One of the emerging trends in comanagement by hospitalists (see “The Comanagement Conundrum,” p. 1, April 2011) is an expanded role in the perioperative care of surgical patients—extending from before the operation into rehabilitation. To be successful, hospitalists should think more broadly than the usual focus on medical needs immediately post-surgery, says Burke Kealey, MD, director of perioperative comanagement at Regions Hospital in St. Paul, Minn.

The perioperative service at Regions includes staffing of a pre-operative clinic, a partnership with the hospital’s anesthesia department, and use of a pre-operative patient checklist. Many primary-care physicians (PCPs) want to retain a role in the pre-operative assessments of their patients, so the Regions service has tried to partner with physicians in the community to work on standardizing the process.

Dr. Kealey, an SHM board member, was hired by Regions’ orthopedic department right out of residency in 1995 to do medical comanagement of its patients. His service later was absorbed into an emerging HM department. It has experimented with models including the use of nurse practitioners and physician assistants.

Today, Regions dedicates three of its 16 full-time hospitalist teams to comanagement services, largely on the orthopedics floor, but also for cardiovascular surgery and urology. “As hospitalists, we can help to facilitate using the best, up-to-date medical knowledge” both before and after surgery, he says.

At the University of Rochester School of Medicine in New York, a group of fellowship-trained geriatric hospitalists has taken on comanagement of hip fracture patients at the Geriatric Fracture Center, leading to improved processes and patient outcomes.¹ According to hospitalist Susan M. Friedman, MD, MPH, the program began as a collaboration between a geriatrician and an orthopedic surgeon. They found that their patients’ outcomes seemed to be better when they worked together on a case, so they sat down to talk about what they were doing and how to standardize it.

“From the start, they set the tone for how this is supposed work, and when it doesn’t, they find out why and address it,” Dr. Friedman says. The program does not use a formal service agreement, but there is a strong emphasis on co-ownership, mutual respect, and communication. “One thing that has helped us a lot is data-gathering,” she adds. The hip fracture comanagement has cut lengths of stay and readmissions by half and complications by one-third for the mostly elderly patients.

Larry Beresford is a freelance writer based in Oakland, Calif.

Reference

1. Friedman SM, Mendelson DA, Bingham KW, Kates SL. Impact of co-managed geriatric fracture center on short-term hip fracture outcomes. Arch Intern Med. 2009;169(18):1712-1717.

One of the emerging trends in comanagement by hospitalists (see “The Comanagement Conundrum,” p. 1, April 2011) is an expanded role in the perioperative care of surgical patients—extending from before the operation into rehabilitation. To be successful, hospitalists should think more broadly than the usual focus on medical needs immediately post-surgery, says Burke Kealey, MD, director of perioperative comanagement at Regions Hospital in St. Paul, Minn.

The perioperative service at Regions includes staffing of a pre-operative clinic, a partnership with the hospital’s anesthesia department, and use of a pre-operative patient checklist. Many primary-care physicians (PCPs) want to retain a role in the pre-operative assessments of their patients, so the Regions service has tried to partner with physicians in the community to work on standardizing the process.

Dr. Kealey, an SHM board member, was hired by Regions’ orthopedic department right out of residency in 1995 to do medical comanagement of its patients. His service later was absorbed into an emerging HM department. It has experimented with models including the use of nurse practitioners and physician assistants.

Today, Regions dedicates three of its 16 full-time hospitalist teams to comanagement services, largely on the orthopedics floor, but also for cardiovascular surgery and urology. “As hospitalists, we can help to facilitate using the best, up-to-date medical knowledge” both before and after surgery, he says.

At the University of Rochester School of Medicine in New York, a group of fellowship-trained geriatric hospitalists has taken on comanagement of hip fracture patients at the Geriatric Fracture Center, leading to improved processes and patient outcomes.¹ According to hospitalist Susan M. Friedman, MD, MPH, the program began as a collaboration between a geriatrician and an orthopedic surgeon. They found that their patients’ outcomes seemed to be better when they worked together on a case, so they sat down to talk about what they were doing and how to standardize it.

“From the start, they set the tone for how this is supposed work, and when it doesn’t, they find out why and address it,” Dr. Friedman says. The program does not use a formal service agreement, but there is a strong emphasis on co-ownership, mutual respect, and communication. “One thing that has helped us a lot is data-gathering,” she adds. The hip fracture comanagement has cut lengths of stay and readmissions by half and complications by one-third for the mostly elderly patients.

Larry Beresford is a freelance writer based in Oakland, Calif.

Reference

1. Friedman SM, Mendelson DA, Bingham KW, Kates SL. Impact of co-managed geriatric fracture center on short-term hip fracture outcomes. Arch Intern Med. 2009;169(18):1712-1717.

One of the emerging trends in comanagement by hospitalists (see “The Comanagement Conundrum,” p. 1, April 2011) is an expanded role in the perioperative care of surgical patients—extending from before the operation into rehabilitation. To be successful, hospitalists should think more broadly than the usual focus on medical needs immediately post-surgery, says Burke Kealey, MD, director of perioperative comanagement at Regions Hospital in St. Paul, Minn.

The perioperative service at Regions includes staffing of a pre-operative clinic, a partnership with the hospital’s anesthesia department, and use of a pre-operative patient checklist. Many primary-care physicians (PCPs) want to retain a role in the pre-operative assessments of their patients, so the Regions service has tried to partner with physicians in the community to work on standardizing the process.

Dr. Kealey, an SHM board member, was hired by Regions’ orthopedic department right out of residency in 1995 to do medical comanagement of its patients. His service later was absorbed into an emerging HM department. It has experimented with models including the use of nurse practitioners and physician assistants.

Today, Regions dedicates three of its 16 full-time hospitalist teams to comanagement services, largely on the orthopedics floor, but also for cardiovascular surgery and urology. “As hospitalists, we can help to facilitate using the best, up-to-date medical knowledge” both before and after surgery, he says.

At the University of Rochester School of Medicine in New York, a group of fellowship-trained geriatric hospitalists has taken on comanagement of hip fracture patients at the Geriatric Fracture Center, leading to improved processes and patient outcomes.¹ According to hospitalist Susan M. Friedman, MD, MPH, the program began as a collaboration between a geriatrician and an orthopedic surgeon. They found that their patients’ outcomes seemed to be better when they worked together on a case, so they sat down to talk about what they were doing and how to standardize it.

“From the start, they set the tone for how this is supposed work, and when it doesn’t, they find out why and address it,” Dr. Friedman says. The program does not use a formal service agreement, but there is a strong emphasis on co-ownership, mutual respect, and communication. “One thing that has helped us a lot is data-gathering,” she adds. The hip fracture comanagement has cut lengths of stay and readmissions by half and complications by one-third for the mostly elderly patients.

Larry Beresford is a freelance writer based in Oakland, Calif.

Reference

1. Friedman SM, Mendelson DA, Bingham KW, Kates SL. Impact of co-managed geriatric fracture center on short-term hip fracture outcomes. Arch Intern Med. 2009;169(18):1712-1717.

Robert Wachter, MD, MHM, has spoken at SHM’s annual meeting every year since 2003.

The opportunity to address 2,500 physician leaders in clinical work, education, and quality improvement—and the chance to suggest where they should be placing their emphasis—is incredibly special, Dr. Wachter says.

“It’s an amazing chance to try to influence the fastest-growing specialty in history,” says the professor, chief of the Division of Hospital Medicine, and chief of the medical service at the University of California at San Francisco Medical Center.

“I like to think I have some small impact on the work they go out and do the next day, so it feels like a way of extending my own influence on this extraordinary field,” adds Dr. Wachter, a former SHM president and author of the blog Wachter’s World (www.wachtersworld.com). “That’s a great privilege.”

Dr. Wachter will speak at HM11 on Friday, May 13. The Hospitalist caught up with him to discuss some of his presentation.

Question: Why would you encourage hospitalists to attend HM11?

Answer: The content is great, and it is broad enough that it doesn’t matter whether you are coming to learn the latest ways to manage sepsis or the best ways to organize your program. We are able to attract the best leaders in the world to come speak, so the talent pool is unmatched. And the collegial exchange is fantastic. There’s as much important work that happens in the hallways as happens in the conference room.

Q: Bob Kocher, MD, a former special assistant to the president for healthcare and economic policy, will be a featured speaker this year. Why is it important for hospitalists to hear from him?

A: He was as important as any architect of the healthcare reform legislation. Because he left the White House, he can be open and honest about what’s working and not working. I think we need to understand what reform means, why it was organized the way it was, and where someone who was in the middle of that thinks it will go over time.

Q: What do you see as the legislation’s most significant impact on HM?

A: The dominant issue is, how do we create an environment, and a set of policy and payment initiatives, that incent and promote the delivery of the highest quality, safest, most satisfying care at the lowest cost? That’s not just within the silo we call a hospital but across the continuum of care. The bill takes that concept and puts it on steroids.

Robert Wachter, MD, MHM, has spoken at SHM’s annual meeting every year since 2003.

The opportunity to address 2,500 physician leaders in clinical work, education, and quality improvement—and the chance to suggest where they should be placing their emphasis—is incredibly special, Dr. Wachter says.

“It’s an amazing chance to try to influence the fastest-growing specialty in history,” says the professor, chief of the Division of Hospital Medicine, and chief of the medical service at the University of California at San Francisco Medical Center.

“I like to think I have some small impact on the work they go out and do the next day, so it feels like a way of extending my own influence on this extraordinary field,” adds Dr. Wachter, a former SHM president and author of the blog Wachter’s World (www.wachtersworld.com). “That’s a great privilege.”

Dr. Wachter will speak at HM11 on Friday, May 13. The Hospitalist caught up with him to discuss some of his presentation.

Question: Why would you encourage hospitalists to attend HM11?

Answer: The content is great, and it is broad enough that it doesn’t matter whether you are coming to learn the latest ways to manage sepsis or the best ways to organize your program. We are able to attract the best leaders in the world to come speak, so the talent pool is unmatched. And the collegial exchange is fantastic. There’s as much important work that happens in the hallways as happens in the conference room.

Q: Bob Kocher, MD, a former special assistant to the president for healthcare and economic policy, will be a featured speaker this year. Why is it important for hospitalists to hear from him?

A: He was as important as any architect of the healthcare reform legislation. Because he left the White House, he can be open and honest about what’s working and not working. I think we need to understand what reform means, why it was organized the way it was, and where someone who was in the middle of that thinks it will go over time.

Q: What do you see as the legislation’s most significant impact on HM?

A: The dominant issue is, how do we create an environment, and a set of policy and payment initiatives, that incent and promote the delivery of the highest quality, safest, most satisfying care at the lowest cost? That’s not just within the silo we call a hospital but across the continuum of care. The bill takes that concept and puts it on steroids.

Robert Wachter, MD, MHM, has spoken at SHM’s annual meeting every year since 2003.

The opportunity to address 2,500 physician leaders in clinical work, education, and quality improvement—and the chance to suggest where they should be placing their emphasis—is incredibly special, Dr. Wachter says.

“It’s an amazing chance to try to influence the fastest-growing specialty in history,” says the professor, chief of the Division of Hospital Medicine, and chief of the medical service at the University of California at San Francisco Medical Center.

“I like to think I have some small impact on the work they go out and do the next day, so it feels like a way of extending my own influence on this extraordinary field,” adds Dr. Wachter, a former SHM president and author of the blog Wachter’s World (www.wachtersworld.com). “That’s a great privilege.”

Dr. Wachter will speak at HM11 on Friday, May 13. The Hospitalist caught up with him to discuss some of his presentation.

Question: Why would you encourage hospitalists to attend HM11?

Answer: The content is great, and it is broad enough that it doesn’t matter whether you are coming to learn the latest ways to manage sepsis or the best ways to organize your program. We are able to attract the best leaders in the world to come speak, so the talent pool is unmatched. And the collegial exchange is fantastic. There’s as much important work that happens in the hallways as happens in the conference room.

Q: Bob Kocher, MD, a former special assistant to the president for healthcare and economic policy, will be a featured speaker this year. Why is it important for hospitalists to hear from him?

A: He was as important as any architect of the healthcare reform legislation. Because he left the White House, he can be open and honest about what’s working and not working. I think we need to understand what reform means, why it was organized the way it was, and where someone who was in the middle of that thinks it will go over time.

Q: What do you see as the legislation’s most significant impact on HM?

A: The dominant issue is, how do we create an environment, and a set of policy and payment initiatives, that incent and promote the delivery of the highest quality, safest, most satisfying care at the lowest cost? That’s not just within the silo we call a hospital but across the continuum of care. The bill takes that concept and puts it on steroids.

Robert Kocher, MD, is not a household name for hospitalists who aren’t policy wonks. That’s not to say he shouldn’t be.

Dr. Kocher, a former special assistant to President Obama on healthcare and economic policy who is now the director of the McKinsey Center for U.S. Health System Reform in Washington, D.C., was a behind-the-scenes player in the landmark healthcare reform legislation signed into law last year. After a two-year stint in the White House, he transitioned back to the private sector late in 2010, landing at McKinsey & Co., a powerhouse consulting firm in the nation’s capital.

On May 11, Dr. Kocher will give HM11’s first keynote speech, “Coming to Your Hospital: Healthcare Reform. What Does This Mean for Hospitalists.” His talk will be an inside look at how the reform package came together and point out how hospitalists can be “the solution that hospitals will want to deploy to allow them to capitalize” on reform.

“Instead of hospitalists being a de facto link [between different departments of a given hospital], I think hospitalists will be a value-creating link,” Dr. Kocher says. “There’s going to be much more information that’s going to have to flow between the inpatient side and the outpatient side if you’re going to manage population health and lower per capita costs. … It’s going to require more specialization, which hospitalists are in the right position to really take on and to deliver.”

Dr. Kocher (pronounced “coacher”) joined the reform fight in January 2009, taking a post at the National Economic Council as special assistant to the president for healthcare. He left that job last fall and rejoined McKinsey, the firm he had been with for seven years before joining the Obama administration. His career began with a medical degree from George Washington University and internal-medicine residency at Beth Israel Deaconess Medical Center in Boston.

I think hospitalists will be a value-creating link. There’s going to be much more information that’s going to have to flow between the inpatient side and the outpatient side if you’re going to manage population health and lower per capita costs. … It’s going to require more specialization, which hospitalists are in the right position to really take on and to deliver.—Robert Kocher, MD, director, McKinsey Center for U.S. Health System Reform, Washington, D.C.

He followed that with a stint as a clinical fellow and instructor at Harvard Medical School. In addition to his role as a principal at McKinsey, Dr. Kocher is a nonresident senior fellow at the Brookings Institution Engleberg Center for Health Reform.

He is a well-known speaker on healthcare topics and a frequent writer who has authored pieces for major outlets, including the New England Journal of Medicine, the Washington Post and The New York Times. The White House last year filmed him as part of its “Reality Check” Web series (www.whitehouse.gov/realitycheck/31), which is aimed at “debunking the myths” swirling around reform.

Dr. Kocher says all of his career stops pale in comparison to being part of once-in-a-generation talks that shaped the future of U.S. healthcare.

“Certainly, [it was] the most impactful thing I’ll ever get to actually do, because we were able to shape the lasting policies that will change the way healthcare is delivered for years to come,” he says. “It was an incredible privilege to get to observe and take part in that policy-making process and understand that some compromises have to happen to make successful legislation.”

Brendon Shank, SHM’s assistant vice president of communications, says that having a White House participant in the reform negotiations as a featured speaker is a treat for hospitalists.

“This is exciting because it’s someone who helped define policy,” Shank says. “This is someone who knows the inside of it. He’s been in the room for discussions that will affect hospitalists for years down the road.”

Exactly what those effects will be will take time to understand. But Dr. Kocher sees reform as a chance for HM to make itself indispensable to hospitals looking to improve quality, efficiency, and transitional-care outcomes.

The responsibility will, of course, come with the challenge of actually proving that HM can deliver on the pledge of better care at better prices.

“For hospitals, as the payment system evolves and matures, we’re going to be paying more often for outcomes,” Dr. Kocher says. “That change is going to require hospitalists to become much more reliable.

“It’s a more specialized skill that doctors who are part-time hospital doctors are going to have a hard time developing. It clearly makes the system more dependent on hospitalists. … That said, I think that it’s the responsibility of hospitalists to prove they can deliver.”

Dr. Kocher is optimistic that the political squabbling the reform process has sparked will have little lasting impact. He understands HM leaders might be nervous about the potential for political upheaval to translate into medical upheaval, but he doubts that will happen.

“The political rhetoric and scuffling going on in Washington has almost no bearing on the fundamental underlying trend which will drive the market to near-universal use of hospitalists,” he says. “Whether you’re a Republican or Democrat, you share the perspective that the current health system is wildly too expensive.” HM11

Richard Quinn is a freelance writer based in New Jersey.

Robert Kocher, MD, is not a household name for hospitalists who aren’t policy wonks. That’s not to say he shouldn’t be.

Dr. Kocher, a former special assistant to President Obama on healthcare and economic policy who is now the director of the McKinsey Center for U.S. Health System Reform in Washington, D.C., was a behind-the-scenes player in the landmark healthcare reform legislation signed into law last year. After a two-year stint in the White House, he transitioned back to the private sector late in 2010, landing at McKinsey & Co., a powerhouse consulting firm in the nation’s capital.

On May 11, Dr. Kocher will give HM11’s first keynote speech, “Coming to Your Hospital: Healthcare Reform. What Does This Mean for Hospitalists.” His talk will be an inside look at how the reform package came together and point out how hospitalists can be “the solution that hospitals will want to deploy to allow them to capitalize” on reform.

“Instead of hospitalists being a de facto link [between different departments of a given hospital], I think hospitalists will be a value-creating link,” Dr. Kocher says. “There’s going to be much more information that’s going to have to flow between the inpatient side and the outpatient side if you’re going to manage population health and lower per capita costs. … It’s going to require more specialization, which hospitalists are in the right position to really take on and to deliver.”

Dr. Kocher (pronounced “coacher”) joined the reform fight in January 2009, taking a post at the National Economic Council as special assistant to the president for healthcare. He left that job last fall and rejoined McKinsey, the firm he had been with for seven years before joining the Obama administration. His career began with a medical degree from George Washington University and internal-medicine residency at Beth Israel Deaconess Medical Center in Boston.

I think hospitalists will be a value-creating link. There’s going to be much more information that’s going to have to flow between the inpatient side and the outpatient side if you’re going to manage population health and lower per capita costs. … It’s going to require more specialization, which hospitalists are in the right position to really take on and to deliver.—Robert Kocher, MD, director, McKinsey Center for U.S. Health System Reform, Washington, D.C.

He followed that with a stint as a clinical fellow and instructor at Harvard Medical School. In addition to his role as a principal at McKinsey, Dr. Kocher is a nonresident senior fellow at the Brookings Institution Engleberg Center for Health Reform.

He is a well-known speaker on healthcare topics and a frequent writer who has authored pieces for major outlets, including the New England Journal of Medicine, the Washington Post and The New York Times. The White House last year filmed him as part of its “Reality Check” Web series (www.whitehouse.gov/realitycheck/31), which is aimed at “debunking the myths” swirling around reform.

Dr. Kocher says all of his career stops pale in comparison to being part of once-in-a-generation talks that shaped the future of U.S. healthcare.

“Certainly, [it was] the most impactful thing I’ll ever get to actually do, because we were able to shape the lasting policies that will change the way healthcare is delivered for years to come,” he says. “It was an incredible privilege to get to observe and take part in that policy-making process and understand that some compromises have to happen to make successful legislation.”

Brendon Shank, SHM’s assistant vice president of communications, says that having a White House participant in the reform negotiations as a featured speaker is a treat for hospitalists.

“This is exciting because it’s someone who helped define policy,” Shank says. “This is someone who knows the inside of it. He’s been in the room for discussions that will affect hospitalists for years down the road.”

Exactly what those effects will be will take time to understand. But Dr. Kocher sees reform as a chance for HM to make itself indispensable to hospitals looking to improve quality, efficiency, and transitional-care outcomes.

The responsibility will, of course, come with the challenge of actually proving that HM can deliver on the pledge of better care at better prices.

“For hospitals, as the payment system evolves and matures, we’re going to be paying more often for outcomes,” Dr. Kocher says. “That change is going to require hospitalists to become much more reliable.

“It’s a more specialized skill that doctors who are part-time hospital doctors are going to have a hard time developing. It clearly makes the system more dependent on hospitalists. … That said, I think that it’s the responsibility of hospitalists to prove they can deliver.”

Dr. Kocher is optimistic that the political squabbling the reform process has sparked will have little lasting impact. He understands HM leaders might be nervous about the potential for political upheaval to translate into medical upheaval, but he doubts that will happen.

“The political rhetoric and scuffling going on in Washington has almost no bearing on the fundamental underlying trend which will drive the market to near-universal use of hospitalists,” he says. “Whether you’re a Republican or Democrat, you share the perspective that the current health system is wildly too expensive.” HM11

Richard Quinn is a freelance writer based in New Jersey.

Robert Kocher, MD, is not a household name for hospitalists who aren’t policy wonks. That’s not to say he shouldn’t be.

Dr. Kocher, a former special assistant to President Obama on healthcare and economic policy who is now the director of the McKinsey Center for U.S. Health System Reform in Washington, D.C., was a behind-the-scenes player in the landmark healthcare reform legislation signed into law last year. After a two-year stint in the White House, he transitioned back to the private sector late in 2010, landing at McKinsey & Co., a powerhouse consulting firm in the nation’s capital.

On May 11, Dr. Kocher will give HM11’s first keynote speech, “Coming to Your Hospital: Healthcare Reform. What Does This Mean for Hospitalists.” His talk will be an inside look at how the reform package came together and point out how hospitalists can be “the solution that hospitals will want to deploy to allow them to capitalize” on reform.

“Instead of hospitalists being a de facto link [between different departments of a given hospital], I think hospitalists will be a value-creating link,” Dr. Kocher says. “There’s going to be much more information that’s going to have to flow between the inpatient side and the outpatient side if you’re going to manage population health and lower per capita costs. … It’s going to require more specialization, which hospitalists are in the right position to really take on and to deliver.”

Dr. Kocher (pronounced “coacher”) joined the reform fight in January 2009, taking a post at the National Economic Council as special assistant to the president for healthcare. He left that job last fall and rejoined McKinsey, the firm he had been with for seven years before joining the Obama administration. His career began with a medical degree from George Washington University and internal-medicine residency at Beth Israel Deaconess Medical Center in Boston.

I think hospitalists will be a value-creating link. There’s going to be much more information that’s going to have to flow between the inpatient side and the outpatient side if you’re going to manage population health and lower per capita costs. … It’s going to require more specialization, which hospitalists are in the right position to really take on and to deliver.—Robert Kocher, MD, director, McKinsey Center for U.S. Health System Reform, Washington, D.C.

He followed that with a stint as a clinical fellow and instructor at Harvard Medical School. In addition to his role as a principal at McKinsey, Dr. Kocher is a nonresident senior fellow at the Brookings Institution Engleberg Center for Health Reform.

He is a well-known speaker on healthcare topics and a frequent writer who has authored pieces for major outlets, including the New England Journal of Medicine, the Washington Post and The New York Times. The White House last year filmed him as part of its “Reality Check” Web series (www.whitehouse.gov/realitycheck/31), which is aimed at “debunking the myths” swirling around reform.

Dr. Kocher says all of his career stops pale in comparison to being part of once-in-a-generation talks that shaped the future of U.S. healthcare.

“Certainly, [it was] the most impactful thing I’ll ever get to actually do, because we were able to shape the lasting policies that will change the way healthcare is delivered for years to come,” he says. “It was an incredible privilege to get to observe and take part in that policy-making process and understand that some compromises have to happen to make successful legislation.”

Brendon Shank, SHM’s assistant vice president of communications, says that having a White House participant in the reform negotiations as a featured speaker is a treat for hospitalists.

“This is exciting because it’s someone who helped define policy,” Shank says. “This is someone who knows the inside of it. He’s been in the room for discussions that will affect hospitalists for years down the road.”

Exactly what those effects will be will take time to understand. But Dr. Kocher sees reform as a chance for HM to make itself indispensable to hospitals looking to improve quality, efficiency, and transitional-care outcomes.

The responsibility will, of course, come with the challenge of actually proving that HM can deliver on the pledge of better care at better prices.

“For hospitals, as the payment system evolves and matures, we’re going to be paying more often for outcomes,” Dr. Kocher says. “That change is going to require hospitalists to become much more reliable.

“It’s a more specialized skill that doctors who are part-time hospital doctors are going to have a hard time developing. It clearly makes the system more dependent on hospitalists. … That said, I think that it’s the responsibility of hospitalists to prove they can deliver.”

Dr. Kocher is optimistic that the political squabbling the reform process has sparked will have little lasting impact. He understands HM leaders might be nervous about the potential for political upheaval to translate into medical upheaval, but he doubts that will happen.

“The political rhetoric and scuffling going on in Washington has almost no bearing on the fundamental underlying trend which will drive the market to near-universal use of hospitalists,” he says. “Whether you’re a Republican or Democrat, you share the perspective that the current health system is wildly too expensive.” HM11

Richard Quinn is a freelance writer based in New Jersey.

Dr. Cox

The position of visiting professor is a bit amorphous at the SHM annual meeting. The honoree presides over the best of the Research, Innovations, and Clinical Vignettes (RIV) presentations and leads rounds of the RIV poster sessions. They can serve as an informal mentor to early-career physicians and be a sounding board for seasoned practitioners.

This year, the visiting professor will be as much a student as a teacher.

“I always think when I go to educate others … the best way of doing that is to have a bidirectional kind of interchange,” says Malcolm Cox, MD, chief academic affiliations officer for the U.S. Department of Veterans Affairs in Washington, D.C., and an adjunct professor of medicine at the University of Pennsylvania in Philadelphia. “I inevitably learn more from my ‘students’ than I think I ever provide to my students, in any teaching opportunity. That’s just a philosophy I’ve had for 40 years.”

Dr. Cox, a kidney specialist and career academician, was invited to be the visiting professor by SHM President Jeff Wiese, MD, FACP, SFHM. Dr. Cox views his role as that of an “interrogative fly on the wall,” and he hopes to stimulate discussions about HM’s role in the broader medical landscape.

“How hospitalists can work with their other colleagues to enhance continuity,” he says, “and, in particular, within that more narrow frame, an even more narrow frame is how they would relate to and work with primary-care folks in the aftercare environment to enhance continuity of care.” HM11

Richard Quinn is a freelance writer based in New Jersey.

Dr. Cox

The position of visiting professor is a bit amorphous at the SHM annual meeting. The honoree presides over the best of the Research, Innovations, and Clinical Vignettes (RIV) presentations and leads rounds of the RIV poster sessions. They can serve as an informal mentor to early-career physicians and be a sounding board for seasoned practitioners.

This year, the visiting professor will be as much a student as a teacher.

“I always think when I go to educate others … the best way of doing that is to have a bidirectional kind of interchange,” says Malcolm Cox, MD, chief academic affiliations officer for the U.S. Department of Veterans Affairs in Washington, D.C., and an adjunct professor of medicine at the University of Pennsylvania in Philadelphia. “I inevitably learn more from my ‘students’ than I think I ever provide to my students, in any teaching opportunity. That’s just a philosophy I’ve had for 40 years.”

Dr. Cox, a kidney specialist and career academician, was invited to be the visiting professor by SHM President Jeff Wiese, MD, FACP, SFHM. Dr. Cox views his role as that of an “interrogative fly on the wall,” and he hopes to stimulate discussions about HM’s role in the broader medical landscape.

“How hospitalists can work with their other colleagues to enhance continuity,” he says, “and, in particular, within that more narrow frame, an even more narrow frame is how they would relate to and work with primary-care folks in the aftercare environment to enhance continuity of care.” HM11

Richard Quinn is a freelance writer based in New Jersey.

Dr. Cox

The position of visiting professor is a bit amorphous at the SHM annual meeting. The honoree presides over the best of the Research, Innovations, and Clinical Vignettes (RIV) presentations and leads rounds of the RIV poster sessions. They can serve as an informal mentor to early-career physicians and be a sounding board for seasoned practitioners.

This year, the visiting professor will be as much a student as a teacher.

“I always think when I go to educate others … the best way of doing that is to have a bidirectional kind of interchange,” says Malcolm Cox, MD, chief academic affiliations officer for the U.S. Department of Veterans Affairs in Washington, D.C., and an adjunct professor of medicine at the University of Pennsylvania in Philadelphia. “I inevitably learn more from my ‘students’ than I think I ever provide to my students, in any teaching opportunity. That’s just a philosophy I’ve had for 40 years.”

Dr. Cox, a kidney specialist and career academician, was invited to be the visiting professor by SHM President Jeff Wiese, MD, FACP, SFHM. Dr. Cox views his role as that of an “interrogative fly on the wall,” and he hopes to stimulate discussions about HM’s role in the broader medical landscape.

“How hospitalists can work with their other colleagues to enhance continuity,” he says, “and, in particular, within that more narrow frame, an even more narrow frame is how they would relate to and work with primary-care folks in the aftercare environment to enhance continuity of care.” HM11

Richard Quinn is a freelance writer based in New Jersey.

Dr. Greeno

Ron Greeno, MD, SFHM, chief medical officer for Brentwood, Tenn.-based Cogent Healthcare, will arrive at HM11 and embark on a whirlwind of meet-and-greets, dinners, drinks, and introductions. At the same time, first-year attendee Amaka Nweke, assistant site director for Hospitalists Management Group at Kenosha Medical Center in Wisconsin, will focus on sessions that will help her learn the management skills she can use to further her career.

To be sure, Dr. Greeno will attend a few classes to brush up on specific topics. And Dr. Nweke will ask for business cards as she builds a professional network. But each has to pick a strategy to navigate the four-day annual meeting in Grapevine, Texas.

“You can’t do everything,” says Daniel Dressler, MD, MSc, SFHM, associate professor and director of internal-medicine teaching services at Emory University Hospital in Atlanta, SHM board member, and HM11’s course director. “You have to plan and ask, ‘What do I want to get out of this meeting this year?’ ”

The Hospitalist talked to more than a half-dozen providers in various HM roles to determine just what they expect out of their annual meeting. The physicians fall into broad categories that capture most of the roughly 2,500 attendees at the annual meeting: first-timer, veteran, academic, rural hospitalist, up-and-comer, socialite. And while each says plenary sessions and keynote addresses are must-sees, the tack they take for the rest of the week is custom-made.

The First-Timer

Dr. Nweke, who finished her residency in 2009, wasn’t sure how to map out her meeting schedule until she decided to attend two medical conferences this year. She plans to get her clinical refreshers at the annual meeting of the American College of Physicians (ACP), and use SHM’s affair to teach her the managerial and administrative skills she needs to eventually become an HM group leader. Her particular focuses include process improvement and length-of-stay (LOS) reduction methods.

“Originally, when I wasn’t sure what I wanted to get out of SHM, it was very daunting,” she says. “For meetings like this, you have to figure out what you want out of the course. Once you figure that out, it makes it easy to register for a course. If you don’t know and you’re just going, it’s definitely extremely daunting.”

The Veteran

Dr. Dichter

Jeffrey Dichter, MD, FACP, SFHM, medical director for the cardiovascular ICU at Regions Hospital in St. Paul, Minn., only missed two of the first 14 annual meetings. He picks a topic area each year that he wants to focus on, then tailors his schedule to that idea. This year, it’s quality improvement. An academician at heart, he also attends the abstract poster sessions to get “a real flavor for the researchers and what people are thinking about for HM.”

“You’re not going to get to everything every year,” he says knowingly. “You just try to mix and match. Early on, you could see everything. Since it’s grown, you realize you can’t see everything. You learn to adapt.”

The Academic

Danielle Scheurer, MD, MSc, SFHM, medical director of quality and safety at the Medical University of South Carolina in Charleston, uses the meeting as a sounding board to solve problems. Community HM groups don’t have the sort of turnover issues that academic medical centers do, so meeting with like-minded colleagues provides the chance to find the “little pearls from any medical center that you can take back.”

“Since I do a lot of quality improvement, I just like the opportunity to see how other people are doing things that we are struggling with,” says Dr. Scheurer, SHM’s physician advisor. “It amazes me the ubiquity of how we all struggle around the same types of things.”

The Rural Hospitalist

Martin Johns, MD, a hospitalist at Gifford Medical Center in Randolph, Vt., (pop. 4,853) could use an entire focused track on rural medicine. In particular, rural hospitalists often perform multiple roles—administrative or clinical—and best-practice recommendations would be valuable. Networking has its place at the meeting, but given that many rural physicians have long tenures, the real goal is bring useful information back to the group. “What is good about the SHM [meeting] is you are exposed to know what’s happening regionally,” Dr. Johns says. “You get a flavor for the national tenor. That’s important, because in a small place, you only have a certain allotment for CME funds.”

The Up-and-Comer

Christina Payne, MD, an academic hospitalist at Emory University Hospital in Atlanta who finished her residency in June, sees herself as a potential future leader in the field. She presented a poster at last year’s meeting and works on a SHM committee for early-career hospitalists.

A quality-minded academician, Dr. Payne plans to take advantage of meeting the leading minds in HM and use them as mentors to help her help the field.

“It’s learning to walk the walk and talk the talk,” she says. “I’m still new at that, but I’m ready to put myself out there. … My excitement for hospital medicine puts me in an ideal spot. In 20 years, hopefully, we’ll be the ones for other people to come to for mentorship.”

The Socialite

Dr. Dressler refers to Dr. Greeno, a cofounder of Cogent, as the “ultimate socialite.” Dr. Greeno is often a panelist at the annual meeting and spends much of his time catching up with colleagues around the country he does not often see in person. He makes sure to catch three or four handpicked sessions but typically looks most forward to being approached by younger physicians as he sees the young field of HM take hold with a new generation.

“The entire time I’m there, I’m talking to someone, whether it’s planned or I run into someone,” he says. “It’s the one time I usually end up having dinner and end up having drinks with folks and talking with people well into the night. It really does give you a chance to recharge your battery and get excited about what we’re doing again.” HM11

Richard Quinn is a freelance writer based in New Jersey.

Dr. Greeno

Ron Greeno, MD, SFHM, chief medical officer for Brentwood, Tenn.-based Cogent Healthcare, will arrive at HM11 and embark on a whirlwind of meet-and-greets, dinners, drinks, and introductions. At the same time, first-year attendee Amaka Nweke, assistant site director for Hospitalists Management Group at Kenosha Medical Center in Wisconsin, will focus on sessions that will help her learn the management skills she can use to further her career.

To be sure, Dr. Greeno will attend a few classes to brush up on specific topics. And Dr. Nweke will ask for business cards as she builds a professional network. But each has to pick a strategy to navigate the four-day annual meeting in Grapevine, Texas.

“You can’t do everything,” says Daniel Dressler, MD, MSc, SFHM, associate professor and director of internal-medicine teaching services at Emory University Hospital in Atlanta, SHM board member, and HM11’s course director. “You have to plan and ask, ‘What do I want to get out of this meeting this year?’ ”

The Hospitalist talked to more than a half-dozen providers in various HM roles to determine just what they expect out of their annual meeting. The physicians fall into broad categories that capture most of the roughly 2,500 attendees at the annual meeting: first-timer, veteran, academic, rural hospitalist, up-and-comer, socialite. And while each says plenary sessions and keynote addresses are must-sees, the tack they take for the rest of the week is custom-made.

The First-Timer

Dr. Nweke, who finished her residency in 2009, wasn’t sure how to map out her meeting schedule until she decided to attend two medical conferences this year. She plans to get her clinical refreshers at the annual meeting of the American College of Physicians (ACP), and use SHM’s affair to teach her the managerial and administrative skills she needs to eventually become an HM group leader. Her particular focuses include process improvement and length-of-stay (LOS) reduction methods.

“Originally, when I wasn’t sure what I wanted to get out of SHM, it was very daunting,” she says. “For meetings like this, you have to figure out what you want out of the course. Once you figure that out, it makes it easy to register for a course. If you don’t know and you’re just going, it’s definitely extremely daunting.”

The Veteran

Dr. Dichter

Jeffrey Dichter, MD, FACP, SFHM, medical director for the cardiovascular ICU at Regions Hospital in St. Paul, Minn., only missed two of the first 14 annual meetings. He picks a topic area each year that he wants to focus on, then tailors his schedule to that idea. This year, it’s quality improvement. An academician at heart, he also attends the abstract poster sessions to get “a real flavor for the researchers and what people are thinking about for HM.”

“You’re not going to get to everything every year,” he says knowingly. “You just try to mix and match. Early on, you could see everything. Since it’s grown, you realize you can’t see everything. You learn to adapt.”

The Academic

Danielle Scheurer, MD, MSc, SFHM, medical director of quality and safety at the Medical University of South Carolina in Charleston, uses the meeting as a sounding board to solve problems. Community HM groups don’t have the sort of turnover issues that academic medical centers do, so meeting with like-minded colleagues provides the chance to find the “little pearls from any medical center that you can take back.”

“Since I do a lot of quality improvement, I just like the opportunity to see how other people are doing things that we are struggling with,” says Dr. Scheurer, SHM’s physician advisor. “It amazes me the ubiquity of how we all struggle around the same types of things.”

The Rural Hospitalist

Martin Johns, MD, a hospitalist at Gifford Medical Center in Randolph, Vt., (pop. 4,853) could use an entire focused track on rural medicine. In particular, rural hospitalists often perform multiple roles—administrative or clinical—and best-practice recommendations would be valuable. Networking has its place at the meeting, but given that many rural physicians have long tenures, the real goal is bring useful information back to the group. “What is good about the SHM [meeting] is you are exposed to know what’s happening regionally,” Dr. Johns says. “You get a flavor for the national tenor. That’s important, because in a small place, you only have a certain allotment for CME funds.”

The Up-and-Comer

Christina Payne, MD, an academic hospitalist at Emory University Hospital in Atlanta who finished her residency in June, sees herself as a potential future leader in the field. She presented a poster at last year’s meeting and works on a SHM committee for early-career hospitalists.

A quality-minded academician, Dr. Payne plans to take advantage of meeting the leading minds in HM and use them as mentors to help her help the field.

“It’s learning to walk the walk and talk the talk,” she says. “I’m still new at that, but I’m ready to put myself out there. … My excitement for hospital medicine puts me in an ideal spot. In 20 years, hopefully, we’ll be the ones for other people to come to for mentorship.”

The Socialite

Dr. Dressler refers to Dr. Greeno, a cofounder of Cogent, as the “ultimate socialite.” Dr. Greeno is often a panelist at the annual meeting and spends much of his time catching up with colleagues around the country he does not often see in person. He makes sure to catch three or four handpicked sessions but typically looks most forward to being approached by younger physicians as he sees the young field of HM take hold with a new generation.

“The entire time I’m there, I’m talking to someone, whether it’s planned or I run into someone,” he says. “It’s the one time I usually end up having dinner and end up having drinks with folks and talking with people well into the night. It really does give you a chance to recharge your battery and get excited about what we’re doing again.” HM11

Richard Quinn is a freelance writer based in New Jersey.

Dr. Greeno

Ron Greeno, MD, SFHM, chief medical officer for Brentwood, Tenn.-based Cogent Healthcare, will arrive at HM11 and embark on a whirlwind of meet-and-greets, dinners, drinks, and introductions. At the same time, first-year attendee Amaka Nweke, assistant site director for Hospitalists Management Group at Kenosha Medical Center in Wisconsin, will focus on sessions that will help her learn the management skills she can use to further her career.

To be sure, Dr. Greeno will attend a few classes to brush up on specific topics. And Dr. Nweke will ask for business cards as she builds a professional network. But each has to pick a strategy to navigate the four-day annual meeting in Grapevine, Texas.

“You can’t do everything,” says Daniel Dressler, MD, MSc, SFHM, associate professor and director of internal-medicine teaching services at Emory University Hospital in Atlanta, SHM board member, and HM11’s course director. “You have to plan and ask, ‘What do I want to get out of this meeting this year?’ ”

The Hospitalist talked to more than a half-dozen providers in various HM roles to determine just what they expect out of their annual meeting. The physicians fall into broad categories that capture most of the roughly 2,500 attendees at the annual meeting: first-timer, veteran, academic, rural hospitalist, up-and-comer, socialite. And while each says plenary sessions and keynote addresses are must-sees, the tack they take for the rest of the week is custom-made.

The First-Timer

Dr. Nweke, who finished her residency in 2009, wasn’t sure how to map out her meeting schedule until she decided to attend two medical conferences this year. She plans to get her clinical refreshers at the annual meeting of the American College of Physicians (ACP), and use SHM’s affair to teach her the managerial and administrative skills she needs to eventually become an HM group leader. Her particular focuses include process improvement and length-of-stay (LOS) reduction methods.

“Originally, when I wasn’t sure what I wanted to get out of SHM, it was very daunting,” she says. “For meetings like this, you have to figure out what you want out of the course. Once you figure that out, it makes it easy to register for a course. If you don’t know and you’re just going, it’s definitely extremely daunting.”

The Veteran

Dr. Dichter

Jeffrey Dichter, MD, FACP, SFHM, medical director for the cardiovascular ICU at Regions Hospital in St. Paul, Minn., only missed two of the first 14 annual meetings. He picks a topic area each year that he wants to focus on, then tailors his schedule to that idea. This year, it’s quality improvement. An academician at heart, he also attends the abstract poster sessions to get “a real flavor for the researchers and what people are thinking about for HM.”

“You’re not going to get to everything every year,” he says knowingly. “You just try to mix and match. Early on, you could see everything. Since it’s grown, you realize you can’t see everything. You learn to adapt.”

The Academic

Danielle Scheurer, MD, MSc, SFHM, medical director of quality and safety at the Medical University of South Carolina in Charleston, uses the meeting as a sounding board to solve problems. Community HM groups don’t have the sort of turnover issues that academic medical centers do, so meeting with like-minded colleagues provides the chance to find the “little pearls from any medical center that you can take back.”

“Since I do a lot of quality improvement, I just like the opportunity to see how other people are doing things that we are struggling with,” says Dr. Scheurer, SHM’s physician advisor. “It amazes me the ubiquity of how we all struggle around the same types of things.”

The Rural Hospitalist

Martin Johns, MD, a hospitalist at Gifford Medical Center in Randolph, Vt., (pop. 4,853) could use an entire focused track on rural medicine. In particular, rural hospitalists often perform multiple roles—administrative or clinical—and best-practice recommendations would be valuable. Networking has its place at the meeting, but given that many rural physicians have long tenures, the real goal is bring useful information back to the group. “What is good about the SHM [meeting] is you are exposed to know what’s happening regionally,” Dr. Johns says. “You get a flavor for the national tenor. That’s important, because in a small place, you only have a certain allotment for CME funds.”

The Up-and-Comer

Christina Payne, MD, an academic hospitalist at Emory University Hospital in Atlanta who finished her residency in June, sees herself as a potential future leader in the field. She presented a poster at last year’s meeting and works on a SHM committee for early-career hospitalists.

A quality-minded academician, Dr. Payne plans to take advantage of meeting the leading minds in HM and use them as mentors to help her help the field.

“It’s learning to walk the walk and talk the talk,” she says. “I’m still new at that, but I’m ready to put myself out there. … My excitement for hospital medicine puts me in an ideal spot. In 20 years, hopefully, we’ll be the ones for other people to come to for mentorship.”

The Socialite

Dr. Dressler refers to Dr. Greeno, a cofounder of Cogent, as the “ultimate socialite.” Dr. Greeno is often a panelist at the annual meeting and spends much of his time catching up with colleagues around the country he does not often see in person. He makes sure to catch three or four handpicked sessions but typically looks most forward to being approached by younger physicians as he sees the young field of HM take hold with a new generation.

“The entire time I’m there, I’m talking to someone, whether it’s planned or I run into someone,” he says. “It’s the one time I usually end up having dinner and end up having drinks with folks and talking with people well into the night. It really does give you a chance to recharge your battery and get excited about what we’re doing again.” HM11

Richard Quinn is a freelance writer based in New Jersey.

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Dr. Watcher

When Robert Wachter, MD, MHM, delivers his keynote address to unofficially close HM11, he’ll toast the field he helped define. His remarks will coincide with the 15th anniversary of the article he and Lee Goldman, MD, coauthored in The New England Journal of Medicine that coined the term “hospitalist” and fostered an understanding that the HM movement was a true phenomenon.

The milestone presents the perfect opportunity to examine the specialty’s meteoric growth and celebrate the successes of its pioneers, says Dr. Wachter, a professor, chief of the Division of Hospital Medicine, and chief of the medical service at the University of California at San Francisco Medical Center. He also considers it an ideal time to examine the unforeseen developments of the past decade and a half, believing a critical analysis of a few key case studies can help lay the groundwork for an even brighter future.

“At 15, you’re in mid- to late adolescence,” Dr. Wachter says. “We can no longer say we’re this new kid on the block and, ‘Gee, whiz, isn’t this neat?’

“This is a good chance to reflect on things that went as we expected,” he adds. “It’s an even better chance to take a second look at things that were surprising but provide valuable lessons as we think about what the next 15 years are going to be like.”

Question: Fifteen years ago, did you envision HM would grow so quickly?

Answer: I had a sense this was a trend that was starting to emerge and could fill an important niche. At the same time, when Sergey (Brin) and Larry (Page) founded Google, I doubt they believed it would become a $200 billion company. In the beginning, I couldn’t have predicted what this would become.

Q: What surprised you most in the past 15 years?

A: I didn’t fully appreciate how quickly the push toward value would become a dominant theme. Once we discovered quality was important and there was a set of skills we needed to learn to improve it, we tackled it aggressively. It has been harder to tackle the cost part of the equation.

This goes beyond making sure patients don’t stay in the hospital longer than they need to. It means looking hard at the cost of care and the way we spend money, such as our patterns of ordering X-rays, consultants, and lab tests. I’m going to focus a fair amount on that.

Q: Why do you want to emphasize that point?

A: The cost of healthcare is going to bankrupt the country unless we get a handle on it. Our field needs to lead the way to show how a good, ethical physician not only focuses on improving quality of care, but also focuses on ridding the system of waste and of care that adds no real value to our patients. We’ve been a little sluggish in that area.

Q: What other surprises do you intend to discuss?

A: I didn’t anticipate the emergence of two different versions of the hospitalist field. One is the role of comanagement. The other is what I call the hyphenated hospitalist—these OB hospitalists and surgery hospitalists. This concept we came up with for general patients has been embraced by a variety of specialties. How do those people fit into our society and our field? Are they really part of us or are they fundamentally different? I think we need to think carefully about it.

Q: Why are the unexpected developments so important to consider?

A: Leaders in the field need to get really good at reading tea leaves. One of the ways you do that is to figure out, when you didn’t read them correctly the first time, why didn’t you? Could you have read them better if you were more clever or more thoughtful?

Q: What is the biggest challenge facing HM?

A: When we have been given new tasks and new opportunities, our members have stepped up to the plate and done what they’ve been asked to do as well, if not better, than expected. I’m a little fearful of the flip side. How we will meet the demand for our services? How do we ensure the job stays attractive and we don’t burn out? We have to demonstrate our value, but we have to make sure the jobs are truly sustainable and that we don’t shoot ourselves in the foot.

Q:What do you see as the solution?

A: I don’t think we’ll be able to meet all of the demand. There will be hospitals that can only partly staff the needs they have with hospitalists. I don’t want them to go too far down the quality curve. We need to be sure people entering the field are good and have the skills they need.

I think we’ll begin to ask important questions like, “Do I really need a hospitalist for this, or can I leverage fewer hospitalists with other nonphysician providers?” Or, “Can some of the work our hospitalists are doing be done as well and more cheaply by computers?” It opens a pathway to think more creatively about people and tasks and technologies.

Q: Despite the challenges associated with growth pressure, is HM better positioned for the future because of it?

A: Definitely. We will see a further extension of our reach into other areas of the hospital and healthcare system. We will continue to see our people begin as leaders in our world of hospital medicine but rapidly graduate to become hospital CEOs, chairs of departments of medicine, and major leaders in healthcare. There is a recognition that there’s no better training ground to be a leader in healthcare than to be a leader in our field. So I can’t help but be optimistic that our place in the world of healthcare is extraordinarily secure. HM11

Mark Leiser is a freelance writer based in New Jersey.

Dr. Watcher

When Robert Wachter, MD, MHM, delivers his keynote address to unofficially close HM11, he’ll toast the field he helped define. His remarks will coincide with the 15th anniversary of the article he and Lee Goldman, MD, coauthored in The New England Journal of Medicine that coined the term “hospitalist” and fostered an understanding that the HM movement was a true phenomenon.

The milestone presents the perfect opportunity to examine the specialty’s meteoric growth and celebrate the successes of its pioneers, says Dr. Wachter, a professor, chief of the Division of Hospital Medicine, and chief of the medical service at the University of California at San Francisco Medical Center. He also considers it an ideal time to examine the unforeseen developments of the past decade and a half, believing a critical analysis of a few key case studies can help lay the groundwork for an even brighter future.

“At 15, you’re in mid- to late adolescence,” Dr. Wachter says. “We can no longer say we’re this new kid on the block and, ‘Gee, whiz, isn’t this neat?’

“This is a good chance to reflect on things that went as we expected,” he adds. “It’s an even better chance to take a second look at things that were surprising but provide valuable lessons as we think about what the next 15 years are going to be like.”

Question: Fifteen years ago, did you envision HM would grow so quickly?

Answer: I had a sense this was a trend that was starting to emerge and could fill an important niche. At the same time, when Sergey (Brin) and Larry (Page) founded Google, I doubt they believed it would become a $200 billion company. In the beginning, I couldn’t have predicted what this would become.

Q: What surprised you most in the past 15 years?

A: I didn’t fully appreciate how quickly the push toward value would become a dominant theme. Once we discovered quality was important and there was a set of skills we needed to learn to improve it, we tackled it aggressively. It has been harder to tackle the cost part of the equation.

This goes beyond making sure patients don’t stay in the hospital longer than they need to. It means looking hard at the cost of care and the way we spend money, such as our patterns of ordering X-rays, consultants, and lab tests. I’m going to focus a fair amount on that.

Q: Why do you want to emphasize that point?

A: The cost of healthcare is going to bankrupt the country unless we get a handle on it. Our field needs to lead the way to show how a good, ethical physician not only focuses on improving quality of care, but also focuses on ridding the system of waste and of care that adds no real value to our patients. We’ve been a little sluggish in that area.

Q: What other surprises do you intend to discuss?

A: I didn’t anticipate the emergence of two different versions of the hospitalist field. One is the role of comanagement. The other is what I call the hyphenated hospitalist—these OB hospitalists and surgery hospitalists. This concept we came up with for general patients has been embraced by a variety of specialties. How do those people fit into our society and our field? Are they really part of us or are they fundamentally different? I think we need to think carefully about it.

Q: Why are the unexpected developments so important to consider?

A: Leaders in the field need to get really good at reading tea leaves. One of the ways you do that is to figure out, when you didn’t read them correctly the first time, why didn’t you? Could you have read them better if you were more clever or more thoughtful?

Q: What is the biggest challenge facing HM?

A: When we have been given new tasks and new opportunities, our members have stepped up to the plate and done what they’ve been asked to do as well, if not better, than expected. I’m a little fearful of the flip side. How we will meet the demand for our services? How do we ensure the job stays attractive and we don’t burn out? We have to demonstrate our value, but we have to make sure the jobs are truly sustainable and that we don’t shoot ourselves in the foot.

Q:What do you see as the solution?

A: I don’t think we’ll be able to meet all of the demand. There will be hospitals that can only partly staff the needs they have with hospitalists. I don’t want them to go too far down the quality curve. We need to be sure people entering the field are good and have the skills they need.

I think we’ll begin to ask important questions like, “Do I really need a hospitalist for this, or can I leverage fewer hospitalists with other nonphysician providers?” Or, “Can some of the work our hospitalists are doing be done as well and more cheaply by computers?” It opens a pathway to think more creatively about people and tasks and technologies.

Q: Despite the challenges associated with growth pressure, is HM better positioned for the future because of it?

A: Definitely. We will see a further extension of our reach into other areas of the hospital and healthcare system. We will continue to see our people begin as leaders in our world of hospital medicine but rapidly graduate to become hospital CEOs, chairs of departments of medicine, and major leaders in healthcare. There is a recognition that there’s no better training ground to be a leader in healthcare than to be a leader in our field. So I can’t help but be optimistic that our place in the world of healthcare is extraordinarily secure. HM11

Mark Leiser is a freelance writer based in New Jersey.

Dr. Watcher

When Robert Wachter, MD, MHM, delivers his keynote address to unofficially close HM11, he’ll toast the field he helped define. His remarks will coincide with the 15th anniversary of the article he and Lee Goldman, MD, coauthored in The New England Journal of Medicine that coined the term “hospitalist” and fostered an understanding that the HM movement was a true phenomenon.

The milestone presents the perfect opportunity to examine the specialty’s meteoric growth and celebrate the successes of its pioneers, says Dr. Wachter, a professor, chief of the Division of Hospital Medicine, and chief of the medical service at the University of California at San Francisco Medical Center. He also considers it an ideal time to examine the unforeseen developments of the past decade and a half, believing a critical analysis of a few key case studies can help lay the groundwork for an even brighter future.

“At 15, you’re in mid- to late adolescence,” Dr. Wachter says. “We can no longer say we’re this new kid on the block and, ‘Gee, whiz, isn’t this neat?’

“This is a good chance to reflect on things that went as we expected,” he adds. “It’s an even better chance to take a second look at things that were surprising but provide valuable lessons as we think about what the next 15 years are going to be like.”

Question: Fifteen years ago, did you envision HM would grow so quickly?

Answer: I had a sense this was a trend that was starting to emerge and could fill an important niche. At the same time, when Sergey (Brin) and Larry (Page) founded Google, I doubt they believed it would become a $200 billion company. In the beginning, I couldn’t have predicted what this would become.

Q: What surprised you most in the past 15 years?

A: I didn’t fully appreciate how quickly the push toward value would become a dominant theme. Once we discovered quality was important and there was a set of skills we needed to learn to improve it, we tackled it aggressively. It has been harder to tackle the cost part of the equation.

This goes beyond making sure patients don’t stay in the hospital longer than they need to. It means looking hard at the cost of care and the way we spend money, such as our patterns of ordering X-rays, consultants, and lab tests. I’m going to focus a fair amount on that.

Q: Why do you want to emphasize that point?

A: The cost of healthcare is going to bankrupt the country unless we get a handle on it. Our field needs to lead the way to show how a good, ethical physician not only focuses on improving quality of care, but also focuses on ridding the system of waste and of care that adds no real value to our patients. We’ve been a little sluggish in that area.

Q: What other surprises do you intend to discuss?

A: I didn’t anticipate the emergence of two different versions of the hospitalist field. One is the role of comanagement. The other is what I call the hyphenated hospitalist—these OB hospitalists and surgery hospitalists. This concept we came up with for general patients has been embraced by a variety of specialties. How do those people fit into our society and our field? Are they really part of us or are they fundamentally different? I think we need to think carefully about it.

Q: Why are the unexpected developments so important to consider?

A: Leaders in the field need to get really good at reading tea leaves. One of the ways you do that is to figure out, when you didn’t read them correctly the first time, why didn’t you? Could you have read them better if you were more clever or more thoughtful?

Q: What is the biggest challenge facing HM?

A: When we have been given new tasks and new opportunities, our members have stepped up to the plate and done what they’ve been asked to do as well, if not better, than expected. I’m a little fearful of the flip side. How we will meet the demand for our services? How do we ensure the job stays attractive and we don’t burn out? We have to demonstrate our value, but we have to make sure the jobs are truly sustainable and that we don’t shoot ourselves in the foot.

Q:What do you see as the solution?

A: I don’t think we’ll be able to meet all of the demand. There will be hospitals that can only partly staff the needs they have with hospitalists. I don’t want them to go too far down the quality curve. We need to be sure people entering the field are good and have the skills they need.

I think we’ll begin to ask important questions like, “Do I really need a hospitalist for this, or can I leverage fewer hospitalists with other nonphysician providers?” Or, “Can some of the work our hospitalists are doing be done as well and more cheaply by computers?” It opens a pathway to think more creatively about people and tasks and technologies.

Q: Despite the challenges associated with growth pressure, is HM better positioned for the future because of it?

A: Definitely. We will see a further extension of our reach into other areas of the hospital and healthcare system. We will continue to see our people begin as leaders in our world of hospital medicine but rapidly graduate to become hospital CEOs, chairs of departments of medicine, and major leaders in healthcare. There is a recognition that there’s no better training ground to be a leader in healthcare than to be a leader in our field. So I can’t help but be optimistic that our place in the world of healthcare is extraordinarily secure. HM11

Mark Leiser is a freelance writer based in New Jersey.

Dr. Lee

A billion-dollar football stadium that offers on-field tours. A real-life cattle ride. A chance to honor the country’s last assassinated president. And don’t overlook the museums, art galleries, and restaurants.

Hospitalists from across the country will have the opportunity to experience all of it during HM11 at the Gaylord Texan Hotel & Convention Center in Grapevine, Texas, situated between Dallas and Fort Worth.

“I think it’s a nice blend of both sides,” says Ben Lee, MD, a hospitalist at Children’s Medical Center of Dallas and assistant professor of pediatrics at University of Texas Southwestern. “You can get the modern amenities, but you also have a capturing of, ‘Hey, this is stuff that’s occurred in the past that’s still available.’ ”

For the sports-minded, Dallas is a veritable Mecca. Cowboys Stadium, which hosted Super Bowl XV in February, offers VIP and self-guided tours. For more information, call 800-745-3000. The Texas Rangers baseball team will be playing at home in Arlington the week of HM11, while NBA fans might be able to catch a Dallas Mavericks playoff game. The same could be true of the NHL’s Dallas Stars.

The art-minded and culturists should not fret, though. Dallas offers both the eponymous Dallas Museum of Art and the outdoor Nasher Sculpture Center. Meanwhile, Fort Worth offers the Modern Art Museum of Forth Worth and a half-dozen other arts institutions in its downtown cultural district.

History buffs can try the Fort Worth Stockyards National Historic District, a nod to Texas’ frontier history that includes twice-daily cattle drives, or the Sixth Floor Museum at Dealey Plaza to learn about the assassination of President Kennedy.

When you’re hungry, steak and Tex-Mex are the specialties. If you aren’t able to leave the Gaylord, try the Old Hickory Steakhouse (just make sure to reserve a table early). Away from the hotel, look for local Tex-Mex chains like Uncle Julio’s or Gloria’s.

One last tip, if we may. “I would definitely rent a car,” Dr. Lee says. “Texas is wide open.” HM11

Richard Quinn is a freelance writer based in New Jersey.

Dr. Lee

A billion-dollar football stadium that offers on-field tours. A real-life cattle ride. A chance to honor the country’s last assassinated president. And don’t overlook the museums, art galleries, and restaurants.

Hospitalists from across the country will have the opportunity to experience all of it during HM11 at the Gaylord Texan Hotel & Convention Center in Grapevine, Texas, situated between Dallas and Fort Worth.

“I think it’s a nice blend of both sides,” says Ben Lee, MD, a hospitalist at Children’s Medical Center of Dallas and assistant professor of pediatrics at University of Texas Southwestern. “You can get the modern amenities, but you also have a capturing of, ‘Hey, this is stuff that’s occurred in the past that’s still available.’ ”

For the sports-minded, Dallas is a veritable Mecca. Cowboys Stadium, which hosted Super Bowl XV in February, offers VIP and self-guided tours. For more information, call 800-745-3000. The Texas Rangers baseball team will be playing at home in Arlington the week of HM11, while NBA fans might be able to catch a Dallas Mavericks playoff game. The same could be true of the NHL’s Dallas Stars.

The art-minded and culturists should not fret, though. Dallas offers both the eponymous Dallas Museum of Art and the outdoor Nasher Sculpture Center. Meanwhile, Fort Worth offers the Modern Art Museum of Forth Worth and a half-dozen other arts institutions in its downtown cultural district.

History buffs can try the Fort Worth Stockyards National Historic District, a nod to Texas’ frontier history that includes twice-daily cattle drives, or the Sixth Floor Museum at Dealey Plaza to learn about the assassination of President Kennedy.

When you’re hungry, steak and Tex-Mex are the specialties. If you aren’t able to leave the Gaylord, try the Old Hickory Steakhouse (just make sure to reserve a table early). Away from the hotel, look for local Tex-Mex chains like Uncle Julio’s or Gloria’s.

One last tip, if we may. “I would definitely rent a car,” Dr. Lee says. “Texas is wide open.” HM11

Richard Quinn is a freelance writer based in New Jersey.

Dr. Lee

A billion-dollar football stadium that offers on-field tours. A real-life cattle ride. A chance to honor the country’s last assassinated president. And don’t overlook the museums, art galleries, and restaurants.

Hospitalists from across the country will have the opportunity to experience all of it during HM11 at the Gaylord Texan Hotel & Convention Center in Grapevine, Texas, situated between Dallas and Fort Worth.

“I think it’s a nice blend of both sides,” says Ben Lee, MD, a hospitalist at Children’s Medical Center of Dallas and assistant professor of pediatrics at University of Texas Southwestern. “You can get the modern amenities, but you also have a capturing of, ‘Hey, this is stuff that’s occurred in the past that’s still available.’ ”

For the sports-minded, Dallas is a veritable Mecca. Cowboys Stadium, which hosted Super Bowl XV in February, offers VIP and self-guided tours. For more information, call 800-745-3000. The Texas Rangers baseball team will be playing at home in Arlington the week of HM11, while NBA fans might be able to catch a Dallas Mavericks playoff game. The same could be true of the NHL’s Dallas Stars.

The art-minded and culturists should not fret, though. Dallas offers both the eponymous Dallas Museum of Art and the outdoor Nasher Sculpture Center. Meanwhile, Fort Worth offers the Modern Art Museum of Forth Worth and a half-dozen other arts institutions in its downtown cultural district.

History buffs can try the Fort Worth Stockyards National Historic District, a nod to Texas’ frontier history that includes twice-daily cattle drives, or the Sixth Floor Museum at Dealey Plaza to learn about the assassination of President Kennedy.

When you’re hungry, steak and Tex-Mex are the specialties. If you aren’t able to leave the Gaylord, try the Old Hickory Steakhouse (just make sure to reserve a table early). Away from the hotel, look for local Tex-Mex chains like Uncle Julio’s or Gloria’s.

One last tip, if we may. “I would definitely rent a car,” Dr. Lee says. “Texas is wide open.” HM11

Richard Quinn is a freelance writer based in New Jersey.

Since its inception, SHM’s annual meeting has grown every year, attracting more hospitalists, bringing influential leaders to presentations, and creating a welcome environment for some of the most innovative ideas in healthcare. That growth in influence—and influencers—will be evident at HM11 next month.

This year, HM11 will bring hospitalists closer than ever to the decision-makers. Featured presenters Robert Wachter, MD, MHM, professor, chief of the division of hospital medicine at the University of California at San Francisco, and former White House advisor Robert Kocher, MD, will be joined by Cecil B. Wilson, MD, president of the American Medical Association.

“The Society of Hospital Medicine is a dynamic, growing organization that is very responsive to the interests and needs of hospitalists,” Dr. Wilson told SHM. “So when the SHM leadership offered me the opportunity to speak at Hospital Medicine 2011, I was pleased and honored. … I am hopeful that the AMA and the SHM can continue to work together productively to advance the interests of physicians and our patients.”

SHM is a dynamic, growing organization that is very responsive to the interests and needs of hospitalists. I am hopeful that the AMA and the SHM can continue to work together productively to advance the interests of physicians and our patients.—Cecil B. Wilson, MD, president, American Medical Association

In addition to hosting the country’s most influential figures in healthcare, HM11 will present some of its most cutting-edge ideas in improving care. The continued focus on reducing unplanned readmissions in hospitals across the country has turned to a search for solutions. A new session will put the spotlight on SHM’s own program, Project BOOST (Boosting Outcomes for Older Adults through Safe Transitions).

“Healthcare Reform and Optimizing Care Transitions to Reduce Readmissions” will be presented by Mark V. Williams, MD, FACP, FHM, principal investigator of Project BOOST; Jeffrey Greenwald, MD, SFHM; and Linda Magno, the director of the Medicare Demonstrations Group in the Office of Research, Development, and Information at the Centers for Medicare & Medicaid Services.

The presentation will bring the audience to the very crossroads of healthcare policy reform and quality improvement (QI) by illustrating the impact of readmissions on healthcare costs and patient safety, coupled with the innovative and individualized approaches that Project BOOST hospitalists are implementing.

Development of and pilot testing of Project BOOST was supported through grant funding from the John A. Hartford Foundation. Today, Project BOOST has been implemented in more than 60 sites and the program is now recruiting for its fall cohort.

For more information about HM11, visit www.hospitalmedicine2011.org.

For information about Project BOOST, visit www.hospitalmedicine.org/boost. TH

Brendon Shank is SHM’s assistant vice president of communications.

Since its inception, SHM’s annual meeting has grown every year, attracting more hospitalists, bringing influential leaders to presentations, and creating a welcome environment for some of the most innovative ideas in healthcare. That growth in influence—and influencers—will be evident at HM11 next month.

This year, HM11 will bring hospitalists closer than ever to the decision-makers. Featured presenters Robert Wachter, MD, MHM, professor, chief of the division of hospital medicine at the University of California at San Francisco, and former White House advisor Robert Kocher, MD, will be joined by Cecil B. Wilson, MD, president of the American Medical Association.

“The Society of Hospital Medicine is a dynamic, growing organization that is very responsive to the interests and needs of hospitalists,” Dr. Wilson told SHM. “So when the SHM leadership offered me the opportunity to speak at Hospital Medicine 2011, I was pleased and honored. … I am hopeful that the AMA and the SHM can continue to work together productively to advance the interests of physicians and our patients.”

SHM is a dynamic, growing organization that is very responsive to the interests and needs of hospitalists. I am hopeful that the AMA and the SHM can continue to work together productively to advance the interests of physicians and our patients.—Cecil B. Wilson, MD, president, American Medical Association

In addition to hosting the country’s most influential figures in healthcare, HM11 will present some of its most cutting-edge ideas in improving care. The continued focus on reducing unplanned readmissions in hospitals across the country has turned to a search for solutions. A new session will put the spotlight on SHM’s own program, Project BOOST (Boosting Outcomes for Older Adults through Safe Transitions).

“Healthcare Reform and Optimizing Care Transitions to Reduce Readmissions” will be presented by Mark V. Williams, MD, FACP, FHM, principal investigator of Project BOOST; Jeffrey Greenwald, MD, SFHM; and Linda Magno, the director of the Medicare Demonstrations Group in the Office of Research, Development, and Information at the Centers for Medicare & Medicaid Services.

The presentation will bring the audience to the very crossroads of healthcare policy reform and quality improvement (QI) by illustrating the impact of readmissions on healthcare costs and patient safety, coupled with the innovative and individualized approaches that Project BOOST hospitalists are implementing.

Development of and pilot testing of Project BOOST was supported through grant funding from the John A. Hartford Foundation. Today, Project BOOST has been implemented in more than 60 sites and the program is now recruiting for its fall cohort.

For more information about HM11, visit www.hospitalmedicine2011.org.

For information about Project BOOST, visit www.hospitalmedicine.org/boost. TH

Brendon Shank is SHM’s assistant vice president of communications.

Since its inception, SHM’s annual meeting has grown every year, attracting more hospitalists, bringing influential leaders to presentations, and creating a welcome environment for some of the most innovative ideas in healthcare. That growth in influence—and influencers—will be evident at HM11 next month.

This year, HM11 will bring hospitalists closer than ever to the decision-makers. Featured presenters Robert Wachter, MD, MHM, professor, chief of the division of hospital medicine at the University of California at San Francisco, and former White House advisor Robert Kocher, MD, will be joined by Cecil B. Wilson, MD, president of the American Medical Association.

“The Society of Hospital Medicine is a dynamic, growing organization that is very responsive to the interests and needs of hospitalists,” Dr. Wilson told SHM. “So when the SHM leadership offered me the opportunity to speak at Hospital Medicine 2011, I was pleased and honored. … I am hopeful that the AMA and the SHM can continue to work together productively to advance the interests of physicians and our patients.”

SHM is a dynamic, growing organization that is very responsive to the interests and needs of hospitalists. I am hopeful that the AMA and the SHM can continue to work together productively to advance the interests of physicians and our patients.—Cecil B. Wilson, MD, president, American Medical Association

In addition to hosting the country’s most influential figures in healthcare, HM11 will present some of its most cutting-edge ideas in improving care. The continued focus on reducing unplanned readmissions in hospitals across the country has turned to a search for solutions. A new session will put the spotlight on SHM’s own program, Project BOOST (Boosting Outcomes for Older Adults through Safe Transitions).

“Healthcare Reform and Optimizing Care Transitions to Reduce Readmissions” will be presented by Mark V. Williams, MD, FACP, FHM, principal investigator of Project BOOST; Jeffrey Greenwald, MD, SFHM; and Linda Magno, the director of the Medicare Demonstrations Group in the Office of Research, Development, and Information at the Centers for Medicare & Medicaid Services.

The presentation will bring the audience to the very crossroads of healthcare policy reform and quality improvement (QI) by illustrating the impact of readmissions on healthcare costs and patient safety, coupled with the innovative and individualized approaches that Project BOOST hospitalists are implementing.

Development of and pilot testing of Project BOOST was supported through grant funding from the John A. Hartford Foundation. Today, Project BOOST has been implemented in more than 60 sites and the program is now recruiting for its fall cohort.

For more information about HM11, visit www.hospitalmedicine2011.org.

For information about Project BOOST, visit www.hospitalmedicine.org/boost. TH

Brendon Shank is SHM’s assistant vice president of communications.

Amit Prachand, MEng

Division Administrator, Hospital Medicine

Northwestern Memorial Hospital and Feinberg School of Medicine,

Northwestern University, Chicago

Question: What motivated you to join SHM’s Administrators Task Force (ATF)?

A: I wanted to be able to directly interface with the community of leaders in similar administrator roles in order to obtain a stronger perspective of the role, its rewards and challenges, and of the creative solutions different practices have implemented to address issues relevant to hospital medicine and the overall healthcare delivery model. I was also relatively new to hospital medicine practice management, and even healthcare, so I wanted to put myself in the best position to soak in as much as possible as well as help facilitate the sharing of ideas amongst my new group of peers.

Q: How is the Administrators Task Force moving HM forward?

A: One of our main thrusts in the task force is to help expand the administrative membership in SHM. As hospitalist programs mature and the environment in which hospital medicine is practiced evolves, it is imperative that we develop the community, the infrastructure, and the tools required to partner with our stakeholders—both internal and external—to help lead hospital medicine forward.

Q: Has your participation in the Administrators Task Force helped your group?

A: The ATF has helped develop direct lines of communication with peers. This helps when it come to issues for which we are finding the best solutions for; areas such as on-boarding of new physicians, negotiations with hospitals, coding and billing improvement, and meaningful performance reporting.

Q: How is the task force helping hospitals improve patient care?

A: By having a peer group on the administrative side, I believe we are now able to more readily share ideas that support the ideas around patient-care improvement that are being shared amongst the physician membership.

One of the key roles we play as an administrator is to help develop the systems and structures that help improve patient care. That may range from advocating for physician representation on certain hospital committees to facilitating a process/QI project that involves hospitalists and other members of the extended patient-care team, such as physicians from other medical specialties, nursing, pharmacists, case management, bed management, environmental services, and information technology.

Q: How is the task force helping hospitals improve healthcare overall?

A: We are continually improving the infrastructure for administrators to share ideas and solutions to address overall healthcare issues (payment reform, readmissions, compliance, cost). It is through this infrastructure that we can identify best implementation practices of ideas. The webinar series (www.hospitalmedicine.org/roundtables) that we’ve developed addresses many of the issues that healthcare in general is facing. This series has exceeded expectations for participation and interest.

Q: What do you like most about your job as an administrator?

A: It is never dull, always exciting. From the firefighting to the long-term planning, the role keeps me on my toes. I enjoy being in a position that is so tightly intertwined with so many critical functions and disciplines across the medical center in a profession—hospital medicine—that is continuing to lead advances in healthcare delivery.

—Brendon Shank

Amit Prachand, MEng

Division Administrator, Hospital Medicine

Northwestern Memorial Hospital and Feinberg School of Medicine,

Northwestern University, Chicago

Question: What motivated you to join SHM’s Administrators Task Force (ATF)?

A: I wanted to be able to directly interface with the community of leaders in similar administrator roles in order to obtain a stronger perspective of the role, its rewards and challenges, and of the creative solutions different practices have implemented to address issues relevant to hospital medicine and the overall healthcare delivery model. I was also relatively new to hospital medicine practice management, and even healthcare, so I wanted to put myself in the best position to soak in as much as possible as well as help facilitate the sharing of ideas amongst my new group of peers.

Q: How is the Administrators Task Force moving HM forward?

A: One of our main thrusts in the task force is to help expand the administrative membership in SHM. As hospitalist programs mature and the environment in which hospital medicine is practiced evolves, it is imperative that we develop the community, the infrastructure, and the tools required to partner with our stakeholders—both internal and external—to help lead hospital medicine forward.

Q: Has your participation in the Administrators Task Force helped your group?

A: The ATF has helped develop direct lines of communication with peers. This helps when it come to issues for which we are finding the best solutions for; areas such as on-boarding of new physicians, negotiations with hospitals, coding and billing improvement, and meaningful performance reporting.

Q: How is the task force helping hospitals improve patient care?

A: By having a peer group on the administrative side, I believe we are now able to more readily share ideas that support the ideas around patient-care improvement that are being shared amongst the physician membership.

One of the key roles we play as an administrator is to help develop the systems and structures that help improve patient care. That may range from advocating for physician representation on certain hospital committees to facilitating a process/QI project that involves hospitalists and other members of the extended patient-care team, such as physicians from other medical specialties, nursing, pharmacists, case management, bed management, environmental services, and information technology.

Q: How is the task force helping hospitals improve healthcare overall?

A: We are continually improving the infrastructure for administrators to share ideas and solutions to address overall healthcare issues (payment reform, readmissions, compliance, cost). It is through this infrastructure that we can identify best implementation practices of ideas. The webinar series (www.hospitalmedicine.org/roundtables) that we’ve developed addresses many of the issues that healthcare in general is facing. This series has exceeded expectations for participation and interest.

Q: What do you like most about your job as an administrator?

A: It is never dull, always exciting. From the firefighting to the long-term planning, the role keeps me on my toes. I enjoy being in a position that is so tightly intertwined with so many critical functions and disciplines across the medical center in a profession—hospital medicine—that is continuing to lead advances in healthcare delivery.

—Brendon Shank

Amit Prachand, MEng

Division Administrator, Hospital Medicine

Northwestern Memorial Hospital and Feinberg School of Medicine,

Northwestern University, Chicago

Question: What motivated you to join SHM’s Administrators Task Force (ATF)?

A: I wanted to be able to directly interface with the community of leaders in similar administrator roles in order to obtain a stronger perspective of the role, its rewards and challenges, and of the creative solutions different practices have implemented to address issues relevant to hospital medicine and the overall healthcare delivery model. I was also relatively new to hospital medicine practice management, and even healthcare, so I wanted to put myself in the best position to soak in as much as possible as well as help facilitate the sharing of ideas amongst my new group of peers.

Q: How is the Administrators Task Force moving HM forward?

A: One of our main thrusts in the task force is to help expand the administrative membership in SHM. As hospitalist programs mature and the environment in which hospital medicine is practiced evolves, it is imperative that we develop the community, the infrastructure, and the tools required to partner with our stakeholders—both internal and external—to help lead hospital medicine forward.

Q: Has your participation in the Administrators Task Force helped your group?

A: The ATF has helped develop direct lines of communication with peers. This helps when it come to issues for which we are finding the best solutions for; areas such as on-boarding of new physicians, negotiations with hospitals, coding and billing improvement, and meaningful performance reporting.

Q: How is the task force helping hospitals improve patient care?

A: By having a peer group on the administrative side, I believe we are now able to more readily share ideas that support the ideas around patient-care improvement that are being shared amongst the physician membership.

One of the key roles we play as an administrator is to help develop the systems and structures that help improve patient care. That may range from advocating for physician representation on certain hospital committees to facilitating a process/QI project that involves hospitalists and other members of the extended patient-care team, such as physicians from other medical specialties, nursing, pharmacists, case management, bed management, environmental services, and information technology.

Q: How is the task force helping hospitals improve healthcare overall?

A: We are continually improving the infrastructure for administrators to share ideas and solutions to address overall healthcare issues (payment reform, readmissions, compliance, cost). It is through this infrastructure that we can identify best implementation practices of ideas. The webinar series (www.hospitalmedicine.org/roundtables) that we’ve developed addresses many of the issues that healthcare in general is facing. This series has exceeded expectations for participation and interest.

Q: What do you like most about your job as an administrator?

A: It is never dull, always exciting. From the firefighting to the long-term planning, the role keeps me on my toes. I enjoy being in a position that is so tightly intertwined with so many critical functions and disciplines across the medical center in a profession—hospital medicine—that is continuing to lead advances in healthcare delivery.

—Brendon Shank