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Popularity of virtual conferences may mean a permanent shift
Fifteen days. That’s how much time the American College of Cardiology (ACC) had to convert its annual conference, scheduled for the end of March this year in Chicago, into a virtual meeting for the estimated 17,000 people who had planned to attend.
Because of the coronavirus pandemic, Illinois announced restrictions on the size of gatherings on March 13, causing the ACC to pivot to an online-only model.
“One big advantage was that we already had all of our content planned,” Janice Sibley, the ACC’s executive vice president of education, told Medscape Medical News. “We knew who the faculty would be for different sessions, and many of them had already planned their slides.”
But determining how to present those hundreds of presentations at an online conference, not to mention addressing the logistics related to registrations, tech platforms, exhibit hall sponsors, and other aspects of an annual meeting, would be no small task.
But according to a Medscape poll, many physicians think that, while the virtual experience is worthwhile and getting better, it’s never going to be the same as spending several days on site, immersed in the experience of an annual meeting.
As one respondent commented, “I miss the intellectual excitement, the electricity in the room, when there is a live presentation that announces a major breakthrough.”
Large medical societies have an advantage
As ACC rapidly prepared for its virtual conference, the society first refunded all registration and expo fees and worked with the vendor partners to resolve the cancellation of rental space, food and beverage services, and decorating. Then they organized a team of 15 people split into three groups. One group focused on the intellectual, scientific, and educational elements of the virtual conference. They chose 24 sessions to livestream and decided to prerecord the rest for on-demand access, limiting the number of presenters they needed to train for online presentation.
A second team focused on business and worked with industry partners on how to translate a large expo into digital offerings. They developed virtual pages, advertisements, promotions, and industry-sponsored education.
The third team’s focus, Ms. Sibley said, was most critical, and the hardest: addressing socio-emotional needs.
“That group was responsible for trying to create the buzz and excitement we would have had at the event,” she said, “pivoting that experience we would have had in a live event to a virtual environment. What we were worried about was, would anyone even come?”
But ACC built it, and they did indeed come. Within a half hour of the opening session, nearly 13,000 people logged on from around the world. “It worked beautifully,” Ms. Sibley said.
By the end of the 3-day event, approximately 34,000 unique visitors had logged in for live or prerecorded sessions. Although ACC worried at first about technical glitches and bandwidth needs, everything ran smoothly. By 90 days after the meeting, 63,000 unique users had logged in to access the conference content.
ACC was among the first organizations forced to switch from an in-person to all-online meeting, but dozens of other organizations have now done the same, discovering the benefits and drawbacks of a virtual environment while experimenting with different formats and offerings. Talks with a few large medical societies about the experience revealed several common themes, including the following:
- Finding new ways to attract and measure attendance.
- Ensuring the actual scientific content was as robust online as in person.
- Realizing the value of social media in enhancing the socio-emotional experience.
- Believing that virtual meetings will become a permanent fixture in a future of “hybrid” conferences.
New ways of attracting and measuring attendance
Previous ways to measure meeting attendance were straightforward: number of registrations and number of people physically walking into sessions. An online conference, however, offers dozens of ways to measure attendance. While the number of registrations remained one tool – and all the organizations interviewed reported record numbers of registrations – organizations also used other metrics to measure success, such as “participation,” “engagement,” and “viewing time.”
ACC defined “participation” as a unique user logging in, and it defined “engagement” as sticking around for a while, possibly using chat functions or discussing the content on social media. The American Society of Clinical Oncology (ASCO) annual conference in May, which attracted more than 44,000 registered attendees, also measured total content views – more than 2.5 million during the meeting – and monitored social media. More than 8,800 Twitter users posted more than 45,000 tweets with the #ASCO20 hashtag during the meeting, generating 750 million likes, shares, and comments. The European League Against Rheumatism (EULAR) annual congress registered a record 18,700 delegates – up from 14,500 in 2019 – but it also measured attendance by average viewing time and visits by congress day and by category.
Organizations shifted fee structures as well. While ACC refunded fees for its first online meeting, it has since developed tiers to match fees to anticipated value, such as charging more for livestreamed sessions that allow interactivity than for viewing recordings. ASCO offered a one-time fee waiver for members plus free registration to cancer survivors and caregivers, discounted registration for patient advocates, and reduced fees for other categories. But adjusting how to measure attendance and charge for events were the easy parts of transitioning to online.
Priority for having robust content
The biggest difficulty for most organizations was the short time they had to move online, with a host of challenges accompanying the switch, said the executive director of EULAR, Julia Rautenstrauch, DrMed. These included technical requirements, communication, training, finances, legal issues, compliance rules, and other logistics.
“The year 2020 will be remembered for being the year of unexpected transformation,” said a spokesperson from European Society for Medical Oncology (ESMO), who declined to be named. “The number of fundamental questions we had to ask ourselves is pages long. The solutions we have implemented so far have been successful, but we won’t rest on our laurels.”
ASCO had an advantage in the pivot, despite only 6 weeks to make the switch, because they already had a robust online platform to build on. “We weren’t starting from scratch, but we were sure changing the way we prepared,” ASCO CEO Clifford Hudis, MD, said.
All of the organizations made the breadth and quality of scientific and educational content a top priority, and those who have already hosted meetings this year report positive feedback.
“The rating of the scientific content was excellent, and the event did indeed fulfill the educational goals and expected learning outcomes for the vast majority of delegates,” EULAR’s Dr. Rautenstrauch said.
“Our goal, when we went into this, was that, in the future when somebody looks back at ASCO20, they should not be able to tell that it was a different year from any other in terms of the science,” Dr. Hudis said.
Missing out on networking and social interaction
Even when logistics run smoothly, virtual conferences must overcome two other challenges: the loss of in-person interactions and the potential for “Zoom burnout.”
“You do miss that human contact, the unsaid reactions in the room when you’re speaking or providing a controversial statement, even the facial expression or seeing people lean in or being distracted,” Ms. Sibley said.
Taher Modarressi, MD, an endocrinologist with Diabetes and Endocrine Associates of Hunterdon in Flemington, N.J., said all the digital conferences he has attended were missing those key social elements: “seeing old friends, sideline discussions that generate new ideas, and meeting new colleagues. However, this has been partly alleviated with the robust rise of social media and ‘MedTwitter,’ in particular, where these discussions and interactions continue.”
To attempt to meet that need for social interaction, societies came up with a variety of options. EULAR offered chatrooms, “Meet the Expert” sessions, and other virtual opportunities for live interaction. ASCO hosted discussion groups with subsets of participants, such as virtual meetings with oncology fellows, and it plans to offer networking sessions and “poster walks” during future meetings.
“The value of an in-person meeting is connecting with people, exchanging ideas over coffee, and making new contacts,” ASCO’s Dr. Hudis said. While virtual meetings lose many of those personal interactions, knowledge can also be shared with more people, he said.
The key to combating digital fatigue is focusing on opportunities for interactivity, ACC’s Ms. Sibley said. “When you are creating a virtual environment, it’s important that you offer choices.” Online learners tend to have shorter attention spans than in-person learners, so people need opportunities to flip between sessions, like flipping between TV channels. Different engagement options are also essential, such as chat functions on the video platforms, asking questions of presenters orally or in writing, and using the familiar hashtags for social media discussion.
“We set up all those different ways to interact, and you allow the user to choose,” Ms. Sibley said.
Some conferences, however, had less time or fewer resources to adjust to a virtual format and couldn’t make up for the lost social interaction. Andy Bowman, MD, a neonatologist in Lubbock, Tex., was supposed to attend the Neonatal & Pediatric Airborne Transport Conference sponsored by International Biomed in the spring, but it was canceled at the last minute. Several weeks later, the organizers released videos of scheduled speakers giving their talks, but it was less engaging and too easy to get distracted, Dr. Bowman said.
“There is a noticeable decrease in energy – you can’t look around to feed off other’s reactions when a speaker says something off the wall, or new, or contrary to expectations,” he said. He also especially missed the social interactions, such as “missing out on the chance encounters in the hallway or seeing the same face in back-to-back sessions and figuring out you have shared interest.” He was also sorry to miss the expo because neonatal transport requires a lot of specialty equipment, and he appreciates the chance to actually touch and see it in person.
Advantages of an online meeting
Despite the challenges, online meetings can overcome obstacles of in-person meetings, particularly for those in low- and middle-income countries, such as travel and registration costs, the hardships of being away from practice, and visa restrictions.
“You really have the potential to broaden your reach,” Ms. Sibley said, noting that people in 157 countries participated in ACC.20.
Another advantage is keeping the experience available to people after the livestreamed event.
“Virtual events have demonstrated the potential for a more democratic conference world, expanding the dissemination of information to a much wider community of stakeholders,” ESMO’s spokesperson said.
Not traveling can actually mean getting more out of the conference, said Atisha Patel Manhas, MD, a hematologist/oncologist in Dallas, who attended ASCO. “I have really enjoyed the access aspect – on the virtual platform there is so much more content available to you, and travel time doesn’t cut into conference time,” she said, though she also missed the interaction with colleagues.
Others found that virtual conferences provided more engagement than in-person conferences. Marwah Abdalla, MD, MPH, an assistant professor of medicine and director of education for the Cardiac Intensive Care Unit at Columbia University Medical Center, New York, felt that moderated Q&A sessions offered more interaction among participants. She attended and spoke on a panel during virtual SLEEP 2020, a joint meeting of the American Academy of Sleep Medicine (AASM) and the Sleep Research Society (SRS).
“Usually during in-person sessions, only a few questions are possible, and participants rarely have an opportunity to discuss the presentations within the session due to time limits,” Dr. Abdalla said. “Because the conference presentations can also be viewed asynchronously, participants have been able to comment on lectures and continue the discussion offline, either via social media or via email.” She acknowledged drawbacks of the virtual experience, such as an inability to socialize in person and participate in activities but appreciated the new opportunities to network and learn from international colleagues who would not have been able to attend in person.
Ritu Thamman, MD, assistant professor of medicine at the University of Pittsburgh School of Medicine, pointed out that many institutions have cut their travel budgets, and physicians would be unable to attend in-person conferences for financial or other reasons. She especially appreciated that the European Society of Cardiology had no registration fee for ESC 2020 and made their content free for all of September, which led to more than 100,000 participants.
“That meant anyone anywhere could learn,” she said. “It makes it much more diverse and more egalitarian. That feels like a good step in the right direction for all of us.”
Dr. Modarressi, who found ESC “exhilarating,” similarly noted the benefit of such an equitably accessible conference. “Decreasing barriers and improving access to top-line results and up-to-date information has always been a challenge to the global health community,” he said, noting that the map of attendance for the virtual meeting was “astonishing.”
Given these benefits, organizers said they expect a future of hybrid conferences: physical meetings for those able to attend in person and virtual ones for those who cannot.
“We also expect that the hybrid congress will cater to the needs of people on-site by allowing them additional access to more scientific content than by physical attendance alone,” Dr. Rautenstrauch said.
Everyone has been in reactive mode this year, Ms. Sibley said, but the future looks bright as they seek ways to overcome challenges such as socio-emotional needs and virtual expo spaces.
“We’ve been thrust into the virtual world much faster than we expected, but we’re finding it’s opening more opportunities than we had live,” Ms. Sibley said. “This has catapulted us, for better or worse, into a new way to deliver education and other types of information.
“I think, if we’re smart, we’ll continue to think of ways this can augment our live environment and not replace it.”
A version of this article originally appeared on Medscape.com.
Fifteen days. That’s how much time the American College of Cardiology (ACC) had to convert its annual conference, scheduled for the end of March this year in Chicago, into a virtual meeting for the estimated 17,000 people who had planned to attend.
Because of the coronavirus pandemic, Illinois announced restrictions on the size of gatherings on March 13, causing the ACC to pivot to an online-only model.
“One big advantage was that we already had all of our content planned,” Janice Sibley, the ACC’s executive vice president of education, told Medscape Medical News. “We knew who the faculty would be for different sessions, and many of them had already planned their slides.”
But determining how to present those hundreds of presentations at an online conference, not to mention addressing the logistics related to registrations, tech platforms, exhibit hall sponsors, and other aspects of an annual meeting, would be no small task.
But according to a Medscape poll, many physicians think that, while the virtual experience is worthwhile and getting better, it’s never going to be the same as spending several days on site, immersed in the experience of an annual meeting.
As one respondent commented, “I miss the intellectual excitement, the electricity in the room, when there is a live presentation that announces a major breakthrough.”
Large medical societies have an advantage
As ACC rapidly prepared for its virtual conference, the society first refunded all registration and expo fees and worked with the vendor partners to resolve the cancellation of rental space, food and beverage services, and decorating. Then they organized a team of 15 people split into three groups. One group focused on the intellectual, scientific, and educational elements of the virtual conference. They chose 24 sessions to livestream and decided to prerecord the rest for on-demand access, limiting the number of presenters they needed to train for online presentation.
A second team focused on business and worked with industry partners on how to translate a large expo into digital offerings. They developed virtual pages, advertisements, promotions, and industry-sponsored education.
The third team’s focus, Ms. Sibley said, was most critical, and the hardest: addressing socio-emotional needs.
“That group was responsible for trying to create the buzz and excitement we would have had at the event,” she said, “pivoting that experience we would have had in a live event to a virtual environment. What we were worried about was, would anyone even come?”
But ACC built it, and they did indeed come. Within a half hour of the opening session, nearly 13,000 people logged on from around the world. “It worked beautifully,” Ms. Sibley said.
By the end of the 3-day event, approximately 34,000 unique visitors had logged in for live or prerecorded sessions. Although ACC worried at first about technical glitches and bandwidth needs, everything ran smoothly. By 90 days after the meeting, 63,000 unique users had logged in to access the conference content.
ACC was among the first organizations forced to switch from an in-person to all-online meeting, but dozens of other organizations have now done the same, discovering the benefits and drawbacks of a virtual environment while experimenting with different formats and offerings. Talks with a few large medical societies about the experience revealed several common themes, including the following:
- Finding new ways to attract and measure attendance.
- Ensuring the actual scientific content was as robust online as in person.
- Realizing the value of social media in enhancing the socio-emotional experience.
- Believing that virtual meetings will become a permanent fixture in a future of “hybrid” conferences.
New ways of attracting and measuring attendance
Previous ways to measure meeting attendance were straightforward: number of registrations and number of people physically walking into sessions. An online conference, however, offers dozens of ways to measure attendance. While the number of registrations remained one tool – and all the organizations interviewed reported record numbers of registrations – organizations also used other metrics to measure success, such as “participation,” “engagement,” and “viewing time.”
ACC defined “participation” as a unique user logging in, and it defined “engagement” as sticking around for a while, possibly using chat functions or discussing the content on social media. The American Society of Clinical Oncology (ASCO) annual conference in May, which attracted more than 44,000 registered attendees, also measured total content views – more than 2.5 million during the meeting – and monitored social media. More than 8,800 Twitter users posted more than 45,000 tweets with the #ASCO20 hashtag during the meeting, generating 750 million likes, shares, and comments. The European League Against Rheumatism (EULAR) annual congress registered a record 18,700 delegates – up from 14,500 in 2019 – but it also measured attendance by average viewing time and visits by congress day and by category.
Organizations shifted fee structures as well. While ACC refunded fees for its first online meeting, it has since developed tiers to match fees to anticipated value, such as charging more for livestreamed sessions that allow interactivity than for viewing recordings. ASCO offered a one-time fee waiver for members plus free registration to cancer survivors and caregivers, discounted registration for patient advocates, and reduced fees for other categories. But adjusting how to measure attendance and charge for events were the easy parts of transitioning to online.
Priority for having robust content
The biggest difficulty for most organizations was the short time they had to move online, with a host of challenges accompanying the switch, said the executive director of EULAR, Julia Rautenstrauch, DrMed. These included technical requirements, communication, training, finances, legal issues, compliance rules, and other logistics.
“The year 2020 will be remembered for being the year of unexpected transformation,” said a spokesperson from European Society for Medical Oncology (ESMO), who declined to be named. “The number of fundamental questions we had to ask ourselves is pages long. The solutions we have implemented so far have been successful, but we won’t rest on our laurels.”
ASCO had an advantage in the pivot, despite only 6 weeks to make the switch, because they already had a robust online platform to build on. “We weren’t starting from scratch, but we were sure changing the way we prepared,” ASCO CEO Clifford Hudis, MD, said.
All of the organizations made the breadth and quality of scientific and educational content a top priority, and those who have already hosted meetings this year report positive feedback.
“The rating of the scientific content was excellent, and the event did indeed fulfill the educational goals and expected learning outcomes for the vast majority of delegates,” EULAR’s Dr. Rautenstrauch said.
“Our goal, when we went into this, was that, in the future when somebody looks back at ASCO20, they should not be able to tell that it was a different year from any other in terms of the science,” Dr. Hudis said.
Missing out on networking and social interaction
Even when logistics run smoothly, virtual conferences must overcome two other challenges: the loss of in-person interactions and the potential for “Zoom burnout.”
“You do miss that human contact, the unsaid reactions in the room when you’re speaking or providing a controversial statement, even the facial expression or seeing people lean in or being distracted,” Ms. Sibley said.
Taher Modarressi, MD, an endocrinologist with Diabetes and Endocrine Associates of Hunterdon in Flemington, N.J., said all the digital conferences he has attended were missing those key social elements: “seeing old friends, sideline discussions that generate new ideas, and meeting new colleagues. However, this has been partly alleviated with the robust rise of social media and ‘MedTwitter,’ in particular, where these discussions and interactions continue.”
To attempt to meet that need for social interaction, societies came up with a variety of options. EULAR offered chatrooms, “Meet the Expert” sessions, and other virtual opportunities for live interaction. ASCO hosted discussion groups with subsets of participants, such as virtual meetings with oncology fellows, and it plans to offer networking sessions and “poster walks” during future meetings.
“The value of an in-person meeting is connecting with people, exchanging ideas over coffee, and making new contacts,” ASCO’s Dr. Hudis said. While virtual meetings lose many of those personal interactions, knowledge can also be shared with more people, he said.
The key to combating digital fatigue is focusing on opportunities for interactivity, ACC’s Ms. Sibley said. “When you are creating a virtual environment, it’s important that you offer choices.” Online learners tend to have shorter attention spans than in-person learners, so people need opportunities to flip between sessions, like flipping between TV channels. Different engagement options are also essential, such as chat functions on the video platforms, asking questions of presenters orally or in writing, and using the familiar hashtags for social media discussion.
“We set up all those different ways to interact, and you allow the user to choose,” Ms. Sibley said.
Some conferences, however, had less time or fewer resources to adjust to a virtual format and couldn’t make up for the lost social interaction. Andy Bowman, MD, a neonatologist in Lubbock, Tex., was supposed to attend the Neonatal & Pediatric Airborne Transport Conference sponsored by International Biomed in the spring, but it was canceled at the last minute. Several weeks later, the organizers released videos of scheduled speakers giving their talks, but it was less engaging and too easy to get distracted, Dr. Bowman said.
“There is a noticeable decrease in energy – you can’t look around to feed off other’s reactions when a speaker says something off the wall, or new, or contrary to expectations,” he said. He also especially missed the social interactions, such as “missing out on the chance encounters in the hallway or seeing the same face in back-to-back sessions and figuring out you have shared interest.” He was also sorry to miss the expo because neonatal transport requires a lot of specialty equipment, and he appreciates the chance to actually touch and see it in person.
Advantages of an online meeting
Despite the challenges, online meetings can overcome obstacles of in-person meetings, particularly for those in low- and middle-income countries, such as travel and registration costs, the hardships of being away from practice, and visa restrictions.
“You really have the potential to broaden your reach,” Ms. Sibley said, noting that people in 157 countries participated in ACC.20.
Another advantage is keeping the experience available to people after the livestreamed event.
“Virtual events have demonstrated the potential for a more democratic conference world, expanding the dissemination of information to a much wider community of stakeholders,” ESMO’s spokesperson said.
Not traveling can actually mean getting more out of the conference, said Atisha Patel Manhas, MD, a hematologist/oncologist in Dallas, who attended ASCO. “I have really enjoyed the access aspect – on the virtual platform there is so much more content available to you, and travel time doesn’t cut into conference time,” she said, though she also missed the interaction with colleagues.
Others found that virtual conferences provided more engagement than in-person conferences. Marwah Abdalla, MD, MPH, an assistant professor of medicine and director of education for the Cardiac Intensive Care Unit at Columbia University Medical Center, New York, felt that moderated Q&A sessions offered more interaction among participants. She attended and spoke on a panel during virtual SLEEP 2020, a joint meeting of the American Academy of Sleep Medicine (AASM) and the Sleep Research Society (SRS).
“Usually during in-person sessions, only a few questions are possible, and participants rarely have an opportunity to discuss the presentations within the session due to time limits,” Dr. Abdalla said. “Because the conference presentations can also be viewed asynchronously, participants have been able to comment on lectures and continue the discussion offline, either via social media or via email.” She acknowledged drawbacks of the virtual experience, such as an inability to socialize in person and participate in activities but appreciated the new opportunities to network and learn from international colleagues who would not have been able to attend in person.
Ritu Thamman, MD, assistant professor of medicine at the University of Pittsburgh School of Medicine, pointed out that many institutions have cut their travel budgets, and physicians would be unable to attend in-person conferences for financial or other reasons. She especially appreciated that the European Society of Cardiology had no registration fee for ESC 2020 and made their content free for all of September, which led to more than 100,000 participants.
“That meant anyone anywhere could learn,” she said. “It makes it much more diverse and more egalitarian. That feels like a good step in the right direction for all of us.”
Dr. Modarressi, who found ESC “exhilarating,” similarly noted the benefit of such an equitably accessible conference. “Decreasing barriers and improving access to top-line results and up-to-date information has always been a challenge to the global health community,” he said, noting that the map of attendance for the virtual meeting was “astonishing.”
Given these benefits, organizers said they expect a future of hybrid conferences: physical meetings for those able to attend in person and virtual ones for those who cannot.
“We also expect that the hybrid congress will cater to the needs of people on-site by allowing them additional access to more scientific content than by physical attendance alone,” Dr. Rautenstrauch said.
Everyone has been in reactive mode this year, Ms. Sibley said, but the future looks bright as they seek ways to overcome challenges such as socio-emotional needs and virtual expo spaces.
“We’ve been thrust into the virtual world much faster than we expected, but we’re finding it’s opening more opportunities than we had live,” Ms. Sibley said. “This has catapulted us, for better or worse, into a new way to deliver education and other types of information.
“I think, if we’re smart, we’ll continue to think of ways this can augment our live environment and not replace it.”
A version of this article originally appeared on Medscape.com.
Fifteen days. That’s how much time the American College of Cardiology (ACC) had to convert its annual conference, scheduled for the end of March this year in Chicago, into a virtual meeting for the estimated 17,000 people who had planned to attend.
Because of the coronavirus pandemic, Illinois announced restrictions on the size of gatherings on March 13, causing the ACC to pivot to an online-only model.
“One big advantage was that we already had all of our content planned,” Janice Sibley, the ACC’s executive vice president of education, told Medscape Medical News. “We knew who the faculty would be for different sessions, and many of them had already planned their slides.”
But determining how to present those hundreds of presentations at an online conference, not to mention addressing the logistics related to registrations, tech platforms, exhibit hall sponsors, and other aspects of an annual meeting, would be no small task.
But according to a Medscape poll, many physicians think that, while the virtual experience is worthwhile and getting better, it’s never going to be the same as spending several days on site, immersed in the experience of an annual meeting.
As one respondent commented, “I miss the intellectual excitement, the electricity in the room, when there is a live presentation that announces a major breakthrough.”
Large medical societies have an advantage
As ACC rapidly prepared for its virtual conference, the society first refunded all registration and expo fees and worked with the vendor partners to resolve the cancellation of rental space, food and beverage services, and decorating. Then they organized a team of 15 people split into three groups. One group focused on the intellectual, scientific, and educational elements of the virtual conference. They chose 24 sessions to livestream and decided to prerecord the rest for on-demand access, limiting the number of presenters they needed to train for online presentation.
A second team focused on business and worked with industry partners on how to translate a large expo into digital offerings. They developed virtual pages, advertisements, promotions, and industry-sponsored education.
The third team’s focus, Ms. Sibley said, was most critical, and the hardest: addressing socio-emotional needs.
“That group was responsible for trying to create the buzz and excitement we would have had at the event,” she said, “pivoting that experience we would have had in a live event to a virtual environment. What we were worried about was, would anyone even come?”
But ACC built it, and they did indeed come. Within a half hour of the opening session, nearly 13,000 people logged on from around the world. “It worked beautifully,” Ms. Sibley said.
By the end of the 3-day event, approximately 34,000 unique visitors had logged in for live or prerecorded sessions. Although ACC worried at first about technical glitches and bandwidth needs, everything ran smoothly. By 90 days after the meeting, 63,000 unique users had logged in to access the conference content.
ACC was among the first organizations forced to switch from an in-person to all-online meeting, but dozens of other organizations have now done the same, discovering the benefits and drawbacks of a virtual environment while experimenting with different formats and offerings. Talks with a few large medical societies about the experience revealed several common themes, including the following:
- Finding new ways to attract and measure attendance.
- Ensuring the actual scientific content was as robust online as in person.
- Realizing the value of social media in enhancing the socio-emotional experience.
- Believing that virtual meetings will become a permanent fixture in a future of “hybrid” conferences.
New ways of attracting and measuring attendance
Previous ways to measure meeting attendance were straightforward: number of registrations and number of people physically walking into sessions. An online conference, however, offers dozens of ways to measure attendance. While the number of registrations remained one tool – and all the organizations interviewed reported record numbers of registrations – organizations also used other metrics to measure success, such as “participation,” “engagement,” and “viewing time.”
ACC defined “participation” as a unique user logging in, and it defined “engagement” as sticking around for a while, possibly using chat functions or discussing the content on social media. The American Society of Clinical Oncology (ASCO) annual conference in May, which attracted more than 44,000 registered attendees, also measured total content views – more than 2.5 million during the meeting – and monitored social media. More than 8,800 Twitter users posted more than 45,000 tweets with the #ASCO20 hashtag during the meeting, generating 750 million likes, shares, and comments. The European League Against Rheumatism (EULAR) annual congress registered a record 18,700 delegates – up from 14,500 in 2019 – but it also measured attendance by average viewing time and visits by congress day and by category.
Organizations shifted fee structures as well. While ACC refunded fees for its first online meeting, it has since developed tiers to match fees to anticipated value, such as charging more for livestreamed sessions that allow interactivity than for viewing recordings. ASCO offered a one-time fee waiver for members plus free registration to cancer survivors and caregivers, discounted registration for patient advocates, and reduced fees for other categories. But adjusting how to measure attendance and charge for events were the easy parts of transitioning to online.
Priority for having robust content
The biggest difficulty for most organizations was the short time they had to move online, with a host of challenges accompanying the switch, said the executive director of EULAR, Julia Rautenstrauch, DrMed. These included technical requirements, communication, training, finances, legal issues, compliance rules, and other logistics.
“The year 2020 will be remembered for being the year of unexpected transformation,” said a spokesperson from European Society for Medical Oncology (ESMO), who declined to be named. “The number of fundamental questions we had to ask ourselves is pages long. The solutions we have implemented so far have been successful, but we won’t rest on our laurels.”
ASCO had an advantage in the pivot, despite only 6 weeks to make the switch, because they already had a robust online platform to build on. “We weren’t starting from scratch, but we were sure changing the way we prepared,” ASCO CEO Clifford Hudis, MD, said.
All of the organizations made the breadth and quality of scientific and educational content a top priority, and those who have already hosted meetings this year report positive feedback.
“The rating of the scientific content was excellent, and the event did indeed fulfill the educational goals and expected learning outcomes for the vast majority of delegates,” EULAR’s Dr. Rautenstrauch said.
“Our goal, when we went into this, was that, in the future when somebody looks back at ASCO20, they should not be able to tell that it was a different year from any other in terms of the science,” Dr. Hudis said.
Missing out on networking and social interaction
Even when logistics run smoothly, virtual conferences must overcome two other challenges: the loss of in-person interactions and the potential for “Zoom burnout.”
“You do miss that human contact, the unsaid reactions in the room when you’re speaking or providing a controversial statement, even the facial expression or seeing people lean in or being distracted,” Ms. Sibley said.
Taher Modarressi, MD, an endocrinologist with Diabetes and Endocrine Associates of Hunterdon in Flemington, N.J., said all the digital conferences he has attended were missing those key social elements: “seeing old friends, sideline discussions that generate new ideas, and meeting new colleagues. However, this has been partly alleviated with the robust rise of social media and ‘MedTwitter,’ in particular, where these discussions and interactions continue.”
To attempt to meet that need for social interaction, societies came up with a variety of options. EULAR offered chatrooms, “Meet the Expert” sessions, and other virtual opportunities for live interaction. ASCO hosted discussion groups with subsets of participants, such as virtual meetings with oncology fellows, and it plans to offer networking sessions and “poster walks” during future meetings.
“The value of an in-person meeting is connecting with people, exchanging ideas over coffee, and making new contacts,” ASCO’s Dr. Hudis said. While virtual meetings lose many of those personal interactions, knowledge can also be shared with more people, he said.
The key to combating digital fatigue is focusing on opportunities for interactivity, ACC’s Ms. Sibley said. “When you are creating a virtual environment, it’s important that you offer choices.” Online learners tend to have shorter attention spans than in-person learners, so people need opportunities to flip between sessions, like flipping between TV channels. Different engagement options are also essential, such as chat functions on the video platforms, asking questions of presenters orally or in writing, and using the familiar hashtags for social media discussion.
“We set up all those different ways to interact, and you allow the user to choose,” Ms. Sibley said.
Some conferences, however, had less time or fewer resources to adjust to a virtual format and couldn’t make up for the lost social interaction. Andy Bowman, MD, a neonatologist in Lubbock, Tex., was supposed to attend the Neonatal & Pediatric Airborne Transport Conference sponsored by International Biomed in the spring, but it was canceled at the last minute. Several weeks later, the organizers released videos of scheduled speakers giving their talks, but it was less engaging and too easy to get distracted, Dr. Bowman said.
“There is a noticeable decrease in energy – you can’t look around to feed off other’s reactions when a speaker says something off the wall, or new, or contrary to expectations,” he said. He also especially missed the social interactions, such as “missing out on the chance encounters in the hallway or seeing the same face in back-to-back sessions and figuring out you have shared interest.” He was also sorry to miss the expo because neonatal transport requires a lot of specialty equipment, and he appreciates the chance to actually touch and see it in person.
Advantages of an online meeting
Despite the challenges, online meetings can overcome obstacles of in-person meetings, particularly for those in low- and middle-income countries, such as travel and registration costs, the hardships of being away from practice, and visa restrictions.
“You really have the potential to broaden your reach,” Ms. Sibley said, noting that people in 157 countries participated in ACC.20.
Another advantage is keeping the experience available to people after the livestreamed event.
“Virtual events have demonstrated the potential for a more democratic conference world, expanding the dissemination of information to a much wider community of stakeholders,” ESMO’s spokesperson said.
Not traveling can actually mean getting more out of the conference, said Atisha Patel Manhas, MD, a hematologist/oncologist in Dallas, who attended ASCO. “I have really enjoyed the access aspect – on the virtual platform there is so much more content available to you, and travel time doesn’t cut into conference time,” she said, though she also missed the interaction with colleagues.
Others found that virtual conferences provided more engagement than in-person conferences. Marwah Abdalla, MD, MPH, an assistant professor of medicine and director of education for the Cardiac Intensive Care Unit at Columbia University Medical Center, New York, felt that moderated Q&A sessions offered more interaction among participants. She attended and spoke on a panel during virtual SLEEP 2020, a joint meeting of the American Academy of Sleep Medicine (AASM) and the Sleep Research Society (SRS).
“Usually during in-person sessions, only a few questions are possible, and participants rarely have an opportunity to discuss the presentations within the session due to time limits,” Dr. Abdalla said. “Because the conference presentations can also be viewed asynchronously, participants have been able to comment on lectures and continue the discussion offline, either via social media or via email.” She acknowledged drawbacks of the virtual experience, such as an inability to socialize in person and participate in activities but appreciated the new opportunities to network and learn from international colleagues who would not have been able to attend in person.
Ritu Thamman, MD, assistant professor of medicine at the University of Pittsburgh School of Medicine, pointed out that many institutions have cut their travel budgets, and physicians would be unable to attend in-person conferences for financial or other reasons. She especially appreciated that the European Society of Cardiology had no registration fee for ESC 2020 and made their content free for all of September, which led to more than 100,000 participants.
“That meant anyone anywhere could learn,” she said. “It makes it much more diverse and more egalitarian. That feels like a good step in the right direction for all of us.”
Dr. Modarressi, who found ESC “exhilarating,” similarly noted the benefit of such an equitably accessible conference. “Decreasing barriers and improving access to top-line results and up-to-date information has always been a challenge to the global health community,” he said, noting that the map of attendance for the virtual meeting was “astonishing.”
Given these benefits, organizers said they expect a future of hybrid conferences: physical meetings for those able to attend in person and virtual ones for those who cannot.
“We also expect that the hybrid congress will cater to the needs of people on-site by allowing them additional access to more scientific content than by physical attendance alone,” Dr. Rautenstrauch said.
Everyone has been in reactive mode this year, Ms. Sibley said, but the future looks bright as they seek ways to overcome challenges such as socio-emotional needs and virtual expo spaces.
“We’ve been thrust into the virtual world much faster than we expected, but we’re finding it’s opening more opportunities than we had live,” Ms. Sibley said. “This has catapulted us, for better or worse, into a new way to deliver education and other types of information.
“I think, if we’re smart, we’ll continue to think of ways this can augment our live environment and not replace it.”
A version of this article originally appeared on Medscape.com.
EMA panel backs peanut allergy desensitizing powder Palforzia
The product is intended for desensitizing children and adolescents to peanut allergy.
Palforzia will be available as an oral powder in capsules (0.5, 1, 10, 20, and 100 mg) and as oral powder in sachet (300 mg). The active substance is defatted powder of Arachis hypogaea.
Through use of the product, children with a peanut allergy receive controlled exposure to precise, increasing amounts of peanut protein, mixed with soft food, every day. Over time, this may help to decrease their sensitivity to small amounts of peanuts.
According to the press release from the EMA, Palforzia can mitigate accidental exposure to small amounts of peanut protein. “[A] single dose of a least 1 gram of peanut protein would cause no more than mild allergy symptoms,” the EMA said.
The treatment is indicated for patients aged 4 to 17 years who have received a confirmed diagnosis of peanut allergy. Treatment may be continued for patients aged 18 years or older, according to the press release.
It should be administered under the supervision of a healthcare provider qualified in the diagnosis and treatment of allergic diseases and should be used in conjunction with a peanut-avoidant diet, the EMA notes.
The most common side effects that have been reported are abdominal pain, throat irritation, itch, nausea, vomiting, urticaria, and upper abdominal discomfort.
The next step in the approval process is to obtain market authorization from the European Commission. Detailed recommendations for use will be described in the summary of product characteristics, which will be published in the European public assessment report and will be made available throughout Europe.
“We are encouraged by the CHMP opinion, which recommends Palforzia as the first and only treatment option in the European Union for patients with peanut allergy and their families,” Andrew Oxtoby, president and chief executive officer of Aimmune Therapeutics, said in a statement. “Today’s decision underscores the strong and compelling data from our Palforzia clinical trials and follows the US FDA approval of Palforzia earlier this year. We look forward to the European Commission’s final decision for the marketing approval of Palforzia, which we expect later this year.”
The FDA said in granting its approval that patients, parents, or caregivers must be counseled on the need for always-available injectable epinephrine, the need for continued peanut avoidance, and on how to recognize signs of anaphylaxis.
This article originally appeared on Medscape.com.
The product is intended for desensitizing children and adolescents to peanut allergy.
Palforzia will be available as an oral powder in capsules (0.5, 1, 10, 20, and 100 mg) and as oral powder in sachet (300 mg). The active substance is defatted powder of Arachis hypogaea.
Through use of the product, children with a peanut allergy receive controlled exposure to precise, increasing amounts of peanut protein, mixed with soft food, every day. Over time, this may help to decrease their sensitivity to small amounts of peanuts.
According to the press release from the EMA, Palforzia can mitigate accidental exposure to small amounts of peanut protein. “[A] single dose of a least 1 gram of peanut protein would cause no more than mild allergy symptoms,” the EMA said.
The treatment is indicated for patients aged 4 to 17 years who have received a confirmed diagnosis of peanut allergy. Treatment may be continued for patients aged 18 years or older, according to the press release.
It should be administered under the supervision of a healthcare provider qualified in the diagnosis and treatment of allergic diseases and should be used in conjunction with a peanut-avoidant diet, the EMA notes.
The most common side effects that have been reported are abdominal pain, throat irritation, itch, nausea, vomiting, urticaria, and upper abdominal discomfort.
The next step in the approval process is to obtain market authorization from the European Commission. Detailed recommendations for use will be described in the summary of product characteristics, which will be published in the European public assessment report and will be made available throughout Europe.
“We are encouraged by the CHMP opinion, which recommends Palforzia as the first and only treatment option in the European Union for patients with peanut allergy and their families,” Andrew Oxtoby, president and chief executive officer of Aimmune Therapeutics, said in a statement. “Today’s decision underscores the strong and compelling data from our Palforzia clinical trials and follows the US FDA approval of Palforzia earlier this year. We look forward to the European Commission’s final decision for the marketing approval of Palforzia, which we expect later this year.”
The FDA said in granting its approval that patients, parents, or caregivers must be counseled on the need for always-available injectable epinephrine, the need for continued peanut avoidance, and on how to recognize signs of anaphylaxis.
This article originally appeared on Medscape.com.
The product is intended for desensitizing children and adolescents to peanut allergy.
Palforzia will be available as an oral powder in capsules (0.5, 1, 10, 20, and 100 mg) and as oral powder in sachet (300 mg). The active substance is defatted powder of Arachis hypogaea.
Through use of the product, children with a peanut allergy receive controlled exposure to precise, increasing amounts of peanut protein, mixed with soft food, every day. Over time, this may help to decrease their sensitivity to small amounts of peanuts.
According to the press release from the EMA, Palforzia can mitigate accidental exposure to small amounts of peanut protein. “[A] single dose of a least 1 gram of peanut protein would cause no more than mild allergy symptoms,” the EMA said.
The treatment is indicated for patients aged 4 to 17 years who have received a confirmed diagnosis of peanut allergy. Treatment may be continued for patients aged 18 years or older, according to the press release.
It should be administered under the supervision of a healthcare provider qualified in the diagnosis and treatment of allergic diseases and should be used in conjunction with a peanut-avoidant diet, the EMA notes.
The most common side effects that have been reported are abdominal pain, throat irritation, itch, nausea, vomiting, urticaria, and upper abdominal discomfort.
The next step in the approval process is to obtain market authorization from the European Commission. Detailed recommendations for use will be described in the summary of product characteristics, which will be published in the European public assessment report and will be made available throughout Europe.
“We are encouraged by the CHMP opinion, which recommends Palforzia as the first and only treatment option in the European Union for patients with peanut allergy and their families,” Andrew Oxtoby, president and chief executive officer of Aimmune Therapeutics, said in a statement. “Today’s decision underscores the strong and compelling data from our Palforzia clinical trials and follows the US FDA approval of Palforzia earlier this year. We look forward to the European Commission’s final decision for the marketing approval of Palforzia, which we expect later this year.”
The FDA said in granting its approval that patients, parents, or caregivers must be counseled on the need for always-available injectable epinephrine, the need for continued peanut avoidance, and on how to recognize signs of anaphylaxis.
This article originally appeared on Medscape.com.
SHM announces 2021 virtual annual conference: SHM Converge
The Society of Hospital Medicine has announced its virtual annual conference for 2021: SHM Converge. Formerly known as Hospital Medicine 2021, SHM Converge will take place virtually from May 3-7, 2021, and will offer a fully digital experience with the same education, professional development, and networking hospitalists have come to expect from SHM’s annual conference.
“This year, COVID-19 has challenged us to embrace change and to innovate to better serve our hospital medicine community,” said Danielle Scheurer, MD, MSCR, SFHM, president of SHM’s board of directors. “In that spirit, not only are we introducing an exciting new brand for the SHM annual conference, we are unveiling a reimagined experience for attendees, complete with sessions highlighting the latest research, best practices and innovations in the field.”
The SHM Converge schedule features 20 educational tracks, including the addition of four new tracks to support hospital medicine professionals in some of the most relevant topics affecting health care: diagnostic safety; diversity, equity, and inclusion; leadership; and wellness and resilience
Attendees will also have the option to follow many of the most popular tracks from previous SHM annual conferences, including Rapid Fire, Clinical Updates, and High-Value Care, among others. In many sessions, speakers will present the latest data and information available about COVID-19’s impact on the practice of hospital medicine. Precourses will be held on May 3.
SHM Converge will also offer additional professional development opportunities, including the Research, Innovations, and Clinical Vignettes scientific abstract competition and a speed mentoring session. Networking will be an integral component of SHM Converge. Attendees will be able to choose from more than 20 Special Interest forums, live Q&A sessions and networking events through the interactive conference platform.
“While SHM Converge may look a bit different than the SHM annual conference we are accustomed to, I am confident the content will be among the best we have ever offered, spanning a broad range of clinical topics and issues affecting hospitalists and their patients,” said Daniel Steinberg, MD, SFHM, course director for SHM Converge. “This virtual experience will unite hospitalists from around the globe and connect them with renowned faculty members and thought leaders in hospital medicine – as well as with their hospitalist colleagues they look forward to reconnecting with each year.”
Keynote speaker announcements are forthcoming.
Registration for SHM Converge opens in November 2020. Learn more at shmconverge.org.
Members of the media can obtain press passes beginning in November 2020 by contacting [email protected].
The Society of Hospital Medicine has announced its virtual annual conference for 2021: SHM Converge. Formerly known as Hospital Medicine 2021, SHM Converge will take place virtually from May 3-7, 2021, and will offer a fully digital experience with the same education, professional development, and networking hospitalists have come to expect from SHM’s annual conference.
“This year, COVID-19 has challenged us to embrace change and to innovate to better serve our hospital medicine community,” said Danielle Scheurer, MD, MSCR, SFHM, president of SHM’s board of directors. “In that spirit, not only are we introducing an exciting new brand for the SHM annual conference, we are unveiling a reimagined experience for attendees, complete with sessions highlighting the latest research, best practices and innovations in the field.”
The SHM Converge schedule features 20 educational tracks, including the addition of four new tracks to support hospital medicine professionals in some of the most relevant topics affecting health care: diagnostic safety; diversity, equity, and inclusion; leadership; and wellness and resilience
Attendees will also have the option to follow many of the most popular tracks from previous SHM annual conferences, including Rapid Fire, Clinical Updates, and High-Value Care, among others. In many sessions, speakers will present the latest data and information available about COVID-19’s impact on the practice of hospital medicine. Precourses will be held on May 3.
SHM Converge will also offer additional professional development opportunities, including the Research, Innovations, and Clinical Vignettes scientific abstract competition and a speed mentoring session. Networking will be an integral component of SHM Converge. Attendees will be able to choose from more than 20 Special Interest forums, live Q&A sessions and networking events through the interactive conference platform.
“While SHM Converge may look a bit different than the SHM annual conference we are accustomed to, I am confident the content will be among the best we have ever offered, spanning a broad range of clinical topics and issues affecting hospitalists and their patients,” said Daniel Steinberg, MD, SFHM, course director for SHM Converge. “This virtual experience will unite hospitalists from around the globe and connect them with renowned faculty members and thought leaders in hospital medicine – as well as with their hospitalist colleagues they look forward to reconnecting with each year.”
Keynote speaker announcements are forthcoming.
Registration for SHM Converge opens in November 2020. Learn more at shmconverge.org.
Members of the media can obtain press passes beginning in November 2020 by contacting [email protected].
The Society of Hospital Medicine has announced its virtual annual conference for 2021: SHM Converge. Formerly known as Hospital Medicine 2021, SHM Converge will take place virtually from May 3-7, 2021, and will offer a fully digital experience with the same education, professional development, and networking hospitalists have come to expect from SHM’s annual conference.
“This year, COVID-19 has challenged us to embrace change and to innovate to better serve our hospital medicine community,” said Danielle Scheurer, MD, MSCR, SFHM, president of SHM’s board of directors. “In that spirit, not only are we introducing an exciting new brand for the SHM annual conference, we are unveiling a reimagined experience for attendees, complete with sessions highlighting the latest research, best practices and innovations in the field.”
The SHM Converge schedule features 20 educational tracks, including the addition of four new tracks to support hospital medicine professionals in some of the most relevant topics affecting health care: diagnostic safety; diversity, equity, and inclusion; leadership; and wellness and resilience
Attendees will also have the option to follow many of the most popular tracks from previous SHM annual conferences, including Rapid Fire, Clinical Updates, and High-Value Care, among others. In many sessions, speakers will present the latest data and information available about COVID-19’s impact on the practice of hospital medicine. Precourses will be held on May 3.
SHM Converge will also offer additional professional development opportunities, including the Research, Innovations, and Clinical Vignettes scientific abstract competition and a speed mentoring session. Networking will be an integral component of SHM Converge. Attendees will be able to choose from more than 20 Special Interest forums, live Q&A sessions and networking events through the interactive conference platform.
“While SHM Converge may look a bit different than the SHM annual conference we are accustomed to, I am confident the content will be among the best we have ever offered, spanning a broad range of clinical topics and issues affecting hospitalists and their patients,” said Daniel Steinberg, MD, SFHM, course director for SHM Converge. “This virtual experience will unite hospitalists from around the globe and connect them with renowned faculty members and thought leaders in hospital medicine – as well as with their hospitalist colleagues they look forward to reconnecting with each year.”
Keynote speaker announcements are forthcoming.
Registration for SHM Converge opens in November 2020. Learn more at shmconverge.org.
Members of the media can obtain press passes beginning in November 2020 by contacting [email protected].
Increasing racial diversity in hospital medicine’s leadership ranks
Have you ever done something where you’re not quite sure why you did it at the time, but later on you realize it was part of some larger cosmic purpose, and you go, “Ahhh, now I understand…that’s why!”? Call it a fortuitous coincidence. Or a subconscious act of anticipation. Maybe a little push from God.
Last summer, as SHM’s Practice Analysis Committee was planning the State of Hospital Medicine survey for 2020, we received a request from SHM’s Diversity, Equity & Inclusion (DEI) Special Interest Group (SIG) to include a series of questions related to hospitalist gender, race and ethnic distribution in the new survey. We’ve generally resisted doing things like this because the SoHM is designed to capture data at the group level, not the individual level – and honestly, it’s as much as a lot of groups can do to tell us reliably how many FTEs they have, much less provide details about individual providers. In addition, the survey is already really long, and we are always looking for ways to make it shorter and easier for participants while still collecting the information report users care most about.
But we wanted to take the asks from the DEI SIG seriously, and as we considered their request, we realized that though it wasn’t practical to collect this information for individual hospital medicine group (HMG) members, we could collect it for group leaders. Little did we know last summer that issues of gender and racial diversity and equity would be so front-and-center right now, as we prepare to release the 2020 SoHM Report in early September. Ahhh, now I understand…that’s why – with the prompting of the DEI SIG – we so fortuitously chose to include those questions this year!
Here’s a sneak preview of what we learned. Among SoHM respondents, 57.1% reported that the highest-ranking leader in their HMG is White, and 23.5% of highest-ranking leaders are Asian. Only 5.5% of HMG leaders were Black/African American. Ethnicity was a separate question, and only 2.2% of HMG leaders were reported as Hispanic/Latino.
I have been profoundly moved by the wretched deaths of George Floyd and other people of color at the hands of police in recent months, and by the subsequent protests and our growing national reckoning over issues of racial equity and justice. In my efforts to understand more about race in America, I have been challenged by my friend Ryan Brown, MD, specialty medical director for hospital medicine with Atrium Health in Charlotte, N.C., and others to go beyond just learning about these issues. I want to use my voice to advocate for change, and my actions to participate in effecting change, within the context of my sphere of influence.
So, what does that have to do with the SoHM data on HMG leader demographics? Well, it’s clear that Black and brown people are woefully underrepresented in the ranks of hospital medicine leadership.
Unfortunately, we don’t have good information on racial diversity for hospitalists as a specialty, though I understand that SHM is working on plans to update membership profiles to begin collecting this information. In searching the Internet, I found a 2018 paper from the Journal of Health Care for the Poor and Underserved that studied racial and ethnic distribution of U.S. primary care physicians (doi: 10.1353/hpu.2018.0036). It reported that, in 2012, 7.8% of general internists were Black, along with 5.8% of family medicine/general practice physicians and 6.8% of pediatricians. A separate data set issued by the Association of American Medical Colleges reported that, in 2019, 6.4% of all actively practicing general internal medicine doctors were Black (5.5% of male IM physicians and 7.9% of female IM physicians). While this doesn’t mean hospitalists have the same racial and ethnic distribution, this is probably the best proxy we can come up with.
At first glance, having 5.5% of HMG leaders who are Black doesn’t seem terribly out of line with the reported range of 6.4 to 7.8% in the general population of internal medicine physicians (apologies to the family medicine and pediatric hospitalists reading this, but I’ll confine my discussion to internists for ease and brevity, since they represent the vast majority of the nation’s hospitalists). But do the math. It means Black hospitalists are likely underrepresented in HMG leadership ranks by something like 14% to 29% compared to their likely presence among hospitalists in general.
The real problem, of course, is that according the U.S. Census Bureau, 13.4% of the U.S. population is Black. So even if the racial distribution of HMG leaders catches up to the general hospitalist population, hospital medicine is still woefully underrepresenting the racial and ethnic distribution of our patient population.
The disconnect between the ethnic distribution of HMG leaders vs. hospitalists (based on general internal medicine distribution) is even more pronounced for Latinos. The JHCPU paper reported that, in 2012, 5.6% of general internists were Hispanic. The AAMC data set reported 5.8% of IM doctors were Hispanic/Latino. But only 2.2% of SoHM respondent HMGs reported a Hispanic/Latino leader, which means Latinos are underrepresented by somewhere around 61% or so relative to the likely hospitalist population, and by a whole lot more considering the fact that Latinos make up about 18.5% of the U.S. population.
I’m not saying that a White or Asian doctor can’t provide skilled, compassionate care to a Black or Latino patient, or vice-versa. It happens every day. I guess what I am saying is that we as a country and in the medical profession need to do a better job of creating pathways and promoting careers in medicine for people of color. A JAMA paper from 2019 reported that while the numbers and proportions of minority medical school matriculants has slowly been increasing from 2002 to 2017, the rate of increase was “slower than their age-matched counterparts in the U.S. population, resulting in increased underrepresentation” (doi:10.1001/jamanetworkopen.2019.10490). This means we’re falling behind, not catching up.
We need to make sure that people like Dr. Ryan Brown aren’t discouraged from pursuing medicine by teachers or school counselors because of their skin color or accent, or their gender or sexual orientation. And among those who become doctors, we need to promote hospital medicine as a desirable specialty for people of color and actively invite them in.
In my view, much of this starts with creating more and better paths to leadership within hospital medicine for people of color. Hospital medicine group leaders wield enormous – and increasing – influence, not only within their HMGs and within SHM, but within their institutions and health care systems. We need their voices and their influence to promote diversity within their groups, their institutions, within hospital medicine, and within medicine and the U.S. health care system more broadly.
The Society of Hospital Medicine is already taking steps to promote diversity, equity and inclusion. These include issuing a formal Diversity and Inclusion Statement, creating the DEI SIG, and the recent formation of a Board-designated DEI task force charged with making recommendations to promote DEI within SHM and in hospital medicine more broadly. But I want to challenge SHM to do more, particularly with regard to promoting diversity in leadership. Here are a few ideas to consider:
- Create and sponsor a mentoring program in which hospitalists volunteer to mentor minority junior high and high school students and help them prepare to pursue a career in medicine.
- Develop a formal, structured advocacy or collaboration effort with organizations like AAMC and the Accreditation Council for Graduate Medical Education designed to promote meaningful increases in the proportion of medical school students and residents who are people of color, and in the proportion who choose primary care – and ultimately, hospital medicine.
- Work hard to collect reliable racial, ethnic and gender information about SHM members and consider collaborating with MGMA to incorporate demographic questions into its survey tool for individual hospitalist compensation and productivity data. Challenge us on the Practice Analysis Committee who are responsible for the SoHM survey to continue surveying leadership demographics, and to consider how we can expand our collection of DEI information in 2022.
- Undertake a public relations campaign to highlight to health systems and other employers the under-representation of Black and Latino hospitalists in leadership positions, and to promote conscious efforts to increase those ranks.
- Create scholarships for hospitalists from underrepresented racial and ethnic groups to attend SHM-sponsored leadership development programs such as Leadership Academy, Academic Hospitalist Academy, and Quality and Safety Educators Academy, with the goal of increasing their ranks in positions of influence throughout healthcare. A scholarship program might even include raising funds to help minority hospitalists pursue Master’s-level programs such as an MBA, MHA, or MMM.
- Develop an educational track, mentoring program, or other support initiative for early-career hospitalist leaders and those interested in developing leadership skills, and ensure it gives specific attention to strategies for increasing the proportion of hospitalists of color in leadership positions.
- Review and revise existing SHM documents such as The Key Principles and Characteristics of an Effective Hospital Medicine Group, the Core Competencies in Hospital Medicine, and various white papers and position statements to ensure they address diversity, equity and inclusion – both with regard to the hospital medicine workforce and leadership, and with regard to patient care and eliminating health disparities.
I’m sure there are plenty of other similar actions we can take that I haven’t thought of. But we need to start the conversation about concrete steps our Society, and the medical specialty we represent, can take to foster real change. And then, we need to follow our words up with actions.
Ms. Flores is a partner at Nelson Flores Hospital Medicine Consultants in La Quinta, Calif. She serves on SHM’s Practice Analysis and Annual Conference Committees and helps to coordinate SHM’s biannual State of Hospital Medicine survey.
Have you ever done something where you’re not quite sure why you did it at the time, but later on you realize it was part of some larger cosmic purpose, and you go, “Ahhh, now I understand…that’s why!”? Call it a fortuitous coincidence. Or a subconscious act of anticipation. Maybe a little push from God.
Last summer, as SHM’s Practice Analysis Committee was planning the State of Hospital Medicine survey for 2020, we received a request from SHM’s Diversity, Equity & Inclusion (DEI) Special Interest Group (SIG) to include a series of questions related to hospitalist gender, race and ethnic distribution in the new survey. We’ve generally resisted doing things like this because the SoHM is designed to capture data at the group level, not the individual level – and honestly, it’s as much as a lot of groups can do to tell us reliably how many FTEs they have, much less provide details about individual providers. In addition, the survey is already really long, and we are always looking for ways to make it shorter and easier for participants while still collecting the information report users care most about.
But we wanted to take the asks from the DEI SIG seriously, and as we considered their request, we realized that though it wasn’t practical to collect this information for individual hospital medicine group (HMG) members, we could collect it for group leaders. Little did we know last summer that issues of gender and racial diversity and equity would be so front-and-center right now, as we prepare to release the 2020 SoHM Report in early September. Ahhh, now I understand…that’s why – with the prompting of the DEI SIG – we so fortuitously chose to include those questions this year!
Here’s a sneak preview of what we learned. Among SoHM respondents, 57.1% reported that the highest-ranking leader in their HMG is White, and 23.5% of highest-ranking leaders are Asian. Only 5.5% of HMG leaders were Black/African American. Ethnicity was a separate question, and only 2.2% of HMG leaders were reported as Hispanic/Latino.
I have been profoundly moved by the wretched deaths of George Floyd and other people of color at the hands of police in recent months, and by the subsequent protests and our growing national reckoning over issues of racial equity and justice. In my efforts to understand more about race in America, I have been challenged by my friend Ryan Brown, MD, specialty medical director for hospital medicine with Atrium Health in Charlotte, N.C., and others to go beyond just learning about these issues. I want to use my voice to advocate for change, and my actions to participate in effecting change, within the context of my sphere of influence.
So, what does that have to do with the SoHM data on HMG leader demographics? Well, it’s clear that Black and brown people are woefully underrepresented in the ranks of hospital medicine leadership.
Unfortunately, we don’t have good information on racial diversity for hospitalists as a specialty, though I understand that SHM is working on plans to update membership profiles to begin collecting this information. In searching the Internet, I found a 2018 paper from the Journal of Health Care for the Poor and Underserved that studied racial and ethnic distribution of U.S. primary care physicians (doi: 10.1353/hpu.2018.0036). It reported that, in 2012, 7.8% of general internists were Black, along with 5.8% of family medicine/general practice physicians and 6.8% of pediatricians. A separate data set issued by the Association of American Medical Colleges reported that, in 2019, 6.4% of all actively practicing general internal medicine doctors were Black (5.5% of male IM physicians and 7.9% of female IM physicians). While this doesn’t mean hospitalists have the same racial and ethnic distribution, this is probably the best proxy we can come up with.
At first glance, having 5.5% of HMG leaders who are Black doesn’t seem terribly out of line with the reported range of 6.4 to 7.8% in the general population of internal medicine physicians (apologies to the family medicine and pediatric hospitalists reading this, but I’ll confine my discussion to internists for ease and brevity, since they represent the vast majority of the nation’s hospitalists). But do the math. It means Black hospitalists are likely underrepresented in HMG leadership ranks by something like 14% to 29% compared to their likely presence among hospitalists in general.
The real problem, of course, is that according the U.S. Census Bureau, 13.4% of the U.S. population is Black. So even if the racial distribution of HMG leaders catches up to the general hospitalist population, hospital medicine is still woefully underrepresenting the racial and ethnic distribution of our patient population.
The disconnect between the ethnic distribution of HMG leaders vs. hospitalists (based on general internal medicine distribution) is even more pronounced for Latinos. The JHCPU paper reported that, in 2012, 5.6% of general internists were Hispanic. The AAMC data set reported 5.8% of IM doctors were Hispanic/Latino. But only 2.2% of SoHM respondent HMGs reported a Hispanic/Latino leader, which means Latinos are underrepresented by somewhere around 61% or so relative to the likely hospitalist population, and by a whole lot more considering the fact that Latinos make up about 18.5% of the U.S. population.
I’m not saying that a White or Asian doctor can’t provide skilled, compassionate care to a Black or Latino patient, or vice-versa. It happens every day. I guess what I am saying is that we as a country and in the medical profession need to do a better job of creating pathways and promoting careers in medicine for people of color. A JAMA paper from 2019 reported that while the numbers and proportions of minority medical school matriculants has slowly been increasing from 2002 to 2017, the rate of increase was “slower than their age-matched counterparts in the U.S. population, resulting in increased underrepresentation” (doi:10.1001/jamanetworkopen.2019.10490). This means we’re falling behind, not catching up.
We need to make sure that people like Dr. Ryan Brown aren’t discouraged from pursuing medicine by teachers or school counselors because of their skin color or accent, or their gender or sexual orientation. And among those who become doctors, we need to promote hospital medicine as a desirable specialty for people of color and actively invite them in.
In my view, much of this starts with creating more and better paths to leadership within hospital medicine for people of color. Hospital medicine group leaders wield enormous – and increasing – influence, not only within their HMGs and within SHM, but within their institutions and health care systems. We need their voices and their influence to promote diversity within their groups, their institutions, within hospital medicine, and within medicine and the U.S. health care system more broadly.
The Society of Hospital Medicine is already taking steps to promote diversity, equity and inclusion. These include issuing a formal Diversity and Inclusion Statement, creating the DEI SIG, and the recent formation of a Board-designated DEI task force charged with making recommendations to promote DEI within SHM and in hospital medicine more broadly. But I want to challenge SHM to do more, particularly with regard to promoting diversity in leadership. Here are a few ideas to consider:
- Create and sponsor a mentoring program in which hospitalists volunteer to mentor minority junior high and high school students and help them prepare to pursue a career in medicine.
- Develop a formal, structured advocacy or collaboration effort with organizations like AAMC and the Accreditation Council for Graduate Medical Education designed to promote meaningful increases in the proportion of medical school students and residents who are people of color, and in the proportion who choose primary care – and ultimately, hospital medicine.
- Work hard to collect reliable racial, ethnic and gender information about SHM members and consider collaborating with MGMA to incorporate demographic questions into its survey tool for individual hospitalist compensation and productivity data. Challenge us on the Practice Analysis Committee who are responsible for the SoHM survey to continue surveying leadership demographics, and to consider how we can expand our collection of DEI information in 2022.
- Undertake a public relations campaign to highlight to health systems and other employers the under-representation of Black and Latino hospitalists in leadership positions, and to promote conscious efforts to increase those ranks.
- Create scholarships for hospitalists from underrepresented racial and ethnic groups to attend SHM-sponsored leadership development programs such as Leadership Academy, Academic Hospitalist Academy, and Quality and Safety Educators Academy, with the goal of increasing their ranks in positions of influence throughout healthcare. A scholarship program might even include raising funds to help minority hospitalists pursue Master’s-level programs such as an MBA, MHA, or MMM.
- Develop an educational track, mentoring program, or other support initiative for early-career hospitalist leaders and those interested in developing leadership skills, and ensure it gives specific attention to strategies for increasing the proportion of hospitalists of color in leadership positions.
- Review and revise existing SHM documents such as The Key Principles and Characteristics of an Effective Hospital Medicine Group, the Core Competencies in Hospital Medicine, and various white papers and position statements to ensure they address diversity, equity and inclusion – both with regard to the hospital medicine workforce and leadership, and with regard to patient care and eliminating health disparities.
I’m sure there are plenty of other similar actions we can take that I haven’t thought of. But we need to start the conversation about concrete steps our Society, and the medical specialty we represent, can take to foster real change. And then, we need to follow our words up with actions.
Ms. Flores is a partner at Nelson Flores Hospital Medicine Consultants in La Quinta, Calif. She serves on SHM’s Practice Analysis and Annual Conference Committees and helps to coordinate SHM’s biannual State of Hospital Medicine survey.
Have you ever done something where you’re not quite sure why you did it at the time, but later on you realize it was part of some larger cosmic purpose, and you go, “Ahhh, now I understand…that’s why!”? Call it a fortuitous coincidence. Or a subconscious act of anticipation. Maybe a little push from God.
Last summer, as SHM’s Practice Analysis Committee was planning the State of Hospital Medicine survey for 2020, we received a request from SHM’s Diversity, Equity & Inclusion (DEI) Special Interest Group (SIG) to include a series of questions related to hospitalist gender, race and ethnic distribution in the new survey. We’ve generally resisted doing things like this because the SoHM is designed to capture data at the group level, not the individual level – and honestly, it’s as much as a lot of groups can do to tell us reliably how many FTEs they have, much less provide details about individual providers. In addition, the survey is already really long, and we are always looking for ways to make it shorter and easier for participants while still collecting the information report users care most about.
But we wanted to take the asks from the DEI SIG seriously, and as we considered their request, we realized that though it wasn’t practical to collect this information for individual hospital medicine group (HMG) members, we could collect it for group leaders. Little did we know last summer that issues of gender and racial diversity and equity would be so front-and-center right now, as we prepare to release the 2020 SoHM Report in early September. Ahhh, now I understand…that’s why – with the prompting of the DEI SIG – we so fortuitously chose to include those questions this year!
Here’s a sneak preview of what we learned. Among SoHM respondents, 57.1% reported that the highest-ranking leader in their HMG is White, and 23.5% of highest-ranking leaders are Asian. Only 5.5% of HMG leaders were Black/African American. Ethnicity was a separate question, and only 2.2% of HMG leaders were reported as Hispanic/Latino.
I have been profoundly moved by the wretched deaths of George Floyd and other people of color at the hands of police in recent months, and by the subsequent protests and our growing national reckoning over issues of racial equity and justice. In my efforts to understand more about race in America, I have been challenged by my friend Ryan Brown, MD, specialty medical director for hospital medicine with Atrium Health in Charlotte, N.C., and others to go beyond just learning about these issues. I want to use my voice to advocate for change, and my actions to participate in effecting change, within the context of my sphere of influence.
So, what does that have to do with the SoHM data on HMG leader demographics? Well, it’s clear that Black and brown people are woefully underrepresented in the ranks of hospital medicine leadership.
Unfortunately, we don’t have good information on racial diversity for hospitalists as a specialty, though I understand that SHM is working on plans to update membership profiles to begin collecting this information. In searching the Internet, I found a 2018 paper from the Journal of Health Care for the Poor and Underserved that studied racial and ethnic distribution of U.S. primary care physicians (doi: 10.1353/hpu.2018.0036). It reported that, in 2012, 7.8% of general internists were Black, along with 5.8% of family medicine/general practice physicians and 6.8% of pediatricians. A separate data set issued by the Association of American Medical Colleges reported that, in 2019, 6.4% of all actively practicing general internal medicine doctors were Black (5.5% of male IM physicians and 7.9% of female IM physicians). While this doesn’t mean hospitalists have the same racial and ethnic distribution, this is probably the best proxy we can come up with.
At first glance, having 5.5% of HMG leaders who are Black doesn’t seem terribly out of line with the reported range of 6.4 to 7.8% in the general population of internal medicine physicians (apologies to the family medicine and pediatric hospitalists reading this, but I’ll confine my discussion to internists for ease and brevity, since they represent the vast majority of the nation’s hospitalists). But do the math. It means Black hospitalists are likely underrepresented in HMG leadership ranks by something like 14% to 29% compared to their likely presence among hospitalists in general.
The real problem, of course, is that according the U.S. Census Bureau, 13.4% of the U.S. population is Black. So even if the racial distribution of HMG leaders catches up to the general hospitalist population, hospital medicine is still woefully underrepresenting the racial and ethnic distribution of our patient population.
The disconnect between the ethnic distribution of HMG leaders vs. hospitalists (based on general internal medicine distribution) is even more pronounced for Latinos. The JHCPU paper reported that, in 2012, 5.6% of general internists were Hispanic. The AAMC data set reported 5.8% of IM doctors were Hispanic/Latino. But only 2.2% of SoHM respondent HMGs reported a Hispanic/Latino leader, which means Latinos are underrepresented by somewhere around 61% or so relative to the likely hospitalist population, and by a whole lot more considering the fact that Latinos make up about 18.5% of the U.S. population.
I’m not saying that a White or Asian doctor can’t provide skilled, compassionate care to a Black or Latino patient, or vice-versa. It happens every day. I guess what I am saying is that we as a country and in the medical profession need to do a better job of creating pathways and promoting careers in medicine for people of color. A JAMA paper from 2019 reported that while the numbers and proportions of minority medical school matriculants has slowly been increasing from 2002 to 2017, the rate of increase was “slower than their age-matched counterparts in the U.S. population, resulting in increased underrepresentation” (doi:10.1001/jamanetworkopen.2019.10490). This means we’re falling behind, not catching up.
We need to make sure that people like Dr. Ryan Brown aren’t discouraged from pursuing medicine by teachers or school counselors because of their skin color or accent, or their gender or sexual orientation. And among those who become doctors, we need to promote hospital medicine as a desirable specialty for people of color and actively invite them in.
In my view, much of this starts with creating more and better paths to leadership within hospital medicine for people of color. Hospital medicine group leaders wield enormous – and increasing – influence, not only within their HMGs and within SHM, but within their institutions and health care systems. We need their voices and their influence to promote diversity within their groups, their institutions, within hospital medicine, and within medicine and the U.S. health care system more broadly.
The Society of Hospital Medicine is already taking steps to promote diversity, equity and inclusion. These include issuing a formal Diversity and Inclusion Statement, creating the DEI SIG, and the recent formation of a Board-designated DEI task force charged with making recommendations to promote DEI within SHM and in hospital medicine more broadly. But I want to challenge SHM to do more, particularly with regard to promoting diversity in leadership. Here are a few ideas to consider:
- Create and sponsor a mentoring program in which hospitalists volunteer to mentor minority junior high and high school students and help them prepare to pursue a career in medicine.
- Develop a formal, structured advocacy or collaboration effort with organizations like AAMC and the Accreditation Council for Graduate Medical Education designed to promote meaningful increases in the proportion of medical school students and residents who are people of color, and in the proportion who choose primary care – and ultimately, hospital medicine.
- Work hard to collect reliable racial, ethnic and gender information about SHM members and consider collaborating with MGMA to incorporate demographic questions into its survey tool for individual hospitalist compensation and productivity data. Challenge us on the Practice Analysis Committee who are responsible for the SoHM survey to continue surveying leadership demographics, and to consider how we can expand our collection of DEI information in 2022.
- Undertake a public relations campaign to highlight to health systems and other employers the under-representation of Black and Latino hospitalists in leadership positions, and to promote conscious efforts to increase those ranks.
- Create scholarships for hospitalists from underrepresented racial and ethnic groups to attend SHM-sponsored leadership development programs such as Leadership Academy, Academic Hospitalist Academy, and Quality and Safety Educators Academy, with the goal of increasing their ranks in positions of influence throughout healthcare. A scholarship program might even include raising funds to help minority hospitalists pursue Master’s-level programs such as an MBA, MHA, or MMM.
- Develop an educational track, mentoring program, or other support initiative for early-career hospitalist leaders and those interested in developing leadership skills, and ensure it gives specific attention to strategies for increasing the proportion of hospitalists of color in leadership positions.
- Review and revise existing SHM documents such as The Key Principles and Characteristics of an Effective Hospital Medicine Group, the Core Competencies in Hospital Medicine, and various white papers and position statements to ensure they address diversity, equity and inclusion – both with regard to the hospital medicine workforce and leadership, and with regard to patient care and eliminating health disparities.
I’m sure there are plenty of other similar actions we can take that I haven’t thought of. But we need to start the conversation about concrete steps our Society, and the medical specialty we represent, can take to foster real change. And then, we need to follow our words up with actions.
Ms. Flores is a partner at Nelson Flores Hospital Medicine Consultants in La Quinta, Calif. She serves on SHM’s Practice Analysis and Annual Conference Committees and helps to coordinate SHM’s biannual State of Hospital Medicine survey.
Calendar
For more information about upcoming events and award deadlines, please visit http://agau.gastro.org and http://www.gastro.org/research-funding.
UPCOMING EVENTS
Jan. 15-17, 2021
Gastrointestinal Cancers Symposium
Through an engaging lineup of novel science, education, and exhibits, the virtual 2021 Gastrointestinal (GI) Cancers Symposium offers new, innovative findings in GI cancer treatment, research, and care.
Early-bird deadline: Dec. 16, 2020.
Jan. 21-24, 2021
Crohn’s & Colitis Congress®Join health care professionals and researchers virtually at the Crohn’s & Colitis Congress® for the premier conference on IBD. Discover different perspectives, practical information you can immediately implement, and potential treatments on the horizon.
Early-bird deadline: Friday, Nov. 6, 2020.
May 21-23, 2021
Digestive Disease Week® (DDW)
Save the date for the world’s leading event in digestive disease. DDW® brings professionals in gastroenterology, hepatology, endoscopy, and GI surgery together. Experience growth when you share your research, converge with trailblazers, and improve the lives of patients suffering from GI and liver diseases.
Abstract submission window Oct. 15 to Dec. 3, 2020.
AWARD DEADLINES
American Gastroenterological Association (AGA) Student Abstract Award
This $500 travel award supports recipients who are graduate students, medical students,or medical residents (residents up to postgraduate year 3) giving abstract-based oral or poster presentations at Digestive Disease Week® (DDW). The top-scoring abstract will be designated the Student Abstract of the Year and receive a $1,000 award.
Application deadline: Feb. 24, 2021
AGA–Moti L. & Kamla Rustgi International Travel Awards
This $750 travel award provides support to early-career (that is, 35 years of age or younger at the time of DDW) basic, translational or clinical investigators residing outside North America to offset travel and related expenses to attend DDW.
Application deadline: Feb. 24, 2021
AGA Fellow Abstract Award
This $500 travel award supports recipients who are MD, PhD, or equivalent fellows giving abstract-based oral or poster presentations DDW. The top-scoring abstract will be designated the Fellow Abstract of the Year and receive a $1,000 award.
Application deadline: Feb. 24, 2021
For more information about upcoming events and award deadlines, please visit http://agau.gastro.org and http://www.gastro.org/research-funding.
UPCOMING EVENTS
Jan. 15-17, 2021
Gastrointestinal Cancers Symposium
Through an engaging lineup of novel science, education, and exhibits, the virtual 2021 Gastrointestinal (GI) Cancers Symposium offers new, innovative findings in GI cancer treatment, research, and care.
Early-bird deadline: Dec. 16, 2020.
Jan. 21-24, 2021
Crohn’s & Colitis Congress®Join health care professionals and researchers virtually at the Crohn’s & Colitis Congress® for the premier conference on IBD. Discover different perspectives, practical information you can immediately implement, and potential treatments on the horizon.
Early-bird deadline: Friday, Nov. 6, 2020.
May 21-23, 2021
Digestive Disease Week® (DDW)
Save the date for the world’s leading event in digestive disease. DDW® brings professionals in gastroenterology, hepatology, endoscopy, and GI surgery together. Experience growth when you share your research, converge with trailblazers, and improve the lives of patients suffering from GI and liver diseases.
Abstract submission window Oct. 15 to Dec. 3, 2020.
AWARD DEADLINES
American Gastroenterological Association (AGA) Student Abstract Award
This $500 travel award supports recipients who are graduate students, medical students,or medical residents (residents up to postgraduate year 3) giving abstract-based oral or poster presentations at Digestive Disease Week® (DDW). The top-scoring abstract will be designated the Student Abstract of the Year and receive a $1,000 award.
Application deadline: Feb. 24, 2021
AGA–Moti L. & Kamla Rustgi International Travel Awards
This $750 travel award provides support to early-career (that is, 35 years of age or younger at the time of DDW) basic, translational or clinical investigators residing outside North America to offset travel and related expenses to attend DDW.
Application deadline: Feb. 24, 2021
AGA Fellow Abstract Award
This $500 travel award supports recipients who are MD, PhD, or equivalent fellows giving abstract-based oral or poster presentations DDW. The top-scoring abstract will be designated the Fellow Abstract of the Year and receive a $1,000 award.
Application deadline: Feb. 24, 2021
For more information about upcoming events and award deadlines, please visit http://agau.gastro.org and http://www.gastro.org/research-funding.
UPCOMING EVENTS
Jan. 15-17, 2021
Gastrointestinal Cancers Symposium
Through an engaging lineup of novel science, education, and exhibits, the virtual 2021 Gastrointestinal (GI) Cancers Symposium offers new, innovative findings in GI cancer treatment, research, and care.
Early-bird deadline: Dec. 16, 2020.
Jan. 21-24, 2021
Crohn’s & Colitis Congress®Join health care professionals and researchers virtually at the Crohn’s & Colitis Congress® for the premier conference on IBD. Discover different perspectives, practical information you can immediately implement, and potential treatments on the horizon.
Early-bird deadline: Friday, Nov. 6, 2020.
May 21-23, 2021
Digestive Disease Week® (DDW)
Save the date for the world’s leading event in digestive disease. DDW® brings professionals in gastroenterology, hepatology, endoscopy, and GI surgery together. Experience growth when you share your research, converge with trailblazers, and improve the lives of patients suffering from GI and liver diseases.
Abstract submission window Oct. 15 to Dec. 3, 2020.
AWARD DEADLINES
American Gastroenterological Association (AGA) Student Abstract Award
This $500 travel award supports recipients who are graduate students, medical students,or medical residents (residents up to postgraduate year 3) giving abstract-based oral or poster presentations at Digestive Disease Week® (DDW). The top-scoring abstract will be designated the Student Abstract of the Year and receive a $1,000 award.
Application deadline: Feb. 24, 2021
AGA–Moti L. & Kamla Rustgi International Travel Awards
This $750 travel award provides support to early-career (that is, 35 years of age or younger at the time of DDW) basic, translational or clinical investigators residing outside North America to offset travel and related expenses to attend DDW.
Application deadline: Feb. 24, 2021
AGA Fellow Abstract Award
This $500 travel award supports recipients who are MD, PhD, or equivalent fellows giving abstract-based oral or poster presentations DDW. The top-scoring abstract will be designated the Fellow Abstract of the Year and receive a $1,000 award.
Application deadline: Feb. 24, 2021
Hospitalists and unit-based assignments
What seems like a usual day to a seasoned hospitalist can be a daunting task for a new hospitalist. A routine day as a hospitalist begins with prerounding, organizing, familiarizing, and gathering data on the list of patients, and most importantly prioritizing the tasks for the day. I have experienced both traditional and unit-based rounding models, and the geographic (unit-based) rounding model stands out for me.
The push for geographic rounding comes from the need to achieve excellence in patient care, coordination with nursing staff, higher HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores, better provider satisfaction, and efficiency in work flow and in documentation. The goal is typically to use this well-established tool to provide quality care to acutely ill patients admitted to the hospital, creating an environment of improved communication with the staff. It’s a “patient-centered care” model – if the patient wants to see a physician, it’s quicker to get to the patient and provides more visibility for the physician. These encounters result in improved patient-provider relationships, which in turn influences HCAHPS scores. Proximity encourages empathy, better work flow, and productivity.
The American health care system is intense and complex, and effective hospital medicine groups (HMGs) strive to provide quality care. Performance of an effective HMG is often scored on a “balanced score card.” The “balanced score” evaluates performance on domains such as clinical quality and safety, financial stability, HCAHPS, and operational effectiveness (length of stay and readmission rates). In my experience, effective unit-based rounding positively influences all the measures of the balanced score card.
Multidisciplinary roundings (MDRs) provide a platform where “the team” meets every morning to discuss the daily plan of care, everyone gets on the same page, and unit-based assignments facilitate hospitalist participation in MDRs. MDRs typically are a collaborative effort between care team members, such as a case manager, nurse, and hospitalist, physical therapist, and pharmacist. Each team member provides a precise input. Team members feel accountable and are better prepared for the day. It’s easier to develop a rapport with your patient when the same organized, comprehensive plan of care gets communicated to the patient.
It is important that each team member is prepared prior to the rounds. The total time for the rounds is often tightly controlled, as a fundamental concern is that MDRs can take up too much time. Use of a checklist or whiteboard during the unit-based rounds can improve efficiency. Midday MDRs are another gem in patient care, where the team proactively addresses early barriers in patient care and discharge plans for the next day.
The 2020 State of Hospital Medicine report highlights utilization of unit-based rounding, including breakdowns based on employment model. In groups serving adults patients only, 43% of university/medical school practices utilized unit-based assignments versus 48% for hospital-employed HMGs and only 32% for HMGs employed by multistate management companies. In HMGs that served pediatric patients only, 27% utilized unit-based assignments.
Undoubtedly geographic rounding has its own challenges. The pros and cons and the feasibility needs to be determined by each HMG. It’s often best to conduct the unit-based rounds on a few units and then roll it out to all the floors.
An important prerequisite to establishing a unit-based model for rounding is a detailed data analysis of total number of patients in various units to ensure there is adequate staffing. It must be practical to localize providers to different units, and complexity of various units can differ. At Lahey Hospital and Medical Center in Burlington, Mass., an efficient unit-based model has been achieved with complex units typically assigned two providers. Units including oncology and the progressive care unit can be a challenge, because of higher intensity and patient turnover.
Each unit is tagged to another unit in the same geographical area; these units are designated “sister pods.” The intention of these units is to strike a balance and level off patient load when needed. This process helps with standardization of the work between the providers. A big challenge of the unit-based model is to understand that it’s not always feasible to maintain consistency in patient assignments. Some patients can get transferred to a different unit due to limited telemetry and specialty units. At Lahey the provider manages their own patient as “patient drift” happens, in an attempt to maintain continuity of care.
The ultimate goal of unit-based assignments is to improve quality, financial, and operational metrics for the organization and take a deeper dive into provider and staff satisfaction. The simplest benefit for a hospitalist is to reduce travel time while rounding.
Education and teaching opportunities during the daily MDRs are still debatable. Another big step in this area may be a “resident-centered MDR” with the dual goals of improving both quality of care and resident education by focusing on evidence-based medicine.
Dr. Puri is a hospitalist at Lahey Hospital and Medical Center in Burlington, Mass.
What seems like a usual day to a seasoned hospitalist can be a daunting task for a new hospitalist. A routine day as a hospitalist begins with prerounding, organizing, familiarizing, and gathering data on the list of patients, and most importantly prioritizing the tasks for the day. I have experienced both traditional and unit-based rounding models, and the geographic (unit-based) rounding model stands out for me.
The push for geographic rounding comes from the need to achieve excellence in patient care, coordination with nursing staff, higher HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores, better provider satisfaction, and efficiency in work flow and in documentation. The goal is typically to use this well-established tool to provide quality care to acutely ill patients admitted to the hospital, creating an environment of improved communication with the staff. It’s a “patient-centered care” model – if the patient wants to see a physician, it’s quicker to get to the patient and provides more visibility for the physician. These encounters result in improved patient-provider relationships, which in turn influences HCAHPS scores. Proximity encourages empathy, better work flow, and productivity.
The American health care system is intense and complex, and effective hospital medicine groups (HMGs) strive to provide quality care. Performance of an effective HMG is often scored on a “balanced score card.” The “balanced score” evaluates performance on domains such as clinical quality and safety, financial stability, HCAHPS, and operational effectiveness (length of stay and readmission rates). In my experience, effective unit-based rounding positively influences all the measures of the balanced score card.
Multidisciplinary roundings (MDRs) provide a platform where “the team” meets every morning to discuss the daily plan of care, everyone gets on the same page, and unit-based assignments facilitate hospitalist participation in MDRs. MDRs typically are a collaborative effort between care team members, such as a case manager, nurse, and hospitalist, physical therapist, and pharmacist. Each team member provides a precise input. Team members feel accountable and are better prepared for the day. It’s easier to develop a rapport with your patient when the same organized, comprehensive plan of care gets communicated to the patient.
It is important that each team member is prepared prior to the rounds. The total time for the rounds is often tightly controlled, as a fundamental concern is that MDRs can take up too much time. Use of a checklist or whiteboard during the unit-based rounds can improve efficiency. Midday MDRs are another gem in patient care, where the team proactively addresses early barriers in patient care and discharge plans for the next day.
The 2020 State of Hospital Medicine report highlights utilization of unit-based rounding, including breakdowns based on employment model. In groups serving adults patients only, 43% of university/medical school practices utilized unit-based assignments versus 48% for hospital-employed HMGs and only 32% for HMGs employed by multistate management companies. In HMGs that served pediatric patients only, 27% utilized unit-based assignments.
Undoubtedly geographic rounding has its own challenges. The pros and cons and the feasibility needs to be determined by each HMG. It’s often best to conduct the unit-based rounds on a few units and then roll it out to all the floors.
An important prerequisite to establishing a unit-based model for rounding is a detailed data analysis of total number of patients in various units to ensure there is adequate staffing. It must be practical to localize providers to different units, and complexity of various units can differ. At Lahey Hospital and Medical Center in Burlington, Mass., an efficient unit-based model has been achieved with complex units typically assigned two providers. Units including oncology and the progressive care unit can be a challenge, because of higher intensity and patient turnover.
Each unit is tagged to another unit in the same geographical area; these units are designated “sister pods.” The intention of these units is to strike a balance and level off patient load when needed. This process helps with standardization of the work between the providers. A big challenge of the unit-based model is to understand that it’s not always feasible to maintain consistency in patient assignments. Some patients can get transferred to a different unit due to limited telemetry and specialty units. At Lahey the provider manages their own patient as “patient drift” happens, in an attempt to maintain continuity of care.
The ultimate goal of unit-based assignments is to improve quality, financial, and operational metrics for the organization and take a deeper dive into provider and staff satisfaction. The simplest benefit for a hospitalist is to reduce travel time while rounding.
Education and teaching opportunities during the daily MDRs are still debatable. Another big step in this area may be a “resident-centered MDR” with the dual goals of improving both quality of care and resident education by focusing on evidence-based medicine.
Dr. Puri is a hospitalist at Lahey Hospital and Medical Center in Burlington, Mass.
What seems like a usual day to a seasoned hospitalist can be a daunting task for a new hospitalist. A routine day as a hospitalist begins with prerounding, organizing, familiarizing, and gathering data on the list of patients, and most importantly prioritizing the tasks for the day. I have experienced both traditional and unit-based rounding models, and the geographic (unit-based) rounding model stands out for me.
The push for geographic rounding comes from the need to achieve excellence in patient care, coordination with nursing staff, higher HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores, better provider satisfaction, and efficiency in work flow and in documentation. The goal is typically to use this well-established tool to provide quality care to acutely ill patients admitted to the hospital, creating an environment of improved communication with the staff. It’s a “patient-centered care” model – if the patient wants to see a physician, it’s quicker to get to the patient and provides more visibility for the physician. These encounters result in improved patient-provider relationships, which in turn influences HCAHPS scores. Proximity encourages empathy, better work flow, and productivity.
The American health care system is intense and complex, and effective hospital medicine groups (HMGs) strive to provide quality care. Performance of an effective HMG is often scored on a “balanced score card.” The “balanced score” evaluates performance on domains such as clinical quality and safety, financial stability, HCAHPS, and operational effectiveness (length of stay and readmission rates). In my experience, effective unit-based rounding positively influences all the measures of the balanced score card.
Multidisciplinary roundings (MDRs) provide a platform where “the team” meets every morning to discuss the daily plan of care, everyone gets on the same page, and unit-based assignments facilitate hospitalist participation in MDRs. MDRs typically are a collaborative effort between care team members, such as a case manager, nurse, and hospitalist, physical therapist, and pharmacist. Each team member provides a precise input. Team members feel accountable and are better prepared for the day. It’s easier to develop a rapport with your patient when the same organized, comprehensive plan of care gets communicated to the patient.
It is important that each team member is prepared prior to the rounds. The total time for the rounds is often tightly controlled, as a fundamental concern is that MDRs can take up too much time. Use of a checklist or whiteboard during the unit-based rounds can improve efficiency. Midday MDRs are another gem in patient care, where the team proactively addresses early barriers in patient care and discharge plans for the next day.
The 2020 State of Hospital Medicine report highlights utilization of unit-based rounding, including breakdowns based on employment model. In groups serving adults patients only, 43% of university/medical school practices utilized unit-based assignments versus 48% for hospital-employed HMGs and only 32% for HMGs employed by multistate management companies. In HMGs that served pediatric patients only, 27% utilized unit-based assignments.
Undoubtedly geographic rounding has its own challenges. The pros and cons and the feasibility needs to be determined by each HMG. It’s often best to conduct the unit-based rounds on a few units and then roll it out to all the floors.
An important prerequisite to establishing a unit-based model for rounding is a detailed data analysis of total number of patients in various units to ensure there is adequate staffing. It must be practical to localize providers to different units, and complexity of various units can differ. At Lahey Hospital and Medical Center in Burlington, Mass., an efficient unit-based model has been achieved with complex units typically assigned two providers. Units including oncology and the progressive care unit can be a challenge, because of higher intensity and patient turnover.
Each unit is tagged to another unit in the same geographical area; these units are designated “sister pods.” The intention of these units is to strike a balance and level off patient load when needed. This process helps with standardization of the work between the providers. A big challenge of the unit-based model is to understand that it’s not always feasible to maintain consistency in patient assignments. Some patients can get transferred to a different unit due to limited telemetry and specialty units. At Lahey the provider manages their own patient as “patient drift” happens, in an attempt to maintain continuity of care.
The ultimate goal of unit-based assignments is to improve quality, financial, and operational metrics for the organization and take a deeper dive into provider and staff satisfaction. The simplest benefit for a hospitalist is to reduce travel time while rounding.
Education and teaching opportunities during the daily MDRs are still debatable. Another big step in this area may be a “resident-centered MDR” with the dual goals of improving both quality of care and resident education by focusing on evidence-based medicine.
Dr. Puri is a hospitalist at Lahey Hospital and Medical Center in Burlington, Mass.
Fecal transplant linked to reduced C. difficile mortality
Vancomycin followed by fecal microbiota transplant (FMT) was associated with reduced Clostridioides difficile (C. diff)-related mortality in patients hospitalized with refractory severe or fulminant C. diff infection (CDI) at a single center. The improvements came after Indiana University implemented an FMT option in 2013.
About 8% of C. diff patients develop severe or fulminant CDI (SFCDI), which can lead to toxic colon and multiorgan failure. Surgery is the current recommended treatment for these patients if they are refractory to vancomycin, but 30-day mortality is above 40%. FMT is recommended for recurrent CDI, and it achieves cure rates greater than 80%, along with fewer relapses compared with anti-CDI antibiotic therapy.
FMT has been shown to be effective for SFCDI, with a 91% cure rate for serious CDI and 66% for fulminant CDI.
In the study published in the September issue of Clinical Gastroenterology and Hepatology, researchers led by Yao-Wen Cheng, MD, and Monika Fischer, MD, of Indiana University, assessed the effect of FMT on SFCDI after their institution adopted it as a treatment protocol for SFCDI. Patients could receive FMT if there was evidence that their SFCDI was refractory, or if they had two or more CDI recurrences. The treatment includes oral vancomycin and pseudomembrane-driven sequential FMT.
Two hundred five patients were admitted before FMT implementation, 225 after. Fifty patients received FMT because of refractory SFCDI. A median of two FMTs was conducted per patient. 21 other patients received FMT for nonrefractory SFCDI or other conditions, including 18 patients with multiple recurrent CDI.
Thirty-day CDI-related mortality dropped after FMT implementation (4.4% versus 10.2%; P =.02). This was true in both the fulminant subset (9.1% versus 21.3%; P =.015) and the refractory group (12.1% versus 43.2%; P < .001).
The researchers used segmented logistic regression to determine if the improved outcomes could be due to nontreatment factors that varied over time, and found that the difference in CDI-related mortality was eliminated except for refractory SFCDI patients (odds of mortality after FMT implementation, 0.09; P =.023). There was no significant difference between those receiving non-CDI antibiotics (4.8%) and those who did not (6.9%; P =.75).
FMT was associated with lower frequency of CDI-related colectomy overall (2.7% versus 6.8%; P =.041), as well as in the fulminant (5.5% versus 15.7%; P =.017) and refractory subgroups (7.6% versus 31.8%; P =.001).
The findings follow another study that showed improved 3-month mortality for FMT among patients hospitalized with severe CDI (12.1% versus 42.2%; P < .003).
The results underscore the utility of FMT for SFCDI, and suggest it might have the most benefit in refractory SFCDI. The authors believe that FMT should be an alternative to colectomy when first-line anti-CDI antibiotics are partially or completely ineffective. In the absence of FMT, patients who go on to fail vancomycin or fidaxomicin will likely continue to be managed medically, with up to 80% mortality, or through salvage colectomy, with postsurgical morality rates of 30-40%.
Although a randomized trial could answer the question of FMT efficacy more definitively, it is unlikely to be conducted for ethical reasons.
“Further investigation is required to clearly define FMT’s role and timing in the clinical course of severe and fulminant CDI. However, our study suggests that FMT should be offered to patients with severe and fulminant CDI who do not respond to a 5-day course of anti-CDI antibiotics and may be considered in lieu of or before colectomy,” the researchers wrote.
No source of funding was disclosed.
SOURCE: Cheng YW et al. Clin Gastroenterol Hepatol. 2020;18:2234-43. doi: 10.1016/j.cgh.2019.12.029.
Vancomycin followed by fecal microbiota transplant (FMT) was associated with reduced Clostridioides difficile (C. diff)-related mortality in patients hospitalized with refractory severe or fulminant C. diff infection (CDI) at a single center. The improvements came after Indiana University implemented an FMT option in 2013.
About 8% of C. diff patients develop severe or fulminant CDI (SFCDI), which can lead to toxic colon and multiorgan failure. Surgery is the current recommended treatment for these patients if they are refractory to vancomycin, but 30-day mortality is above 40%. FMT is recommended for recurrent CDI, and it achieves cure rates greater than 80%, along with fewer relapses compared with anti-CDI antibiotic therapy.
FMT has been shown to be effective for SFCDI, with a 91% cure rate for serious CDI and 66% for fulminant CDI.
In the study published in the September issue of Clinical Gastroenterology and Hepatology, researchers led by Yao-Wen Cheng, MD, and Monika Fischer, MD, of Indiana University, assessed the effect of FMT on SFCDI after their institution adopted it as a treatment protocol for SFCDI. Patients could receive FMT if there was evidence that their SFCDI was refractory, or if they had two or more CDI recurrences. The treatment includes oral vancomycin and pseudomembrane-driven sequential FMT.
Two hundred five patients were admitted before FMT implementation, 225 after. Fifty patients received FMT because of refractory SFCDI. A median of two FMTs was conducted per patient. 21 other patients received FMT for nonrefractory SFCDI or other conditions, including 18 patients with multiple recurrent CDI.
Thirty-day CDI-related mortality dropped after FMT implementation (4.4% versus 10.2%; P =.02). This was true in both the fulminant subset (9.1% versus 21.3%; P =.015) and the refractory group (12.1% versus 43.2%; P < .001).
The researchers used segmented logistic regression to determine if the improved outcomes could be due to nontreatment factors that varied over time, and found that the difference in CDI-related mortality was eliminated except for refractory SFCDI patients (odds of mortality after FMT implementation, 0.09; P =.023). There was no significant difference between those receiving non-CDI antibiotics (4.8%) and those who did not (6.9%; P =.75).
FMT was associated with lower frequency of CDI-related colectomy overall (2.7% versus 6.8%; P =.041), as well as in the fulminant (5.5% versus 15.7%; P =.017) and refractory subgroups (7.6% versus 31.8%; P =.001).
The findings follow another study that showed improved 3-month mortality for FMT among patients hospitalized with severe CDI (12.1% versus 42.2%; P < .003).
The results underscore the utility of FMT for SFCDI, and suggest it might have the most benefit in refractory SFCDI. The authors believe that FMT should be an alternative to colectomy when first-line anti-CDI antibiotics are partially or completely ineffective. In the absence of FMT, patients who go on to fail vancomycin or fidaxomicin will likely continue to be managed medically, with up to 80% mortality, or through salvage colectomy, with postsurgical morality rates of 30-40%.
Although a randomized trial could answer the question of FMT efficacy more definitively, it is unlikely to be conducted for ethical reasons.
“Further investigation is required to clearly define FMT’s role and timing in the clinical course of severe and fulminant CDI. However, our study suggests that FMT should be offered to patients with severe and fulminant CDI who do not respond to a 5-day course of anti-CDI antibiotics and may be considered in lieu of or before colectomy,” the researchers wrote.
No source of funding was disclosed.
SOURCE: Cheng YW et al. Clin Gastroenterol Hepatol. 2020;18:2234-43. doi: 10.1016/j.cgh.2019.12.029.
Vancomycin followed by fecal microbiota transplant (FMT) was associated with reduced Clostridioides difficile (C. diff)-related mortality in patients hospitalized with refractory severe or fulminant C. diff infection (CDI) at a single center. The improvements came after Indiana University implemented an FMT option in 2013.
About 8% of C. diff patients develop severe or fulminant CDI (SFCDI), which can lead to toxic colon and multiorgan failure. Surgery is the current recommended treatment for these patients if they are refractory to vancomycin, but 30-day mortality is above 40%. FMT is recommended for recurrent CDI, and it achieves cure rates greater than 80%, along with fewer relapses compared with anti-CDI antibiotic therapy.
FMT has been shown to be effective for SFCDI, with a 91% cure rate for serious CDI and 66% for fulminant CDI.
In the study published in the September issue of Clinical Gastroenterology and Hepatology, researchers led by Yao-Wen Cheng, MD, and Monika Fischer, MD, of Indiana University, assessed the effect of FMT on SFCDI after their institution adopted it as a treatment protocol for SFCDI. Patients could receive FMT if there was evidence that their SFCDI was refractory, or if they had two or more CDI recurrences. The treatment includes oral vancomycin and pseudomembrane-driven sequential FMT.
Two hundred five patients were admitted before FMT implementation, 225 after. Fifty patients received FMT because of refractory SFCDI. A median of two FMTs was conducted per patient. 21 other patients received FMT for nonrefractory SFCDI or other conditions, including 18 patients with multiple recurrent CDI.
Thirty-day CDI-related mortality dropped after FMT implementation (4.4% versus 10.2%; P =.02). This was true in both the fulminant subset (9.1% versus 21.3%; P =.015) and the refractory group (12.1% versus 43.2%; P < .001).
The researchers used segmented logistic regression to determine if the improved outcomes could be due to nontreatment factors that varied over time, and found that the difference in CDI-related mortality was eliminated except for refractory SFCDI patients (odds of mortality after FMT implementation, 0.09; P =.023). There was no significant difference between those receiving non-CDI antibiotics (4.8%) and those who did not (6.9%; P =.75).
FMT was associated with lower frequency of CDI-related colectomy overall (2.7% versus 6.8%; P =.041), as well as in the fulminant (5.5% versus 15.7%; P =.017) and refractory subgroups (7.6% versus 31.8%; P =.001).
The findings follow another study that showed improved 3-month mortality for FMT among patients hospitalized with severe CDI (12.1% versus 42.2%; P < .003).
The results underscore the utility of FMT for SFCDI, and suggest it might have the most benefit in refractory SFCDI. The authors believe that FMT should be an alternative to colectomy when first-line anti-CDI antibiotics are partially or completely ineffective. In the absence of FMT, patients who go on to fail vancomycin or fidaxomicin will likely continue to be managed medically, with up to 80% mortality, or through salvage colectomy, with postsurgical morality rates of 30-40%.
Although a randomized trial could answer the question of FMT efficacy more definitively, it is unlikely to be conducted for ethical reasons.
“Further investigation is required to clearly define FMT’s role and timing in the clinical course of severe and fulminant CDI. However, our study suggests that FMT should be offered to patients with severe and fulminant CDI who do not respond to a 5-day course of anti-CDI antibiotics and may be considered in lieu of or before colectomy,” the researchers wrote.
No source of funding was disclosed.
SOURCE: Cheng YW et al. Clin Gastroenterol Hepatol. 2020;18:2234-43. doi: 10.1016/j.cgh.2019.12.029.
FROM CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
November 2020 – ICYMI
Gastroenterology
July 2020
Role of cannabis and its derivatives in gastrointestinal and hepatic disease. Jonathan Gotfried et al. 2020 July;159(1):62-80. doi: 10.1053/j.gastro.2020.03.087
Effects of blended (yellow) vs forced coagulation (blue) currents on adverse events, complete resection, or polyp recurrence after polypectomy in a large randomized trial. Heiko Pohl et al. 2020 July;159(1):119-28.e2. doi: 10.1053/j.gastro.2020.03.014
Calculating the starting age for screening in relatives of patients with colorectal cancer based on data from large nationwide data sets.
Yu Tian et al. July 2020;159(1):159-168.e3. doi: 10.1053/j.gastro.2020.03.063
August 2020
Corticosteroids, but not TNF antagonists, are associated with adverse COVID-19 outcomes in patients with inflammatory bowel diseases: results from an international registry. Erica J. Brenner et al. 2020 Aug 159;(2):481-91.e3. doi: 10.1053/j.gastro.2020.05.032
Collagenous colitis is associated with HLA signature and shares genetic risks with other immune-mediated diseases. Eli Stahl et al. 2020 Aug;159(2):549-61.e8. doi: 10.1053/j.gastro.2020.04.063
Efficacy of real-time computer-aided detection of colorectal neoplasia in a randomized trial. Alessandro Repici et al. 2020 Aug;159(2):512-20.e7. doi: 10.1053/j.gastro.2020.04.062
September 2020
Dietary inflammatory potential and risk of Crohn’s disease and ulcerative colitis. Chun-Han Lo et al. 2020 Sept;159(3):p873-83.e1. doi: 10.1053/j.gastro.2020.05.011
Rates of incomplete resection of 1- to 20-mm colorectal polyps: A systematic review and meta-analysis. Roupen Djinbachian et al. 2020 Sept;159(3):904-14.e12. doi: 10.1053/j.gastro.2020.05.018
Clinical Gastroenterology and Hepatology
August 2020
Prevalence and characteristics of avoidant/restrictive food intake disorder in adult neurogastroenterology patients. Helen Burton Murray et al. 2020 Aug;18(9):1995-2002.e1. doi: 10.1016/j.cgh.2019.10.030
Ten things every gastroenterologist should know about antireflux surgery. Steven Park et al. 2020 Aug;18(9):1923-9. doi: 10.1016/j.cgh.2020.02.041
Biopsies from ascending and descending colon are sufficient for diagnosis of microscopic colitis. Boris Virine et al. 2020 Aug;18(9):2003-9. doi: 10.1016/j.cgh.2020.02.036
September 2020
Association between endoscopist annual procedure volume and colonoscopy quality: Systematic review and meta-analysis. Nauzer Forbes et al. 2020 Sept:18(10):2192-208.e12. doi: 10.1016/j.cgh.2020.03.046
Plans to reactivate gastroenterology practices following the COVID-19 pandemic: A survey of North American centers. Vladimir M. Kushnir et al on Behalf of the North American Alliance for the Study of Digestive Manifestations of COVID-19. 2020 Sept;18(10):2287-94.e1. doi: 10.1016/j.cgh.2020.05.030
Cost effectiveness of different strategies for detecting cirrhosis in patients with nonalcoholic fatty liver disease based on United States health care system. Eduardo Vilar-Gomez et al. 2020 Sept;18(10):2305-14.e12. doi: 10.1016/j.cgh.2020.04.017
October 2020
AGA Clinical Practice Update on young adult–onset colorectal cancer diagnosis and management: Expert review. Lisa A. Boardman et al. 2020 Oct:18(11):2415-24. doi: 10.1016/j.cgh.2020.05.058
Frequency of eating disorder pathology among patients with chronic constipation and contribution of gastrointestinal-specific anxiety. Helen Burton Murray et al. 2020 Oct;18(11):2471-8. doi: 10.1016/j.cgh.2019.12.030
Correction of dyssynergic defecation, but not fiber supplementation, reduces symptoms of functional dyspepsia in patients with constipation in a randomized trial. Jose-Walter Huaman et al. 2020 Oct;18(11):2463-70.e1. doi: 10.1016/j.cgh.2019.11.048
Cellular and Molecular Gastroenterology and Hepatology
A new treatment for chronic hepatitis B and D offers novel insights into obesity and hepatic steatosis. Robert Schierwagen et al. 2020;10(3):649-51. doi: 10.1016/j.jcmgh.2020.05.011
Techniques and Innovations in Gastrointestinal Endoscopy
The impact of endoscopic submucosal dissection for gastric adenocarcinomas in the United States. Shria Kumar et al. 2020 July:22(3):93-8. doi: 10.1016/j.tige.2020.03.009
Gastroenterology
July 2020
Role of cannabis and its derivatives in gastrointestinal and hepatic disease. Jonathan Gotfried et al. 2020 July;159(1):62-80. doi: 10.1053/j.gastro.2020.03.087
Effects of blended (yellow) vs forced coagulation (blue) currents on adverse events, complete resection, or polyp recurrence after polypectomy in a large randomized trial. Heiko Pohl et al. 2020 July;159(1):119-28.e2. doi: 10.1053/j.gastro.2020.03.014
Calculating the starting age for screening in relatives of patients with colorectal cancer based on data from large nationwide data sets.
Yu Tian et al. July 2020;159(1):159-168.e3. doi: 10.1053/j.gastro.2020.03.063
August 2020
Corticosteroids, but not TNF antagonists, are associated with adverse COVID-19 outcomes in patients with inflammatory bowel diseases: results from an international registry. Erica J. Brenner et al. 2020 Aug 159;(2):481-91.e3. doi: 10.1053/j.gastro.2020.05.032
Collagenous colitis is associated with HLA signature and shares genetic risks with other immune-mediated diseases. Eli Stahl et al. 2020 Aug;159(2):549-61.e8. doi: 10.1053/j.gastro.2020.04.063
Efficacy of real-time computer-aided detection of colorectal neoplasia in a randomized trial. Alessandro Repici et al. 2020 Aug;159(2):512-20.e7. doi: 10.1053/j.gastro.2020.04.062
September 2020
Dietary inflammatory potential and risk of Crohn’s disease and ulcerative colitis. Chun-Han Lo et al. 2020 Sept;159(3):p873-83.e1. doi: 10.1053/j.gastro.2020.05.011
Rates of incomplete resection of 1- to 20-mm colorectal polyps: A systematic review and meta-analysis. Roupen Djinbachian et al. 2020 Sept;159(3):904-14.e12. doi: 10.1053/j.gastro.2020.05.018
Clinical Gastroenterology and Hepatology
August 2020
Prevalence and characteristics of avoidant/restrictive food intake disorder in adult neurogastroenterology patients. Helen Burton Murray et al. 2020 Aug;18(9):1995-2002.e1. doi: 10.1016/j.cgh.2019.10.030
Ten things every gastroenterologist should know about antireflux surgery. Steven Park et al. 2020 Aug;18(9):1923-9. doi: 10.1016/j.cgh.2020.02.041
Biopsies from ascending and descending colon are sufficient for diagnosis of microscopic colitis. Boris Virine et al. 2020 Aug;18(9):2003-9. doi: 10.1016/j.cgh.2020.02.036
September 2020
Association between endoscopist annual procedure volume and colonoscopy quality: Systematic review and meta-analysis. Nauzer Forbes et al. 2020 Sept:18(10):2192-208.e12. doi: 10.1016/j.cgh.2020.03.046
Plans to reactivate gastroenterology practices following the COVID-19 pandemic: A survey of North American centers. Vladimir M. Kushnir et al on Behalf of the North American Alliance for the Study of Digestive Manifestations of COVID-19. 2020 Sept;18(10):2287-94.e1. doi: 10.1016/j.cgh.2020.05.030
Cost effectiveness of different strategies for detecting cirrhosis in patients with nonalcoholic fatty liver disease based on United States health care system. Eduardo Vilar-Gomez et al. 2020 Sept;18(10):2305-14.e12. doi: 10.1016/j.cgh.2020.04.017
October 2020
AGA Clinical Practice Update on young adult–onset colorectal cancer diagnosis and management: Expert review. Lisa A. Boardman et al. 2020 Oct:18(11):2415-24. doi: 10.1016/j.cgh.2020.05.058
Frequency of eating disorder pathology among patients with chronic constipation and contribution of gastrointestinal-specific anxiety. Helen Burton Murray et al. 2020 Oct;18(11):2471-8. doi: 10.1016/j.cgh.2019.12.030
Correction of dyssynergic defecation, but not fiber supplementation, reduces symptoms of functional dyspepsia in patients with constipation in a randomized trial. Jose-Walter Huaman et al. 2020 Oct;18(11):2463-70.e1. doi: 10.1016/j.cgh.2019.11.048
Cellular and Molecular Gastroenterology and Hepatology
A new treatment for chronic hepatitis B and D offers novel insights into obesity and hepatic steatosis. Robert Schierwagen et al. 2020;10(3):649-51. doi: 10.1016/j.jcmgh.2020.05.011
Techniques and Innovations in Gastrointestinal Endoscopy
The impact of endoscopic submucosal dissection for gastric adenocarcinomas in the United States. Shria Kumar et al. 2020 July:22(3):93-8. doi: 10.1016/j.tige.2020.03.009
Gastroenterology
July 2020
Role of cannabis and its derivatives in gastrointestinal and hepatic disease. Jonathan Gotfried et al. 2020 July;159(1):62-80. doi: 10.1053/j.gastro.2020.03.087
Effects of blended (yellow) vs forced coagulation (blue) currents on adverse events, complete resection, or polyp recurrence after polypectomy in a large randomized trial. Heiko Pohl et al. 2020 July;159(1):119-28.e2. doi: 10.1053/j.gastro.2020.03.014
Calculating the starting age for screening in relatives of patients with colorectal cancer based on data from large nationwide data sets.
Yu Tian et al. July 2020;159(1):159-168.e3. doi: 10.1053/j.gastro.2020.03.063
August 2020
Corticosteroids, but not TNF antagonists, are associated with adverse COVID-19 outcomes in patients with inflammatory bowel diseases: results from an international registry. Erica J. Brenner et al. 2020 Aug 159;(2):481-91.e3. doi: 10.1053/j.gastro.2020.05.032
Collagenous colitis is associated with HLA signature and shares genetic risks with other immune-mediated diseases. Eli Stahl et al. 2020 Aug;159(2):549-61.e8. doi: 10.1053/j.gastro.2020.04.063
Efficacy of real-time computer-aided detection of colorectal neoplasia in a randomized trial. Alessandro Repici et al. 2020 Aug;159(2):512-20.e7. doi: 10.1053/j.gastro.2020.04.062
September 2020
Dietary inflammatory potential and risk of Crohn’s disease and ulcerative colitis. Chun-Han Lo et al. 2020 Sept;159(3):p873-83.e1. doi: 10.1053/j.gastro.2020.05.011
Rates of incomplete resection of 1- to 20-mm colorectal polyps: A systematic review and meta-analysis. Roupen Djinbachian et al. 2020 Sept;159(3):904-14.e12. doi: 10.1053/j.gastro.2020.05.018
Clinical Gastroenterology and Hepatology
August 2020
Prevalence and characteristics of avoidant/restrictive food intake disorder in adult neurogastroenterology patients. Helen Burton Murray et al. 2020 Aug;18(9):1995-2002.e1. doi: 10.1016/j.cgh.2019.10.030
Ten things every gastroenterologist should know about antireflux surgery. Steven Park et al. 2020 Aug;18(9):1923-9. doi: 10.1016/j.cgh.2020.02.041
Biopsies from ascending and descending colon are sufficient for diagnosis of microscopic colitis. Boris Virine et al. 2020 Aug;18(9):2003-9. doi: 10.1016/j.cgh.2020.02.036
September 2020
Association between endoscopist annual procedure volume and colonoscopy quality: Systematic review and meta-analysis. Nauzer Forbes et al. 2020 Sept:18(10):2192-208.e12. doi: 10.1016/j.cgh.2020.03.046
Plans to reactivate gastroenterology practices following the COVID-19 pandemic: A survey of North American centers. Vladimir M. Kushnir et al on Behalf of the North American Alliance for the Study of Digestive Manifestations of COVID-19. 2020 Sept;18(10):2287-94.e1. doi: 10.1016/j.cgh.2020.05.030
Cost effectiveness of different strategies for detecting cirrhosis in patients with nonalcoholic fatty liver disease based on United States health care system. Eduardo Vilar-Gomez et al. 2020 Sept;18(10):2305-14.e12. doi: 10.1016/j.cgh.2020.04.017
October 2020
AGA Clinical Practice Update on young adult–onset colorectal cancer diagnosis and management: Expert review. Lisa A. Boardman et al. 2020 Oct:18(11):2415-24. doi: 10.1016/j.cgh.2020.05.058
Frequency of eating disorder pathology among patients with chronic constipation and contribution of gastrointestinal-specific anxiety. Helen Burton Murray et al. 2020 Oct;18(11):2471-8. doi: 10.1016/j.cgh.2019.12.030
Correction of dyssynergic defecation, but not fiber supplementation, reduces symptoms of functional dyspepsia in patients with constipation in a randomized trial. Jose-Walter Huaman et al. 2020 Oct;18(11):2463-70.e1. doi: 10.1016/j.cgh.2019.11.048
Cellular and Molecular Gastroenterology and Hepatology
A new treatment for chronic hepatitis B and D offers novel insights into obesity and hepatic steatosis. Robert Schierwagen et al. 2020;10(3):649-51. doi: 10.1016/j.jcmgh.2020.05.011
Techniques and Innovations in Gastrointestinal Endoscopy
The impact of endoscopic submucosal dissection for gastric adenocarcinomas in the United States. Shria Kumar et al. 2020 July:22(3):93-8. doi: 10.1016/j.tige.2020.03.009
AGA News
Receive $300,000 for your research in health disparities
Applications for the research scholar award are due by Nov. 9, 2020.
The American Gastroenterological Association Research Foundation is pleased to announce an important addition to its prestigious awards portfolio. The AGA Research Scholar Award in Digestive Disease Health Disparities supports early-career faculty dedicated to investigating digestive diseases or disorders that disproportionately affect racial or ethnic minority populations in North America.
Applicants must have a full-time faculty (or equivalent) position and may be performing any type of research (clinical, basic, or translational). Awardees will receive a total of $300,000 over 3 years with funding to commence in July 2021. The deadline to apply is Nov. 9, 2020.
This award is just one example of how AGA is helping to improve patient care for those who need it most. Support AGA Giving Day and learn more about the AGA Equity Project – a multiyear effort spanning all aspects of our organization to achieve equity and eradicate disparities in digestive diseases.
Save the date for DDW Virtual™
In 2021, Digestive Disease Week® moves online as a fully virtual meeting with slightly new dates: May 21-23, 2021.
For more than 50 years, the digestive disease community has connected over the best science, education, and networking at DDW, and we’re confident this year will be no exception. In fact, we’re excited by opportunities the new format provides to learn, share, and connect with each other.
Watch the DDW website for more information as it becomes available. In the meantime, check out our FAQs about DDW Virtual™. If you have a question we didn’t answer, please submit a ticket to our help desk.
DDW is jointly sponsored by AGA, the American Association for the Study of Liver Diseases, the American Society for Gastrointestinal Endoscopy, and the Society for Surgery of the Alimentary Tract.
Virtual 2021 Crohn’s & Colitis Congress® now open for registration
Help forge the roadmap to advance prevention, treatments, and cures for all patients living with inflammatory bowel disease (IBD).
Join the Crohn’s & Colitis Foundation, AGA, and a true community of friends and colleagues at the premier conference on IBD. The fourth annual Crohn’s & Colitis Congress®, taking place virtually Jan. 21-24, 2021, is now open for registration.
The 2021 Crohn’s & Colitis Congress virtual experience will look a little different but will still bring you all the benefits and quality programming you have come to expect. The Congress will offer 4 days of learning, with more than 100 speakers and more than 200 expected abstracts – all from the safety of your home or work. Now at an even more affordable price, access from anywhere, and the ability to hear from the top leaders in the IBD field – this is a unique opportunity to join us as we come together virtually.
By moving our event online, we can now pass on greater savings to you. Registration for the conference provides you with substantial savings over last year and access to all sessions and networking opportunities. This virtual experience will bring our community of IBD professionals together in an engaging, interactive setting which will include breakout rooms, receptions, and much more.
The 2021 congress committee chair David T. Rubin, MD, AGAF, University of Chicago, and cochair Bruce E. Sands, MD, MS, AGAF, Icahn School of Medicine at Mount Sinai, New York, lead a faculty that includes thought leaders in the fields of GI, research investigation, surgery, pediatrics, advanced practice, IBD nursing, diet and nutrition, mental health, radiology, pathology, and more.
Register and get inspired to improve skills and patient outcomes, learn practical information you can immediately implement, hear what’s on the horizon in potential IBD treatments, discover fresh perspectives from multidisciplinary faculty and attendees.
You don’t want to miss the 2021 Crohn’s & Colitis Congress, connecting virtually on Jan. 21-24, 2021.
Register today to save before the early bird deadline of Friday, Nov. 6.
Learn more, submit an abstract, and register by visiting crohnscolitiscongress.org.
AGA releases largest real-world report on safety and effectiveness of fecal microbiota transplantation
About 90% of patients tracked in the AGA FMT National Registry were cured of Clostridioides difficile infection with few serious side effects.
AGA has released the first results from the NIH-funded AGA Fecal Microbiota Transplantation (FMT) National Registry, the largest real-world study on the safety and effectiveness of FMT. Published in Gastroenterology, the registry reported that FMT led to a cure of C. difficile infection in 90% of patients across 20 North American FMT practice sites. Few serious side effects were reported.
“While the value of fecal microbiota transplantation for treating recurrent C. difficile infection is clear from research studies, the potential long-term consequences of altering a patient’s gut microbiota are not fully known,” says Colleen R. Kelly, MD, AGAF, associate professor of medicine at Brown University, Providence, R.I. and coprincipal investigator of the AGA FMT National Registry. “Releasing the initial results of the AGA FMT National Registry is an important step toward understanding the true risks and benefits of microbiota therapeutics in a real-world setting.”
This new report details effectiveness and safety outcomes from the first 259 patients enrolled in the registry between December 2017 and September 2019. Almost all participants received FMT using an unknown donor from stool banks. The most common method of FMT delivery was colonoscopy followed by upper endoscopy. Of the 222 participants who returned for the 1-month follow-up, 200 participants (90%) had their C. difficile infection cured with 197 of those requiring only a single FMT. Infections were reported in 11 participants, but only 2 were thought to be possibly related to the procedure. FMT response was deemed durable, with recurrence of C. difficile infection in the 6 months after successful FMT occurring in only 4% of participants. This data includes patients with comorbidities, such as IBD and immunocompromised status, who are typically excluded from FMT clinical trials.
“These initial results show a high success rate of FMT in the real-world setting. We’ll continue to track these patients for 10 years to assess long-term safety, which will be critical to determining the full safety profile of FMT,” added Dr. Kelly.
AGA raises concerns about recent executive order
We are speaking out to ensure a brighter and more equitable future.
AGA is concerned by the Executive Order on Combating Race and Sex Stereotyping issued on Sept. 22, 2020. This order, while confirming that training of the federal workforce to create an inclusive workspace is beneficial, also leads to a misguided perception of the purpose and outcomes of this type of training. In addition, it may have unintended ramifications for institutions receiving federal research funding.
We believe it is critical and necessary to understand both the positive and negative realities of our nation’s history, so that together we can forge forward into a brighter, and more equitable future.
As highlighted in AGA’s commentary published in Gastroenterology, AGA believes that equity is defined by fair treatment, access, opportunity, and advancement for all, acknowledging that there are historically underserved and underrepresented populations. Equity requires identifying and eliminating barriers that have created unbalanced conditions and prevented the full participation of some groups in order to provide equal opportunity for all groups.
By default, teaching and practicing equity, diversity and inclusion aims not to place any group above or below any other group, or to create division. It rather seeks to achieve fairness and understanding, and fully recognize the dignity of all groups, identities, and individuals.
AGA stands with the Association of American Medical Colleges in our commitment to being a diverse, inclusive, equitable, and antiracist organization.
Our commitment to this issue is manifest in the AGA Equity Project.
Receive $300,000 for your research in health disparities
Applications for the research scholar award are due by Nov. 9, 2020.
The American Gastroenterological Association Research Foundation is pleased to announce an important addition to its prestigious awards portfolio. The AGA Research Scholar Award in Digestive Disease Health Disparities supports early-career faculty dedicated to investigating digestive diseases or disorders that disproportionately affect racial or ethnic minority populations in North America.
Applicants must have a full-time faculty (or equivalent) position and may be performing any type of research (clinical, basic, or translational). Awardees will receive a total of $300,000 over 3 years with funding to commence in July 2021. The deadline to apply is Nov. 9, 2020.
This award is just one example of how AGA is helping to improve patient care for those who need it most. Support AGA Giving Day and learn more about the AGA Equity Project – a multiyear effort spanning all aspects of our organization to achieve equity and eradicate disparities in digestive diseases.
Save the date for DDW Virtual™
In 2021, Digestive Disease Week® moves online as a fully virtual meeting with slightly new dates: May 21-23, 2021.
For more than 50 years, the digestive disease community has connected over the best science, education, and networking at DDW, and we’re confident this year will be no exception. In fact, we’re excited by opportunities the new format provides to learn, share, and connect with each other.
Watch the DDW website for more information as it becomes available. In the meantime, check out our FAQs about DDW Virtual™. If you have a question we didn’t answer, please submit a ticket to our help desk.
DDW is jointly sponsored by AGA, the American Association for the Study of Liver Diseases, the American Society for Gastrointestinal Endoscopy, and the Society for Surgery of the Alimentary Tract.
Virtual 2021 Crohn’s & Colitis Congress® now open for registration
Help forge the roadmap to advance prevention, treatments, and cures for all patients living with inflammatory bowel disease (IBD).
Join the Crohn’s & Colitis Foundation, AGA, and a true community of friends and colleagues at the premier conference on IBD. The fourth annual Crohn’s & Colitis Congress®, taking place virtually Jan. 21-24, 2021, is now open for registration.
The 2021 Crohn’s & Colitis Congress virtual experience will look a little different but will still bring you all the benefits and quality programming you have come to expect. The Congress will offer 4 days of learning, with more than 100 speakers and more than 200 expected abstracts – all from the safety of your home or work. Now at an even more affordable price, access from anywhere, and the ability to hear from the top leaders in the IBD field – this is a unique opportunity to join us as we come together virtually.
By moving our event online, we can now pass on greater savings to you. Registration for the conference provides you with substantial savings over last year and access to all sessions and networking opportunities. This virtual experience will bring our community of IBD professionals together in an engaging, interactive setting which will include breakout rooms, receptions, and much more.
The 2021 congress committee chair David T. Rubin, MD, AGAF, University of Chicago, and cochair Bruce E. Sands, MD, MS, AGAF, Icahn School of Medicine at Mount Sinai, New York, lead a faculty that includes thought leaders in the fields of GI, research investigation, surgery, pediatrics, advanced practice, IBD nursing, diet and nutrition, mental health, radiology, pathology, and more.
Register and get inspired to improve skills and patient outcomes, learn practical information you can immediately implement, hear what’s on the horizon in potential IBD treatments, discover fresh perspectives from multidisciplinary faculty and attendees.
You don’t want to miss the 2021 Crohn’s & Colitis Congress, connecting virtually on Jan. 21-24, 2021.
Register today to save before the early bird deadline of Friday, Nov. 6.
Learn more, submit an abstract, and register by visiting crohnscolitiscongress.org.
AGA releases largest real-world report on safety and effectiveness of fecal microbiota transplantation
About 90% of patients tracked in the AGA FMT National Registry were cured of Clostridioides difficile infection with few serious side effects.
AGA has released the first results from the NIH-funded AGA Fecal Microbiota Transplantation (FMT) National Registry, the largest real-world study on the safety and effectiveness of FMT. Published in Gastroenterology, the registry reported that FMT led to a cure of C. difficile infection in 90% of patients across 20 North American FMT practice sites. Few serious side effects were reported.
“While the value of fecal microbiota transplantation for treating recurrent C. difficile infection is clear from research studies, the potential long-term consequences of altering a patient’s gut microbiota are not fully known,” says Colleen R. Kelly, MD, AGAF, associate professor of medicine at Brown University, Providence, R.I. and coprincipal investigator of the AGA FMT National Registry. “Releasing the initial results of the AGA FMT National Registry is an important step toward understanding the true risks and benefits of microbiota therapeutics in a real-world setting.”
This new report details effectiveness and safety outcomes from the first 259 patients enrolled in the registry between December 2017 and September 2019. Almost all participants received FMT using an unknown donor from stool banks. The most common method of FMT delivery was colonoscopy followed by upper endoscopy. Of the 222 participants who returned for the 1-month follow-up, 200 participants (90%) had their C. difficile infection cured with 197 of those requiring only a single FMT. Infections were reported in 11 participants, but only 2 were thought to be possibly related to the procedure. FMT response was deemed durable, with recurrence of C. difficile infection in the 6 months after successful FMT occurring in only 4% of participants. This data includes patients with comorbidities, such as IBD and immunocompromised status, who are typically excluded from FMT clinical trials.
“These initial results show a high success rate of FMT in the real-world setting. We’ll continue to track these patients for 10 years to assess long-term safety, which will be critical to determining the full safety profile of FMT,” added Dr. Kelly.
AGA raises concerns about recent executive order
We are speaking out to ensure a brighter and more equitable future.
AGA is concerned by the Executive Order on Combating Race and Sex Stereotyping issued on Sept. 22, 2020. This order, while confirming that training of the federal workforce to create an inclusive workspace is beneficial, also leads to a misguided perception of the purpose and outcomes of this type of training. In addition, it may have unintended ramifications for institutions receiving federal research funding.
We believe it is critical and necessary to understand both the positive and negative realities of our nation’s history, so that together we can forge forward into a brighter, and more equitable future.
As highlighted in AGA’s commentary published in Gastroenterology, AGA believes that equity is defined by fair treatment, access, opportunity, and advancement for all, acknowledging that there are historically underserved and underrepresented populations. Equity requires identifying and eliminating barriers that have created unbalanced conditions and prevented the full participation of some groups in order to provide equal opportunity for all groups.
By default, teaching and practicing equity, diversity and inclusion aims not to place any group above or below any other group, or to create division. It rather seeks to achieve fairness and understanding, and fully recognize the dignity of all groups, identities, and individuals.
AGA stands with the Association of American Medical Colleges in our commitment to being a diverse, inclusive, equitable, and antiracist organization.
Our commitment to this issue is manifest in the AGA Equity Project.
Receive $300,000 for your research in health disparities
Applications for the research scholar award are due by Nov. 9, 2020.
The American Gastroenterological Association Research Foundation is pleased to announce an important addition to its prestigious awards portfolio. The AGA Research Scholar Award in Digestive Disease Health Disparities supports early-career faculty dedicated to investigating digestive diseases or disorders that disproportionately affect racial or ethnic minority populations in North America.
Applicants must have a full-time faculty (or equivalent) position and may be performing any type of research (clinical, basic, or translational). Awardees will receive a total of $300,000 over 3 years with funding to commence in July 2021. The deadline to apply is Nov. 9, 2020.
This award is just one example of how AGA is helping to improve patient care for those who need it most. Support AGA Giving Day and learn more about the AGA Equity Project – a multiyear effort spanning all aspects of our organization to achieve equity and eradicate disparities in digestive diseases.
Save the date for DDW Virtual™
In 2021, Digestive Disease Week® moves online as a fully virtual meeting with slightly new dates: May 21-23, 2021.
For more than 50 years, the digestive disease community has connected over the best science, education, and networking at DDW, and we’re confident this year will be no exception. In fact, we’re excited by opportunities the new format provides to learn, share, and connect with each other.
Watch the DDW website for more information as it becomes available. In the meantime, check out our FAQs about DDW Virtual™. If you have a question we didn’t answer, please submit a ticket to our help desk.
DDW is jointly sponsored by AGA, the American Association for the Study of Liver Diseases, the American Society for Gastrointestinal Endoscopy, and the Society for Surgery of the Alimentary Tract.
Virtual 2021 Crohn’s & Colitis Congress® now open for registration
Help forge the roadmap to advance prevention, treatments, and cures for all patients living with inflammatory bowel disease (IBD).
Join the Crohn’s & Colitis Foundation, AGA, and a true community of friends and colleagues at the premier conference on IBD. The fourth annual Crohn’s & Colitis Congress®, taking place virtually Jan. 21-24, 2021, is now open for registration.
The 2021 Crohn’s & Colitis Congress virtual experience will look a little different but will still bring you all the benefits and quality programming you have come to expect. The Congress will offer 4 days of learning, with more than 100 speakers and more than 200 expected abstracts – all from the safety of your home or work. Now at an even more affordable price, access from anywhere, and the ability to hear from the top leaders in the IBD field – this is a unique opportunity to join us as we come together virtually.
By moving our event online, we can now pass on greater savings to you. Registration for the conference provides you with substantial savings over last year and access to all sessions and networking opportunities. This virtual experience will bring our community of IBD professionals together in an engaging, interactive setting which will include breakout rooms, receptions, and much more.
The 2021 congress committee chair David T. Rubin, MD, AGAF, University of Chicago, and cochair Bruce E. Sands, MD, MS, AGAF, Icahn School of Medicine at Mount Sinai, New York, lead a faculty that includes thought leaders in the fields of GI, research investigation, surgery, pediatrics, advanced practice, IBD nursing, diet and nutrition, mental health, radiology, pathology, and more.
Register and get inspired to improve skills and patient outcomes, learn practical information you can immediately implement, hear what’s on the horizon in potential IBD treatments, discover fresh perspectives from multidisciplinary faculty and attendees.
You don’t want to miss the 2021 Crohn’s & Colitis Congress, connecting virtually on Jan. 21-24, 2021.
Register today to save before the early bird deadline of Friday, Nov. 6.
Learn more, submit an abstract, and register by visiting crohnscolitiscongress.org.
AGA releases largest real-world report on safety and effectiveness of fecal microbiota transplantation
About 90% of patients tracked in the AGA FMT National Registry were cured of Clostridioides difficile infection with few serious side effects.
AGA has released the first results from the NIH-funded AGA Fecal Microbiota Transplantation (FMT) National Registry, the largest real-world study on the safety and effectiveness of FMT. Published in Gastroenterology, the registry reported that FMT led to a cure of C. difficile infection in 90% of patients across 20 North American FMT practice sites. Few serious side effects were reported.
“While the value of fecal microbiota transplantation for treating recurrent C. difficile infection is clear from research studies, the potential long-term consequences of altering a patient’s gut microbiota are not fully known,” says Colleen R. Kelly, MD, AGAF, associate professor of medicine at Brown University, Providence, R.I. and coprincipal investigator of the AGA FMT National Registry. “Releasing the initial results of the AGA FMT National Registry is an important step toward understanding the true risks and benefits of microbiota therapeutics in a real-world setting.”
This new report details effectiveness and safety outcomes from the first 259 patients enrolled in the registry between December 2017 and September 2019. Almost all participants received FMT using an unknown donor from stool banks. The most common method of FMT delivery was colonoscopy followed by upper endoscopy. Of the 222 participants who returned for the 1-month follow-up, 200 participants (90%) had their C. difficile infection cured with 197 of those requiring only a single FMT. Infections were reported in 11 participants, but only 2 were thought to be possibly related to the procedure. FMT response was deemed durable, with recurrence of C. difficile infection in the 6 months after successful FMT occurring in only 4% of participants. This data includes patients with comorbidities, such as IBD and immunocompromised status, who are typically excluded from FMT clinical trials.
“These initial results show a high success rate of FMT in the real-world setting. We’ll continue to track these patients for 10 years to assess long-term safety, which will be critical to determining the full safety profile of FMT,” added Dr. Kelly.
AGA raises concerns about recent executive order
We are speaking out to ensure a brighter and more equitable future.
AGA is concerned by the Executive Order on Combating Race and Sex Stereotyping issued on Sept. 22, 2020. This order, while confirming that training of the federal workforce to create an inclusive workspace is beneficial, also leads to a misguided perception of the purpose and outcomes of this type of training. In addition, it may have unintended ramifications for institutions receiving federal research funding.
We believe it is critical and necessary to understand both the positive and negative realities of our nation’s history, so that together we can forge forward into a brighter, and more equitable future.
As highlighted in AGA’s commentary published in Gastroenterology, AGA believes that equity is defined by fair treatment, access, opportunity, and advancement for all, acknowledging that there are historically underserved and underrepresented populations. Equity requires identifying and eliminating barriers that have created unbalanced conditions and prevented the full participation of some groups in order to provide equal opportunity for all groups.
By default, teaching and practicing equity, diversity and inclusion aims not to place any group above or below any other group, or to create division. It rather seeks to achieve fairness and understanding, and fully recognize the dignity of all groups, identities, and individuals.
AGA stands with the Association of American Medical Colleges in our commitment to being a diverse, inclusive, equitable, and antiracist organization.
Our commitment to this issue is manifest in the AGA Equity Project.
COVID-19 pandemic amplifies uncertainty for immigrant hospitalists
H1-B visa program needs improvement
Statistics tell the tale of immigrants in the American health care workforce in broad strokes. In an interview, though, one hospitalist shared the particulars of his professional and personal journey since arriving in the United States from India 15 years ago.
Mihir Patel, MD, MPH, FHM, came to the United States in 2005 to complete a Master’s in Public Health. Fifteen years later, he is still waiting for the green card that signifies U.S. permanent residency status. The paperwork for the application, he said, was completed in 2012. Since then, he’s been renewing his H-1B visa every three years, and he has no expectation that anything will change soon.
“If you are from India, which has a significant backlog of green cards – up to 50 years…you just wait forever,” he said. “Many people even die waiting for their green card to arrive.”
Arriving on a student visa, Dr. Patel completed his MPH in 2008 and began an internal medicine residency that same year, holding a J-1 visa for the 3 years of his US residency program.
“Post-residency, I started working in a rural hospital in an underserved area of northeast Tennessee as a hospitalist,” thus completing the 3 years of service in a rural underserved area that’s a requirement for J-1 visa holders, said Dr. Patel. “I loved this rural community hospital so much that I ended up staying there for 6 years. During my work at this rural hospital, I was able to enjoy the autonomy of managing a small ICU, doing both critical care procedures and management of intubated critical patients while working as a hospitalist,” he said. Dr. Patel served as chief of staff at the hospital for two years, and also served on the board of directors for his 400-physician medical group.
“I was a proud member of this rural community – Rogersville,” said Dr. Patel. Although he and his wife, who was completing her hospitalist residency, lived in Johnson City, Tenn., “I did not mind driving 120 miles round trip every day to go to my small-town hospital for 6 years,” he said.
Spending this time in rural Tennessee allowed Dr. Patel to finish the requirements necessary for the Physician National Interest Waiver and submit his application for permanent residency. The waiver, though, doesn’t give him priority status in the waiting list for permanent residency status.
After a stint in northern California to be closer to extended family, the pull of “beautiful northeast Tennesse and the rural community” was too strong, so Dr. Patel and his family moved back to Johnson City in 2018.
Now, Dr. Patel is a hospitalist at Ballad Health System in Johnson City. He is the corporate director of Ballad’s telemedicine program and is now also the medical director of the COVID-19 Strike Team. He co-founded and is president of the Blue Ridge Chapter of the Society of Hospital Medicine. Under another H-1B visa, Dr. Patel works part-time from home as a telehospitalist, covering six hospitals in 4 different states.
Even in ordinary circumstances, the H-1B visa comes with constraints. Although Dr. Patel’s 6-year old daughter was born in the U.S. and is a citizen, Dr. Patel and his wife have to reapply for their visas every 3 years. “If we travel outside the U.S., we have to get our visas stamped. We cannot change jobs easily due to fear of visa denial, especially with the recent political environment,” said Dr. Patel. “It feels like we are essential health care workers but non-essential immigrants.”
Having recently completed a physician executive MBA program, Dr. Patel said he’d like to start a business of his own using Lean health care principles and telemedicine to improve rural health care. “But while on an H-1B I cannot do anything outside my sponsored employment,” he said.
Ideally, health care organizations would have high flexibility in how and where staff are deployed when a surge of COVID-19 patients hits. Dr. Patel made the point that visa restrictions can make this much harder: “During this COVID crisis, this restriction can cause significant negative impact for small rural hospitals, where local physicians are quarantined and available physicians are on a visa who cannot legally work outside their primary facilities – even though they are willing to work,” he said. “One cannot even work using telemedicine in the same health system, if that is not specifically mentioned during H-1B petition filling. More than 15,000 physicians who are struck by the green card backlog are in the same situation all over U.S.,” he added.
These constraints, though, pale before the consequences of a worst-case pandemic scenario for an immigrant family, where the physician – the primary visa-holder – becomes disabled or dies. In this case, dependent family members must self-deport. “In addition, there would not be any disability or Social Security benefits for the physician or dependents, as they are not citizens or green card holders and they cannot legally stay in the US,” noted Dr. Patel. “Any hospitalist working during the COVID-19 pandemic can have this fate due to our high exposure risk.”
Reauthorizing the H1-B visa program
SHM has been advocating to improve the H1-B visa system for years, Dr. Patel said, The Fairness for High Skilled Immigrants Act passed the U.S. House of Representatives with bipartisan support, and the Society is advocating for its passage in the Senate.
The Fairness for High-Skilled Immigrants Act (S. 386) simplifies the employment-based immigration system by removing per-country caps, converting the employment-based immigration system into a “first-come, first serve” system that does not discriminate on country of origin. The act will also help alleviate the decades-long green card and permanent residency application backlogs.
Dr. Patel emphasized the importance of action by Congress to reauthorize the physician visa waiver program and expediting physician permanent residency. “This is a crisis and we are all physicians who are ready to serve, regardless of our country of origin. Please let us help this great nation by giving us freedom from visa restrictions and providing security for our families.
“During wartime, all frontline soldiers are naturalized and given citizenship by presidential mandate; this is more than war and we are not asking for citizenship – but at least give us a green card which we have already satisfied all requirements for. If not now, then when?” he asked.
H1-B visa program needs improvement
H1-B visa program needs improvement
Statistics tell the tale of immigrants in the American health care workforce in broad strokes. In an interview, though, one hospitalist shared the particulars of his professional and personal journey since arriving in the United States from India 15 years ago.
Mihir Patel, MD, MPH, FHM, came to the United States in 2005 to complete a Master’s in Public Health. Fifteen years later, he is still waiting for the green card that signifies U.S. permanent residency status. The paperwork for the application, he said, was completed in 2012. Since then, he’s been renewing his H-1B visa every three years, and he has no expectation that anything will change soon.
“If you are from India, which has a significant backlog of green cards – up to 50 years…you just wait forever,” he said. “Many people even die waiting for their green card to arrive.”
Arriving on a student visa, Dr. Patel completed his MPH in 2008 and began an internal medicine residency that same year, holding a J-1 visa for the 3 years of his US residency program.
“Post-residency, I started working in a rural hospital in an underserved area of northeast Tennessee as a hospitalist,” thus completing the 3 years of service in a rural underserved area that’s a requirement for J-1 visa holders, said Dr. Patel. “I loved this rural community hospital so much that I ended up staying there for 6 years. During my work at this rural hospital, I was able to enjoy the autonomy of managing a small ICU, doing both critical care procedures and management of intubated critical patients while working as a hospitalist,” he said. Dr. Patel served as chief of staff at the hospital for two years, and also served on the board of directors for his 400-physician medical group.
“I was a proud member of this rural community – Rogersville,” said Dr. Patel. Although he and his wife, who was completing her hospitalist residency, lived in Johnson City, Tenn., “I did not mind driving 120 miles round trip every day to go to my small-town hospital for 6 years,” he said.
Spending this time in rural Tennessee allowed Dr. Patel to finish the requirements necessary for the Physician National Interest Waiver and submit his application for permanent residency. The waiver, though, doesn’t give him priority status in the waiting list for permanent residency status.
After a stint in northern California to be closer to extended family, the pull of “beautiful northeast Tennesse and the rural community” was too strong, so Dr. Patel and his family moved back to Johnson City in 2018.
Now, Dr. Patel is a hospitalist at Ballad Health System in Johnson City. He is the corporate director of Ballad’s telemedicine program and is now also the medical director of the COVID-19 Strike Team. He co-founded and is president of the Blue Ridge Chapter of the Society of Hospital Medicine. Under another H-1B visa, Dr. Patel works part-time from home as a telehospitalist, covering six hospitals in 4 different states.
Even in ordinary circumstances, the H-1B visa comes with constraints. Although Dr. Patel’s 6-year old daughter was born in the U.S. and is a citizen, Dr. Patel and his wife have to reapply for their visas every 3 years. “If we travel outside the U.S., we have to get our visas stamped. We cannot change jobs easily due to fear of visa denial, especially with the recent political environment,” said Dr. Patel. “It feels like we are essential health care workers but non-essential immigrants.”
Having recently completed a physician executive MBA program, Dr. Patel said he’d like to start a business of his own using Lean health care principles and telemedicine to improve rural health care. “But while on an H-1B I cannot do anything outside my sponsored employment,” he said.
Ideally, health care organizations would have high flexibility in how and where staff are deployed when a surge of COVID-19 patients hits. Dr. Patel made the point that visa restrictions can make this much harder: “During this COVID crisis, this restriction can cause significant negative impact for small rural hospitals, where local physicians are quarantined and available physicians are on a visa who cannot legally work outside their primary facilities – even though they are willing to work,” he said. “One cannot even work using telemedicine in the same health system, if that is not specifically mentioned during H-1B petition filling. More than 15,000 physicians who are struck by the green card backlog are in the same situation all over U.S.,” he added.
These constraints, though, pale before the consequences of a worst-case pandemic scenario for an immigrant family, where the physician – the primary visa-holder – becomes disabled or dies. In this case, dependent family members must self-deport. “In addition, there would not be any disability or Social Security benefits for the physician or dependents, as they are not citizens or green card holders and they cannot legally stay in the US,” noted Dr. Patel. “Any hospitalist working during the COVID-19 pandemic can have this fate due to our high exposure risk.”
Reauthorizing the H1-B visa program
SHM has been advocating to improve the H1-B visa system for years, Dr. Patel said, The Fairness for High Skilled Immigrants Act passed the U.S. House of Representatives with bipartisan support, and the Society is advocating for its passage in the Senate.
The Fairness for High-Skilled Immigrants Act (S. 386) simplifies the employment-based immigration system by removing per-country caps, converting the employment-based immigration system into a “first-come, first serve” system that does not discriminate on country of origin. The act will also help alleviate the decades-long green card and permanent residency application backlogs.
Dr. Patel emphasized the importance of action by Congress to reauthorize the physician visa waiver program and expediting physician permanent residency. “This is a crisis and we are all physicians who are ready to serve, regardless of our country of origin. Please let us help this great nation by giving us freedom from visa restrictions and providing security for our families.
“During wartime, all frontline soldiers are naturalized and given citizenship by presidential mandate; this is more than war and we are not asking for citizenship – but at least give us a green card which we have already satisfied all requirements for. If not now, then when?” he asked.
Statistics tell the tale of immigrants in the American health care workforce in broad strokes. In an interview, though, one hospitalist shared the particulars of his professional and personal journey since arriving in the United States from India 15 years ago.
Mihir Patel, MD, MPH, FHM, came to the United States in 2005 to complete a Master’s in Public Health. Fifteen years later, he is still waiting for the green card that signifies U.S. permanent residency status. The paperwork for the application, he said, was completed in 2012. Since then, he’s been renewing his H-1B visa every three years, and he has no expectation that anything will change soon.
“If you are from India, which has a significant backlog of green cards – up to 50 years…you just wait forever,” he said. “Many people even die waiting for their green card to arrive.”
Arriving on a student visa, Dr. Patel completed his MPH in 2008 and began an internal medicine residency that same year, holding a J-1 visa for the 3 years of his US residency program.
“Post-residency, I started working in a rural hospital in an underserved area of northeast Tennessee as a hospitalist,” thus completing the 3 years of service in a rural underserved area that’s a requirement for J-1 visa holders, said Dr. Patel. “I loved this rural community hospital so much that I ended up staying there for 6 years. During my work at this rural hospital, I was able to enjoy the autonomy of managing a small ICU, doing both critical care procedures and management of intubated critical patients while working as a hospitalist,” he said. Dr. Patel served as chief of staff at the hospital for two years, and also served on the board of directors for his 400-physician medical group.
“I was a proud member of this rural community – Rogersville,” said Dr. Patel. Although he and his wife, who was completing her hospitalist residency, lived in Johnson City, Tenn., “I did not mind driving 120 miles round trip every day to go to my small-town hospital for 6 years,” he said.
Spending this time in rural Tennessee allowed Dr. Patel to finish the requirements necessary for the Physician National Interest Waiver and submit his application for permanent residency. The waiver, though, doesn’t give him priority status in the waiting list for permanent residency status.
After a stint in northern California to be closer to extended family, the pull of “beautiful northeast Tennesse and the rural community” was too strong, so Dr. Patel and his family moved back to Johnson City in 2018.
Now, Dr. Patel is a hospitalist at Ballad Health System in Johnson City. He is the corporate director of Ballad’s telemedicine program and is now also the medical director of the COVID-19 Strike Team. He co-founded and is president of the Blue Ridge Chapter of the Society of Hospital Medicine. Under another H-1B visa, Dr. Patel works part-time from home as a telehospitalist, covering six hospitals in 4 different states.
Even in ordinary circumstances, the H-1B visa comes with constraints. Although Dr. Patel’s 6-year old daughter was born in the U.S. and is a citizen, Dr. Patel and his wife have to reapply for their visas every 3 years. “If we travel outside the U.S., we have to get our visas stamped. We cannot change jobs easily due to fear of visa denial, especially with the recent political environment,” said Dr. Patel. “It feels like we are essential health care workers but non-essential immigrants.”
Having recently completed a physician executive MBA program, Dr. Patel said he’d like to start a business of his own using Lean health care principles and telemedicine to improve rural health care. “But while on an H-1B I cannot do anything outside my sponsored employment,” he said.
Ideally, health care organizations would have high flexibility in how and where staff are deployed when a surge of COVID-19 patients hits. Dr. Patel made the point that visa restrictions can make this much harder: “During this COVID crisis, this restriction can cause significant negative impact for small rural hospitals, where local physicians are quarantined and available physicians are on a visa who cannot legally work outside their primary facilities – even though they are willing to work,” he said. “One cannot even work using telemedicine in the same health system, if that is not specifically mentioned during H-1B petition filling. More than 15,000 physicians who are struck by the green card backlog are in the same situation all over U.S.,” he added.
These constraints, though, pale before the consequences of a worst-case pandemic scenario for an immigrant family, where the physician – the primary visa-holder – becomes disabled or dies. In this case, dependent family members must self-deport. “In addition, there would not be any disability or Social Security benefits for the physician or dependents, as they are not citizens or green card holders and they cannot legally stay in the US,” noted Dr. Patel. “Any hospitalist working during the COVID-19 pandemic can have this fate due to our high exposure risk.”
Reauthorizing the H1-B visa program
SHM has been advocating to improve the H1-B visa system for years, Dr. Patel said, The Fairness for High Skilled Immigrants Act passed the U.S. House of Representatives with bipartisan support, and the Society is advocating for its passage in the Senate.
The Fairness for High-Skilled Immigrants Act (S. 386) simplifies the employment-based immigration system by removing per-country caps, converting the employment-based immigration system into a “first-come, first serve” system that does not discriminate on country of origin. The act will also help alleviate the decades-long green card and permanent residency application backlogs.
Dr. Patel emphasized the importance of action by Congress to reauthorize the physician visa waiver program and expediting physician permanent residency. “This is a crisis and we are all physicians who are ready to serve, regardless of our country of origin. Please let us help this great nation by giving us freedom from visa restrictions and providing security for our families.
“During wartime, all frontline soldiers are naturalized and given citizenship by presidential mandate; this is more than war and we are not asking for citizenship – but at least give us a green card which we have already satisfied all requirements for. If not now, then when?” he asked.