencies among physicians and maintain close working relationships with clinical and business leaders throughout the hospital, we can provide unique insight into healthcare reform, quality initiatives, and other issues shaping the healthcare industry today.

Expanding Membership

Although we are seeing the increasing diversity in the hospital medicine field play out in SHM membership, many specialty hospitalists, advanced practice providers, and even family medicine and pediatric physicians don’t yet consider SHM a professional “home.” And our membership ranks represent only a fraction of the hospitalists practicing across the country.

One of the goals for my presidency is to help spread the word that SHM isn’t just for internal medicine hospitalists—though they certainly make up a majority of our membership and we owe them a debt of gratitude for getting us to where we are today—but for all providers involved in the hospital-based care of patients. We are an organization that truly represents all of the professionals across the continuum of hospital-based medicine. We can be a valuable professional resource for the growing number of physicians, advanced practice providers, administrators, and other care providers who choose to focus their careers on the care of hospitalized patients.

Looking Ahead

Though I happened into the hospital medicine field by chance, making my career in the field was no accident. I’m proud to work in a specialty that is so uniquely positioned to enhance the care and experience for hospitalized patients. I’m excited to see so many providers from various fields of medicine choosing hospital-based practice.

I hope the trend will continue and that our organization will have the opportunity to welcome many of them in the months ahead.

My path to the SHM presidency has been a long and winding one. After paying back some student loans courtesy of the U.S. Air Force, I joined a busy traditional family medicine practice. Routinely, we would have a census of 20-25 patients in our local community hospital on any given day, and we shared the hospital duties as the “hospital doc” for a week at a time. I truly enjoyed the hospital-based portion of my practice, and this eventually led me to start and build a hospitalist program at our small community hospital. I’ve been a hospitalist ever since and have never looked back.

My story is similar to the experiences of thousands of hospitalists across the country today. Many physicians who entered medical school with the intention of working in an office-based or traditional practice have been drawn into the fast-growing hospital medicine field—where they’ve happily stayed.

Today, according to our best estimates, there are more than 44,000 hospitalists practicing in the U.S. Most have come to the specialty from the internal medicine field, but that is rapidly changing. As the first hospitalist trained in family medicine to serve as SHM president, I couldn’t be more excited or encouraged by the increasing diversity in the types of healthcare practitioners who call themselves hospitalists.

A Changing Profession

Today’s hospitalists come from diverse training environments. In addition to internal medicine, hospitalists are trained in family medicine, pediatrics, intensive care, obstetrics and gynecology, surgery, orthopedics, neurology, oncology, and a variety of other specialties and subspecialties. The specialty hospitalist movement has grown on the back of the same forces that gave a dramatic push to the hospitalist movement over the past 15 years—in-house provider availability, the need for greater inpatient efficiency, the aging physician workforce, and the enormous difficulty of staying competent in both an ambulatory and inpatient setting, just to name a few. Needless to say, it’s become a well-established dynamic with evidence pointing to its long-term benefits for both patients and healthcare delivery systems.

In addition, as demand for hospitalist services continues to grow, hospitals and hospital medicine groups are increasingly adding nurse practitioners (NPs), physician assistants (PAs), and other advanced practice providers to their ranks. According to the 2014 State of Hospital Medicine Report, the use of NPs and PAs in hospital medicine programs serving adults has risen nearly 12% since 2012. Today, more than 65% of hospital medicine groups employ NPs or PAs.

Within SHM, we’re seeing these changes begin to play out in our membership makeup, as well. Though the vast majority of our 14,000 members are internal medicine physicians, more than 10% are hospitalists trained in family medicine (HTFMs), 3% are trained in pediatrics, and 3% are internal medicine/pediatrics. Our fastest growing segments are family medicine and NPs/PAs.

Strength in Diversity

The expansion of the hospitalist field to include so many different kinds of providers is beneficial to both SHM and the broader profession.

On a macro level, the increasing diversity of the field has the potential to improve care for hospitalized patients. For example, when more hospital providers are based within the facility, there’s an opportunity for providers to develop improved relationships and communication, which leads to better patient handoffs and expedited care across the inpatient care continuum. Studies have shown that hospitalist practices have a positive impact on patient lengths of stay, readmission rates, and patient satisfaction scores.

Among our peers in healthcare, this diversity opens up opportunities for even more physicians and clinicians to work as hospitalists and improve care delivery in America’s hospitals. For instance, the American Academy of Family Physicians (AAFP) and SHM recently endorsed the growing contribution of hospitalists trained in family medicine. Together, our two organizations stated that “the opportunity to participate as a hospitalist should be granted to all physicians commensurate with their documented training and/or experience, demonstrated abilities and current competencies.”

SHM is stronger when we can draw upon a membership of varying types of training, opinions, and expertise in developing initiatives and educational programs in support of our mission to promote exceptional care for hospitalized patients. Diverse membership also provides an additional level of authority to our organization and is one of the reasons we are often invited to Washington, D.C., to testify in front of Congress about various medical topics. Because we represent many constituencies among physicians and maintain close working relationships with clinical and business leaders throughout the hospital, we can provide unique insight into healthcare reform, quality initiatives, and other issues shaping the healthcare industry today.

Expanding Membership

Although we are seeing the increasing diversity in the hospital medicine field play out in SHM membership, many specialty hospitalists, advanced practice providers, and even family medicine and pediatric physicians don’t yet consider SHM a professional “home.” And our membership ranks represent only a fraction of the hospitalists practicing across the country.

One of the goals for my presidency is to help spread the word that SHM isn’t just for internal medicine hospitalists—though they certainly make up a majority of our membership and we owe them a debt of gratitude for getting us to where we are today—but for all providers involved in the hospital-based care of patients. We are an organization that truly represents all of the professionals across the continuum of hospital-based medicine. We can be a valuable professional resource for the growing number of physicians, advanced practice providers, administrators, and other care providers who choose to focus their careers on the care of hospitalized patients.

Looking Ahead

Though I happened into the hospital medicine field by chance, making my career in the field was no accident. I’m proud to work in a specialty that is so uniquely positioned to enhance the care and experience for hospitalized patients. I’m excited to see so many providers from various fields of medicine choosing hospital-based practice.

I hope the trend will continue and that our organization will have the opportunity to welcome many of them in the months ahead.