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Video : The SHM Research Committee: Expanding the role and footprint of research in hospital medicine
ORLANDO – In a video interview, Stephanie Mueller, MD, SFHM, of Brigham and Women’s Hospital, Boston, discusses the scope and importance of the SHM Research Committee.
One of its most important roles is overseeing the yearly Scientific Abstract and Poster Competition, known as the Research, Innovations and Clinical Vignettes (RIV) portion of the annual conference, which brings the best of current research in hospital medicine, especially in the increasingly important area of value in patient care, to the members.
In discussing the work of the committee, Dr. Mueller – who is in her third year as a member – adds that they “are working to expand the research footprint within the Society of Hospital Medicine,” including implementing initiatives such as the VIP program, which is a visiting professorship in which junior and mid-level faculty can do an exchange program between institutions.
ORLANDO – In a video interview, Stephanie Mueller, MD, SFHM, of Brigham and Women’s Hospital, Boston, discusses the scope and importance of the SHM Research Committee.
One of its most important roles is overseeing the yearly Scientific Abstract and Poster Competition, known as the Research, Innovations and Clinical Vignettes (RIV) portion of the annual conference, which brings the best of current research in hospital medicine, especially in the increasingly important area of value in patient care, to the members.
In discussing the work of the committee, Dr. Mueller – who is in her third year as a member – adds that they “are working to expand the research footprint within the Society of Hospital Medicine,” including implementing initiatives such as the VIP program, which is a visiting professorship in which junior and mid-level faculty can do an exchange program between institutions.
ORLANDO – In a video interview, Stephanie Mueller, MD, SFHM, of Brigham and Women’s Hospital, Boston, discusses the scope and importance of the SHM Research Committee.
One of its most important roles is overseeing the yearly Scientific Abstract and Poster Competition, known as the Research, Innovations and Clinical Vignettes (RIV) portion of the annual conference, which brings the best of current research in hospital medicine, especially in the increasingly important area of value in patient care, to the members.
In discussing the work of the committee, Dr. Mueller – who is in her third year as a member – adds that they “are working to expand the research footprint within the Society of Hospital Medicine,” including implementing initiatives such as the VIP program, which is a visiting professorship in which junior and mid-level faculty can do an exchange program between institutions.
REPORTING FROM HOSPITAL MEDICINE 2018
SHM presidents: Innovate and avoid complacency
ORLANDO – In a time of tumult in American health care, hospital medicine can expect to see a reimagined – but not reduced – role, said the outgoing and current presidents of the Society of Hospital Medicine at Monday’s HM18 opening plenary.
Despite the many successes of the relatively young field of hospital medicine, there’s no room for complacency, said SHM’s immediate past president Ron Greeno, MD, MHM.
Dr. Greeno drew on his 25-year career in hospital medicine to frame past successes and upcoming challenges for hospital medicine in the 21st century.
As the profession defined itself and grew from the 1980s onward, “the model was challenged, and challenged significantly, mostly by our physician colleagues,” who either feared or didn’t understand the model, he said. All along, though, pioneers in hospital medicine were just trying “to figure out a way to take better care of patients in the hospital.”
The result, said Dr. Greeno, is that hospital medicine stands unique among physician specialties. “We as a specialty are in a very enviable position as we move into the post–health care reform era. More than any other specialty in the history of medicine, we are not expected to p
“Colleagues honor us by trusting us with their patients’ care … but we need to be aware that they are watching us and judging whether we are living up to our promises,” Dr. Greeno said. “So we need to be asking ourselves some tough questions. Perhaps we’re becoming too self-satisfied. Perhaps we are starting to believe our own press.”
Without an appetite for innovation as well as hard work, hospitalists could risk becoming “highly paid worker bees,” said Dr. Greeno.
“There are people who think this is happening. I know because I have talked to them while traveling around the country” as SHM president, he said. “I am not among that group. I think the best is yet to come … that we will become more integrated and have ever more impact and influence in the redesign of the U.S. health care system.”
More than anything, Dr. Greeno’s faith in the profession’s future is grounded in its human capital. Addressing the plenary attendees, he said, “You come here just to become better, to try to make things better. I see all of you who refuse to let the urgent get in the way of the important.”
In her first address as the new SHM president, Nasim Afsar, MD, SFHM, agreed that the people really do make the profession. “We will prevail because of our perseverance and our passion to be part of the solution for challenges in health care,” she said.
Dr. Afsar is chief ambulatory officer and chief medical officer for ACOs at UC Irvine Health. She said that earlier this year, she’d never felt more sure of her job security. Serving on the inpatient hospitalist service during the height of this year’s surging influenza season, Dr. Afsar saw a packed emergency department and a completely full house for her hospital. “We had to create a new hospitalist service” just to handle the volume, she said.
A sobering experience later that month, though, had her rethinking things. At a meeting of chief executive officers of health care systems, leaders spoke of hospitals transitioning from profit centers to cost centers. Some of the proposed innovations were startling: “When I heard talk of hospitals at home, and of virtual hospitals, I got a very different sense of our specialty,” said Dr. Afsar.
Still, she said, she’s confident there will be jobs for hospitalists in the future. “We can’t ignore the significant, irrefutable fact that has emerged: Value will prevail. And the only way to deliver that is population health management,” meaning the delivery of high value care at fair cost across the entire human lifespan, she said.
This call can be answered in two ways, said Dr. Afsar. “First, we have to define and deliver value for hospitalized patients every single day. Second, we have to look at what population health management means for our specialty.”
“I encourage us not to be confined by our names,” Dr. Afsar said. Rather, hospitalists will be defined by the attributes that they’ve become known for over the years: “Innovators. Problem solvers. Collaborators. Patient advocates.”
ORLANDO – In a time of tumult in American health care, hospital medicine can expect to see a reimagined – but not reduced – role, said the outgoing and current presidents of the Society of Hospital Medicine at Monday’s HM18 opening plenary.
Despite the many successes of the relatively young field of hospital medicine, there’s no room for complacency, said SHM’s immediate past president Ron Greeno, MD, MHM.
Dr. Greeno drew on his 25-year career in hospital medicine to frame past successes and upcoming challenges for hospital medicine in the 21st century.
As the profession defined itself and grew from the 1980s onward, “the model was challenged, and challenged significantly, mostly by our physician colleagues,” who either feared or didn’t understand the model, he said. All along, though, pioneers in hospital medicine were just trying “to figure out a way to take better care of patients in the hospital.”
The result, said Dr. Greeno, is that hospital medicine stands unique among physician specialties. “We as a specialty are in a very enviable position as we move into the post–health care reform era. More than any other specialty in the history of medicine, we are not expected to p
“Colleagues honor us by trusting us with their patients’ care … but we need to be aware that they are watching us and judging whether we are living up to our promises,” Dr. Greeno said. “So we need to be asking ourselves some tough questions. Perhaps we’re becoming too self-satisfied. Perhaps we are starting to believe our own press.”
Without an appetite for innovation as well as hard work, hospitalists could risk becoming “highly paid worker bees,” said Dr. Greeno.
“There are people who think this is happening. I know because I have talked to them while traveling around the country” as SHM president, he said. “I am not among that group. I think the best is yet to come … that we will become more integrated and have ever more impact and influence in the redesign of the U.S. health care system.”
More than anything, Dr. Greeno’s faith in the profession’s future is grounded in its human capital. Addressing the plenary attendees, he said, “You come here just to become better, to try to make things better. I see all of you who refuse to let the urgent get in the way of the important.”
In her first address as the new SHM president, Nasim Afsar, MD, SFHM, agreed that the people really do make the profession. “We will prevail because of our perseverance and our passion to be part of the solution for challenges in health care,” she said.
Dr. Afsar is chief ambulatory officer and chief medical officer for ACOs at UC Irvine Health. She said that earlier this year, she’d never felt more sure of her job security. Serving on the inpatient hospitalist service during the height of this year’s surging influenza season, Dr. Afsar saw a packed emergency department and a completely full house for her hospital. “We had to create a new hospitalist service” just to handle the volume, she said.
A sobering experience later that month, though, had her rethinking things. At a meeting of chief executive officers of health care systems, leaders spoke of hospitals transitioning from profit centers to cost centers. Some of the proposed innovations were startling: “When I heard talk of hospitals at home, and of virtual hospitals, I got a very different sense of our specialty,” said Dr. Afsar.
Still, she said, she’s confident there will be jobs for hospitalists in the future. “We can’t ignore the significant, irrefutable fact that has emerged: Value will prevail. And the only way to deliver that is population health management,” meaning the delivery of high value care at fair cost across the entire human lifespan, she said.
This call can be answered in two ways, said Dr. Afsar. “First, we have to define and deliver value for hospitalized patients every single day. Second, we have to look at what population health management means for our specialty.”
“I encourage us not to be confined by our names,” Dr. Afsar said. Rather, hospitalists will be defined by the attributes that they’ve become known for over the years: “Innovators. Problem solvers. Collaborators. Patient advocates.”
ORLANDO – In a time of tumult in American health care, hospital medicine can expect to see a reimagined – but not reduced – role, said the outgoing and current presidents of the Society of Hospital Medicine at Monday’s HM18 opening plenary.
Despite the many successes of the relatively young field of hospital medicine, there’s no room for complacency, said SHM’s immediate past president Ron Greeno, MD, MHM.
Dr. Greeno drew on his 25-year career in hospital medicine to frame past successes and upcoming challenges for hospital medicine in the 21st century.
As the profession defined itself and grew from the 1980s onward, “the model was challenged, and challenged significantly, mostly by our physician colleagues,” who either feared or didn’t understand the model, he said. All along, though, pioneers in hospital medicine were just trying “to figure out a way to take better care of patients in the hospital.”
The result, said Dr. Greeno, is that hospital medicine stands unique among physician specialties. “We as a specialty are in a very enviable position as we move into the post–health care reform era. More than any other specialty in the history of medicine, we are not expected to p
“Colleagues honor us by trusting us with their patients’ care … but we need to be aware that they are watching us and judging whether we are living up to our promises,” Dr. Greeno said. “So we need to be asking ourselves some tough questions. Perhaps we’re becoming too self-satisfied. Perhaps we are starting to believe our own press.”
Without an appetite for innovation as well as hard work, hospitalists could risk becoming “highly paid worker bees,” said Dr. Greeno.
“There are people who think this is happening. I know because I have talked to them while traveling around the country” as SHM president, he said. “I am not among that group. I think the best is yet to come … that we will become more integrated and have ever more impact and influence in the redesign of the U.S. health care system.”
More than anything, Dr. Greeno’s faith in the profession’s future is grounded in its human capital. Addressing the plenary attendees, he said, “You come here just to become better, to try to make things better. I see all of you who refuse to let the urgent get in the way of the important.”
In her first address as the new SHM president, Nasim Afsar, MD, SFHM, agreed that the people really do make the profession. “We will prevail because of our perseverance and our passion to be part of the solution for challenges in health care,” she said.
Dr. Afsar is chief ambulatory officer and chief medical officer for ACOs at UC Irvine Health. She said that earlier this year, she’d never felt more sure of her job security. Serving on the inpatient hospitalist service during the height of this year’s surging influenza season, Dr. Afsar saw a packed emergency department and a completely full house for her hospital. “We had to create a new hospitalist service” just to handle the volume, she said.
A sobering experience later that month, though, had her rethinking things. At a meeting of chief executive officers of health care systems, leaders spoke of hospitals transitioning from profit centers to cost centers. Some of the proposed innovations were startling: “When I heard talk of hospitals at home, and of virtual hospitals, I got a very different sense of our specialty,” said Dr. Afsar.
Still, she said, she’s confident there will be jobs for hospitalists in the future. “We can’t ignore the significant, irrefutable fact that has emerged: Value will prevail. And the only way to deliver that is population health management,” meaning the delivery of high value care at fair cost across the entire human lifespan, she said.
This call can be answered in two ways, said Dr. Afsar. “First, we have to define and deliver value for hospitalized patients every single day. Second, we have to look at what population health management means for our specialty.”
“I encourage us not to be confined by our names,” Dr. Afsar said. Rather, hospitalists will be defined by the attributes that they’ve become known for over the years: “Innovators. Problem solvers. Collaborators. Patient advocates.”
Video: SHM President Nasim Afsar seeks an “unrelenting focus on delivering value”
ORLANDO – In a video interview, Nasim Afsar, MD, SFHM, details the career road that led her to the “tremendous honor” of becoming president of the Society of Hospital Medicine.
Having been on the board of directors for 6 years was a profound experience, according to Dr. Afsar, and now as president she looks to take what she has learned and focus on the future of the field.
When asked about her overall vision for the coming year for the Society, Dr. Afsar said that she is committed to “an unrelenting focus on delivering value to our patients, our institutions, and society, and the way we do that is through population health management.”
ORLANDO – In a video interview, Nasim Afsar, MD, SFHM, details the career road that led her to the “tremendous honor” of becoming president of the Society of Hospital Medicine.
Having been on the board of directors for 6 years was a profound experience, according to Dr. Afsar, and now as president she looks to take what she has learned and focus on the future of the field.
When asked about her overall vision for the coming year for the Society, Dr. Afsar said that she is committed to “an unrelenting focus on delivering value to our patients, our institutions, and society, and the way we do that is through population health management.”
ORLANDO – In a video interview, Nasim Afsar, MD, SFHM, details the career road that led her to the “tremendous honor” of becoming president of the Society of Hospital Medicine.
Having been on the board of directors for 6 years was a profound experience, according to Dr. Afsar, and now as president she looks to take what she has learned and focus on the future of the field.
When asked about her overall vision for the coming year for the Society, Dr. Afsar said that she is committed to “an unrelenting focus on delivering value to our patients, our institutions, and society, and the way we do that is through population health management.”
REPORTING FROM HOSPITAL MEDICINE 2018
Analytics, board support are quality improvement keys
Jeffrey Glasheen, MD, had not considered focusing on quality improvement (QI) while studying at the University of Wisconsin, Madison. It was not until a medical error led to the death of a family member that his eyes were opened to the potential consequences of a system not invested in care quality.
“I couldn’t square with it because I had spent the last two to three years of my life working with some of the most dedicated, passionate, hard working people who all were trying to improve lives, and the fact that what I was seeing could result in a family member dying just didn’t make sense,” said Dr. Glasheen. “At the time I thought ‘This must be one of those unfortunate things that happens once in a lifetime,’ and I put it on the back burner.”
As more research on medical errors emerged, however, Dr. Glasheen realized his family’s experience was not as unique as he had thought.
It was after reading the now famous Institute of Medicine report, “To err is human,” which found that medical errors were responsible for 44,000-98,000 deaths a year, that Dr. Glasheen resolved to pursue a career in quality improvement.
Because it was early in his medical career, he began on a small level, teaching his residents about the importance of patient safety and giving lessons on core competencies involved in quality care and higher liability. But he quickly expanded his efforts.
“I started with what I had control over,” Dr. Glasheen explained. “From there, I moved to teaching more medical students, which lead to teaching in front of classrooms, which opened the door to the idea of starting a hospitalist training program.”
In 2003, Dr. Glasheen pitched the program to the University of Colorado at Denver, Aurora, where he completed his residency; this pitch led to the development of a hospitalist training program that focused on improving safety outcomes.
He served as the director of the University of Colorado Hospital Medicine Group from 2003 to 2015, during which time he was approached by the dean to assist in creating and leading the hospitalist training program for internal medicine residents.
The first of its kind, the rigorous University of Colorado program was designed to give residents tools useful beyond the clinical setting to become successful health system leaders.
In 2013, Dr. Glasheen and his colleagues founded the Institute for Healthcare Quality, Safety & Efficiency, which is guided by the mission to improve the quality of care provided on the local level. He has since become the chief quality officer for UCHealth and the University of Colorado Hospital Authority and an associate dean for clinical affairs in quality and safety education, as well as continuing to be a professor of medicine.
For those hoping to pursue quality improvement, Dr. Glasheen stressed the importance of a strong basis in data analytics.
“One of the most common things I see with data is people start to chase what’s called common cause variation, which means they’ll look at a run chart over the course of 12 months and react to every up and down when those are essentially random,” Dr. Glasheen said. “Being able to understand when something is particularly significant and when your interventions are actually making an impact is a skill set I think people who are new to quality improvement don’t often have.”
Having support from board members is also critical to success, although starting without such support should not deter future QI leaders.
“There needs to be a vision from the leadership that this work is important, and not just through words but through deeds, because no board in the country will say that quality is not important,” Dr. Glasheen said. “I would say start with small projects you can control, that tie back not only to patient lives but financial performance as well. If you can tell a board you saved the lives of 40 patients who would have died during the year and saved $1-$2 million in the process, the question will shift from whether the board should invest in QI resources to how much should be invested.”
Looking ahead, Dr. Glasheen highlighted the growing importance of hospital-acquired infections, such as surgical-site infections, catheter-associated urinary tract infections, and ventilator-associated pneumonia, as areas that need to be focused on in the QI sphere.
Jeffrey Glasheen, MD, had not considered focusing on quality improvement (QI) while studying at the University of Wisconsin, Madison. It was not until a medical error led to the death of a family member that his eyes were opened to the potential consequences of a system not invested in care quality.
“I couldn’t square with it because I had spent the last two to three years of my life working with some of the most dedicated, passionate, hard working people who all were trying to improve lives, and the fact that what I was seeing could result in a family member dying just didn’t make sense,” said Dr. Glasheen. “At the time I thought ‘This must be one of those unfortunate things that happens once in a lifetime,’ and I put it on the back burner.”
As more research on medical errors emerged, however, Dr. Glasheen realized his family’s experience was not as unique as he had thought.
It was after reading the now famous Institute of Medicine report, “To err is human,” which found that medical errors were responsible for 44,000-98,000 deaths a year, that Dr. Glasheen resolved to pursue a career in quality improvement.
Because it was early in his medical career, he began on a small level, teaching his residents about the importance of patient safety and giving lessons on core competencies involved in quality care and higher liability. But he quickly expanded his efforts.
“I started with what I had control over,” Dr. Glasheen explained. “From there, I moved to teaching more medical students, which lead to teaching in front of classrooms, which opened the door to the idea of starting a hospitalist training program.”
In 2003, Dr. Glasheen pitched the program to the University of Colorado at Denver, Aurora, where he completed his residency; this pitch led to the development of a hospitalist training program that focused on improving safety outcomes.
He served as the director of the University of Colorado Hospital Medicine Group from 2003 to 2015, during which time he was approached by the dean to assist in creating and leading the hospitalist training program for internal medicine residents.
The first of its kind, the rigorous University of Colorado program was designed to give residents tools useful beyond the clinical setting to become successful health system leaders.
In 2013, Dr. Glasheen and his colleagues founded the Institute for Healthcare Quality, Safety & Efficiency, which is guided by the mission to improve the quality of care provided on the local level. He has since become the chief quality officer for UCHealth and the University of Colorado Hospital Authority and an associate dean for clinical affairs in quality and safety education, as well as continuing to be a professor of medicine.
For those hoping to pursue quality improvement, Dr. Glasheen stressed the importance of a strong basis in data analytics.
“One of the most common things I see with data is people start to chase what’s called common cause variation, which means they’ll look at a run chart over the course of 12 months and react to every up and down when those are essentially random,” Dr. Glasheen said. “Being able to understand when something is particularly significant and when your interventions are actually making an impact is a skill set I think people who are new to quality improvement don’t often have.”
Having support from board members is also critical to success, although starting without such support should not deter future QI leaders.
“There needs to be a vision from the leadership that this work is important, and not just through words but through deeds, because no board in the country will say that quality is not important,” Dr. Glasheen said. “I would say start with small projects you can control, that tie back not only to patient lives but financial performance as well. If you can tell a board you saved the lives of 40 patients who would have died during the year and saved $1-$2 million in the process, the question will shift from whether the board should invest in QI resources to how much should be invested.”
Looking ahead, Dr. Glasheen highlighted the growing importance of hospital-acquired infections, such as surgical-site infections, catheter-associated urinary tract infections, and ventilator-associated pneumonia, as areas that need to be focused on in the QI sphere.
Jeffrey Glasheen, MD, had not considered focusing on quality improvement (QI) while studying at the University of Wisconsin, Madison. It was not until a medical error led to the death of a family member that his eyes were opened to the potential consequences of a system not invested in care quality.
“I couldn’t square with it because I had spent the last two to three years of my life working with some of the most dedicated, passionate, hard working people who all were trying to improve lives, and the fact that what I was seeing could result in a family member dying just didn’t make sense,” said Dr. Glasheen. “At the time I thought ‘This must be one of those unfortunate things that happens once in a lifetime,’ and I put it on the back burner.”
As more research on medical errors emerged, however, Dr. Glasheen realized his family’s experience was not as unique as he had thought.
It was after reading the now famous Institute of Medicine report, “To err is human,” which found that medical errors were responsible for 44,000-98,000 deaths a year, that Dr. Glasheen resolved to pursue a career in quality improvement.
Because it was early in his medical career, he began on a small level, teaching his residents about the importance of patient safety and giving lessons on core competencies involved in quality care and higher liability. But he quickly expanded his efforts.
“I started with what I had control over,” Dr. Glasheen explained. “From there, I moved to teaching more medical students, which lead to teaching in front of classrooms, which opened the door to the idea of starting a hospitalist training program.”
In 2003, Dr. Glasheen pitched the program to the University of Colorado at Denver, Aurora, where he completed his residency; this pitch led to the development of a hospitalist training program that focused on improving safety outcomes.
He served as the director of the University of Colorado Hospital Medicine Group from 2003 to 2015, during which time he was approached by the dean to assist in creating and leading the hospitalist training program for internal medicine residents.
The first of its kind, the rigorous University of Colorado program was designed to give residents tools useful beyond the clinical setting to become successful health system leaders.
In 2013, Dr. Glasheen and his colleagues founded the Institute for Healthcare Quality, Safety & Efficiency, which is guided by the mission to improve the quality of care provided on the local level. He has since become the chief quality officer for UCHealth and the University of Colorado Hospital Authority and an associate dean for clinical affairs in quality and safety education, as well as continuing to be a professor of medicine.
For those hoping to pursue quality improvement, Dr. Glasheen stressed the importance of a strong basis in data analytics.
“One of the most common things I see with data is people start to chase what’s called common cause variation, which means they’ll look at a run chart over the course of 12 months and react to every up and down when those are essentially random,” Dr. Glasheen said. “Being able to understand when something is particularly significant and when your interventions are actually making an impact is a skill set I think people who are new to quality improvement don’t often have.”
Having support from board members is also critical to success, although starting without such support should not deter future QI leaders.
“There needs to be a vision from the leadership that this work is important, and not just through words but through deeds, because no board in the country will say that quality is not important,” Dr. Glasheen said. “I would say start with small projects you can control, that tie back not only to patient lives but financial performance as well. If you can tell a board you saved the lives of 40 patients who would have died during the year and saved $1-$2 million in the process, the question will shift from whether the board should invest in QI resources to how much should be invested.”
Looking ahead, Dr. Glasheen highlighted the growing importance of hospital-acquired infections, such as surgical-site infections, catheter-associated urinary tract infections, and ventilator-associated pneumonia, as areas that need to be focused on in the QI sphere.
Hospital Medicine: An international specialty
This past fall, I had the honor of being invited to speak at a hospitalist physician conference in Tokyo. The conference was hosted by the Japanese Society of Hospital General Medicine (JSHGM) and was attended by over 800 hospitalists, including some from other East Asian countries.
The JSHGM is 7 years old and has 1,400 members; its growth mirroring the growth of practicing hospitalists in Japan. They wanted me to speak about the evolution of the hospitalist model in the United States and to learn more about their efforts to grow the nascent specialty in Japan. We also jointly wanted to discuss the opportunity for the JSHGM and the Society of Hospital Medicine to work together to benefit the hospitalist model in both countries.
This emerging partnership of the two societies is only the latest of a growing series of efforts on the part of SHM to support the growth of the hospitalist specialty internationally. It started with Canada in 2001, when a contingent of Canadian hospitalists requested to form their own chapter of SHM. They wanted to become the first international chapter and to join a group that has now grown to 56 state and regional chapters. Within a few years, the Canadian Chapter evolved to become its own independent and flourishing Canadian Society of Hospital Medicine.
More recently, SHM has helped develop chapters in Brazil and the Middle East, with more chapters being planned. The International Special Interest Forum at Hospital Medicine 2018 in Orlando in April expects attendees from Holland, Germany, Spain, Chile, Taiwan, China and more.
So why all of this activity by hospitalists in countries whose health systems are so different from ours and from each other’s? What is it about our specialty that has captured the interest of physicians, health systems, and governments from around the globe?
Talking to hospitalists from abroad, the answer is very consistent and very simple. It is the desire to lower cost and improve the quality of care. It turns out that the American health care system is not the only one that struggles with these issues. It seems that health care costs are too high everywhere and that the quest for higher quality, lower cost health care is a universal struggle. As Scottish-born health care economist Ian Morrison jokes, “Every health care system sucks in its own way.”
Let’s look at Japan. They have the longest average life expectancy in the world at 84 years, with about a quarter of their population over 65 years of age. On any given day, almost 14% of the population has a physician visit. Historically, they also have long hospital length of stays with current average length of stay anywhere between 14 and 21 days. This, of course, is very costly. … and in their single-payer system, the entire cost of this care falls on the Japanese government. And as birth rates in Japan have decreased, there are fewer taxpayers to bear the financial burden of the progressively aging and sicker population.
Canada has a different challenge. Also a single-payer system, their largest issue for the acutely ill is the availability of an open hospital bed. Although the system varies somewhat from province to province, it is typical that hospitals are given a total annual budget that must cover all expenses for the year, independent of the volume of patients. Since most hospitals are perpetually full, the discharge of a patient results in another new admission, which in turn actually costs the hospital more money. This perverse incentive keeps hospital beds full as patients wait for one to open (especially for any elective procedure). Adding to the problem, physicians are paid fee for service and therefore also have no incentive to discharge patients.
As Canadian citizens clamor for more access to care, the government looks for ways to lower excessively long length of stays. Wait times for elective surgeries are unacceptable with some patients coming to the United States for surgery that they must then pay for themselves. The result is mounting pressure to move to models of care that are more efficient and less wasteful.
It is no wonder that physicians and health care planners from Japan, Canada, and around the world have viewed with great interest what hospitalists have accomplished in the American health care system. They recognize the potential of this relatively new model to decrease hospital length of stays, lower health care costs, and improve outcomes. After all, this is what the hospitalist model was invented to accomplish – to create value not through high production, but by improving the efficiency of care delivery, overall quality of care, and contributing to improved hospital operations.
As unrelenting economic forces continue to put pressure on health care systems worldwide, it will be fascinating to follow and continue assessing the impact of the hospitalist model in nations where it is implemented. That includes, of course, in the United States, where the model is still very young and continually evolving.
In the meantime, SHM will continue to learn about and work with our international partners. This certainly will be the focus of a special “Hospital Medicine in Japan” session at Hospital Medicine 2018 along with the International Special Interest Forum. And for the first time, we will also have an International Lounge where our international members can meet with each other and our American members to share ideas and enthusiasm for the future of our specialty.
These are just the first steps to expanding the hospital medicine movement across the globe. SHM is optimistic about the future opportunities for international collaboration and is committed to supporting the growth of the specialty and its practitioners, not only in the United States, but worldwide.
Dr. Greeno is president of the Society of Hospital Medicine, and senior adviser for medical affairs, TeamHealth.
This past fall, I had the honor of being invited to speak at a hospitalist physician conference in Tokyo. The conference was hosted by the Japanese Society of Hospital General Medicine (JSHGM) and was attended by over 800 hospitalists, including some from other East Asian countries.
The JSHGM is 7 years old and has 1,400 members; its growth mirroring the growth of practicing hospitalists in Japan. They wanted me to speak about the evolution of the hospitalist model in the United States and to learn more about their efforts to grow the nascent specialty in Japan. We also jointly wanted to discuss the opportunity for the JSHGM and the Society of Hospital Medicine to work together to benefit the hospitalist model in both countries.
This emerging partnership of the two societies is only the latest of a growing series of efforts on the part of SHM to support the growth of the hospitalist specialty internationally. It started with Canada in 2001, when a contingent of Canadian hospitalists requested to form their own chapter of SHM. They wanted to become the first international chapter and to join a group that has now grown to 56 state and regional chapters. Within a few years, the Canadian Chapter evolved to become its own independent and flourishing Canadian Society of Hospital Medicine.
More recently, SHM has helped develop chapters in Brazil and the Middle East, with more chapters being planned. The International Special Interest Forum at Hospital Medicine 2018 in Orlando in April expects attendees from Holland, Germany, Spain, Chile, Taiwan, China and more.
So why all of this activity by hospitalists in countries whose health systems are so different from ours and from each other’s? What is it about our specialty that has captured the interest of physicians, health systems, and governments from around the globe?
Talking to hospitalists from abroad, the answer is very consistent and very simple. It is the desire to lower cost and improve the quality of care. It turns out that the American health care system is not the only one that struggles with these issues. It seems that health care costs are too high everywhere and that the quest for higher quality, lower cost health care is a universal struggle. As Scottish-born health care economist Ian Morrison jokes, “Every health care system sucks in its own way.”
Let’s look at Japan. They have the longest average life expectancy in the world at 84 years, with about a quarter of their population over 65 years of age. On any given day, almost 14% of the population has a physician visit. Historically, they also have long hospital length of stays with current average length of stay anywhere between 14 and 21 days. This, of course, is very costly. … and in their single-payer system, the entire cost of this care falls on the Japanese government. And as birth rates in Japan have decreased, there are fewer taxpayers to bear the financial burden of the progressively aging and sicker population.
Canada has a different challenge. Also a single-payer system, their largest issue for the acutely ill is the availability of an open hospital bed. Although the system varies somewhat from province to province, it is typical that hospitals are given a total annual budget that must cover all expenses for the year, independent of the volume of patients. Since most hospitals are perpetually full, the discharge of a patient results in another new admission, which in turn actually costs the hospital more money. This perverse incentive keeps hospital beds full as patients wait for one to open (especially for any elective procedure). Adding to the problem, physicians are paid fee for service and therefore also have no incentive to discharge patients.
As Canadian citizens clamor for more access to care, the government looks for ways to lower excessively long length of stays. Wait times for elective surgeries are unacceptable with some patients coming to the United States for surgery that they must then pay for themselves. The result is mounting pressure to move to models of care that are more efficient and less wasteful.
It is no wonder that physicians and health care planners from Japan, Canada, and around the world have viewed with great interest what hospitalists have accomplished in the American health care system. They recognize the potential of this relatively new model to decrease hospital length of stays, lower health care costs, and improve outcomes. After all, this is what the hospitalist model was invented to accomplish – to create value not through high production, but by improving the efficiency of care delivery, overall quality of care, and contributing to improved hospital operations.
As unrelenting economic forces continue to put pressure on health care systems worldwide, it will be fascinating to follow and continue assessing the impact of the hospitalist model in nations where it is implemented. That includes, of course, in the United States, where the model is still very young and continually evolving.
In the meantime, SHM will continue to learn about and work with our international partners. This certainly will be the focus of a special “Hospital Medicine in Japan” session at Hospital Medicine 2018 along with the International Special Interest Forum. And for the first time, we will also have an International Lounge where our international members can meet with each other and our American members to share ideas and enthusiasm for the future of our specialty.
These are just the first steps to expanding the hospital medicine movement across the globe. SHM is optimistic about the future opportunities for international collaboration and is committed to supporting the growth of the specialty and its practitioners, not only in the United States, but worldwide.
Dr. Greeno is president of the Society of Hospital Medicine, and senior adviser for medical affairs, TeamHealth.
This past fall, I had the honor of being invited to speak at a hospitalist physician conference in Tokyo. The conference was hosted by the Japanese Society of Hospital General Medicine (JSHGM) and was attended by over 800 hospitalists, including some from other East Asian countries.
The JSHGM is 7 years old and has 1,400 members; its growth mirroring the growth of practicing hospitalists in Japan. They wanted me to speak about the evolution of the hospitalist model in the United States and to learn more about their efforts to grow the nascent specialty in Japan. We also jointly wanted to discuss the opportunity for the JSHGM and the Society of Hospital Medicine to work together to benefit the hospitalist model in both countries.
This emerging partnership of the two societies is only the latest of a growing series of efforts on the part of SHM to support the growth of the hospitalist specialty internationally. It started with Canada in 2001, when a contingent of Canadian hospitalists requested to form their own chapter of SHM. They wanted to become the first international chapter and to join a group that has now grown to 56 state and regional chapters. Within a few years, the Canadian Chapter evolved to become its own independent and flourishing Canadian Society of Hospital Medicine.
More recently, SHM has helped develop chapters in Brazil and the Middle East, with more chapters being planned. The International Special Interest Forum at Hospital Medicine 2018 in Orlando in April expects attendees from Holland, Germany, Spain, Chile, Taiwan, China and more.
So why all of this activity by hospitalists in countries whose health systems are so different from ours and from each other’s? What is it about our specialty that has captured the interest of physicians, health systems, and governments from around the globe?
Talking to hospitalists from abroad, the answer is very consistent and very simple. It is the desire to lower cost and improve the quality of care. It turns out that the American health care system is not the only one that struggles with these issues. It seems that health care costs are too high everywhere and that the quest for higher quality, lower cost health care is a universal struggle. As Scottish-born health care economist Ian Morrison jokes, “Every health care system sucks in its own way.”
Let’s look at Japan. They have the longest average life expectancy in the world at 84 years, with about a quarter of their population over 65 years of age. On any given day, almost 14% of the population has a physician visit. Historically, they also have long hospital length of stays with current average length of stay anywhere between 14 and 21 days. This, of course, is very costly. … and in their single-payer system, the entire cost of this care falls on the Japanese government. And as birth rates in Japan have decreased, there are fewer taxpayers to bear the financial burden of the progressively aging and sicker population.
Canada has a different challenge. Also a single-payer system, their largest issue for the acutely ill is the availability of an open hospital bed. Although the system varies somewhat from province to province, it is typical that hospitals are given a total annual budget that must cover all expenses for the year, independent of the volume of patients. Since most hospitals are perpetually full, the discharge of a patient results in another new admission, which in turn actually costs the hospital more money. This perverse incentive keeps hospital beds full as patients wait for one to open (especially for any elective procedure). Adding to the problem, physicians are paid fee for service and therefore also have no incentive to discharge patients.
As Canadian citizens clamor for more access to care, the government looks for ways to lower excessively long length of stays. Wait times for elective surgeries are unacceptable with some patients coming to the United States for surgery that they must then pay for themselves. The result is mounting pressure to move to models of care that are more efficient and less wasteful.
It is no wonder that physicians and health care planners from Japan, Canada, and around the world have viewed with great interest what hospitalists have accomplished in the American health care system. They recognize the potential of this relatively new model to decrease hospital length of stays, lower health care costs, and improve outcomes. After all, this is what the hospitalist model was invented to accomplish – to create value not through high production, but by improving the efficiency of care delivery, overall quality of care, and contributing to improved hospital operations.
As unrelenting economic forces continue to put pressure on health care systems worldwide, it will be fascinating to follow and continue assessing the impact of the hospitalist model in nations where it is implemented. That includes, of course, in the United States, where the model is still very young and continually evolving.
In the meantime, SHM will continue to learn about and work with our international partners. This certainly will be the focus of a special “Hospital Medicine in Japan” session at Hospital Medicine 2018 along with the International Special Interest Forum. And for the first time, we will also have an International Lounge where our international members can meet with each other and our American members to share ideas and enthusiasm for the future of our specialty.
These are just the first steps to expanding the hospital medicine movement across the globe. SHM is optimistic about the future opportunities for international collaboration and is committed to supporting the growth of the specialty and its practitioners, not only in the United States, but worldwide.
Dr. Greeno is president of the Society of Hospital Medicine, and senior adviser for medical affairs, TeamHealth.
Career development: One of many new focal points at HM 2018
Editor’s note: Each month, the Society of Hospital Medicine puts the spotlight on some of our most active members who are making substantial contributions to hospital medicine. Visit www.hospitalmedicine.org for more information on how you can lend your expertise to help SHM improve the care of hospitalized patients.
This month, The Hospitalist spotlights Kathleen Finn, MD, M. Phil, FACP, FHM, the inpatient associate program director of the internal medicine residency program at Massachusetts General Hospital and an assistant professor of medicine at Harvard Medical School, both in Boston. Dr. Finn has been a member of the Society of Hospital Medicine’s Annual Conference Committee for the past 8 years and is the course director for Hospital Medicine 2018 (HM18), to be held April 8-11 in Orlando.
When did you become a member of SHM, and how did you initially become involved with the Annual Conference Committee?
I became involved with the Annual Conference Committee 8 years ago because of my interest in education. Being a founding member of the SHM Boston Chapter, I gained experience planning the quarterly local chapter meetings. As a clinical educator and hospitalist, I was involved in planning conferences for faculty at my hospital. I found I really enjoyed developing educational conferences and curriculum, so when I heard about the Annual Conference Committee, I thought it would be a perfect fit.
It’s been a great experience getting to know committee members from all over the country and hearing their thoughts about the annual conference. It’s always exciting to brainstorm topic ideas and think about what would interest conference attendees.
Describe your role as course director.
My job as course director is to challenge committee members to be as creative as possible and help focus the discussion around the needs of SHM members while keeping to a schedule. I led a team of 23 amazing committee members through the planning stages for HM18 this past summer. With the help of Brittany Evans, SHM’s Education and Meetings Project Manager, and Dustin Smith, MD, FHM, the cocourse director, the committee reviewed prior conference agendas and feedback from attendees and from other SHM committees. Using that information, we discussed, brainstormed, voted on, and planned this year’s clinical content talks, workshops, and many of the specialty tracks.
What are you most looking forward to at HM18?
I am looking forward to the entire meeting! First, the location is exciting since this is our first time in Orlando. I’m curious to see what the facility is like, and I am hoping attendees use the location as a reason to bring their families and visit the theme parks. In recognition of our Orlando location, the committee got creative with titles for the conference. For example, geriatrics became “The Tale as Old as Time.” I hope some of the titles put a smile on the attendees’ faces.
I am also eagerly anticipating the nationally recognized speakers. We invited the best speakers we know from both subspecialty backgrounds and fellow hospitalists, and given the Orlando location, we tried to feature the best speakers from the Southeast. Finally, I am looking forward to the diversity of topics. The committee really thought broadly about relevant topics to today’s practicing hospitalists.
What will be new and different for attendees at HM18 in comparison to previous annual conferences?
There are many new things this year. Given the field of hospital medicine is now more than 20 years old, the committee thought it was important to focus on career development – not just for new hospitalists, but midcareer hospitalists as well. How do you make hospital medicine a lifelong, enjoyable, and engaging career? To explore and answer these questions, the Annual Conference Committee created several new tracks for HM18.
We created a Seasoning Your Career track that offers ideas on how to change your role midcareer – how to advance to a leadership position, how to use emotional intelligence to achieve success, how to prevent burnout, and, best of all, how to consider and change your hospitalist group’s work schedule, which rules our lives and our families’ lives. We also added financial planning advice to help you prepare for retirement.
Another new track at HM18 is the Career Development Workshops track, which includes a diversity of workshops meant to help build leadership skills, develop presentation/communication skills, encourage peers to give each other feedback, promote women in hospital medicine, prevent burnout, and turn ideas into clinical research. The Medical Education track also has a session on how to break into educational roles, especially if you want to expand your career into a leadership position in medical education.
In addition to Seasoning Your Career and Career Development Workshops, we have three other new tracks: Palliative Care, NP/PA, and The Great Debate. The Great Debate track uses the popular format of the perioperative debate given every year at the annual conference to tackle topics in infectious disease and pulmonary medicine. We ask very talented, opinionated, and humorous speakers to debate with each other over clinical content; it will be a great “smack down!”
Other new things for HM18 include:
- An interventional radiologist will speak about the latest procedures and when to refer your patients.
- A few surgeons will talk about managing surgical patients on your service and about decubitus ulcers.
- An oncologist will discuss the complications of the latest advanced agents on the wards.
- A rheumatologist will discuss the complications of new biologic agents.
- A rehab specialist will discuss the benefits and limitations of physical/occupational therapists and physiatrists.
- A speaker will discussing vulnerable populations, focusing on the social determinants of health, which last year’s HM17 plenary speaker Karen DeSalvo, MD, MPH, MSc raised as an important issue.
- There will be an “Updates in Addiction Medicine” lecture.
- There will be a new cardiology precourse and an expanded infectious disease precourse, which will also focus on sepsis.
How has the committee worked to ensure the course content is refreshed and current?
The reason the Annual Conference Committee is large is to ensure that there is a diversity of voices and talents from all over the country. There are both academic and community hospitalists on the committee; its members represent internal medicine, family medicine, pediatrics, and subspecialists, as well as administrators and hospitalist leaders. The annual meetings are planned over 3-4 months via weekly calls. In between calls, committee members are encouraged to discuss topics with their colleagues at home for opinions and advice.
The best ideas from the committee come from the group discussion and brainstorming. Someone mentions a topic, which leads someone else to add to it, and so on. Within the hour, we have some fantastic suggestions that the committee can run with. We also rely on input from SHM members: For example, many of the workshops’ topics are chosen from hundreds of submissions from members; speaker and content suggestions are submitted by hospitalist leaders from around the country and thereby provide insight into current topics. Combined, these offer a richness of ideas, which allows the committee to stay up to date and refresh old ideas.
What advice can you offer to early career hospitalists looking to get involved with the Annual Conference Committee or other conference planning roles?
My advice for early career hospitalists is to start locally. Join your local SHM chapter, or start one. In trying to plan local conferences, you begin to figure out which content areas interest hospitalists and how they can best be delivered. You might offer to give a talk at your local chapter or at your hospital and develop presentation skills. Developing a network of fellow hospitalists through your local chapter is important. The more local hospitalists you connect with, the more likely it is that they will think of you when they are planning a conference. At the national level, consider submitting a workshop or submitting an idea for content. Workshops are a great way to get recognized at the national level.
The Annual Conference Committee takes applications every year. Once you have some experience planning conferences or coordinating speakers, it would definitely be worth applying. You may not be selected your first year, but do not let that discourage you! Demonstrating interest and perseverance goes a long way. There are also many other national SHM committees to join and other ways to get involved. Your willingness to provide some of your time makes the society – and the specialty – what it is.
Ms. Steele is the marketing communications specialist at the Society of Hospital Medicine.
Editor’s note: Each month, the Society of Hospital Medicine puts the spotlight on some of our most active members who are making substantial contributions to hospital medicine. Visit www.hospitalmedicine.org for more information on how you can lend your expertise to help SHM improve the care of hospitalized patients.
This month, The Hospitalist spotlights Kathleen Finn, MD, M. Phil, FACP, FHM, the inpatient associate program director of the internal medicine residency program at Massachusetts General Hospital and an assistant professor of medicine at Harvard Medical School, both in Boston. Dr. Finn has been a member of the Society of Hospital Medicine’s Annual Conference Committee for the past 8 years and is the course director for Hospital Medicine 2018 (HM18), to be held April 8-11 in Orlando.
When did you become a member of SHM, and how did you initially become involved with the Annual Conference Committee?
I became involved with the Annual Conference Committee 8 years ago because of my interest in education. Being a founding member of the SHM Boston Chapter, I gained experience planning the quarterly local chapter meetings. As a clinical educator and hospitalist, I was involved in planning conferences for faculty at my hospital. I found I really enjoyed developing educational conferences and curriculum, so when I heard about the Annual Conference Committee, I thought it would be a perfect fit.
It’s been a great experience getting to know committee members from all over the country and hearing their thoughts about the annual conference. It’s always exciting to brainstorm topic ideas and think about what would interest conference attendees.
Describe your role as course director.
My job as course director is to challenge committee members to be as creative as possible and help focus the discussion around the needs of SHM members while keeping to a schedule. I led a team of 23 amazing committee members through the planning stages for HM18 this past summer. With the help of Brittany Evans, SHM’s Education and Meetings Project Manager, and Dustin Smith, MD, FHM, the cocourse director, the committee reviewed prior conference agendas and feedback from attendees and from other SHM committees. Using that information, we discussed, brainstormed, voted on, and planned this year’s clinical content talks, workshops, and many of the specialty tracks.
What are you most looking forward to at HM18?
I am looking forward to the entire meeting! First, the location is exciting since this is our first time in Orlando. I’m curious to see what the facility is like, and I am hoping attendees use the location as a reason to bring their families and visit the theme parks. In recognition of our Orlando location, the committee got creative with titles for the conference. For example, geriatrics became “The Tale as Old as Time.” I hope some of the titles put a smile on the attendees’ faces.
I am also eagerly anticipating the nationally recognized speakers. We invited the best speakers we know from both subspecialty backgrounds and fellow hospitalists, and given the Orlando location, we tried to feature the best speakers from the Southeast. Finally, I am looking forward to the diversity of topics. The committee really thought broadly about relevant topics to today’s practicing hospitalists.
What will be new and different for attendees at HM18 in comparison to previous annual conferences?
There are many new things this year. Given the field of hospital medicine is now more than 20 years old, the committee thought it was important to focus on career development – not just for new hospitalists, but midcareer hospitalists as well. How do you make hospital medicine a lifelong, enjoyable, and engaging career? To explore and answer these questions, the Annual Conference Committee created several new tracks for HM18.
We created a Seasoning Your Career track that offers ideas on how to change your role midcareer – how to advance to a leadership position, how to use emotional intelligence to achieve success, how to prevent burnout, and, best of all, how to consider and change your hospitalist group’s work schedule, which rules our lives and our families’ lives. We also added financial planning advice to help you prepare for retirement.
Another new track at HM18 is the Career Development Workshops track, which includes a diversity of workshops meant to help build leadership skills, develop presentation/communication skills, encourage peers to give each other feedback, promote women in hospital medicine, prevent burnout, and turn ideas into clinical research. The Medical Education track also has a session on how to break into educational roles, especially if you want to expand your career into a leadership position in medical education.
In addition to Seasoning Your Career and Career Development Workshops, we have three other new tracks: Palliative Care, NP/PA, and The Great Debate. The Great Debate track uses the popular format of the perioperative debate given every year at the annual conference to tackle topics in infectious disease and pulmonary medicine. We ask very talented, opinionated, and humorous speakers to debate with each other over clinical content; it will be a great “smack down!”
Other new things for HM18 include:
- An interventional radiologist will speak about the latest procedures and when to refer your patients.
- A few surgeons will talk about managing surgical patients on your service and about decubitus ulcers.
- An oncologist will discuss the complications of the latest advanced agents on the wards.
- A rheumatologist will discuss the complications of new biologic agents.
- A rehab specialist will discuss the benefits and limitations of physical/occupational therapists and physiatrists.
- A speaker will discussing vulnerable populations, focusing on the social determinants of health, which last year’s HM17 plenary speaker Karen DeSalvo, MD, MPH, MSc raised as an important issue.
- There will be an “Updates in Addiction Medicine” lecture.
- There will be a new cardiology precourse and an expanded infectious disease precourse, which will also focus on sepsis.
How has the committee worked to ensure the course content is refreshed and current?
The reason the Annual Conference Committee is large is to ensure that there is a diversity of voices and talents from all over the country. There are both academic and community hospitalists on the committee; its members represent internal medicine, family medicine, pediatrics, and subspecialists, as well as administrators and hospitalist leaders. The annual meetings are planned over 3-4 months via weekly calls. In between calls, committee members are encouraged to discuss topics with their colleagues at home for opinions and advice.
The best ideas from the committee come from the group discussion and brainstorming. Someone mentions a topic, which leads someone else to add to it, and so on. Within the hour, we have some fantastic suggestions that the committee can run with. We also rely on input from SHM members: For example, many of the workshops’ topics are chosen from hundreds of submissions from members; speaker and content suggestions are submitted by hospitalist leaders from around the country and thereby provide insight into current topics. Combined, these offer a richness of ideas, which allows the committee to stay up to date and refresh old ideas.
What advice can you offer to early career hospitalists looking to get involved with the Annual Conference Committee or other conference planning roles?
My advice for early career hospitalists is to start locally. Join your local SHM chapter, or start one. In trying to plan local conferences, you begin to figure out which content areas interest hospitalists and how they can best be delivered. You might offer to give a talk at your local chapter or at your hospital and develop presentation skills. Developing a network of fellow hospitalists through your local chapter is important. The more local hospitalists you connect with, the more likely it is that they will think of you when they are planning a conference. At the national level, consider submitting a workshop or submitting an idea for content. Workshops are a great way to get recognized at the national level.
The Annual Conference Committee takes applications every year. Once you have some experience planning conferences or coordinating speakers, it would definitely be worth applying. You may not be selected your first year, but do not let that discourage you! Demonstrating interest and perseverance goes a long way. There are also many other national SHM committees to join and other ways to get involved. Your willingness to provide some of your time makes the society – and the specialty – what it is.
Ms. Steele is the marketing communications specialist at the Society of Hospital Medicine.
Editor’s note: Each month, the Society of Hospital Medicine puts the spotlight on some of our most active members who are making substantial contributions to hospital medicine. Visit www.hospitalmedicine.org for more information on how you can lend your expertise to help SHM improve the care of hospitalized patients.
This month, The Hospitalist spotlights Kathleen Finn, MD, M. Phil, FACP, FHM, the inpatient associate program director of the internal medicine residency program at Massachusetts General Hospital and an assistant professor of medicine at Harvard Medical School, both in Boston. Dr. Finn has been a member of the Society of Hospital Medicine’s Annual Conference Committee for the past 8 years and is the course director for Hospital Medicine 2018 (HM18), to be held April 8-11 in Orlando.
When did you become a member of SHM, and how did you initially become involved with the Annual Conference Committee?
I became involved with the Annual Conference Committee 8 years ago because of my interest in education. Being a founding member of the SHM Boston Chapter, I gained experience planning the quarterly local chapter meetings. As a clinical educator and hospitalist, I was involved in planning conferences for faculty at my hospital. I found I really enjoyed developing educational conferences and curriculum, so when I heard about the Annual Conference Committee, I thought it would be a perfect fit.
It’s been a great experience getting to know committee members from all over the country and hearing their thoughts about the annual conference. It’s always exciting to brainstorm topic ideas and think about what would interest conference attendees.
Describe your role as course director.
My job as course director is to challenge committee members to be as creative as possible and help focus the discussion around the needs of SHM members while keeping to a schedule. I led a team of 23 amazing committee members through the planning stages for HM18 this past summer. With the help of Brittany Evans, SHM’s Education and Meetings Project Manager, and Dustin Smith, MD, FHM, the cocourse director, the committee reviewed prior conference agendas and feedback from attendees and from other SHM committees. Using that information, we discussed, brainstormed, voted on, and planned this year’s clinical content talks, workshops, and many of the specialty tracks.
What are you most looking forward to at HM18?
I am looking forward to the entire meeting! First, the location is exciting since this is our first time in Orlando. I’m curious to see what the facility is like, and I am hoping attendees use the location as a reason to bring their families and visit the theme parks. In recognition of our Orlando location, the committee got creative with titles for the conference. For example, geriatrics became “The Tale as Old as Time.” I hope some of the titles put a smile on the attendees’ faces.
I am also eagerly anticipating the nationally recognized speakers. We invited the best speakers we know from both subspecialty backgrounds and fellow hospitalists, and given the Orlando location, we tried to feature the best speakers from the Southeast. Finally, I am looking forward to the diversity of topics. The committee really thought broadly about relevant topics to today’s practicing hospitalists.
What will be new and different for attendees at HM18 in comparison to previous annual conferences?
There are many new things this year. Given the field of hospital medicine is now more than 20 years old, the committee thought it was important to focus on career development – not just for new hospitalists, but midcareer hospitalists as well. How do you make hospital medicine a lifelong, enjoyable, and engaging career? To explore and answer these questions, the Annual Conference Committee created several new tracks for HM18.
We created a Seasoning Your Career track that offers ideas on how to change your role midcareer – how to advance to a leadership position, how to use emotional intelligence to achieve success, how to prevent burnout, and, best of all, how to consider and change your hospitalist group’s work schedule, which rules our lives and our families’ lives. We also added financial planning advice to help you prepare for retirement.
Another new track at HM18 is the Career Development Workshops track, which includes a diversity of workshops meant to help build leadership skills, develop presentation/communication skills, encourage peers to give each other feedback, promote women in hospital medicine, prevent burnout, and turn ideas into clinical research. The Medical Education track also has a session on how to break into educational roles, especially if you want to expand your career into a leadership position in medical education.
In addition to Seasoning Your Career and Career Development Workshops, we have three other new tracks: Palliative Care, NP/PA, and The Great Debate. The Great Debate track uses the popular format of the perioperative debate given every year at the annual conference to tackle topics in infectious disease and pulmonary medicine. We ask very talented, opinionated, and humorous speakers to debate with each other over clinical content; it will be a great “smack down!”
Other new things for HM18 include:
- An interventional radiologist will speak about the latest procedures and when to refer your patients.
- A few surgeons will talk about managing surgical patients on your service and about decubitus ulcers.
- An oncologist will discuss the complications of the latest advanced agents on the wards.
- A rheumatologist will discuss the complications of new biologic agents.
- A rehab specialist will discuss the benefits and limitations of physical/occupational therapists and physiatrists.
- A speaker will discussing vulnerable populations, focusing on the social determinants of health, which last year’s HM17 plenary speaker Karen DeSalvo, MD, MPH, MSc raised as an important issue.
- There will be an “Updates in Addiction Medicine” lecture.
- There will be a new cardiology precourse and an expanded infectious disease precourse, which will also focus on sepsis.
How has the committee worked to ensure the course content is refreshed and current?
The reason the Annual Conference Committee is large is to ensure that there is a diversity of voices and talents from all over the country. There are both academic and community hospitalists on the committee; its members represent internal medicine, family medicine, pediatrics, and subspecialists, as well as administrators and hospitalist leaders. The annual meetings are planned over 3-4 months via weekly calls. In between calls, committee members are encouraged to discuss topics with their colleagues at home for opinions and advice.
The best ideas from the committee come from the group discussion and brainstorming. Someone mentions a topic, which leads someone else to add to it, and so on. Within the hour, we have some fantastic suggestions that the committee can run with. We also rely on input from SHM members: For example, many of the workshops’ topics are chosen from hundreds of submissions from members; speaker and content suggestions are submitted by hospitalist leaders from around the country and thereby provide insight into current topics. Combined, these offer a richness of ideas, which allows the committee to stay up to date and refresh old ideas.
What advice can you offer to early career hospitalists looking to get involved with the Annual Conference Committee or other conference planning roles?
My advice for early career hospitalists is to start locally. Join your local SHM chapter, or start one. In trying to plan local conferences, you begin to figure out which content areas interest hospitalists and how they can best be delivered. You might offer to give a talk at your local chapter or at your hospital and develop presentation skills. Developing a network of fellow hospitalists through your local chapter is important. The more local hospitalists you connect with, the more likely it is that they will think of you when they are planning a conference. At the national level, consider submitting a workshop or submitting an idea for content. Workshops are a great way to get recognized at the national level.
The Annual Conference Committee takes applications every year. Once you have some experience planning conferences or coordinating speakers, it would definitely be worth applying. You may not be selected your first year, but do not let that discourage you! Demonstrating interest and perseverance goes a long way. There are also many other national SHM committees to join and other ways to get involved. Your willingness to provide some of your time makes the society – and the specialty – what it is.
Ms. Steele is the marketing communications specialist at the Society of Hospital Medicine.
Here are the ‘must-see’ sessions at HM18
Welcome to Hospital Medicine 2018, the second-happiest place in Orlando – at least for hospitalists who want to be in the know.
The 2018 education program is a ride through the diverse world of hospital medicine, with sessions ranging from clinical updates to cutting-edge techniques, communication tools, building a satisfying career, and finding your way through tangles of red tape and policy.
Two tracks new for 2018 hone in on managing alternative providers and palliative care.
The half-day NP/PA track (beginning April 11 at 7:30 a.m.) recognizes these practitioners for their crucial roles in hospital medicine care delivery. Among the discussions aimed at hospitalists: Best practices in provider utilization and collaboration; supervision vs. collaboration; and challenging situations when working with mid-level providers.
The palliative care track (also a half day, starting April 11 at 10 a.m.) recognizes the crucial role hospitalists play in optimizing end-of-life care. Sessions will help hospitalists understand that role, and guide them in managing pain and other symptoms commonly encountered during this transitional time.
As for the rest of the meeting, picking favorites is as tough as picking between Disney’s Big Thunder Railroad and Splash Mountain, said HM18 course director Dustin Smith, MD, SFHM, of Emory University, Atlanta. “We feel strongly that all offerings at the conference are ‘must-sees,’ and it’s why we offer repeat sessions of what we predict will be the most popular talks overall. Since there are so many good sessions competing for attendees at the same time, we wanted to make sure we offered these repeat sessions of common, high-yield clinical topics.”
The Repeated Sessions track is set for April 10, and runs a full day. The track includes these dynamic sessions:
- Updates in congestive heart failure: Pablo Quintero, MD; 11-11:40 a.m.
- He-who-shall-not-be-named: Updates in sepsis and critical care: Patricia Kritek, MD, EdM; 11:50 a.m.-12:30 p.m.
- Not true love’s kiss? Updates in infectious disease: John Sanders, MD, MPHTM; 2:50-3:30 p.m.
- Updates in acute coronary syndrome: Jeff Trost, MD; 3:40-4:20 p.m.
- Waiting in line for ‘It’s a Small World’ and other things we do for no reason: Tony Breu, MD, FHM; 4:30-5:10 p.m.
- “The Mad Hatter”: Updates in delirium: Ethan Cumbler, MD, FHM; 5:20-6:00 p.m.
In addition to the sepsis update in the Repeated Sessions track, Dr. Smith noted that sepsis will also be the topic of a pre-course offering (April 8, 8:15 a.m.-4:50 p.m.). “The topic of sepsis remains a hot item in hospital medicine,” he said.
“I’d also like to highlight a new pre-course offering this year – ‘Keep your finger on the pulse: Cardiology update for the hospitalist’ (April 8, 8:30 a.m.-4:50 p.m.),” he said. “Many of our pre-course offerings are carry-overs from previous years due to ongoing great success with the individual pre-courses themselves. Although we have had a cardiology pre-course in our lineup of offerings in the past, we chose to offer a freshly redesigned pre-course in cardiology this year to round out the lineup of pre-course offerings and to keep things fresh.”
The “Stump the attentive (not absent-minded) professor” sessions on clinical unknowns in the Diagnostics Reasoning track are also must-sees, Dr. Smith said. So much so, that SHM is offering two of them this year (April 9, 2:00-2:40 p.m.; 3:45-4:25 p.m.).
Dr. Smith’s codirector Kathleen Finn, MD, MPhil, SFHM, also has a few personal favorites on the education program.
“I know the talks in the ‘Seasoning your career track’ will be great,” said Dr. Finn, a hospitalist at Massachusetts General Hospital, Boston. “This new track provides mid-career hospitalists (and new hospitalists) ideas in how to continue to make their career enjoyable and stimulating. It includes talks on how to advance in a leadership position, use emotional intelligence to achieve success, prevent burnout or design your groups schedule so it doesn’t rule your life.”
The board weighs in
The 2018 HM18 line-up garnered an enthusiastic thumbs-up from The Hospitalist’s editorial advisory board. We polled these experts for their 2018 “must-see” sessions, and they responded with a selection that spans the meeting’s wide-ranging offerings.
1. Leadership essentials for success in hospital medicine (April 9, 10:35 a.m.-12:05 p.m.)
Amit Vashist, MD, MBA, FHM, system chair, hospitalist division, Mountain State Health Alliance, Virginia/Tennessee, is especially excited about this session, intended to help hospitalists assume leadership roles.
“Given the ever-expanding footprint of hospitalists inside the hospitals and beyond, and the way they are being called upon to be the drivers of an increasingly value-based care, I believe it is imperative for every hospitalist provider – regardless of being in a leadership role or not – to have a fundamental understanding of the leadership nuances pertaining specifically to hospital medicine in order to optimally leverage their skill set to drive transformational changes in the health care arena,” he said. “This primer on leadership essentials should pique the interest of the hospitalists further towards developing a deeper appreciation of some of the leadership dimensions must-haves in the realm of hospital medicine.”
Raj Sehgal, MD, FHM, clinical associate professor of medicine, University of Texas Health Sciences Center at San Antonio, pegged communication and behavioral medicine as two top picks.
2. Do you have a minute to talk? Peer-to-peer feedback (April 9, 2:50-4:20 p.m.)
“Those of us in academic settings spend a lot of time thinking about giving feedback to – and receiving feedback from – students and residents, but some of the most valuable feedback we can get is from our coworkers,” he said. “Many hospitalist groups are actively working on ways for their providers to learn from each other, such as peer observations, and this session should help in guiding some of those programs.”
3. Through the looking glass: A psychiatrist’s tricks for inpatient acute behavioral emergencies (April 10, 2:50-3:50 p.m.)
“Even for a seasoned hospitalist who never breaks a sweat treating the most acutely medically ill patients, the acutely psychotic (or agitated, or suicidal) patient can provoke significant anxiety,” Dr. Sehgal said. “The opportunity to gain another couple of ‘tools’ to add to our kit for these patients should help alleviate that feeling.”
No need for an academic meeting to be boring, said Weijen Chang, MD, SFHM, chief of pediatric hospital medicine at Baystate Children’s Hospital, Springfield, Mass.
4. Can we just stick to the “Bare Necessities”? – Things we do for no reason (April 9, 10:35-11:35 a.m.)
5. “Mirror, Mirror on the Wall”: Which articles are the fairest of them all? Top pediatric updates (April 10, 5:45-6:45 p.m.)
“I’d say Dr. Lenny Feldman’s [SFHM] ‘Things we do for no reason’ is a must-see. Lenny is a master at simplifying complex issues and communicating them in an easily understood manner, and he’s quite entertaining,” Dr. Chang said. “And of course, another must-see is Top Pediatric Updates. It is entertaining, educational, and we almost got thrown out last year for bringing beer!”
Sarah Stella, MD, FHM, a hospitalist at Denver Health, had a hard time choosing between the many interesting offerings. “There are quite a few great sessions this year that I’m interested in, but these are my top picks:”
6. Convert your everyday work into scholarship (and get it funded) (April 9, 1:35-2:35 p.m.)
“By virtue of their daily clinical and quality improvement/committee work, many hospitalists are well on their way to generating scholarship and funding, but are unsure how to make this conversion,” she said. “This workshop is a must for academic hospitalists working toward promotion who want a framework and tangible steps on how to get credit for what they are already doing.”
7. “Heigh ho, heigh ho,” it’s off to changing roles mid-career we go (April 11, 8:20-9:00 a.m.)
“Part of what attracts many of us to hospital medicine in the first place is the versatility of what we do and the ability to diversify based on our interests. I think this is a must-see for mid-career hospitalists like myself, or really any hospitalist dreaming of reinventing oneself.”
8. Winning hearts and minds at the bedside: Battling unconscious bias through cultural humility (April 11, 9:10-9:50 a.m.)
“Recognizing and confronting our implicit biases and how they affect patient-physician interactions is hard but incredibly important work,” Dr. Stella said. “I’ll definitely be attending this session by Aziz Ansari, DO, SFHM, to learn how to improve my relationship (and hence outcomes) with my patients.”
Harry (Hyung) Cho, MD, FHM, assistant professor of medicine and director of quality, safety, and value, division of hospital medicine, Mount Sinai Hospital, New York, had some diverse choices.
9. Being female in hospital medicine: Overcoming individual and institutional barriers in the workplace (April 9, 12:40-2:15 p.m.)
“This is a very timely, very important topic in the news and I think it will draw a lot of people,” he said.
10. Every patient tells a story and the art of diagnosis (April 9, 2:55-3:35 p.m.)
“The presenter is Dr. Lisa Sanders, who writes the ‘Diagnosis’ column for the New York Times and is a Yale University faculty member. She’s a great speaker and, incidentally, was a consultant on the TV show, ‘House, MD.’ ”
Raman Palabindala, MD, FHM, a hospitalist at the University of Mississippi Medical Center, Jackson, thinks the most important session at HM18 is the annual update.
11. Update in hospital medicine (April 10, 1:40-2:40 p.m.)“Almost every year, this is the most high energy presentation, and I don’t think I ever missed this session, no matter who is the presenter is,” he said. “As physicians, I think we need this update every year, and this is the best single hour where we can learn a lot as a hospitalist related to hospital medicine. This is the most concentrated extract of the entire meeting. What I learned about the behind scenes efforts up to 50-100 hours of work – why not we take advantage of this session.”
Lonika Sood, MD, FHM of the department of hospital medicine, Aurora BayCare Medical Center, Green Bay, Wis., has a passion for both leadership and scholarship, and her choices reflect that interest.
12. How to write a winning abstract (April 11, 7:30-8:30 a.m.)
13. Leadership positions in medical education: How to break into the field (April 11, 11:40 a.m.-12:20 p.m.)
14. Serious illness communication: A skills-based workshop (April 11, 8:00-9:30 a.m.)
“I would recommend all of those, especially for early-career hospitalists. And, having enjoyed and learned a lot from the workshops at HM17, I would highly recommend checking out a few that will help polish your communications – a much-needed skill in hospital medicine,” she said.
Finally, don’t just pick up another embroidered mouse ear hat on your way out. The best HM18 souvenir is taking back the knowledge you gained and – as Dr. Sood said – there’s a session for that.
15. How to bring the things you learn at SHM back to your institution: Advocating for high value care on hospital committees (April 11, 8:00-9:30 a.m.).
For more information on the HM18 education sessions, check the latest version of the conference schedule at http://shmannualconference.org/conference-schedule.
Welcome to Hospital Medicine 2018, the second-happiest place in Orlando – at least for hospitalists who want to be in the know.
The 2018 education program is a ride through the diverse world of hospital medicine, with sessions ranging from clinical updates to cutting-edge techniques, communication tools, building a satisfying career, and finding your way through tangles of red tape and policy.
Two tracks new for 2018 hone in on managing alternative providers and palliative care.
The half-day NP/PA track (beginning April 11 at 7:30 a.m.) recognizes these practitioners for their crucial roles in hospital medicine care delivery. Among the discussions aimed at hospitalists: Best practices in provider utilization and collaboration; supervision vs. collaboration; and challenging situations when working with mid-level providers.
The palliative care track (also a half day, starting April 11 at 10 a.m.) recognizes the crucial role hospitalists play in optimizing end-of-life care. Sessions will help hospitalists understand that role, and guide them in managing pain and other symptoms commonly encountered during this transitional time.
As for the rest of the meeting, picking favorites is as tough as picking between Disney’s Big Thunder Railroad and Splash Mountain, said HM18 course director Dustin Smith, MD, SFHM, of Emory University, Atlanta. “We feel strongly that all offerings at the conference are ‘must-sees,’ and it’s why we offer repeat sessions of what we predict will be the most popular talks overall. Since there are so many good sessions competing for attendees at the same time, we wanted to make sure we offered these repeat sessions of common, high-yield clinical topics.”
The Repeated Sessions track is set for April 10, and runs a full day. The track includes these dynamic sessions:
- Updates in congestive heart failure: Pablo Quintero, MD; 11-11:40 a.m.
- He-who-shall-not-be-named: Updates in sepsis and critical care: Patricia Kritek, MD, EdM; 11:50 a.m.-12:30 p.m.
- Not true love’s kiss? Updates in infectious disease: John Sanders, MD, MPHTM; 2:50-3:30 p.m.
- Updates in acute coronary syndrome: Jeff Trost, MD; 3:40-4:20 p.m.
- Waiting in line for ‘It’s a Small World’ and other things we do for no reason: Tony Breu, MD, FHM; 4:30-5:10 p.m.
- “The Mad Hatter”: Updates in delirium: Ethan Cumbler, MD, FHM; 5:20-6:00 p.m.
In addition to the sepsis update in the Repeated Sessions track, Dr. Smith noted that sepsis will also be the topic of a pre-course offering (April 8, 8:15 a.m.-4:50 p.m.). “The topic of sepsis remains a hot item in hospital medicine,” he said.
“I’d also like to highlight a new pre-course offering this year – ‘Keep your finger on the pulse: Cardiology update for the hospitalist’ (April 8, 8:30 a.m.-4:50 p.m.),” he said. “Many of our pre-course offerings are carry-overs from previous years due to ongoing great success with the individual pre-courses themselves. Although we have had a cardiology pre-course in our lineup of offerings in the past, we chose to offer a freshly redesigned pre-course in cardiology this year to round out the lineup of pre-course offerings and to keep things fresh.”
The “Stump the attentive (not absent-minded) professor” sessions on clinical unknowns in the Diagnostics Reasoning track are also must-sees, Dr. Smith said. So much so, that SHM is offering two of them this year (April 9, 2:00-2:40 p.m.; 3:45-4:25 p.m.).
Dr. Smith’s codirector Kathleen Finn, MD, MPhil, SFHM, also has a few personal favorites on the education program.
“I know the talks in the ‘Seasoning your career track’ will be great,” said Dr. Finn, a hospitalist at Massachusetts General Hospital, Boston. “This new track provides mid-career hospitalists (and new hospitalists) ideas in how to continue to make their career enjoyable and stimulating. It includes talks on how to advance in a leadership position, use emotional intelligence to achieve success, prevent burnout or design your groups schedule so it doesn’t rule your life.”
The board weighs in
The 2018 HM18 line-up garnered an enthusiastic thumbs-up from The Hospitalist’s editorial advisory board. We polled these experts for their 2018 “must-see” sessions, and they responded with a selection that spans the meeting’s wide-ranging offerings.
1. Leadership essentials for success in hospital medicine (April 9, 10:35 a.m.-12:05 p.m.)
Amit Vashist, MD, MBA, FHM, system chair, hospitalist division, Mountain State Health Alliance, Virginia/Tennessee, is especially excited about this session, intended to help hospitalists assume leadership roles.
“Given the ever-expanding footprint of hospitalists inside the hospitals and beyond, and the way they are being called upon to be the drivers of an increasingly value-based care, I believe it is imperative for every hospitalist provider – regardless of being in a leadership role or not – to have a fundamental understanding of the leadership nuances pertaining specifically to hospital medicine in order to optimally leverage their skill set to drive transformational changes in the health care arena,” he said. “This primer on leadership essentials should pique the interest of the hospitalists further towards developing a deeper appreciation of some of the leadership dimensions must-haves in the realm of hospital medicine.”
Raj Sehgal, MD, FHM, clinical associate professor of medicine, University of Texas Health Sciences Center at San Antonio, pegged communication and behavioral medicine as two top picks.
2. Do you have a minute to talk? Peer-to-peer feedback (April 9, 2:50-4:20 p.m.)
“Those of us in academic settings spend a lot of time thinking about giving feedback to – and receiving feedback from – students and residents, but some of the most valuable feedback we can get is from our coworkers,” he said. “Many hospitalist groups are actively working on ways for their providers to learn from each other, such as peer observations, and this session should help in guiding some of those programs.”
3. Through the looking glass: A psychiatrist’s tricks for inpatient acute behavioral emergencies (April 10, 2:50-3:50 p.m.)
“Even for a seasoned hospitalist who never breaks a sweat treating the most acutely medically ill patients, the acutely psychotic (or agitated, or suicidal) patient can provoke significant anxiety,” Dr. Sehgal said. “The opportunity to gain another couple of ‘tools’ to add to our kit for these patients should help alleviate that feeling.”
No need for an academic meeting to be boring, said Weijen Chang, MD, SFHM, chief of pediatric hospital medicine at Baystate Children’s Hospital, Springfield, Mass.
4. Can we just stick to the “Bare Necessities”? – Things we do for no reason (April 9, 10:35-11:35 a.m.)
5. “Mirror, Mirror on the Wall”: Which articles are the fairest of them all? Top pediatric updates (April 10, 5:45-6:45 p.m.)
“I’d say Dr. Lenny Feldman’s [SFHM] ‘Things we do for no reason’ is a must-see. Lenny is a master at simplifying complex issues and communicating them in an easily understood manner, and he’s quite entertaining,” Dr. Chang said. “And of course, another must-see is Top Pediatric Updates. It is entertaining, educational, and we almost got thrown out last year for bringing beer!”
Sarah Stella, MD, FHM, a hospitalist at Denver Health, had a hard time choosing between the many interesting offerings. “There are quite a few great sessions this year that I’m interested in, but these are my top picks:”
6. Convert your everyday work into scholarship (and get it funded) (April 9, 1:35-2:35 p.m.)
“By virtue of their daily clinical and quality improvement/committee work, many hospitalists are well on their way to generating scholarship and funding, but are unsure how to make this conversion,” she said. “This workshop is a must for academic hospitalists working toward promotion who want a framework and tangible steps on how to get credit for what they are already doing.”
7. “Heigh ho, heigh ho,” it’s off to changing roles mid-career we go (April 11, 8:20-9:00 a.m.)
“Part of what attracts many of us to hospital medicine in the first place is the versatility of what we do and the ability to diversify based on our interests. I think this is a must-see for mid-career hospitalists like myself, or really any hospitalist dreaming of reinventing oneself.”
8. Winning hearts and minds at the bedside: Battling unconscious bias through cultural humility (April 11, 9:10-9:50 a.m.)
“Recognizing and confronting our implicit biases and how they affect patient-physician interactions is hard but incredibly important work,” Dr. Stella said. “I’ll definitely be attending this session by Aziz Ansari, DO, SFHM, to learn how to improve my relationship (and hence outcomes) with my patients.”
Harry (Hyung) Cho, MD, FHM, assistant professor of medicine and director of quality, safety, and value, division of hospital medicine, Mount Sinai Hospital, New York, had some diverse choices.
9. Being female in hospital medicine: Overcoming individual and institutional barriers in the workplace (April 9, 12:40-2:15 p.m.)
“This is a very timely, very important topic in the news and I think it will draw a lot of people,” he said.
10. Every patient tells a story and the art of diagnosis (April 9, 2:55-3:35 p.m.)
“The presenter is Dr. Lisa Sanders, who writes the ‘Diagnosis’ column for the New York Times and is a Yale University faculty member. She’s a great speaker and, incidentally, was a consultant on the TV show, ‘House, MD.’ ”
Raman Palabindala, MD, FHM, a hospitalist at the University of Mississippi Medical Center, Jackson, thinks the most important session at HM18 is the annual update.
11. Update in hospital medicine (April 10, 1:40-2:40 p.m.)“Almost every year, this is the most high energy presentation, and I don’t think I ever missed this session, no matter who is the presenter is,” he said. “As physicians, I think we need this update every year, and this is the best single hour where we can learn a lot as a hospitalist related to hospital medicine. This is the most concentrated extract of the entire meeting. What I learned about the behind scenes efforts up to 50-100 hours of work – why not we take advantage of this session.”
Lonika Sood, MD, FHM of the department of hospital medicine, Aurora BayCare Medical Center, Green Bay, Wis., has a passion for both leadership and scholarship, and her choices reflect that interest.
12. How to write a winning abstract (April 11, 7:30-8:30 a.m.)
13. Leadership positions in medical education: How to break into the field (April 11, 11:40 a.m.-12:20 p.m.)
14. Serious illness communication: A skills-based workshop (April 11, 8:00-9:30 a.m.)
“I would recommend all of those, especially for early-career hospitalists. And, having enjoyed and learned a lot from the workshops at HM17, I would highly recommend checking out a few that will help polish your communications – a much-needed skill in hospital medicine,” she said.
Finally, don’t just pick up another embroidered mouse ear hat on your way out. The best HM18 souvenir is taking back the knowledge you gained and – as Dr. Sood said – there’s a session for that.
15. How to bring the things you learn at SHM back to your institution: Advocating for high value care on hospital committees (April 11, 8:00-9:30 a.m.).
For more information on the HM18 education sessions, check the latest version of the conference schedule at http://shmannualconference.org/conference-schedule.
Welcome to Hospital Medicine 2018, the second-happiest place in Orlando – at least for hospitalists who want to be in the know.
The 2018 education program is a ride through the diverse world of hospital medicine, with sessions ranging from clinical updates to cutting-edge techniques, communication tools, building a satisfying career, and finding your way through tangles of red tape and policy.
Two tracks new for 2018 hone in on managing alternative providers and palliative care.
The half-day NP/PA track (beginning April 11 at 7:30 a.m.) recognizes these practitioners for their crucial roles in hospital medicine care delivery. Among the discussions aimed at hospitalists: Best practices in provider utilization and collaboration; supervision vs. collaboration; and challenging situations when working with mid-level providers.
The palliative care track (also a half day, starting April 11 at 10 a.m.) recognizes the crucial role hospitalists play in optimizing end-of-life care. Sessions will help hospitalists understand that role, and guide them in managing pain and other symptoms commonly encountered during this transitional time.
As for the rest of the meeting, picking favorites is as tough as picking between Disney’s Big Thunder Railroad and Splash Mountain, said HM18 course director Dustin Smith, MD, SFHM, of Emory University, Atlanta. “We feel strongly that all offerings at the conference are ‘must-sees,’ and it’s why we offer repeat sessions of what we predict will be the most popular talks overall. Since there are so many good sessions competing for attendees at the same time, we wanted to make sure we offered these repeat sessions of common, high-yield clinical topics.”
The Repeated Sessions track is set for April 10, and runs a full day. The track includes these dynamic sessions:
- Updates in congestive heart failure: Pablo Quintero, MD; 11-11:40 a.m.
- He-who-shall-not-be-named: Updates in sepsis and critical care: Patricia Kritek, MD, EdM; 11:50 a.m.-12:30 p.m.
- Not true love’s kiss? Updates in infectious disease: John Sanders, MD, MPHTM; 2:50-3:30 p.m.
- Updates in acute coronary syndrome: Jeff Trost, MD; 3:40-4:20 p.m.
- Waiting in line for ‘It’s a Small World’ and other things we do for no reason: Tony Breu, MD, FHM; 4:30-5:10 p.m.
- “The Mad Hatter”: Updates in delirium: Ethan Cumbler, MD, FHM; 5:20-6:00 p.m.
In addition to the sepsis update in the Repeated Sessions track, Dr. Smith noted that sepsis will also be the topic of a pre-course offering (April 8, 8:15 a.m.-4:50 p.m.). “The topic of sepsis remains a hot item in hospital medicine,” he said.
“I’d also like to highlight a new pre-course offering this year – ‘Keep your finger on the pulse: Cardiology update for the hospitalist’ (April 8, 8:30 a.m.-4:50 p.m.),” he said. “Many of our pre-course offerings are carry-overs from previous years due to ongoing great success with the individual pre-courses themselves. Although we have had a cardiology pre-course in our lineup of offerings in the past, we chose to offer a freshly redesigned pre-course in cardiology this year to round out the lineup of pre-course offerings and to keep things fresh.”
The “Stump the attentive (not absent-minded) professor” sessions on clinical unknowns in the Diagnostics Reasoning track are also must-sees, Dr. Smith said. So much so, that SHM is offering two of them this year (April 9, 2:00-2:40 p.m.; 3:45-4:25 p.m.).
Dr. Smith’s codirector Kathleen Finn, MD, MPhil, SFHM, also has a few personal favorites on the education program.
“I know the talks in the ‘Seasoning your career track’ will be great,” said Dr. Finn, a hospitalist at Massachusetts General Hospital, Boston. “This new track provides mid-career hospitalists (and new hospitalists) ideas in how to continue to make their career enjoyable and stimulating. It includes talks on how to advance in a leadership position, use emotional intelligence to achieve success, prevent burnout or design your groups schedule so it doesn’t rule your life.”
The board weighs in
The 2018 HM18 line-up garnered an enthusiastic thumbs-up from The Hospitalist’s editorial advisory board. We polled these experts for their 2018 “must-see” sessions, and they responded with a selection that spans the meeting’s wide-ranging offerings.
1. Leadership essentials for success in hospital medicine (April 9, 10:35 a.m.-12:05 p.m.)
Amit Vashist, MD, MBA, FHM, system chair, hospitalist division, Mountain State Health Alliance, Virginia/Tennessee, is especially excited about this session, intended to help hospitalists assume leadership roles.
“Given the ever-expanding footprint of hospitalists inside the hospitals and beyond, and the way they are being called upon to be the drivers of an increasingly value-based care, I believe it is imperative for every hospitalist provider – regardless of being in a leadership role or not – to have a fundamental understanding of the leadership nuances pertaining specifically to hospital medicine in order to optimally leverage their skill set to drive transformational changes in the health care arena,” he said. “This primer on leadership essentials should pique the interest of the hospitalists further towards developing a deeper appreciation of some of the leadership dimensions must-haves in the realm of hospital medicine.”
Raj Sehgal, MD, FHM, clinical associate professor of medicine, University of Texas Health Sciences Center at San Antonio, pegged communication and behavioral medicine as two top picks.
2. Do you have a minute to talk? Peer-to-peer feedback (April 9, 2:50-4:20 p.m.)
“Those of us in academic settings spend a lot of time thinking about giving feedback to – and receiving feedback from – students and residents, but some of the most valuable feedback we can get is from our coworkers,” he said. “Many hospitalist groups are actively working on ways for their providers to learn from each other, such as peer observations, and this session should help in guiding some of those programs.”
3. Through the looking glass: A psychiatrist’s tricks for inpatient acute behavioral emergencies (April 10, 2:50-3:50 p.m.)
“Even for a seasoned hospitalist who never breaks a sweat treating the most acutely medically ill patients, the acutely psychotic (or agitated, or suicidal) patient can provoke significant anxiety,” Dr. Sehgal said. “The opportunity to gain another couple of ‘tools’ to add to our kit for these patients should help alleviate that feeling.”
No need for an academic meeting to be boring, said Weijen Chang, MD, SFHM, chief of pediatric hospital medicine at Baystate Children’s Hospital, Springfield, Mass.
4. Can we just stick to the “Bare Necessities”? – Things we do for no reason (April 9, 10:35-11:35 a.m.)
5. “Mirror, Mirror on the Wall”: Which articles are the fairest of them all? Top pediatric updates (April 10, 5:45-6:45 p.m.)
“I’d say Dr. Lenny Feldman’s [SFHM] ‘Things we do for no reason’ is a must-see. Lenny is a master at simplifying complex issues and communicating them in an easily understood manner, and he’s quite entertaining,” Dr. Chang said. “And of course, another must-see is Top Pediatric Updates. It is entertaining, educational, and we almost got thrown out last year for bringing beer!”
Sarah Stella, MD, FHM, a hospitalist at Denver Health, had a hard time choosing between the many interesting offerings. “There are quite a few great sessions this year that I’m interested in, but these are my top picks:”
6. Convert your everyday work into scholarship (and get it funded) (April 9, 1:35-2:35 p.m.)
“By virtue of their daily clinical and quality improvement/committee work, many hospitalists are well on their way to generating scholarship and funding, but are unsure how to make this conversion,” she said. “This workshop is a must for academic hospitalists working toward promotion who want a framework and tangible steps on how to get credit for what they are already doing.”
7. “Heigh ho, heigh ho,” it’s off to changing roles mid-career we go (April 11, 8:20-9:00 a.m.)
“Part of what attracts many of us to hospital medicine in the first place is the versatility of what we do and the ability to diversify based on our interests. I think this is a must-see for mid-career hospitalists like myself, or really any hospitalist dreaming of reinventing oneself.”
8. Winning hearts and minds at the bedside: Battling unconscious bias through cultural humility (April 11, 9:10-9:50 a.m.)
“Recognizing and confronting our implicit biases and how they affect patient-physician interactions is hard but incredibly important work,” Dr. Stella said. “I’ll definitely be attending this session by Aziz Ansari, DO, SFHM, to learn how to improve my relationship (and hence outcomes) with my patients.”
Harry (Hyung) Cho, MD, FHM, assistant professor of medicine and director of quality, safety, and value, division of hospital medicine, Mount Sinai Hospital, New York, had some diverse choices.
9. Being female in hospital medicine: Overcoming individual and institutional barriers in the workplace (April 9, 12:40-2:15 p.m.)
“This is a very timely, very important topic in the news and I think it will draw a lot of people,” he said.
10. Every patient tells a story and the art of diagnosis (April 9, 2:55-3:35 p.m.)
“The presenter is Dr. Lisa Sanders, who writes the ‘Diagnosis’ column for the New York Times and is a Yale University faculty member. She’s a great speaker and, incidentally, was a consultant on the TV show, ‘House, MD.’ ”
Raman Palabindala, MD, FHM, a hospitalist at the University of Mississippi Medical Center, Jackson, thinks the most important session at HM18 is the annual update.
11. Update in hospital medicine (April 10, 1:40-2:40 p.m.)“Almost every year, this is the most high energy presentation, and I don’t think I ever missed this session, no matter who is the presenter is,” he said. “As physicians, I think we need this update every year, and this is the best single hour where we can learn a lot as a hospitalist related to hospital medicine. This is the most concentrated extract of the entire meeting. What I learned about the behind scenes efforts up to 50-100 hours of work – why not we take advantage of this session.”
Lonika Sood, MD, FHM of the department of hospital medicine, Aurora BayCare Medical Center, Green Bay, Wis., has a passion for both leadership and scholarship, and her choices reflect that interest.
12. How to write a winning abstract (April 11, 7:30-8:30 a.m.)
13. Leadership positions in medical education: How to break into the field (April 11, 11:40 a.m.-12:20 p.m.)
14. Serious illness communication: A skills-based workshop (April 11, 8:00-9:30 a.m.)
“I would recommend all of those, especially for early-career hospitalists. And, having enjoyed and learned a lot from the workshops at HM17, I would highly recommend checking out a few that will help polish your communications – a much-needed skill in hospital medicine,” she said.
Finally, don’t just pick up another embroidered mouse ear hat on your way out. The best HM18 souvenir is taking back the knowledge you gained and – as Dr. Sood said – there’s a session for that.
15. How to bring the things you learn at SHM back to your institution: Advocating for high value care on hospital committees (April 11, 8:00-9:30 a.m.).
For more information on the HM18 education sessions, check the latest version of the conference schedule at http://shmannualconference.org/conference-schedule.
HM18 plenaries explore future of hospital medicine
The plenary sessions bookending the Society of Hospital Medicine’s HM18 conference will provide insight into the current state of hospital medicine and a glimpse at the directions in which it is evolving.
Opening the conference will be Kate Goodrich, MD, chief medical officer at the Centers for Medicare & Medicaid Services.
“What I want people to understand is the evolution within our health care system from one where we pay for volume to paying for value, and the role that Medicare can play in that,” Dr. Goodrich said in an interview. “Medicare has traditionally been sort of a passive payer, if you will, a passive payer of claims without a great deal of emphasis on the cost of care and the quality of care. [Now there is] a groundswell of concern nationally, not just here at CMS but nationwide, around the rising cost of care, and our quality of care is not as good as it should be for the amount that we spend.”
Dr. Goodrich said her plenary talk will look at how “that came to be, and then what CMS and other payers in the country are trying to do about it.” She said the United States is in a “truly transformative era in our health care system in changing how we pay for care, in service of better outcomes for patients and lower costs. I would like to give attendees the larger picture, of how we got here and what’s happening both at CMS and nationally to try and reverse some of those trends.”
Closing HM18, as has become tradition at the annual meeting, will be Robert Wachter, MD, MHM, of the University of California San Francisco, who will focus on the broader changes that must happen as the role of the hospitalist continues to evolve.
“I am going to talk about the changes in the world of hospital care and the importance of the field to innovate,” Dr. Wachter said. “To me, there are gravitational forces in the health care world that are making … patients who are in hospitals sicker than they were before. More and more patients are going to be cared for in outpatient settings and at home. We are going start to ... see things like sensors and telemedicine to enable more care outside of the hospital.”
Dr. Wachter said hospital medicine must evolve and mature, to continue to prove that hospitalists are indispensable staff members within the hospital.
“That was why the field became the fastest-growing profession in medical history. We can’t sit on our laurels. We have to continue to innovate,” he said. “Even as the system changes around us, I am confident that we will innovate. My talk will be a pep talk and include reflections on how the world of health care is changing, and what those changes will mean to hospitalists.”
As value-based purchasing programs – and the push to pay for value over volume in Medicare and the private sector – continue to become the norm, the expected trend of sicker, more complex patients entering the hospital is already happening, Dr. Goodrich said. She is experiencing it in her own clinical work, which continues in addition to her role at CMS.
“I can confirm from my own personal experience [that] I have absolutely encountered that exact trend,” she said. “I feel like every time I go in the hospital, my patients are sicker and more complex. That is the population of patients that hospitalists are dealing with. That’s why we are actually in that practice. We enjoy taking care of those types of patients and the challenges they bring, both on a clinical level but I would say also even on a social and economic level.”
Dr. Goodrich said that trend will present one of the key challenges hospitalists face in the future, especially as paying for value entails more two-sided risk.
“In a value-based purchasing world, transitioning to payments based on quality and cost is harder because by nature the sicker patients cost more and it is harder to improve their outcomes. They come to you already quite sick,” she said. “That’s a dilemma that a lot of hospitalists face, wondering ‘How is this going to affect me if I am already seeing the sickest of the sick?’ ”
Dr. Wachter noted that the trend of steering less sick patients to the outpatient setting, as well as other economic factors, would change the nature of hospitalist practice.
“It will be more acuity, more intensity, more complex relationships with your own hospital and often with partner hospitals,” he said. “More of the work will be digitally enabled than it would have been five or ten years ago.”
Integration of data and technology innovation will be a key to better serving this sicker population, Dr. Wachter predicted. We need “to take much fuller advantage than we have so far of the fact that we are all dealing with digital records and the decision support, the data analytics, the artificial intelligence that we get from our computer systems is pretty puny,” he said. “That is partly why physicians don’t love their computers so much. They spend huge amounts of time entering data into computers and don’t get much useful information out of it.”
Dr. Goodrich agreed that this is a challenge.
“How do we make it usable for the average front-line nurse or doctor who didn’t go to school to learn how to code and analyze data?” she asked. “How do we get platforms and analytics that are developed using human-centered design principles to make it very understandable and actionable to the front-end clinician, but also to patients and consumers? What is really needed to truly drive improvement is not just access to the data but usability.” She added that this problem is directly related to the usability of electronic health records. “That is a significant focus right now for the Office of the National Coordinator [of Health Information Technology] – to move away from just [adopting] EHRs, to promoting interoperability and also the usability aspects that exactly gets to the problems we’ve identified.”
Dr. Wachter also warned that too much data could have a negative impact on the delivery of care.
“One of the challenges we face is continuing to stay alert, not turn our brains off, and become increasingly dependent on the computer to give us information,” he said. “How do we avoid the challenges we’ve already seen from things like alert and alarm fatigue as the computer becomes more robust as an information source. There is always the risk it is going to overwhelm us with too much information, and we are going to fall asleep at the switch. Or when the computer says something that really is not right for a patient, we will not be thinking clearly enough to catch it.”
Despite the looming challenges and industry consolidation that are expected, Dr. Wachter doesn’t believe there will be any shortage of demand for hospitalists.
“I think in most circumstances, [hospitalists are a protected] profession, given the complexity, the high variations, and the dependence that it still has on seeing the patient, talking to the patient, and talking to multiple consultants,” he said. “It’s a pretty hard thing to replace with technology. Overall, the job situation is pretty bright.”
The plenary sessions bookending the Society of Hospital Medicine’s HM18 conference will provide insight into the current state of hospital medicine and a glimpse at the directions in which it is evolving.
Opening the conference will be Kate Goodrich, MD, chief medical officer at the Centers for Medicare & Medicaid Services.
“What I want people to understand is the evolution within our health care system from one where we pay for volume to paying for value, and the role that Medicare can play in that,” Dr. Goodrich said in an interview. “Medicare has traditionally been sort of a passive payer, if you will, a passive payer of claims without a great deal of emphasis on the cost of care and the quality of care. [Now there is] a groundswell of concern nationally, not just here at CMS but nationwide, around the rising cost of care, and our quality of care is not as good as it should be for the amount that we spend.”
Dr. Goodrich said her plenary talk will look at how “that came to be, and then what CMS and other payers in the country are trying to do about it.” She said the United States is in a “truly transformative era in our health care system in changing how we pay for care, in service of better outcomes for patients and lower costs. I would like to give attendees the larger picture, of how we got here and what’s happening both at CMS and nationally to try and reverse some of those trends.”
Closing HM18, as has become tradition at the annual meeting, will be Robert Wachter, MD, MHM, of the University of California San Francisco, who will focus on the broader changes that must happen as the role of the hospitalist continues to evolve.
“I am going to talk about the changes in the world of hospital care and the importance of the field to innovate,” Dr. Wachter said. “To me, there are gravitational forces in the health care world that are making … patients who are in hospitals sicker than they were before. More and more patients are going to be cared for in outpatient settings and at home. We are going start to ... see things like sensors and telemedicine to enable more care outside of the hospital.”
Dr. Wachter said hospital medicine must evolve and mature, to continue to prove that hospitalists are indispensable staff members within the hospital.
“That was why the field became the fastest-growing profession in medical history. We can’t sit on our laurels. We have to continue to innovate,” he said. “Even as the system changes around us, I am confident that we will innovate. My talk will be a pep talk and include reflections on how the world of health care is changing, and what those changes will mean to hospitalists.”
As value-based purchasing programs – and the push to pay for value over volume in Medicare and the private sector – continue to become the norm, the expected trend of sicker, more complex patients entering the hospital is already happening, Dr. Goodrich said. She is experiencing it in her own clinical work, which continues in addition to her role at CMS.
“I can confirm from my own personal experience [that] I have absolutely encountered that exact trend,” she said. “I feel like every time I go in the hospital, my patients are sicker and more complex. That is the population of patients that hospitalists are dealing with. That’s why we are actually in that practice. We enjoy taking care of those types of patients and the challenges they bring, both on a clinical level but I would say also even on a social and economic level.”
Dr. Goodrich said that trend will present one of the key challenges hospitalists face in the future, especially as paying for value entails more two-sided risk.
“In a value-based purchasing world, transitioning to payments based on quality and cost is harder because by nature the sicker patients cost more and it is harder to improve their outcomes. They come to you already quite sick,” she said. “That’s a dilemma that a lot of hospitalists face, wondering ‘How is this going to affect me if I am already seeing the sickest of the sick?’ ”
Dr. Wachter noted that the trend of steering less sick patients to the outpatient setting, as well as other economic factors, would change the nature of hospitalist practice.
“It will be more acuity, more intensity, more complex relationships with your own hospital and often with partner hospitals,” he said. “More of the work will be digitally enabled than it would have been five or ten years ago.”
Integration of data and technology innovation will be a key to better serving this sicker population, Dr. Wachter predicted. We need “to take much fuller advantage than we have so far of the fact that we are all dealing with digital records and the decision support, the data analytics, the artificial intelligence that we get from our computer systems is pretty puny,” he said. “That is partly why physicians don’t love their computers so much. They spend huge amounts of time entering data into computers and don’t get much useful information out of it.”
Dr. Goodrich agreed that this is a challenge.
“How do we make it usable for the average front-line nurse or doctor who didn’t go to school to learn how to code and analyze data?” she asked. “How do we get platforms and analytics that are developed using human-centered design principles to make it very understandable and actionable to the front-end clinician, but also to patients and consumers? What is really needed to truly drive improvement is not just access to the data but usability.” She added that this problem is directly related to the usability of electronic health records. “That is a significant focus right now for the Office of the National Coordinator [of Health Information Technology] – to move away from just [adopting] EHRs, to promoting interoperability and also the usability aspects that exactly gets to the problems we’ve identified.”
Dr. Wachter also warned that too much data could have a negative impact on the delivery of care.
“One of the challenges we face is continuing to stay alert, not turn our brains off, and become increasingly dependent on the computer to give us information,” he said. “How do we avoid the challenges we’ve already seen from things like alert and alarm fatigue as the computer becomes more robust as an information source. There is always the risk it is going to overwhelm us with too much information, and we are going to fall asleep at the switch. Or when the computer says something that really is not right for a patient, we will not be thinking clearly enough to catch it.”
Despite the looming challenges and industry consolidation that are expected, Dr. Wachter doesn’t believe there will be any shortage of demand for hospitalists.
“I think in most circumstances, [hospitalists are a protected] profession, given the complexity, the high variations, and the dependence that it still has on seeing the patient, talking to the patient, and talking to multiple consultants,” he said. “It’s a pretty hard thing to replace with technology. Overall, the job situation is pretty bright.”
The plenary sessions bookending the Society of Hospital Medicine’s HM18 conference will provide insight into the current state of hospital medicine and a glimpse at the directions in which it is evolving.
Opening the conference will be Kate Goodrich, MD, chief medical officer at the Centers for Medicare & Medicaid Services.
“What I want people to understand is the evolution within our health care system from one where we pay for volume to paying for value, and the role that Medicare can play in that,” Dr. Goodrich said in an interview. “Medicare has traditionally been sort of a passive payer, if you will, a passive payer of claims without a great deal of emphasis on the cost of care and the quality of care. [Now there is] a groundswell of concern nationally, not just here at CMS but nationwide, around the rising cost of care, and our quality of care is not as good as it should be for the amount that we spend.”
Dr. Goodrich said her plenary talk will look at how “that came to be, and then what CMS and other payers in the country are trying to do about it.” She said the United States is in a “truly transformative era in our health care system in changing how we pay for care, in service of better outcomes for patients and lower costs. I would like to give attendees the larger picture, of how we got here and what’s happening both at CMS and nationally to try and reverse some of those trends.”
Closing HM18, as has become tradition at the annual meeting, will be Robert Wachter, MD, MHM, of the University of California San Francisco, who will focus on the broader changes that must happen as the role of the hospitalist continues to evolve.
“I am going to talk about the changes in the world of hospital care and the importance of the field to innovate,” Dr. Wachter said. “To me, there are gravitational forces in the health care world that are making … patients who are in hospitals sicker than they were before. More and more patients are going to be cared for in outpatient settings and at home. We are going start to ... see things like sensors and telemedicine to enable more care outside of the hospital.”
Dr. Wachter said hospital medicine must evolve and mature, to continue to prove that hospitalists are indispensable staff members within the hospital.
“That was why the field became the fastest-growing profession in medical history. We can’t sit on our laurels. We have to continue to innovate,” he said. “Even as the system changes around us, I am confident that we will innovate. My talk will be a pep talk and include reflections on how the world of health care is changing, and what those changes will mean to hospitalists.”
As value-based purchasing programs – and the push to pay for value over volume in Medicare and the private sector – continue to become the norm, the expected trend of sicker, more complex patients entering the hospital is already happening, Dr. Goodrich said. She is experiencing it in her own clinical work, which continues in addition to her role at CMS.
“I can confirm from my own personal experience [that] I have absolutely encountered that exact trend,” she said. “I feel like every time I go in the hospital, my patients are sicker and more complex. That is the population of patients that hospitalists are dealing with. That’s why we are actually in that practice. We enjoy taking care of those types of patients and the challenges they bring, both on a clinical level but I would say also even on a social and economic level.”
Dr. Goodrich said that trend will present one of the key challenges hospitalists face in the future, especially as paying for value entails more two-sided risk.
“In a value-based purchasing world, transitioning to payments based on quality and cost is harder because by nature the sicker patients cost more and it is harder to improve their outcomes. They come to you already quite sick,” she said. “That’s a dilemma that a lot of hospitalists face, wondering ‘How is this going to affect me if I am already seeing the sickest of the sick?’ ”
Dr. Wachter noted that the trend of steering less sick patients to the outpatient setting, as well as other economic factors, would change the nature of hospitalist practice.
“It will be more acuity, more intensity, more complex relationships with your own hospital and often with partner hospitals,” he said. “More of the work will be digitally enabled than it would have been five or ten years ago.”
Integration of data and technology innovation will be a key to better serving this sicker population, Dr. Wachter predicted. We need “to take much fuller advantage than we have so far of the fact that we are all dealing with digital records and the decision support, the data analytics, the artificial intelligence that we get from our computer systems is pretty puny,” he said. “That is partly why physicians don’t love their computers so much. They spend huge amounts of time entering data into computers and don’t get much useful information out of it.”
Dr. Goodrich agreed that this is a challenge.
“How do we make it usable for the average front-line nurse or doctor who didn’t go to school to learn how to code and analyze data?” she asked. “How do we get platforms and analytics that are developed using human-centered design principles to make it very understandable and actionable to the front-end clinician, but also to patients and consumers? What is really needed to truly drive improvement is not just access to the data but usability.” She added that this problem is directly related to the usability of electronic health records. “That is a significant focus right now for the Office of the National Coordinator [of Health Information Technology] – to move away from just [adopting] EHRs, to promoting interoperability and also the usability aspects that exactly gets to the problems we’ve identified.”
Dr. Wachter also warned that too much data could have a negative impact on the delivery of care.
“One of the challenges we face is continuing to stay alert, not turn our brains off, and become increasingly dependent on the computer to give us information,” he said. “How do we avoid the challenges we’ve already seen from things like alert and alarm fatigue as the computer becomes more robust as an information source. There is always the risk it is going to overwhelm us with too much information, and we are going to fall asleep at the switch. Or when the computer says something that really is not right for a patient, we will not be thinking clearly enough to catch it.”
Despite the looming challenges and industry consolidation that are expected, Dr. Wachter doesn’t believe there will be any shortage of demand for hospitalists.
“I think in most circumstances, [hospitalists are a protected] profession, given the complexity, the high variations, and the dependence that it still has on seeing the patient, talking to the patient, and talking to multiple consultants,” he said. “It’s a pretty hard thing to replace with technology. Overall, the job situation is pretty bright.”
SHM launches 2018 State of Hospital Medicine Survey
The Society of Hospital Medicine recently opened the 2018 State of Hospital Medicine (SoHM) Survey and is now seeking participants from hospital medicine groups to contribute to the collective understanding of the state of the specialty.
Results from the biennial survey will be analyzed and compiled into the 2018 SoHM Report to provide current data on hospitalist compensation and production, as well as cutting-edge knowledge covering practice demographics, staffing levels, turnover, staff growth, and financial support. The SoHM Survey closes on Feb. 16, 2018.
“The SoHM Survey lays the foundation for the creation of one of the most expansive tools for hospital medicine professionals,” said Beth Hawley, MBA, FACHE, chief operating officer of SHM. “With the help of participants from hospital medicine groups nationwide, it creates an up-to-date snapshot of trends in the specialty to help inform staffing and management decisions.”
The 2018 SoHM Survey includes new questions about open hospitalist physician positions during the year, including what percentage of approved staffing was unfilled and how the group filled the coverage. Other new topics ask about the number of work Relative Value Units generated by participating hospital medicine groups and who selects the billing codes for the groups.
Over the past year and a half, five distinct efforts were completed to collect user feedback for both the survey and report development processes. Efforts ranged from in-person focus groups at SHM’s Annual Conference to online user surveys. After information was collected and summarized, SHM’s Practice Analysis Committee ranked every question to trim down the Survey from 70 questions in 2016 to 52 questions in 2018.
The 2018 SoHM Report will be available this fall in print only, as a bundle of print and digital, or as digital only, with special discounts available for SHM members.
Committee members are available for one-on-one guidance as participants complete the Survey. For more information and to participate, visit www.hospitalmedicine.org/sohm.
The Society of Hospital Medicine recently opened the 2018 State of Hospital Medicine (SoHM) Survey and is now seeking participants from hospital medicine groups to contribute to the collective understanding of the state of the specialty.
Results from the biennial survey will be analyzed and compiled into the 2018 SoHM Report to provide current data on hospitalist compensation and production, as well as cutting-edge knowledge covering practice demographics, staffing levels, turnover, staff growth, and financial support. The SoHM Survey closes on Feb. 16, 2018.
“The SoHM Survey lays the foundation for the creation of one of the most expansive tools for hospital medicine professionals,” said Beth Hawley, MBA, FACHE, chief operating officer of SHM. “With the help of participants from hospital medicine groups nationwide, it creates an up-to-date snapshot of trends in the specialty to help inform staffing and management decisions.”
The 2018 SoHM Survey includes new questions about open hospitalist physician positions during the year, including what percentage of approved staffing was unfilled and how the group filled the coverage. Other new topics ask about the number of work Relative Value Units generated by participating hospital medicine groups and who selects the billing codes for the groups.
Over the past year and a half, five distinct efforts were completed to collect user feedback for both the survey and report development processes. Efforts ranged from in-person focus groups at SHM’s Annual Conference to online user surveys. After information was collected and summarized, SHM’s Practice Analysis Committee ranked every question to trim down the Survey from 70 questions in 2016 to 52 questions in 2018.
The 2018 SoHM Report will be available this fall in print only, as a bundle of print and digital, or as digital only, with special discounts available for SHM members.
Committee members are available for one-on-one guidance as participants complete the Survey. For more information and to participate, visit www.hospitalmedicine.org/sohm.
The Society of Hospital Medicine recently opened the 2018 State of Hospital Medicine (SoHM) Survey and is now seeking participants from hospital medicine groups to contribute to the collective understanding of the state of the specialty.
Results from the biennial survey will be analyzed and compiled into the 2018 SoHM Report to provide current data on hospitalist compensation and production, as well as cutting-edge knowledge covering practice demographics, staffing levels, turnover, staff growth, and financial support. The SoHM Survey closes on Feb. 16, 2018.
“The SoHM Survey lays the foundation for the creation of one of the most expansive tools for hospital medicine professionals,” said Beth Hawley, MBA, FACHE, chief operating officer of SHM. “With the help of participants from hospital medicine groups nationwide, it creates an up-to-date snapshot of trends in the specialty to help inform staffing and management decisions.”
The 2018 SoHM Survey includes new questions about open hospitalist physician positions during the year, including what percentage of approved staffing was unfilled and how the group filled the coverage. Other new topics ask about the number of work Relative Value Units generated by participating hospital medicine groups and who selects the billing codes for the groups.
Over the past year and a half, five distinct efforts were completed to collect user feedback for both the survey and report development processes. Efforts ranged from in-person focus groups at SHM’s Annual Conference to online user surveys. After information was collected and summarized, SHM’s Practice Analysis Committee ranked every question to trim down the Survey from 70 questions in 2016 to 52 questions in 2018.
The 2018 SoHM Report will be available this fall in print only, as a bundle of print and digital, or as digital only, with special discounts available for SHM members.
Committee members are available for one-on-one guidance as participants complete the Survey. For more information and to participate, visit www.hospitalmedicine.org/sohm.
Hospitalist leader: Are you burned out? Are you resilient?
I had the privilege of teaching two seminars at the recent Society of Hospital Medicine Leadership Academy in Scottsdale, Ariz. The theme of my second seminar was “Swarm Leadership,” the topic of my September column. There seemed to be enthusiasm and interest in the topic. Participants were intrigued at the notion of leveraging instinctual responses to encourage team spirit and collective outcomes.
The key principles of these swarm-like behaviors are: 1) unity of mission, 2) generosity of spirit, 3) staying in lanes and helping others succeed in theirs, 4) no ego/no blame, and 5) a foundation of trust among those working together. Leaders create the conditions in which these behaviors are more likely to emerge. The resulting team spirit and productivity raise morale and increase the sense of work-related purpose and mission.
People expressed their sense of being burned out and overworked, even to the extent of being exploited. I was stunned at the prevalence of this sensation in the room. Not everyone spoke though many people identified with the theme.
What I heard was enough to raise the question here: For hospitalist leaders, to what extent is burnout significant enough to give it serious attention? (I want to be abundantly clear: I report observations as anecdotal and impressionistic. There is no implied critique of hospitalists on the whole nor any individual or groups.)
Burnout includes sensations of being exhausted, overburdened, underappreciated, undercompensated, cynical, and depressed. These phenomena together can affect your productivity, the quality of your work, and your endurance when the workload gets tough.
By contrast, the opposite of burnout is balance, including sensations of being engaged, enthusiastic, energetic, absorbed, challenged, and dedicated. Work is part of the equilibrium you establish in your life, which includes a variety of fulfilling and motivating experiences and accomplishments.
Ideal balance would have all the different parts of your life – from family to hobbies to work – in perfect synergy with one another. Complete burnout would have all parts of your life imploding on one another, with little room for joy, personal contentment, and professional satisfaction.
How do you assess the differences between burnout and balance? First, this is a very individual metric. What one person might consider challenging and engaging another would experience as overwhelming and alienating. When you assess a group of people, these differences are important and could inform how work assignments and heavy lifting are assigned.
During the SHM session and in private comments, people described this rise in burnout not as a personal phenomena. Rather, it results from the health system expecting more of hospitalists than they can reasonably and reliably produce. People described hospitalists getting to the breaking point with no relief in sight. What can be done about this phenomenon?
First, hold a mirror up to yourself. You cannot help others as a leader if you are not clear with your own state of burnout and balance. The questions for you – a leader of other hospitalists – include: To what extent are you burned out? If so, why? If not, why not? If you were to draw a continuum between burned out and balanced, where on that range would you place yourself? Where would others in your group or department pinpoint themselves, relative to one another, on this continuum?
How might burnout develop for hospitalist leaders? Like a car, even a high performance vehicle, you can only go so fast and so far. Push too hard on the accelerator and the vehicle begins to shake as performance declines. If your system is expecting the pace and productivity to outstrip what you consider reasonable, your performance, job satisfaction and morale drops. Impose those demands upon a group of people and the unhappiness can become infectious.
With a decline in performance comes a decline in confidence. You and your colleagues strive for top-rate outcomes. Fatigue, pressure, and unreasonable expectations challenge your ability to feel good about what you are doing. That satisfaction is part of why you chose hospital medicine and without it, you wonder about what you are doing and why you are doing it.
When you and your colleagues sense that you are unappreciated, it can spark a profound sense of disappointment. That realization could express itself in many forms, including unhappiness about pay and workload to dissatisfaction with professional support or acknowledgment. When the system on the whole is driving so fast that it cannot stop to ensure and reward good work, the rattling can have a stunting effect on performance.
When I first began teaching at SHM conferences and had hospitalists in my classes at the Harvard School of Public Health – way back when – the field was novel, revolutionary, and striving to establish a newly effective and efficient way to provide patient services. It is useful to keep these roots in perspective – hospital medicine over the arc of time – from what WAS, to what IS and eventually what WILL BE. The cleverness of hospitalist leaders has been their capacity to understand this evolution and work with it. Hospitalist medicine built opportunities in response to high costs, the lack of continuity of care, and problems of communication. It was a solution.
How might you diagnose your burnout – and that of others with whom you work – in order to build solutions? Is it a phenomenon that involves just several individuals or is it characteristic of your group as a whole? What are the causes? What are the symptoms and what are the core issues? Some are system problems in which expectations for performance – and the resources to meet those objectives – are not reasonably aligned. There is a cost for trying to reduce costs on the backs of overworked clinicians.
If this is more than an individual problem, systematically ask the question and seek systematic answers. The better you document root causes and implications, the better are you able to make a data-driven case for change. Interview, survey, and with all this, you demonstrate your concern for staff, their work, and their work experience.
Showing that you care about the professional and personal well-being and balance of your workforce, in and of itself, is the beginning of an intervention. Be honest with yourself about your own experience. And then be open to the experiences of others. As a leader, your colleagues may suggest changes you make in your own leadership that could ameliorate some of that burnout. Better communication? Improved organization? Enhanced flexibility as appropriate? These are problems you can fix.
Other solutions must be negotiated with others on the systems level. With documentation in hand, build your case for the necessary changes, whatever that might entail. Hospitalist leaders negotiated their way into respected and productive positions in the health care system. Similarly, they must negotiate the right balance now to ensure the quality, morale, and reasonable productivity of their departments and workforce.
As a hospitalist leader, you know that each day will bring its complexities, challenges, and at times, its burdens. Your objective is to encourage – for yourself, for your colleagues, and for your system – resilience that is both personal and organizational. That resilience – the ability to take a hit and bounce back – is an encouraging signal of hope and recovery, for your workforce as well as the people for whom you care. The principles of swarm leadership – reinvigorated for your group – could very well provide signposts on that everyday quest for personal and group resilience.
Leonard J. Marcus, PhD, is coauthor of “Renegotiating Health Care: Resolving Conflict to Build Collaboration,” Second Edition (San Francisco: Jossey-Bass Publishers, 2011) and is director of the Program for Health Care Negotiation and Conflict Resolution at the Harvard T.H. Chan School of Public Health. Dr. Marcus teaches regularly in the SHM Leadership Academy. He can be reached at [email protected].
I had the privilege of teaching two seminars at the recent Society of Hospital Medicine Leadership Academy in Scottsdale, Ariz. The theme of my second seminar was “Swarm Leadership,” the topic of my September column. There seemed to be enthusiasm and interest in the topic. Participants were intrigued at the notion of leveraging instinctual responses to encourage team spirit and collective outcomes.
The key principles of these swarm-like behaviors are: 1) unity of mission, 2) generosity of spirit, 3) staying in lanes and helping others succeed in theirs, 4) no ego/no blame, and 5) a foundation of trust among those working together. Leaders create the conditions in which these behaviors are more likely to emerge. The resulting team spirit and productivity raise morale and increase the sense of work-related purpose and mission.
People expressed their sense of being burned out and overworked, even to the extent of being exploited. I was stunned at the prevalence of this sensation in the room. Not everyone spoke though many people identified with the theme.
What I heard was enough to raise the question here: For hospitalist leaders, to what extent is burnout significant enough to give it serious attention? (I want to be abundantly clear: I report observations as anecdotal and impressionistic. There is no implied critique of hospitalists on the whole nor any individual or groups.)
Burnout includes sensations of being exhausted, overburdened, underappreciated, undercompensated, cynical, and depressed. These phenomena together can affect your productivity, the quality of your work, and your endurance when the workload gets tough.
By contrast, the opposite of burnout is balance, including sensations of being engaged, enthusiastic, energetic, absorbed, challenged, and dedicated. Work is part of the equilibrium you establish in your life, which includes a variety of fulfilling and motivating experiences and accomplishments.
Ideal balance would have all the different parts of your life – from family to hobbies to work – in perfect synergy with one another. Complete burnout would have all parts of your life imploding on one another, with little room for joy, personal contentment, and professional satisfaction.
How do you assess the differences between burnout and balance? First, this is a very individual metric. What one person might consider challenging and engaging another would experience as overwhelming and alienating. When you assess a group of people, these differences are important and could inform how work assignments and heavy lifting are assigned.
During the SHM session and in private comments, people described this rise in burnout not as a personal phenomena. Rather, it results from the health system expecting more of hospitalists than they can reasonably and reliably produce. People described hospitalists getting to the breaking point with no relief in sight. What can be done about this phenomenon?
First, hold a mirror up to yourself. You cannot help others as a leader if you are not clear with your own state of burnout and balance. The questions for you – a leader of other hospitalists – include: To what extent are you burned out? If so, why? If not, why not? If you were to draw a continuum between burned out and balanced, where on that range would you place yourself? Where would others in your group or department pinpoint themselves, relative to one another, on this continuum?
How might burnout develop for hospitalist leaders? Like a car, even a high performance vehicle, you can only go so fast and so far. Push too hard on the accelerator and the vehicle begins to shake as performance declines. If your system is expecting the pace and productivity to outstrip what you consider reasonable, your performance, job satisfaction and morale drops. Impose those demands upon a group of people and the unhappiness can become infectious.
With a decline in performance comes a decline in confidence. You and your colleagues strive for top-rate outcomes. Fatigue, pressure, and unreasonable expectations challenge your ability to feel good about what you are doing. That satisfaction is part of why you chose hospital medicine and without it, you wonder about what you are doing and why you are doing it.
When you and your colleagues sense that you are unappreciated, it can spark a profound sense of disappointment. That realization could express itself in many forms, including unhappiness about pay and workload to dissatisfaction with professional support or acknowledgment. When the system on the whole is driving so fast that it cannot stop to ensure and reward good work, the rattling can have a stunting effect on performance.
When I first began teaching at SHM conferences and had hospitalists in my classes at the Harvard School of Public Health – way back when – the field was novel, revolutionary, and striving to establish a newly effective and efficient way to provide patient services. It is useful to keep these roots in perspective – hospital medicine over the arc of time – from what WAS, to what IS and eventually what WILL BE. The cleverness of hospitalist leaders has been their capacity to understand this evolution and work with it. Hospitalist medicine built opportunities in response to high costs, the lack of continuity of care, and problems of communication. It was a solution.
How might you diagnose your burnout – and that of others with whom you work – in order to build solutions? Is it a phenomenon that involves just several individuals or is it characteristic of your group as a whole? What are the causes? What are the symptoms and what are the core issues? Some are system problems in which expectations for performance – and the resources to meet those objectives – are not reasonably aligned. There is a cost for trying to reduce costs on the backs of overworked clinicians.
If this is more than an individual problem, systematically ask the question and seek systematic answers. The better you document root causes and implications, the better are you able to make a data-driven case for change. Interview, survey, and with all this, you demonstrate your concern for staff, their work, and their work experience.
Showing that you care about the professional and personal well-being and balance of your workforce, in and of itself, is the beginning of an intervention. Be honest with yourself about your own experience. And then be open to the experiences of others. As a leader, your colleagues may suggest changes you make in your own leadership that could ameliorate some of that burnout. Better communication? Improved organization? Enhanced flexibility as appropriate? These are problems you can fix.
Other solutions must be negotiated with others on the systems level. With documentation in hand, build your case for the necessary changes, whatever that might entail. Hospitalist leaders negotiated their way into respected and productive positions in the health care system. Similarly, they must negotiate the right balance now to ensure the quality, morale, and reasonable productivity of their departments and workforce.
As a hospitalist leader, you know that each day will bring its complexities, challenges, and at times, its burdens. Your objective is to encourage – for yourself, for your colleagues, and for your system – resilience that is both personal and organizational. That resilience – the ability to take a hit and bounce back – is an encouraging signal of hope and recovery, for your workforce as well as the people for whom you care. The principles of swarm leadership – reinvigorated for your group – could very well provide signposts on that everyday quest for personal and group resilience.
Leonard J. Marcus, PhD, is coauthor of “Renegotiating Health Care: Resolving Conflict to Build Collaboration,” Second Edition (San Francisco: Jossey-Bass Publishers, 2011) and is director of the Program for Health Care Negotiation and Conflict Resolution at the Harvard T.H. Chan School of Public Health. Dr. Marcus teaches regularly in the SHM Leadership Academy. He can be reached at [email protected].
I had the privilege of teaching two seminars at the recent Society of Hospital Medicine Leadership Academy in Scottsdale, Ariz. The theme of my second seminar was “Swarm Leadership,” the topic of my September column. There seemed to be enthusiasm and interest in the topic. Participants were intrigued at the notion of leveraging instinctual responses to encourage team spirit and collective outcomes.
The key principles of these swarm-like behaviors are: 1) unity of mission, 2) generosity of spirit, 3) staying in lanes and helping others succeed in theirs, 4) no ego/no blame, and 5) a foundation of trust among those working together. Leaders create the conditions in which these behaviors are more likely to emerge. The resulting team spirit and productivity raise morale and increase the sense of work-related purpose and mission.
People expressed their sense of being burned out and overworked, even to the extent of being exploited. I was stunned at the prevalence of this sensation in the room. Not everyone spoke though many people identified with the theme.
What I heard was enough to raise the question here: For hospitalist leaders, to what extent is burnout significant enough to give it serious attention? (I want to be abundantly clear: I report observations as anecdotal and impressionistic. There is no implied critique of hospitalists on the whole nor any individual or groups.)
Burnout includes sensations of being exhausted, overburdened, underappreciated, undercompensated, cynical, and depressed. These phenomena together can affect your productivity, the quality of your work, and your endurance when the workload gets tough.
By contrast, the opposite of burnout is balance, including sensations of being engaged, enthusiastic, energetic, absorbed, challenged, and dedicated. Work is part of the equilibrium you establish in your life, which includes a variety of fulfilling and motivating experiences and accomplishments.
Ideal balance would have all the different parts of your life – from family to hobbies to work – in perfect synergy with one another. Complete burnout would have all parts of your life imploding on one another, with little room for joy, personal contentment, and professional satisfaction.
How do you assess the differences between burnout and balance? First, this is a very individual metric. What one person might consider challenging and engaging another would experience as overwhelming and alienating. When you assess a group of people, these differences are important and could inform how work assignments and heavy lifting are assigned.
During the SHM session and in private comments, people described this rise in burnout not as a personal phenomena. Rather, it results from the health system expecting more of hospitalists than they can reasonably and reliably produce. People described hospitalists getting to the breaking point with no relief in sight. What can be done about this phenomenon?
First, hold a mirror up to yourself. You cannot help others as a leader if you are not clear with your own state of burnout and balance. The questions for you – a leader of other hospitalists – include: To what extent are you burned out? If so, why? If not, why not? If you were to draw a continuum between burned out and balanced, where on that range would you place yourself? Where would others in your group or department pinpoint themselves, relative to one another, on this continuum?
How might burnout develop for hospitalist leaders? Like a car, even a high performance vehicle, you can only go so fast and so far. Push too hard on the accelerator and the vehicle begins to shake as performance declines. If your system is expecting the pace and productivity to outstrip what you consider reasonable, your performance, job satisfaction and morale drops. Impose those demands upon a group of people and the unhappiness can become infectious.
With a decline in performance comes a decline in confidence. You and your colleagues strive for top-rate outcomes. Fatigue, pressure, and unreasonable expectations challenge your ability to feel good about what you are doing. That satisfaction is part of why you chose hospital medicine and without it, you wonder about what you are doing and why you are doing it.
When you and your colleagues sense that you are unappreciated, it can spark a profound sense of disappointment. That realization could express itself in many forms, including unhappiness about pay and workload to dissatisfaction with professional support or acknowledgment. When the system on the whole is driving so fast that it cannot stop to ensure and reward good work, the rattling can have a stunting effect on performance.
When I first began teaching at SHM conferences and had hospitalists in my classes at the Harvard School of Public Health – way back when – the field was novel, revolutionary, and striving to establish a newly effective and efficient way to provide patient services. It is useful to keep these roots in perspective – hospital medicine over the arc of time – from what WAS, to what IS and eventually what WILL BE. The cleverness of hospitalist leaders has been their capacity to understand this evolution and work with it. Hospitalist medicine built opportunities in response to high costs, the lack of continuity of care, and problems of communication. It was a solution.
How might you diagnose your burnout – and that of others with whom you work – in order to build solutions? Is it a phenomenon that involves just several individuals or is it characteristic of your group as a whole? What are the causes? What are the symptoms and what are the core issues? Some are system problems in which expectations for performance – and the resources to meet those objectives – are not reasonably aligned. There is a cost for trying to reduce costs on the backs of overworked clinicians.
If this is more than an individual problem, systematically ask the question and seek systematic answers. The better you document root causes and implications, the better are you able to make a data-driven case for change. Interview, survey, and with all this, you demonstrate your concern for staff, their work, and their work experience.
Showing that you care about the professional and personal well-being and balance of your workforce, in and of itself, is the beginning of an intervention. Be honest with yourself about your own experience. And then be open to the experiences of others. As a leader, your colleagues may suggest changes you make in your own leadership that could ameliorate some of that burnout. Better communication? Improved organization? Enhanced flexibility as appropriate? These are problems you can fix.
Other solutions must be negotiated with others on the systems level. With documentation in hand, build your case for the necessary changes, whatever that might entail. Hospitalist leaders negotiated their way into respected and productive positions in the health care system. Similarly, they must negotiate the right balance now to ensure the quality, morale, and reasonable productivity of their departments and workforce.
As a hospitalist leader, you know that each day will bring its complexities, challenges, and at times, its burdens. Your objective is to encourage – for yourself, for your colleagues, and for your system – resilience that is both personal and organizational. That resilience – the ability to take a hit and bounce back – is an encouraging signal of hope and recovery, for your workforce as well as the people for whom you care. The principles of swarm leadership – reinvigorated for your group – could very well provide signposts on that everyday quest for personal and group resilience.
Leonard J. Marcus, PhD, is coauthor of “Renegotiating Health Care: Resolving Conflict to Build Collaboration,” Second Edition (San Francisco: Jossey-Bass Publishers, 2011) and is director of the Program for Health Care Negotiation and Conflict Resolution at the Harvard T.H. Chan School of Public Health. Dr. Marcus teaches regularly in the SHM Leadership Academy. He can be reached at [email protected].