LAS VEGAS – Colorectal surgeon Jamie Cannon, MD, doesn’t think there’s a rivalry between laparoscopic surgery and robotic surgery. Instead, she told colleagues, they should be seen as parts of the same whole: “Robotics is laparoscopy. It’s just a tool that allows us to do laparoscopic surgery better.”

Master Video/Shutterstock

LAS VEGAS – Colorectal surgeon Jamie Cannon, MD, doesn’t think there’s a rivalry between laparoscopic surgery and robotic surgery. Instead, she told colleagues, they should be seen as parts of the same whole: “Robotics is laparoscopy. It’s just a tool that allows us to do laparoscopic surgery better.”

Master Video/Shutterstock

LAS VEGAS – Colorectal surgeon Jamie Cannon, MD, doesn’t think there’s a rivalry between laparoscopic surgery and robotic surgery. Instead, she told colleagues, they should be seen as parts of the same whole: “Robotics is laparoscopy. It’s just a tool that allows us to do laparoscopic surgery better.”

Master Video/Shutterstock

WASHINGTON – Expenditures for combination acne products increased from $82 million in 1996 to $487 million in 2016, according to an analysis presented at the annual meeting of the American Academy of Dermatology.

During a late-breaking research session, David Li, a fourth-year medical student at Tufts University, Boston, presented the results of a retrospective cost analysis study, conducted to identify trends in overall spending for combination acne products. Spending measures were adjusted for inflation to 2016 U.S. dollars.

While spending on combination products for acne has increased significantly over the past 2 decades, comparative efficacy data for these products are limited, he noted. Combination products are more expensive than the sum of their component parts, and prescribing generic formulations of individual acne treatments could potentially reduce costs, but possible advantages of combination products for acne include improved patient adherence and increased efficacy.

Mr. Li, a research fellow in the department of dermatology at Brigham and Women’s Hospital in Boston, and his colleagues drafted a comprehensive list of available combination products (eight brand-name products and two generics). Most combine benzoyl peroxide with another common acne medication. To analyze trends in medication use, they performed a retrospective cost analysis using Medical Expenditure Panel Survey (MEPS) data from 1996 to 2016, searching for these combination medications to gather the annual number of prescriptions, number of users, expenditures, and aggregate demographics for each product. The data were weighted to represent national estimates.

They also used data from the National Average Drug Acquisition Cost (NADAC) database, used by the Centers for Medicare & Medicaid Services as a pricing benchmark, and calculated the difference between the unit price of each combination product and the sum of the prices of its generic components. They multiplied this difference by the median number of units prescribed annually for the given combination.

The researchers found that most users of combination acne products were younger than 18 years (23%), female (55%), and white (83%), and the most commonly prescribed combination product changed over time. From 1996 to 2002, Benzamycin (benzoyl peroxide and erythromycin) was the most frequently prescribed combination. Several years later, its place was taken by BenzaClin (benzoyl peroxide and clindamycin) from 2003 to 2010, followed by Ziana (clindamycin and tretinoin) in 2011 and Epiduo (adapalene and benzoyl peroxide) from 2012 to 2016.

“Spending has increased steadily from a little bit over $82 million in 1996 to nearly half a billion dollars in 2016,” Mr. Li said. “That’s a rise of more than 500% in the last 20 years. Based on the median pricing and utilization data that we derived from the NADAC database, we determined that substitution with component generics can provide median annual savings of at least a quarter billion dollars each year.”

Although the data indicate a trend toward increased use of and spending on new, branded combination products, the literature includes “minimal data to suggest whether one combination acne product is better than the next one, or how it compares to its component medications when used in combination,” he said. He and his colleagues found no comparative data apart from a 2001 study that examined Benzamycin and BenzaClin, which suggested that there was no difference in efficacy or tolerability between the products.

The present study is limited by reporting bias and recall bias because it relies partly on MEPS, a survey, and the NADAC pricing database had information only for 2013-2016. The researchers consequently used the most recent prices to calculate potential savings.

“Until we have more meaningful data to suggest otherwise, we’re in a state of equipoise,” said Mr. Li.

The research was funded by the National Center for Advancing Translational Sciences, part of the National Institutes of Health.
 

egreb@mdedge.com

SOURCE: Li D et al. AAD 2019, Abstract 11333.

WASHINGTON – Expenditures for combination acne products increased from $82 million in 1996 to $487 million in 2016, according to an analysis presented at the annual meeting of the American Academy of Dermatology.

During a late-breaking research session, David Li, a fourth-year medical student at Tufts University, Boston, presented the results of a retrospective cost analysis study, conducted to identify trends in overall spending for combination acne products. Spending measures were adjusted for inflation to 2016 U.S. dollars.

While spending on combination products for acne has increased significantly over the past 2 decades, comparative efficacy data for these products are limited, he noted. Combination products are more expensive than the sum of their component parts, and prescribing generic formulations of individual acne treatments could potentially reduce costs, but possible advantages of combination products for acne include improved patient adherence and increased efficacy.

Mr. Li, a research fellow in the department of dermatology at Brigham and Women’s Hospital in Boston, and his colleagues drafted a comprehensive list of available combination products (eight brand-name products and two generics). Most combine benzoyl peroxide with another common acne medication. To analyze trends in medication use, they performed a retrospective cost analysis using Medical Expenditure Panel Survey (MEPS) data from 1996 to 2016, searching for these combination medications to gather the annual number of prescriptions, number of users, expenditures, and aggregate demographics for each product. The data were weighted to represent national estimates.

They also used data from the National Average Drug Acquisition Cost (NADAC) database, used by the Centers for Medicare & Medicaid Services as a pricing benchmark, and calculated the difference between the unit price of each combination product and the sum of the prices of its generic components. They multiplied this difference by the median number of units prescribed annually for the given combination.

The researchers found that most users of combination acne products were younger than 18 years (23%), female (55%), and white (83%), and the most commonly prescribed combination product changed over time. From 1996 to 2002, Benzamycin (benzoyl peroxide and erythromycin) was the most frequently prescribed combination. Several years later, its place was taken by BenzaClin (benzoyl peroxide and clindamycin) from 2003 to 2010, followed by Ziana (clindamycin and tretinoin) in 2011 and Epiduo (adapalene and benzoyl peroxide) from 2012 to 2016.

“Spending has increased steadily from a little bit over $82 million in 1996 to nearly half a billion dollars in 2016,” Mr. Li said. “That’s a rise of more than 500% in the last 20 years. Based on the median pricing and utilization data that we derived from the NADAC database, we determined that substitution with component generics can provide median annual savings of at least a quarter billion dollars each year.”

Although the data indicate a trend toward increased use of and spending on new, branded combination products, the literature includes “minimal data to suggest whether one combination acne product is better than the next one, or how it compares to its component medications when used in combination,” he said. He and his colleagues found no comparative data apart from a 2001 study that examined Benzamycin and BenzaClin, which suggested that there was no difference in efficacy or tolerability between the products.

The present study is limited by reporting bias and recall bias because it relies partly on MEPS, a survey, and the NADAC pricing database had information only for 2013-2016. The researchers consequently used the most recent prices to calculate potential savings.

“Until we have more meaningful data to suggest otherwise, we’re in a state of equipoise,” said Mr. Li.

The research was funded by the National Center for Advancing Translational Sciences, part of the National Institutes of Health.
 

egreb@mdedge.com

SOURCE: Li D et al. AAD 2019, Abstract 11333.

WASHINGTON – Expenditures for combination acne products increased from $82 million in 1996 to $487 million in 2016, according to an analysis presented at the annual meeting of the American Academy of Dermatology.

During a late-breaking research session, David Li, a fourth-year medical student at Tufts University, Boston, presented the results of a retrospective cost analysis study, conducted to identify trends in overall spending for combination acne products. Spending measures were adjusted for inflation to 2016 U.S. dollars.

While spending on combination products for acne has increased significantly over the past 2 decades, comparative efficacy data for these products are limited, he noted. Combination products are more expensive than the sum of their component parts, and prescribing generic formulations of individual acne treatments could potentially reduce costs, but possible advantages of combination products for acne include improved patient adherence and increased efficacy.

Mr. Li, a research fellow in the department of dermatology at Brigham and Women’s Hospital in Boston, and his colleagues drafted a comprehensive list of available combination products (eight brand-name products and two generics). Most combine benzoyl peroxide with another common acne medication. To analyze trends in medication use, they performed a retrospective cost analysis using Medical Expenditure Panel Survey (MEPS) data from 1996 to 2016, searching for these combination medications to gather the annual number of prescriptions, number of users, expenditures, and aggregate demographics for each product. The data were weighted to represent national estimates.

They also used data from the National Average Drug Acquisition Cost (NADAC) database, used by the Centers for Medicare & Medicaid Services as a pricing benchmark, and calculated the difference between the unit price of each combination product and the sum of the prices of its generic components. They multiplied this difference by the median number of units prescribed annually for the given combination.

The researchers found that most users of combination acne products were younger than 18 years (23%), female (55%), and white (83%), and the most commonly prescribed combination product changed over time. From 1996 to 2002, Benzamycin (benzoyl peroxide and erythromycin) was the most frequently prescribed combination. Several years later, its place was taken by BenzaClin (benzoyl peroxide and clindamycin) from 2003 to 2010, followed by Ziana (clindamycin and tretinoin) in 2011 and Epiduo (adapalene and benzoyl peroxide) from 2012 to 2016.

“Spending has increased steadily from a little bit over $82 million in 1996 to nearly half a billion dollars in 2016,” Mr. Li said. “That’s a rise of more than 500% in the last 20 years. Based on the median pricing and utilization data that we derived from the NADAC database, we determined that substitution with component generics can provide median annual savings of at least a quarter billion dollars each year.”

Although the data indicate a trend toward increased use of and spending on new, branded combination products, the literature includes “minimal data to suggest whether one combination acne product is better than the next one, or how it compares to its component medications when used in combination,” he said. He and his colleagues found no comparative data apart from a 2001 study that examined Benzamycin and BenzaClin, which suggested that there was no difference in efficacy or tolerability between the products.

The present study is limited by reporting bias and recall bias because it relies partly on MEPS, a survey, and the NADAC pricing database had information only for 2013-2016. The researchers consequently used the most recent prices to calculate potential savings.

“Until we have more meaningful data to suggest otherwise, we’re in a state of equipoise,” said Mr. Li.

The research was funded by the National Center for Advancing Translational Sciences, part of the National Institutes of Health.
 

egreb@mdedge.com

SOURCE: Li D et al. AAD 2019, Abstract 11333.

The U.S. Department of Justice has signaled it will not oppose any aspect of the recent court ruling to invalidate the Affordable Care Act.

designer491/Thinkstock

“The Department of Justice has determined that the district court’s judgment should be affirmed, according to a March 25 letter to the U.S. Court of Appeal for the Fifth Circuit in New Orleans. “Because the United States is not urging that any portion of the district court’s judgment be reversed, the government intends to file a brief on the appellees’ schedule.”


At the onset of the trial in the U.S. District Court for the Northern District of Texas, the DOJ had initially challenged portions of the ACA, including declaring guaranteed issue unconstitutional by arguing that it could not be enacted with no penalty for failure to obtain coverage.

However, the judge ruled in the Texas v. United States case that the tax bill passed by Congress in December 2017 effectively rendered the entire health law unconstitutional.


“We said before that the district court’s decision was misguided and wrong. So, too, is the government’s reversal to now support it,” Matt Eyles, president and CEO of America’s Health Insurance Plans said in a statement. “This harmful position puts coverage at risk for more than 100 million Americans that rely on it. We will continue to engage on this issue as it continues through the appeals process so we can support and strengthen affordable coverage for every American.”

gtwachtman@mdedge.com

The U.S. Department of Justice has signaled it will not oppose any aspect of the recent court ruling to invalidate the Affordable Care Act.

designer491/Thinkstock

“The Department of Justice has determined that the district court’s judgment should be affirmed, according to a March 25 letter to the U.S. Court of Appeal for the Fifth Circuit in New Orleans. “Because the United States is not urging that any portion of the district court’s judgment be reversed, the government intends to file a brief on the appellees’ schedule.”


At the onset of the trial in the U.S. District Court for the Northern District of Texas, the DOJ had initially challenged portions of the ACA, including declaring guaranteed issue unconstitutional by arguing that it could not be enacted with no penalty for failure to obtain coverage.

However, the judge ruled in the Texas v. United States case that the tax bill passed by Congress in December 2017 effectively rendered the entire health law unconstitutional.


“We said before that the district court’s decision was misguided and wrong. So, too, is the government’s reversal to now support it,” Matt Eyles, president and CEO of America’s Health Insurance Plans said in a statement. “This harmful position puts coverage at risk for more than 100 million Americans that rely on it. We will continue to engage on this issue as it continues through the appeals process so we can support and strengthen affordable coverage for every American.”

gtwachtman@mdedge.com

The U.S. Department of Justice has signaled it will not oppose any aspect of the recent court ruling to invalidate the Affordable Care Act.

designer491/Thinkstock

“The Department of Justice has determined that the district court’s judgment should be affirmed, according to a March 25 letter to the U.S. Court of Appeal for the Fifth Circuit in New Orleans. “Because the United States is not urging that any portion of the district court’s judgment be reversed, the government intends to file a brief on the appellees’ schedule.”


At the onset of the trial in the U.S. District Court for the Northern District of Texas, the DOJ had initially challenged portions of the ACA, including declaring guaranteed issue unconstitutional by arguing that it could not be enacted with no penalty for failure to obtain coverage.

However, the judge ruled in the Texas v. United States case that the tax bill passed by Congress in December 2017 effectively rendered the entire health law unconstitutional.


“We said before that the district court’s decision was misguided and wrong. So, too, is the government’s reversal to now support it,” Matt Eyles, president and CEO of America’s Health Insurance Plans said in a statement. “This harmful position puts coverage at risk for more than 100 million Americans that rely on it. We will continue to engage on this issue as it continues through the appeals process so we can support and strengthen affordable coverage for every American.”

gtwachtman@mdedge.com

LAS VEGAS – Anesthesiologist Michael W. Manning, MD, has a few unusual rules about preparing patients for surgery: Give them a carb-heavy beverage. Definitely provide caffeine to coffee addicts who haven’t had a cup for quite a while. And tell them – again and again – what to expect in terms of pain.

Lynda Banzi/IMNG Medical Media

Dr. Manning’s tips

Don’t starve patients before procedures: “We should prep for a surgery like a marathon,” Dr. Manning recommended. That means allowing patients to eat and drink instead of starving them via fasting out of fear that they’ll aspirate under anesthesia, he said.

He pointed to 2017 guidelines issued by the American Society of Anesthesiologists, indicating that patients may drink clear liquids for up to 2 hours before procedures that require general or regional anesthesia or procedural sedation and anesthesia. And patients may consume a light meal, such as toast and a clear liquid, or nonhuman milk, until 6 hours before a procedure. However, they should fast 8 hours after eating fried or fatty foods or meat (Anesthesiology 2017:376-93).

Extensive research supports carb-loading via liquid prior to surgery, said Dr. Manning, who cited a 2014 Cochrane Library review that examined 27 trials on preoperative consumption of carbs prior to various types of surgery. The review found no increase in complications in patients who consumed carbs, compared with placebo or fasting, and there was a slight decrease in length of stay (Cochrane Database Syst Rev. 2014 Aug 14;[8]).

In terms of benefits, research suggests that carb-loading improves patient comfort and gastric emptying, Dr. Manning said, and patients welcome it.
 

Educate patients about pain expectations

“We surgeons and anesthesiologists need to partner together and talk to patients and define what the pain expectations are,” Dr. Manning said.

At Duke, physicians worked together to set up a script that patients will hear four different times by medical personnel such as the surgeon, the anesthesiologist, and nursing staff, he said.

The script aims to educate patients about what to expect in terms of pain. For example, he says, before some surgeries, patients might be told: “You’re going to have shoulder pain that’s going to feel like you’ve been in the garage all day putting boxes on the shelf all the time,” or “Your belly is going to feel like you did 1,000 sit-ups.”

This eliminates the “fear and anxiety” that comes with not knowing what to expect regarding pain, he said.
 

Ask about coffee. Yes, coffee.

According to Dr. Manning, patients who regularly drink “a robust amount” of coffee may experience more postoperative pain following afternoon surgery because they’ve gone for an unusually long time without caffeine. Take a “coffee history,” he advised, and ask how much coffee the patient would have consumed by this time on a normal day. Then give patients caffeine as needed. (Coffee is considered a clear beverage under the American Society of Anesthesiologists guidelines.)

“It takes the edge off and helps reduce postoperative pain,” he said.

Global Academy for Medical Education and this news organization are owned by the same parent company. Dr. Manning has no disclosures.

LAS VEGAS – Anesthesiologist Michael W. Manning, MD, has a few unusual rules about preparing patients for surgery: Give them a carb-heavy beverage. Definitely provide caffeine to coffee addicts who haven’t had a cup for quite a while. And tell them – again and again – what to expect in terms of pain.

Lynda Banzi/IMNG Medical Media

Dr. Manning’s tips

Don’t starve patients before procedures: “We should prep for a surgery like a marathon,” Dr. Manning recommended. That means allowing patients to eat and drink instead of starving them via fasting out of fear that they’ll aspirate under anesthesia, he said.

He pointed to 2017 guidelines issued by the American Society of Anesthesiologists, indicating that patients may drink clear liquids for up to 2 hours before procedures that require general or regional anesthesia or procedural sedation and anesthesia. And patients may consume a light meal, such as toast and a clear liquid, or nonhuman milk, until 6 hours before a procedure. However, they should fast 8 hours after eating fried or fatty foods or meat (Anesthesiology 2017:376-93).

Extensive research supports carb-loading via liquid prior to surgery, said Dr. Manning, who cited a 2014 Cochrane Library review that examined 27 trials on preoperative consumption of carbs prior to various types of surgery. The review found no increase in complications in patients who consumed carbs, compared with placebo or fasting, and there was a slight decrease in length of stay (Cochrane Database Syst Rev. 2014 Aug 14;[8]).

In terms of benefits, research suggests that carb-loading improves patient comfort and gastric emptying, Dr. Manning said, and patients welcome it.
 

Educate patients about pain expectations

“We surgeons and anesthesiologists need to partner together and talk to patients and define what the pain expectations are,” Dr. Manning said.

At Duke, physicians worked together to set up a script that patients will hear four different times by medical personnel such as the surgeon, the anesthesiologist, and nursing staff, he said.

The script aims to educate patients about what to expect in terms of pain. For example, he says, before some surgeries, patients might be told: “You’re going to have shoulder pain that’s going to feel like you’ve been in the garage all day putting boxes on the shelf all the time,” or “Your belly is going to feel like you did 1,000 sit-ups.”

This eliminates the “fear and anxiety” that comes with not knowing what to expect regarding pain, he said.
 

Ask about coffee. Yes, coffee.

According to Dr. Manning, patients who regularly drink “a robust amount” of coffee may experience more postoperative pain following afternoon surgery because they’ve gone for an unusually long time without caffeine. Take a “coffee history,” he advised, and ask how much coffee the patient would have consumed by this time on a normal day. Then give patients caffeine as needed. (Coffee is considered a clear beverage under the American Society of Anesthesiologists guidelines.)

“It takes the edge off and helps reduce postoperative pain,” he said.

Global Academy for Medical Education and this news organization are owned by the same parent company. Dr. Manning has no disclosures.

LAS VEGAS – Anesthesiologist Michael W. Manning, MD, has a few unusual rules about preparing patients for surgery: Give them a carb-heavy beverage. Definitely provide caffeine to coffee addicts who haven’t had a cup for quite a while. And tell them – again and again – what to expect in terms of pain.

Lynda Banzi/IMNG Medical Media

Dr. Manning’s tips

Don’t starve patients before procedures: “We should prep for a surgery like a marathon,” Dr. Manning recommended. That means allowing patients to eat and drink instead of starving them via fasting out of fear that they’ll aspirate under anesthesia, he said.

He pointed to 2017 guidelines issued by the American Society of Anesthesiologists, indicating that patients may drink clear liquids for up to 2 hours before procedures that require general or regional anesthesia or procedural sedation and anesthesia. And patients may consume a light meal, such as toast and a clear liquid, or nonhuman milk, until 6 hours before a procedure. However, they should fast 8 hours after eating fried or fatty foods or meat (Anesthesiology 2017:376-93).

Extensive research supports carb-loading via liquid prior to surgery, said Dr. Manning, who cited a 2014 Cochrane Library review that examined 27 trials on preoperative consumption of carbs prior to various types of surgery. The review found no increase in complications in patients who consumed carbs, compared with placebo or fasting, and there was a slight decrease in length of stay (Cochrane Database Syst Rev. 2014 Aug 14;[8]).

In terms of benefits, research suggests that carb-loading improves patient comfort and gastric emptying, Dr. Manning said, and patients welcome it.
 

Educate patients about pain expectations

“We surgeons and anesthesiologists need to partner together and talk to patients and define what the pain expectations are,” Dr. Manning said.

At Duke, physicians worked together to set up a script that patients will hear four different times by medical personnel such as the surgeon, the anesthesiologist, and nursing staff, he said.

The script aims to educate patients about what to expect in terms of pain. For example, he says, before some surgeries, patients might be told: “You’re going to have shoulder pain that’s going to feel like you’ve been in the garage all day putting boxes on the shelf all the time,” or “Your belly is going to feel like you did 1,000 sit-ups.”

This eliminates the “fear and anxiety” that comes with not knowing what to expect regarding pain, he said.
 

Ask about coffee. Yes, coffee.

According to Dr. Manning, patients who regularly drink “a robust amount” of coffee may experience more postoperative pain following afternoon surgery because they’ve gone for an unusually long time without caffeine. Take a “coffee history,” he advised, and ask how much coffee the patient would have consumed by this time on a normal day. Then give patients caffeine as needed. (Coffee is considered a clear beverage under the American Society of Anesthesiologists guidelines.)

“It takes the edge off and helps reduce postoperative pain,” he said.

Global Academy for Medical Education and this news organization are owned by the same parent company. Dr. Manning has no disclosures.

Social media can be more than a tool to connect with friends and family, said Vineet Chopra, MD, MBBS, FHM, Charlie Wray, DO, and Vineet Arora, MD, MAPP, MHM, at Monday’s “Tweet Your Way to the Top? Social Media as a Career Development Tool in Hospital Medicine” session.

Online outreach can play crucial roles in everything from continuing education and research to networking and career advancement, but most of the conversations in medicine are really focused in the Twittersphere, the three hospitalists said.

“Social media has allowed me to connect with leaders in hospital medicine and many other medical communities,” said Dr. Wray, an assistant professor of medicine at the University of California, San Francisco. “It has allowed me to share my work and success with the hospitalist community in addition to highlighting my trainees’ and colleagues’ successes. My engagement has created opportunities to get involved with projects that I could never have previously imagined. And it has extended my networking circle and made annual gatherings like the SHM Annual Conference even more beneficial and high yield for my career.”

For session copresenter Dr. Chopra, associate professor and chief of the division of hospital medicine at the University of Michigan, Ann Arbor, social media “helps develop your brand and your identity. It is a wonderful way for people to know what you do, who you are, what you stand for, and your views and opinions on various topics.”

On the career front, social media “can connect you to leaders in the community so that they know who you are and what you are accomplishing. So when time comes for you to move on, people within this community will know who you are and what you’re known for at a national level,” said Dr. Wray, who is also deputy digital media editor for the Journal of Hospital Medicine.

Sharing on social media – and Twitter in particular – for the medical profession is focused mainly on dissemination of information, engaging in communities, and networking beyond your institution. The three presenters shared tips of the trade during the session, such as how to boost exposure to a tweet by including hashtags, posting photos, and sharing links. To overcome time commitment barriers, tie your Twitter contributions to something you are doing already, said Dr. Arora, associate chief medical officer-clinical learning environment at the University of Chicago.

A presence on social media isn’t just a tool to boost your own profile, Dr. Wray said. It also helps you stay on top of medical news. “There is so much information and new data coming out nowadays, it can be hard to keep up,” he said. “A properly curated social media feed can help a busy clinician stay on top of what is really important. This is an invaluable skill for the modern hospitalist.”

But be careful how much you disclose on social media about yourself and, especially, other people. “A good rule of thumb is: Don’t put anything online that you wouldn’t want your mother to read,” Dr. Chopra said. “As well, sharing any personal or patient information without understanding your institution’s guidelines or obtaining explicit permission is a general no-no,” he said.

“Also, many employers look at social media profiles before they hire people. We certainly do so when we are looking at various individuals. We often call this a ‘Google biopsy.’ ”

Randy Dotinga contributed to this report.

Social media can be more than a tool to connect with friends and family, said Vineet Chopra, MD, MBBS, FHM, Charlie Wray, DO, and Vineet Arora, MD, MAPP, MHM, at Monday’s “Tweet Your Way to the Top? Social Media as a Career Development Tool in Hospital Medicine” session.

Online outreach can play crucial roles in everything from continuing education and research to networking and career advancement, but most of the conversations in medicine are really focused in the Twittersphere, the three hospitalists said.

“Social media has allowed me to connect with leaders in hospital medicine and many other medical communities,” said Dr. Wray, an assistant professor of medicine at the University of California, San Francisco. “It has allowed me to share my work and success with the hospitalist community in addition to highlighting my trainees’ and colleagues’ successes. My engagement has created opportunities to get involved with projects that I could never have previously imagined. And it has extended my networking circle and made annual gatherings like the SHM Annual Conference even more beneficial and high yield for my career.”

For session copresenter Dr. Chopra, associate professor and chief of the division of hospital medicine at the University of Michigan, Ann Arbor, social media “helps develop your brand and your identity. It is a wonderful way for people to know what you do, who you are, what you stand for, and your views and opinions on various topics.”

On the career front, social media “can connect you to leaders in the community so that they know who you are and what you are accomplishing. So when time comes for you to move on, people within this community will know who you are and what you’re known for at a national level,” said Dr. Wray, who is also deputy digital media editor for the Journal of Hospital Medicine.

Sharing on social media – and Twitter in particular – for the medical profession is focused mainly on dissemination of information, engaging in communities, and networking beyond your institution. The three presenters shared tips of the trade during the session, such as how to boost exposure to a tweet by including hashtags, posting photos, and sharing links. To overcome time commitment barriers, tie your Twitter contributions to something you are doing already, said Dr. Arora, associate chief medical officer-clinical learning environment at the University of Chicago.

A presence on social media isn’t just a tool to boost your own profile, Dr. Wray said. It also helps you stay on top of medical news. “There is so much information and new data coming out nowadays, it can be hard to keep up,” he said. “A properly curated social media feed can help a busy clinician stay on top of what is really important. This is an invaluable skill for the modern hospitalist.”

But be careful how much you disclose on social media about yourself and, especially, other people. “A good rule of thumb is: Don’t put anything online that you wouldn’t want your mother to read,” Dr. Chopra said. “As well, sharing any personal or patient information without understanding your institution’s guidelines or obtaining explicit permission is a general no-no,” he said.

“Also, many employers look at social media profiles before they hire people. We certainly do so when we are looking at various individuals. We often call this a ‘Google biopsy.’ ”

Randy Dotinga contributed to this report.

Social media can be more than a tool to connect with friends and family, said Vineet Chopra, MD, MBBS, FHM, Charlie Wray, DO, and Vineet Arora, MD, MAPP, MHM, at Monday’s “Tweet Your Way to the Top? Social Media as a Career Development Tool in Hospital Medicine” session.

Online outreach can play crucial roles in everything from continuing education and research to networking and career advancement, but most of the conversations in medicine are really focused in the Twittersphere, the three hospitalists said.

“Social media has allowed me to connect with leaders in hospital medicine and many other medical communities,” said Dr. Wray, an assistant professor of medicine at the University of California, San Francisco. “It has allowed me to share my work and success with the hospitalist community in addition to highlighting my trainees’ and colleagues’ successes. My engagement has created opportunities to get involved with projects that I could never have previously imagined. And it has extended my networking circle and made annual gatherings like the SHM Annual Conference even more beneficial and high yield for my career.”

For session copresenter Dr. Chopra, associate professor and chief of the division of hospital medicine at the University of Michigan, Ann Arbor, social media “helps develop your brand and your identity. It is a wonderful way for people to know what you do, who you are, what you stand for, and your views and opinions on various topics.”

On the career front, social media “can connect you to leaders in the community so that they know who you are and what you are accomplishing. So when time comes for you to move on, people within this community will know who you are and what you’re known for at a national level,” said Dr. Wray, who is also deputy digital media editor for the Journal of Hospital Medicine.

Sharing on social media – and Twitter in particular – for the medical profession is focused mainly on dissemination of information, engaging in communities, and networking beyond your institution. The three presenters shared tips of the trade during the session, such as how to boost exposure to a tweet by including hashtags, posting photos, and sharing links. To overcome time commitment barriers, tie your Twitter contributions to something you are doing already, said Dr. Arora, associate chief medical officer-clinical learning environment at the University of Chicago.

A presence on social media isn’t just a tool to boost your own profile, Dr. Wray said. It also helps you stay on top of medical news. “There is so much information and new data coming out nowadays, it can be hard to keep up,” he said. “A properly curated social media feed can help a busy clinician stay on top of what is really important. This is an invaluable skill for the modern hospitalist.”

But be careful how much you disclose on social media about yourself and, especially, other people. “A good rule of thumb is: Don’t put anything online that you wouldn’t want your mother to read,” Dr. Chopra said. “As well, sharing any personal or patient information without understanding your institution’s guidelines or obtaining explicit permission is a general no-no,” he said.

“Also, many employers look at social media profiles before they hire people. We certainly do so when we are looking at various individuals. We often call this a ‘Google biopsy.’ ”

Randy Dotinga contributed to this report.

LAS VEGAS – Hernia surgeons are square in the path of a growing backlash against the use of mesh in surgery, a fellow surgeon says, and he’s warning colleagues to take heed of the trend.

Randy Dotinga/MDedge News

LAS VEGAS – Hernia surgeons are square in the path of a growing backlash against the use of mesh in surgery, a fellow surgeon says, and he’s warning colleagues to take heed of the trend.

Randy Dotinga/MDedge News

LAS VEGAS – Hernia surgeons are square in the path of a growing backlash against the use of mesh in surgery, a fellow surgeon says, and he’s warning colleagues to take heed of the trend.

Randy Dotinga/MDedge News

Physicians have had diverse patients as long as there have been physicians (and patients). But diversity among health professionals remains elusive.

Can we do better? Absolutely, says a team of experts who will offer perspective to colleagues in a Wednesday morning session titled, “Best Practices and Tips for Developing Diversity in a Hospitalist Group.”

“The goals of our session are to review best practices for recruiting and retaining a diverse health care workforce, discuss strategies for dealing with implicit and explicit bias, and identify ways in which we can achieve common goals when working across cultures,” said hospitalist Amira del Pino-Jones, MD, assistant professor of medicine at the University of Colorado at Denver, Aurora, and director of the CU Hospitalist Scholars Program.

“Those who are interested in achieving excellence in hospital medicine through prioritizing diversity and equity efforts within their divisions, departments, and groups should attend,” said Dr. del Pino-Jones, who will be one of the speakers at the session.

Why is diversity important in hospital medicine? “Studies have shown that diversity enhances learning and work environments, promotes innovation, broadens research agendas, and improves the quality of care we provide for patients,” Dr. del Pino-Jones said. “In short, it is central to achieving excellence in hospital medicine.”

The session will focus on diverse groups, which have been historically underrepresented or discriminated against in medicine, including racial and ethnic minorities, women, LGBTQ+ individuals, and those with disabilities.

All speakers at the session are physicians, and each has seen or experienced challenges in diversifying their groups and divisions. “We hope to share our experiences, what we have learned, and ways to approach each of these issues. We also are hoping to hear from others and come up with new ways to approach these issues as a collective,” Dr. del Pino-Jones said.

Women and members of minority groups often have small numbers in their hospital medicine workplaces, especially in higher-level positions, and have trouble developing the critical mass to make progress on the diversity front, she said. Even when leaders recognize the importance of a diverse workforce, she said, “there is often a disconnect between motivation for increasing diversity and the ability to develop tangible, evidence-based methods that can be used to increase diversity.”

The session will tackle more than diversity at the workplace. Speakers also will discuss the relationship between medical professionals and patients.

“We will focus on the importance of inclusion and belonging, both of which are essential for creating a positive climate for all individuals,” Dr. del Pino-Jones said. “We will also discuss ways in which to cultivate cultural intelligence and enhance cross-cultural interactions between patients and providers. And we’ll look at ways to reduce and/or mitigate implicit and explicit bias in medicine.”

Dr. del Pino-Jones has no relevant disclosures.
 

Best Practices and Tips
for Developing Diversity in a Hospitalist Group
Wednesday, 10 - 11:30 a.m.
Potomac 4-6

Physicians have had diverse patients as long as there have been physicians (and patients). But diversity among health professionals remains elusive.

Can we do better? Absolutely, says a team of experts who will offer perspective to colleagues in a Wednesday morning session titled, “Best Practices and Tips for Developing Diversity in a Hospitalist Group.”

“The goals of our session are to review best practices for recruiting and retaining a diverse health care workforce, discuss strategies for dealing with implicit and explicit bias, and identify ways in which we can achieve common goals when working across cultures,” said hospitalist Amira del Pino-Jones, MD, assistant professor of medicine at the University of Colorado at Denver, Aurora, and director of the CU Hospitalist Scholars Program.

“Those who are interested in achieving excellence in hospital medicine through prioritizing diversity and equity efforts within their divisions, departments, and groups should attend,” said Dr. del Pino-Jones, who will be one of the speakers at the session.

Why is diversity important in hospital medicine? “Studies have shown that diversity enhances learning and work environments, promotes innovation, broadens research agendas, and improves the quality of care we provide for patients,” Dr. del Pino-Jones said. “In short, it is central to achieving excellence in hospital medicine.”

The session will focus on diverse groups, which have been historically underrepresented or discriminated against in medicine, including racial and ethnic minorities, women, LGBTQ+ individuals, and those with disabilities.

All speakers at the session are physicians, and each has seen or experienced challenges in diversifying their groups and divisions. “We hope to share our experiences, what we have learned, and ways to approach each of these issues. We also are hoping to hear from others and come up with new ways to approach these issues as a collective,” Dr. del Pino-Jones said.

Women and members of minority groups often have small numbers in their hospital medicine workplaces, especially in higher-level positions, and have trouble developing the critical mass to make progress on the diversity front, she said. Even when leaders recognize the importance of a diverse workforce, she said, “there is often a disconnect between motivation for increasing diversity and the ability to develop tangible, evidence-based methods that can be used to increase diversity.”

The session will tackle more than diversity at the workplace. Speakers also will discuss the relationship between medical professionals and patients.

“We will focus on the importance of inclusion and belonging, both of which are essential for creating a positive climate for all individuals,” Dr. del Pino-Jones said. “We will also discuss ways in which to cultivate cultural intelligence and enhance cross-cultural interactions between patients and providers. And we’ll look at ways to reduce and/or mitigate implicit and explicit bias in medicine.”

Dr. del Pino-Jones has no relevant disclosures.
 

Best Practices and Tips
for Developing Diversity in a Hospitalist Group
Wednesday, 10 - 11:30 a.m.
Potomac 4-6

Physicians have had diverse patients as long as there have been physicians (and patients). But diversity among health professionals remains elusive.

Can we do better? Absolutely, says a team of experts who will offer perspective to colleagues in a Wednesday morning session titled, “Best Practices and Tips for Developing Diversity in a Hospitalist Group.”

“The goals of our session are to review best practices for recruiting and retaining a diverse health care workforce, discuss strategies for dealing with implicit and explicit bias, and identify ways in which we can achieve common goals when working across cultures,” said hospitalist Amira del Pino-Jones, MD, assistant professor of medicine at the University of Colorado at Denver, Aurora, and director of the CU Hospitalist Scholars Program.

“Those who are interested in achieving excellence in hospital medicine through prioritizing diversity and equity efforts within their divisions, departments, and groups should attend,” said Dr. del Pino-Jones, who will be one of the speakers at the session.

Why is diversity important in hospital medicine? “Studies have shown that diversity enhances learning and work environments, promotes innovation, broadens research agendas, and improves the quality of care we provide for patients,” Dr. del Pino-Jones said. “In short, it is central to achieving excellence in hospital medicine.”

The session will focus on diverse groups, which have been historically underrepresented or discriminated against in medicine, including racial and ethnic minorities, women, LGBTQ+ individuals, and those with disabilities.

All speakers at the session are physicians, and each has seen or experienced challenges in diversifying their groups and divisions. “We hope to share our experiences, what we have learned, and ways to approach each of these issues. We also are hoping to hear from others and come up with new ways to approach these issues as a collective,” Dr. del Pino-Jones said.

Women and members of minority groups often have small numbers in their hospital medicine workplaces, especially in higher-level positions, and have trouble developing the critical mass to make progress on the diversity front, she said. Even when leaders recognize the importance of a diverse workforce, she said, “there is often a disconnect between motivation for increasing diversity and the ability to develop tangible, evidence-based methods that can be used to increase diversity.”

The session will tackle more than diversity at the workplace. Speakers also will discuss the relationship between medical professionals and patients.

“We will focus on the importance of inclusion and belonging, both of which are essential for creating a positive climate for all individuals,” Dr. del Pino-Jones said. “We will also discuss ways in which to cultivate cultural intelligence and enhance cross-cultural interactions between patients and providers. And we’ll look at ways to reduce and/or mitigate implicit and explicit bias in medicine.”

Dr. del Pino-Jones has no relevant disclosures.
 

Best Practices and Tips
for Developing Diversity in a Hospitalist Group
Wednesday, 10 - 11:30 a.m.
Potomac 4-6

A few lucky hospitalists had the chance to compete for dedicated consultation time from experienced hospital medicine mentors during the SHM Annual Conference’s first Research Shark Tank.

Lou Ferraro/Park South Photography

During the Monday afternoon session, four hospitalist projects were each presented in a 5-minute “pitch” to three senior quality and research leaders in hospital medicine who served as the “sharks.” These pitches were followed by 7 minutes of moderated questions and feedback from the sharks and the audience. Sharks then “bid” on the projects, offering up to 2 hours of one-on-one consultation during the conference or as needed.

The four projects included a study of the use of off-site scribes listening in to patient/hospitalist interactions to eliminate the need for the doctor to be glued to the computer screen, which was presented by Thea Dalfino, MD, chief of hospital medicine at Albany (N.Y.) Memorial Hospital; a rethinking of medical education to emphasize the role of hospitalists as mentors to individual student “apprentices,” presented by Amulya Nagarur, MD, of the department of medicine at Massachusetts General Hospital, Boston, and Christiana Renner, MD, of University of Texas Southwestern Medical Center, Dallas; and a redesign of patient hospital gowns to optimize, comfort, morale, and functionality, presented by Cheryl Dellasega, PhD, professor of medicine and humanities at Penn State University, Hershey.

The winning project was presented by Meera Udayakumar, MD, medical director at the University of North Carolina REX Healthcare in Raleigh. She discussed “The Equalizer,” a computerized tool to optimize patient distribution among hospitalists in order to balance workflow in a practice.

In discussing the thinking behind this unique session, Luci Leykum, MD, SFHM, chief of the division of general and hospital medicine at the University of Texas, San Antonio, who served as one of the sharks, stated that: “We’ve always tried to do things to promote the pipeline of research in hospital medicine and to raise the visibility of research activities at the annual conference. In the past, we have done one-on-one ‘speed dating’ with mentors, but the research committee thought this format would be more interactive and that audience members could benefit from hearing the discussion.”

The other participating sharks were Andrew Auerbach, MD, MPH, MHM, professor of medicine at the University of California, San Francisco, and former editor of the Journal of Hospital Medicine, and Hardeep Singh, MD, MPH, chief of the health policy, quality, and informatics program at the Center for Innovations in Quality, Effectiveness, and Safety at the Michael E. DeBakey Veterans Affairs Medical Center in Houston.

The selection process for those looking to pitch was rigorous. Projects submitted to the research committee had to focus on research, quality improvement, or medical education and be very specific to the practice of hospital medicine. In addition, the ideas needed to be relatively well developed, ideally with some pilot data. Applicants also needed to address a significant problem in hospital medicine, showcase an innovative approach, and make the case for how their solution would have short- and long-term effects.

Dr. Leykum said she was looking to see whether the pitched projects have clearly articulated questions that are important and interesting and whether the proposed methods would sufficiently answer those questions. She also considered what the implications were if the work was done.

Audience members had a chance to ask questions and, if they were interested, to potentially partner with presenters or adopt similar ideas at their own institutions. Attendees were exposed to innovative ways of solving problems that are common and ideas that have a big impact on the way problems are approached in hospital medicine.

“I think it was a fun, fast, interactive session, and it was interesting to see,” said Dr. Leykum. “Those of us who were the sharks know each other and each other’s work, so that was a fun dynamic.”

A few lucky hospitalists had the chance to compete for dedicated consultation time from experienced hospital medicine mentors during the SHM Annual Conference’s first Research Shark Tank.

Lou Ferraro/Park South Photography

During the Monday afternoon session, four hospitalist projects were each presented in a 5-minute “pitch” to three senior quality and research leaders in hospital medicine who served as the “sharks.” These pitches were followed by 7 minutes of moderated questions and feedback from the sharks and the audience. Sharks then “bid” on the projects, offering up to 2 hours of one-on-one consultation during the conference or as needed.

The four projects included a study of the use of off-site scribes listening in to patient/hospitalist interactions to eliminate the need for the doctor to be glued to the computer screen, which was presented by Thea Dalfino, MD, chief of hospital medicine at Albany (N.Y.) Memorial Hospital; a rethinking of medical education to emphasize the role of hospitalists as mentors to individual student “apprentices,” presented by Amulya Nagarur, MD, of the department of medicine at Massachusetts General Hospital, Boston, and Christiana Renner, MD, of University of Texas Southwestern Medical Center, Dallas; and a redesign of patient hospital gowns to optimize, comfort, morale, and functionality, presented by Cheryl Dellasega, PhD, professor of medicine and humanities at Penn State University, Hershey.

The winning project was presented by Meera Udayakumar, MD, medical director at the University of North Carolina REX Healthcare in Raleigh. She discussed “The Equalizer,” a computerized tool to optimize patient distribution among hospitalists in order to balance workflow in a practice.

In discussing the thinking behind this unique session, Luci Leykum, MD, SFHM, chief of the division of general and hospital medicine at the University of Texas, San Antonio, who served as one of the sharks, stated that: “We’ve always tried to do things to promote the pipeline of research in hospital medicine and to raise the visibility of research activities at the annual conference. In the past, we have done one-on-one ‘speed dating’ with mentors, but the research committee thought this format would be more interactive and that audience members could benefit from hearing the discussion.”

The other participating sharks were Andrew Auerbach, MD, MPH, MHM, professor of medicine at the University of California, San Francisco, and former editor of the Journal of Hospital Medicine, and Hardeep Singh, MD, MPH, chief of the health policy, quality, and informatics program at the Center for Innovations in Quality, Effectiveness, and Safety at the Michael E. DeBakey Veterans Affairs Medical Center in Houston.

The selection process for those looking to pitch was rigorous. Projects submitted to the research committee had to focus on research, quality improvement, or medical education and be very specific to the practice of hospital medicine. In addition, the ideas needed to be relatively well developed, ideally with some pilot data. Applicants also needed to address a significant problem in hospital medicine, showcase an innovative approach, and make the case for how their solution would have short- and long-term effects.

Dr. Leykum said she was looking to see whether the pitched projects have clearly articulated questions that are important and interesting and whether the proposed methods would sufficiently answer those questions. She also considered what the implications were if the work was done.

Audience members had a chance to ask questions and, if they were interested, to potentially partner with presenters or adopt similar ideas at their own institutions. Attendees were exposed to innovative ways of solving problems that are common and ideas that have a big impact on the way problems are approached in hospital medicine.

“I think it was a fun, fast, interactive session, and it was interesting to see,” said Dr. Leykum. “Those of us who were the sharks know each other and each other’s work, so that was a fun dynamic.”

A few lucky hospitalists had the chance to compete for dedicated consultation time from experienced hospital medicine mentors during the SHM Annual Conference’s first Research Shark Tank.

Lou Ferraro/Park South Photography

During the Monday afternoon session, four hospitalist projects were each presented in a 5-minute “pitch” to three senior quality and research leaders in hospital medicine who served as the “sharks.” These pitches were followed by 7 minutes of moderated questions and feedback from the sharks and the audience. Sharks then “bid” on the projects, offering up to 2 hours of one-on-one consultation during the conference or as needed.

The four projects included a study of the use of off-site scribes listening in to patient/hospitalist interactions to eliminate the need for the doctor to be glued to the computer screen, which was presented by Thea Dalfino, MD, chief of hospital medicine at Albany (N.Y.) Memorial Hospital; a rethinking of medical education to emphasize the role of hospitalists as mentors to individual student “apprentices,” presented by Amulya Nagarur, MD, of the department of medicine at Massachusetts General Hospital, Boston, and Christiana Renner, MD, of University of Texas Southwestern Medical Center, Dallas; and a redesign of patient hospital gowns to optimize, comfort, morale, and functionality, presented by Cheryl Dellasega, PhD, professor of medicine and humanities at Penn State University, Hershey.

The winning project was presented by Meera Udayakumar, MD, medical director at the University of North Carolina REX Healthcare in Raleigh. She discussed “The Equalizer,” a computerized tool to optimize patient distribution among hospitalists in order to balance workflow in a practice.

In discussing the thinking behind this unique session, Luci Leykum, MD, SFHM, chief of the division of general and hospital medicine at the University of Texas, San Antonio, who served as one of the sharks, stated that: “We’ve always tried to do things to promote the pipeline of research in hospital medicine and to raise the visibility of research activities at the annual conference. In the past, we have done one-on-one ‘speed dating’ with mentors, but the research committee thought this format would be more interactive and that audience members could benefit from hearing the discussion.”

The other participating sharks were Andrew Auerbach, MD, MPH, MHM, professor of medicine at the University of California, San Francisco, and former editor of the Journal of Hospital Medicine, and Hardeep Singh, MD, MPH, chief of the health policy, quality, and informatics program at the Center for Innovations in Quality, Effectiveness, and Safety at the Michael E. DeBakey Veterans Affairs Medical Center in Houston.

The selection process for those looking to pitch was rigorous. Projects submitted to the research committee had to focus on research, quality improvement, or medical education and be very specific to the practice of hospital medicine. In addition, the ideas needed to be relatively well developed, ideally with some pilot data. Applicants also needed to address a significant problem in hospital medicine, showcase an innovative approach, and make the case for how their solution would have short- and long-term effects.

Dr. Leykum said she was looking to see whether the pitched projects have clearly articulated questions that are important and interesting and whether the proposed methods would sufficiently answer those questions. She also considered what the implications were if the work was done.

Audience members had a chance to ask questions and, if they were interested, to potentially partner with presenters or adopt similar ideas at their own institutions. Attendees were exposed to innovative ways of solving problems that are common and ideas that have a big impact on the way problems are approached in hospital medicine.

“I think it was a fun, fast, interactive session, and it was interesting to see,” said Dr. Leykum. “Those of us who were the sharks know each other and each other’s work, so that was a fun dynamic.”

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