Leadership Training

Changing times

After more than 20 years, my leadership role as CEO at the Society of Hospital Medicine (SHM) has ended with the transition to Dr. Eric Howell as the new SHM CEO on July 1, 2020. Looking back, I think we can all be proud of how we have helped to shape the specialty of hospital medicine over these two decades and of how strong SHM has become to support our new specialty.

In 2000, few people knew what a hospitalist was (or more importantly what we could become) and the specialty of hospital medicine had not even been named yet. Today the reputation of SHM is firmly established and the specialty has been defined by a unique curriculum through the Core Competencies in Hospital Medicine for both adult and pediatric patients, and by several textbooks in hospital medicine. There are divisions or departments of hospital medicine at many hospitals and academic medical centers. We even managed to convince the American Board of Internal Medicine, the American Board of Family Medicine, and the American Board of Medical Specialties to create a credential of Focused Practice in Hospital Medicine as the first-ever certification not tied to specific fellowship training.

To recognize the contributions of our members, SHM has established Awards of Excellence and the Fellow and Senior Fellow in Hospital Medicine (FHM and SFHM) designations. We have gone from a small national association in Philadelphia to create 68 active chapters and more than 20 Special Interest Groups. In my time at SHM I have attended more than 75-chapter meetings and met with thousands of hospitalists in 46 states. We now have over 20,000 members at SHM, making us the fastest growing medical specialty ever.

When I started at the National Association of Inpatient Physicians (NAIP) our only meeting was an annual CME meeting for about 150-200 people. We now hold a national meeting every year for more than 4,000 attendees that is the “Center of the Universe for Hospital Medicine.” Understanding that we needed to educate the people who will lead change in our health care system, we developed from scratch a set of Leadership Academies that has already educated more than 2,500 hospitalist leaders. To train the educators in quality improvement in medical education we developed our Quality and Safety Educator Academy (QSEA) programs, and to promote career development of academic hospitalists we created our Academic Hospitalist Academy.

SHM is the leader in adult in-practice learning, specifically designed for hospitalists. SHM members have access to a state-of-the-art comprehensive hospitalist-based online education system as well as board review and maintenance of certification (MOC) review tools in our SPARK program, specifically for hospital medicine.

In the area of quality improvement, most medical societies convene a panel of experts, develop guidelines, publish them, and hope that change will occur. SHM has been much more proactive, creating the Center for Quality Improvement that has raised more than $10 million and developed Quality Improvement programs in more than 400 hospitals over the years, winning the prestigious Eisenberg Award along the way.

When I started at NAIP in 2000, our only communication tools were a 4-page newsletter and an email listserv. Along the way we have developed a broadly read newsmagazine (The Hospitalist), a well-recognized peer reviewed journal (Journal of Hospital Medicine), a robust website, and a significant social media presence.

From the very early days we knew that our specialty would not be totally successful by only facing inward. Change was coming to our health care system and hospitalists were going to be right in the middle. Despite our young age and limited resources, we have always hit above our weight class in advocacy. We actively participated in the development of the Affordable Care Act (Obamacare), making suggestions in payment reform, expanding the workforce with visa reform, and expanding the team of clinicians. Along the way SHM members rose to run the Centers for Medicare & Medicaid Services (CMS) and the Food and Drug Administration (FDA), and serve as U.S. Surgeon General.

Today in these troubled times, SHM continues to be a positive voice in promoting the use of PPE, the need for increased COVID-19 testing, and the recognition of our nation’s 60,000 hospitalists as essential frontline workers in the COVID-19 pandemic. With its longstanding role in promoting diversity and overcoming social injustice, SHM has had a positive national voice during the protests over police brutality.

We have proved to be a good partner with many other organizations and consistently were invited to partner in coalitions with the ED physicians (ACEP), the critical care docs (SCCM), the hospitals (AHA), the house of medicine (AMA), other internists (ACP), surgeons (ACS), and pediatricians (AAP), and so many other much more established societies, because we could be an active, flexible, and knowledgeable partner for more than 20 years.

Today, SHM and hospital medicine are clearly recognized as a force in the rapidly evolving health care system. With this comes not only influence but also responsibility, and I am certain the SHM Board, membership, and staff are ready for this challenge. The economic toll of our current pandemic will see colleges and other major companies and institutions go out of business and leave the landscape. SHM has a deep foundation and a well of strength to call on and will survive and thrive into the future.

SHM has been a good fit for me professionally and personally. Many of my skills and strengths have served SHM in our “early” years. I am very proud of what we have been able to accomplish TOGETHER. In the end it is the people I have been fortunate enough to meet and work with throughout these past 20 years that will stay with me, many of whom are lifelong friends. My mother, even today at 93, has always asked me to leave anything I do better off than when I came in the door. As I look back at my time helping to shape and lead SHM, I am sure I have answered my mother’s challenge and more.

I look forward to seeing many of you at a future SHM meeting and reveling in the way that hospitalists will actively play an important role in shaping our health care system in the future.
 

Dr. Wellikson is retiring as CEO of SHM.

Live long and prosper

Back in 2000, I was extremely fortunate to land my dream job as a hospitalist at Johns Hopkins Bayview in Baltimore. That dream exceeded my wildest aspirations. During my 20-year career as faculty in the Johns Hopkins School of Medicine I grew our tiny, 4 physician hospitalist group at Johns Hopkins Bayview into a multihospital program, complete with more than 150 physicians. That exceedingly rewarding work helped to shape the field of hospital medicine nationally and provided the foundation for my promotion to professor of medicine at Johns Hopkins in 2016.

Most professionals are lucky if they find one inspiring institution; I have found two. SHM has been my professional home since I became a hospitalist in 2000, and in that time I have dedicated as much creative energy to SHM as I have at Johns Hopkins.

Even at this time when the medical profession, and the entire world, has been rocked by the coronavirus, the fundamentals that have made SHM so successful will serve us well through the effects of this pandemic and beyond. It takes a skilled leader to nurture a professional society through the growth from only a few hundred members to thousands upon thousands, and at the same time crafting the profession into one of quality and high impact. These past 22 years Dr. Larry Wellikson, our retiring CEO, has skillfully accomplished just that by building lasting programs and people.

As you might imagine, my approach will work to add onto the legacy that Larry has left us. Yes, we will have to adapt SHM to the realities of the near future: virtual meetings, in-person events (yes, those will return one day) with appropriate social distancing until the coronavirus has faded, modified chapter meetings, and more. Someday the world will find a new normal, and SHM will evolve to meet the needs of our members and the patients we serve.

Through this pandemic and beyond, my vision – in partnership with the Board of Directors – will be to:

• Continue the work to enhance member engagement. We are primarily a membership organization, after all.
• Maintain our profession’s leadership role in the care continuum, particularly acute care.
• Be a deliberate sponsor of diversity and inclusion. I believe social justice is a moral imperative, and good business.
• Invest in teams: Chapters, special interest groups, and committees are key to success.
• Be financially prudent, so that this organization can serve its members through the best of times and those most challenging times.

Back in 2000 I joined my dream society, the Society of Hospital Medicine. That society exceeded my wildest aspirations. During my 20-year membership I started an SHM Chapter, was a leader in the Leadership Academies, joined the Board of Directors, participated in Annual Conferences, and helped lead the SHM Center for Quality Improvement. That exceedingly rewarding partnership helped shape the field of hospital medicine nationally and provided the foundation for my next role at SHM. I am excited and grateful to be the CEO of SHM.

I’ll end with something I use every day – “Eric Howell’s Core Values”:

• Make the world a better place.
• Invest in people.
• Be ethical and transparent.
• Do what you love.
• Try to use Star Trek references whenever possible. (Okay, this last one is not really a core value, but maybe a character trait?) At least the Vulcan greeting is appropriate for our times: Live long and prosper.

Dr. Howell is the new CEO for SHM as of July 1, 2020.

Changing times

After more than 20 years, my leadership role as CEO at the Society of Hospital Medicine (SHM) has ended with the transition to Dr. Eric Howell as the new SHM CEO on July 1, 2020. Looking back, I think we can all be proud of how we have helped to shape the specialty of hospital medicine over these two decades and of how strong SHM has become to support our new specialty.

In 2000, few people knew what a hospitalist was (or more importantly what we could become) and the specialty of hospital medicine had not even been named yet. Today the reputation of SHM is firmly established and the specialty has been defined by a unique curriculum through the Core Competencies in Hospital Medicine for both adult and pediatric patients, and by several textbooks in hospital medicine. There are divisions or departments of hospital medicine at many hospitals and academic medical centers. We even managed to convince the American Board of Internal Medicine, the American Board of Family Medicine, and the American Board of Medical Specialties to create a credential of Focused Practice in Hospital Medicine as the first-ever certification not tied to specific fellowship training.

To recognize the contributions of our members, SHM has established Awards of Excellence and the Fellow and Senior Fellow in Hospital Medicine (FHM and SFHM) designations. We have gone from a small national association in Philadelphia to create 68 active chapters and more than 20 Special Interest Groups. In my time at SHM I have attended more than 75-chapter meetings and met with thousands of hospitalists in 46 states. We now have over 20,000 members at SHM, making us the fastest growing medical specialty ever.

When I started at the National Association of Inpatient Physicians (NAIP) our only meeting was an annual CME meeting for about 150-200 people. We now hold a national meeting every year for more than 4,000 attendees that is the “Center of the Universe for Hospital Medicine.” Understanding that we needed to educate the people who will lead change in our health care system, we developed from scratch a set of Leadership Academies that has already educated more than 2,500 hospitalist leaders. To train the educators in quality improvement in medical education we developed our Quality and Safety Educator Academy (QSEA) programs, and to promote career development of academic hospitalists we created our Academic Hospitalist Academy.

SHM is the leader in adult in-practice learning, specifically designed for hospitalists. SHM members have access to a state-of-the-art comprehensive hospitalist-based online education system as well as board review and maintenance of certification (MOC) review tools in our SPARK program, specifically for hospital medicine.

In the area of quality improvement, most medical societies convene a panel of experts, develop guidelines, publish them, and hope that change will occur. SHM has been much more proactive, creating the Center for Quality Improvement that has raised more than $10 million and developed Quality Improvement programs in more than 400 hospitals over the years, winning the prestigious Eisenberg Award along the way.

When I started at NAIP in 2000, our only communication tools were a 4-page newsletter and an email listserv. Along the way we have developed a broadly read newsmagazine (The Hospitalist), a well-recognized peer reviewed journal (Journal of Hospital Medicine), a robust website, and a significant social media presence.

From the very early days we knew that our specialty would not be totally successful by only facing inward. Change was coming to our health care system and hospitalists were going to be right in the middle. Despite our young age and limited resources, we have always hit above our weight class in advocacy. We actively participated in the development of the Affordable Care Act (Obamacare), making suggestions in payment reform, expanding the workforce with visa reform, and expanding the team of clinicians. Along the way SHM members rose to run the Centers for Medicare & Medicaid Services (CMS) and the Food and Drug Administration (FDA), and serve as U.S. Surgeon General.

Today in these troubled times, SHM continues to be a positive voice in promoting the use of PPE, the need for increased COVID-19 testing, and the recognition of our nation’s 60,000 hospitalists as essential frontline workers in the COVID-19 pandemic. With its longstanding role in promoting diversity and overcoming social injustice, SHM has had a positive national voice during the protests over police brutality.

We have proved to be a good partner with many other organizations and consistently were invited to partner in coalitions with the ED physicians (ACEP), the critical care docs (SCCM), the hospitals (AHA), the house of medicine (AMA), other internists (ACP), surgeons (ACS), and pediatricians (AAP), and so many other much more established societies, because we could be an active, flexible, and knowledgeable partner for more than 20 years.

Today, SHM and hospital medicine are clearly recognized as a force in the rapidly evolving health care system. With this comes not only influence but also responsibility, and I am certain the SHM Board, membership, and staff are ready for this challenge. The economic toll of our current pandemic will see colleges and other major companies and institutions go out of business and leave the landscape. SHM has a deep foundation and a well of strength to call on and will survive and thrive into the future.

SHM has been a good fit for me professionally and personally. Many of my skills and strengths have served SHM in our “early” years. I am very proud of what we have been able to accomplish TOGETHER. In the end it is the people I have been fortunate enough to meet and work with throughout these past 20 years that will stay with me, many of whom are lifelong friends. My mother, even today at 93, has always asked me to leave anything I do better off than when I came in the door. As I look back at my time helping to shape and lead SHM, I am sure I have answered my mother’s challenge and more.

I look forward to seeing many of you at a future SHM meeting and reveling in the way that hospitalists will actively play an important role in shaping our health care system in the future.
 

Dr. Wellikson is retiring as CEO of SHM.

Live long and prosper

Back in 2000, I was extremely fortunate to land my dream job as a hospitalist at Johns Hopkins Bayview in Baltimore. That dream exceeded my wildest aspirations. During my 20-year career as faculty in the Johns Hopkins School of Medicine I grew our tiny, 4 physician hospitalist group at Johns Hopkins Bayview into a multihospital program, complete with more than 150 physicians. That exceedingly rewarding work helped to shape the field of hospital medicine nationally and provided the foundation for my promotion to professor of medicine at Johns Hopkins in 2016.

Most professionals are lucky if they find one inspiring institution; I have found two. SHM has been my professional home since I became a hospitalist in 2000, and in that time I have dedicated as much creative energy to SHM as I have at Johns Hopkins.

Even at this time when the medical profession, and the entire world, has been rocked by the coronavirus, the fundamentals that have made SHM so successful will serve us well through the effects of this pandemic and beyond. It takes a skilled leader to nurture a professional society through the growth from only a few hundred members to thousands upon thousands, and at the same time crafting the profession into one of quality and high impact. These past 22 years Dr. Larry Wellikson, our retiring CEO, has skillfully accomplished just that by building lasting programs and people.

As you might imagine, my approach will work to add onto the legacy that Larry has left us. Yes, we will have to adapt SHM to the realities of the near future: virtual meetings, in-person events (yes, those will return one day) with appropriate social distancing until the coronavirus has faded, modified chapter meetings, and more. Someday the world will find a new normal, and SHM will evolve to meet the needs of our members and the patients we serve.

Through this pandemic and beyond, my vision – in partnership with the Board of Directors – will be to:

• Continue the work to enhance member engagement. We are primarily a membership organization, after all.
• Maintain our profession’s leadership role in the care continuum, particularly acute care.
• Be a deliberate sponsor of diversity and inclusion. I believe social justice is a moral imperative, and good business.
• Invest in teams: Chapters, special interest groups, and committees are key to success.
• Be financially prudent, so that this organization can serve its members through the best of times and those most challenging times.

Back in 2000 I joined my dream society, the Society of Hospital Medicine. That society exceeded my wildest aspirations. During my 20-year membership I started an SHM Chapter, was a leader in the Leadership Academies, joined the Board of Directors, participated in Annual Conferences, and helped lead the SHM Center for Quality Improvement. That exceedingly rewarding partnership helped shape the field of hospital medicine nationally and provided the foundation for my next role at SHM. I am excited and grateful to be the CEO of SHM.

I’ll end with something I use every day – “Eric Howell’s Core Values”:

• Make the world a better place.
• Invest in people.
• Be ethical and transparent.
• Do what you love.
• Try to use Star Trek references whenever possible. (Okay, this last one is not really a core value, but maybe a character trait?) At least the Vulcan greeting is appropriate for our times: Live long and prosper.

Dr. Howell is the new CEO for SHM as of July 1, 2020.

Changing times

After more than 20 years, my leadership role as CEO at the Society of Hospital Medicine (SHM) has ended with the transition to Dr. Eric Howell as the new SHM CEO on July 1, 2020. Looking back, I think we can all be proud of how we have helped to shape the specialty of hospital medicine over these two decades and of how strong SHM has become to support our new specialty.

In 2000, few people knew what a hospitalist was (or more importantly what we could become) and the specialty of hospital medicine had not even been named yet. Today the reputation of SHM is firmly established and the specialty has been defined by a unique curriculum through the Core Competencies in Hospital Medicine for both adult and pediatric patients, and by several textbooks in hospital medicine. There are divisions or departments of hospital medicine at many hospitals and academic medical centers. We even managed to convince the American Board of Internal Medicine, the American Board of Family Medicine, and the American Board of Medical Specialties to create a credential of Focused Practice in Hospital Medicine as the first-ever certification not tied to specific fellowship training.

To recognize the contributions of our members, SHM has established Awards of Excellence and the Fellow and Senior Fellow in Hospital Medicine (FHM and SFHM) designations. We have gone from a small national association in Philadelphia to create 68 active chapters and more than 20 Special Interest Groups. In my time at SHM I have attended more than 75-chapter meetings and met with thousands of hospitalists in 46 states. We now have over 20,000 members at SHM, making us the fastest growing medical specialty ever.

When I started at the National Association of Inpatient Physicians (NAIP) our only meeting was an annual CME meeting for about 150-200 people. We now hold a national meeting every year for more than 4,000 attendees that is the “Center of the Universe for Hospital Medicine.” Understanding that we needed to educate the people who will lead change in our health care system, we developed from scratch a set of Leadership Academies that has already educated more than 2,500 hospitalist leaders. To train the educators in quality improvement in medical education we developed our Quality and Safety Educator Academy (QSEA) programs, and to promote career development of academic hospitalists we created our Academic Hospitalist Academy.

SHM is the leader in adult in-practice learning, specifically designed for hospitalists. SHM members have access to a state-of-the-art comprehensive hospitalist-based online education system as well as board review and maintenance of certification (MOC) review tools in our SPARK program, specifically for hospital medicine.

In the area of quality improvement, most medical societies convene a panel of experts, develop guidelines, publish them, and hope that change will occur. SHM has been much more proactive, creating the Center for Quality Improvement that has raised more than $10 million and developed Quality Improvement programs in more than 400 hospitals over the years, winning the prestigious Eisenberg Award along the way.

When I started at NAIP in 2000, our only communication tools were a 4-page newsletter and an email listserv. Along the way we have developed a broadly read newsmagazine (The Hospitalist), a well-recognized peer reviewed journal (Journal of Hospital Medicine), a robust website, and a significant social media presence.

From the very early days we knew that our specialty would not be totally successful by only facing inward. Change was coming to our health care system and hospitalists were going to be right in the middle. Despite our young age and limited resources, we have always hit above our weight class in advocacy. We actively participated in the development of the Affordable Care Act (Obamacare), making suggestions in payment reform, expanding the workforce with visa reform, and expanding the team of clinicians. Along the way SHM members rose to run the Centers for Medicare & Medicaid Services (CMS) and the Food and Drug Administration (FDA), and serve as U.S. Surgeon General.

Today in these troubled times, SHM continues to be a positive voice in promoting the use of PPE, the need for increased COVID-19 testing, and the recognition of our nation’s 60,000 hospitalists as essential frontline workers in the COVID-19 pandemic. With its longstanding role in promoting diversity and overcoming social injustice, SHM has had a positive national voice during the protests over police brutality.

We have proved to be a good partner with many other organizations and consistently were invited to partner in coalitions with the ED physicians (ACEP), the critical care docs (SCCM), the hospitals (AHA), the house of medicine (AMA), other internists (ACP), surgeons (ACS), and pediatricians (AAP), and so many other much more established societies, because we could be an active, flexible, and knowledgeable partner for more than 20 years.

Today, SHM and hospital medicine are clearly recognized as a force in the rapidly evolving health care system. With this comes not only influence but also responsibility, and I am certain the SHM Board, membership, and staff are ready for this challenge. The economic toll of our current pandemic will see colleges and other major companies and institutions go out of business and leave the landscape. SHM has a deep foundation and a well of strength to call on and will survive and thrive into the future.

SHM has been a good fit for me professionally and personally. Many of my skills and strengths have served SHM in our “early” years. I am very proud of what we have been able to accomplish TOGETHER. In the end it is the people I have been fortunate enough to meet and work with throughout these past 20 years that will stay with me, many of whom are lifelong friends. My mother, even today at 93, has always asked me to leave anything I do better off than when I came in the door. As I look back at my time helping to shape and lead SHM, I am sure I have answered my mother’s challenge and more.

I look forward to seeing many of you at a future SHM meeting and reveling in the way that hospitalists will actively play an important role in shaping our health care system in the future.
 

Dr. Wellikson is retiring as CEO of SHM.

Live long and prosper

Back in 2000, I was extremely fortunate to land my dream job as a hospitalist at Johns Hopkins Bayview in Baltimore. That dream exceeded my wildest aspirations. During my 20-year career as faculty in the Johns Hopkins School of Medicine I grew our tiny, 4 physician hospitalist group at Johns Hopkins Bayview into a multihospital program, complete with more than 150 physicians. That exceedingly rewarding work helped to shape the field of hospital medicine nationally and provided the foundation for my promotion to professor of medicine at Johns Hopkins in 2016.

Most professionals are lucky if they find one inspiring institution; I have found two. SHM has been my professional home since I became a hospitalist in 2000, and in that time I have dedicated as much creative energy to SHM as I have at Johns Hopkins.

Even at this time when the medical profession, and the entire world, has been rocked by the coronavirus, the fundamentals that have made SHM so successful will serve us well through the effects of this pandemic and beyond. It takes a skilled leader to nurture a professional society through the growth from only a few hundred members to thousands upon thousands, and at the same time crafting the profession into one of quality and high impact. These past 22 years Dr. Larry Wellikson, our retiring CEO, has skillfully accomplished just that by building lasting programs and people.

As you might imagine, my approach will work to add onto the legacy that Larry has left us. Yes, we will have to adapt SHM to the realities of the near future: virtual meetings, in-person events (yes, those will return one day) with appropriate social distancing until the coronavirus has faded, modified chapter meetings, and more. Someday the world will find a new normal, and SHM will evolve to meet the needs of our members and the patients we serve.

Through this pandemic and beyond, my vision – in partnership with the Board of Directors – will be to:

• Continue the work to enhance member engagement. We are primarily a membership organization, after all.
• Maintain our profession’s leadership role in the care continuum, particularly acute care.
• Be a deliberate sponsor of diversity and inclusion. I believe social justice is a moral imperative, and good business.
• Invest in teams: Chapters, special interest groups, and committees are key to success.
• Be financially prudent, so that this organization can serve its members through the best of times and those most challenging times.

Back in 2000 I joined my dream society, the Society of Hospital Medicine. That society exceeded my wildest aspirations. During my 20-year membership I started an SHM Chapter, was a leader in the Leadership Academies, joined the Board of Directors, participated in Annual Conferences, and helped lead the SHM Center for Quality Improvement. That exceedingly rewarding partnership helped shape the field of hospital medicine nationally and provided the foundation for my next role at SHM. I am excited and grateful to be the CEO of SHM.

I’ll end with something I use every day – “Eric Howell’s Core Values”:

• Make the world a better place.
• Invest in people.
• Be ethical and transparent.
• Do what you love.
• Try to use Star Trek references whenever possible. (Okay, this last one is not really a core value, but maybe a character trait?) At least the Vulcan greeting is appropriate for our times: Live long and prosper.

Dr. Howell is the new CEO for SHM as of July 1, 2020.

Keshav Khanijow, MD, is a hospitalist at Northwestern Memorial Hospital and assistant professor at Northwestern University, Chicago. Originally from the San Francisco Bay area, he studied anthropology as an undergrad at Johns Hopkins University, Baltimore, then went to medical school at the University of California, San Francisco, followed by internal medicine residency and a hospital medicine fellowship at Johns Hopkins Bayview Medical Center. He came out as gay in 2006 as an undergrad. He is a founding member of the Society of Hospital Medicine’s LGBTQ+ Task Force and is involved with SHM’s Diversity and Inclusion Special Interest Group.

What challenges have you faced because of your sexual orientation in the different stages of your career, from training to now as a practicing physician?

In my early training, there weren’t a lot of accessible LGBTQ role models to talk about balancing my personal identities with my professional aspirations. Being a double minority as both South Asian and a gay male, made it that much more difficult. “What is it like to work in health care as a gay cismale? Will being out on my personal statement affect my entry into medical school? Should I list my LGBTQ activism activities or not?” Those were important to me.

And did you make your activism known?

Thankfully, I did. I joke that my application might as well have been printed on rainbow paper, if you will. I decided to be out because I wanted to be part of an environment that would accept me for who I was. But it was a difficult decision.

In medical school at UCSF, it’s San Francisco, so they were a little ahead of the game. They had a lot of social networking opportunities with LGBTQ and ally faculty. Those connections were important in helping me explore different fields, and I even got to write my first publication. That said, networking could sometimes be challenging, especially when it came to residency interviews. While many people would talk about family activities and engagements, I’d only been out to my family for a few years. As such, there would be somewhat of a disconnect. On the flip side, there were LGBTQ celebrations and cultural concepts important to me, but I couldn’t always connect on those fronts either.

When it comes to patients, I do have a bit of a higher-pitched voice, and my mannerisms can be gender nonconforming. While it did make me the target of some cruel middle school humor, I’ve come to be proud of myself, mannerisms and all. That said, I have had patients make remarks to me about being gay, whether it be positive or negative. For LGBTQ patients, they’re like, “this is great, I have a gay doctor. They’ll know a bit more about what I’m talking about or be able to relate to the community pressures I face.”

But sometimes homophobic patients can be a bit more cold. I’ve never had anyone say that they don’t want to have me as their physician, but I definitely have patients who disagree with me and say, essentially, “oh well, you don’t know what you’re talking about because you’re gay.” Of course, there have also been comments based on my ethnicity as well.
 

What specific progress could you point to that you’ve seen over the course of your training and your career so far with regard to LGBTQ health care workers’ experience and LGBTQ patients?

When I was in college, there was a case in 2007 where a woman wasn’t able to see her partner or children before dying in a Florida hospital. Since then, there’s been great strides with a 2011 executive order extending hospital visitation rights to LGBTQ families. In 2013, there was the legalization of same-sex marriage. More recently, in June 2020, the Supreme Court extended protections against workplace discrimination to LGBTQ employees.

But there are certain things that continue to be problems, such as the recent Final Rule from the Department of Health & Human Services that fails to protect our LGBTQ patients and friends against discrimination in health care.
 

Can you remember a specific episode with a patient who was in the LGBTQ community that was particularly satisfying or moving?

There are two that I think about. In medical school, I was working in a more conservative area of California, and there was a patient who identified as lesbian. She felt more able to talk about her fears of raising a family in a conservative area. She even said, “I feel you can understand the stuff, I can talk to you a bit more about it freely, which is really nice.” Later on, I was able to see them on another rotation I was on, after she’d had a baby with her partner. I was honored that they considered me a part of their family’s journey.

A couple years ago as an attending hospitalist, I had a gay male patient that came in for hepatitis A treatment. Although we typically think of hepatitis A as a foodborne illness, oral-anal sex (rimming) is also a risk factor. After having an open discussion with him about his sexual practices, I said, “it was probably an STI in your case,” and was able to give him guidelines on how to prevent giving it to anyone else during the recovery period. He was very appreciative, and I was glad to have been there for that patient.
 

What is SHM’s role in regard to improving the care of LGBTQ patients, improving inclusiveness for LGBTQ health professionals?

Continuing to have educational activities, whether it be lectures at the annual conference or online learning modules, will be critical to care for our LGBTQ patients. With regard to membership, we need to make sure that hospitalists feel included and protected. To this end, our Diversity and Inclusion Special Interest Group was working toward having gender-neutral bathrooms and personal pronoun tags for the in-person 2020 annual conference before it was converted to an online format.

Does it ever get tiring for you to work on “social issues” in addition to strictly medical issues?

I will say I definitely experienced a moment in time during residency where I had to take a step back and recenter myself. Sometimes, realizing how much work needs to get done, coupled with the challenges of one’s personal life, can be daunting. That said, I can only stare at a problem so long before needing to work on creating a solution. At the end of the day I didn’t want to run away from these newfound problems of exclusion – I wanted to be a part of the solution.

In my hospital medicine fellowship, I was lucky to have Flora Kisuule, MD, as a mentor who encouraged me to take my prior work with LGBTQ health and leverage it into hospital medicine projects. As such, I was able to combine a topic I was passionate about with my interests in research and teaching so that they work synergistically. After all, the social issues affect our medical histories, just as our medical issues affect our social being. They go hand in hand.

Keshav Khanijow, MD, is a hospitalist at Northwestern Memorial Hospital and assistant professor at Northwestern University, Chicago. Originally from the San Francisco Bay area, he studied anthropology as an undergrad at Johns Hopkins University, Baltimore, then went to medical school at the University of California, San Francisco, followed by internal medicine residency and a hospital medicine fellowship at Johns Hopkins Bayview Medical Center. He came out as gay in 2006 as an undergrad. He is a founding member of the Society of Hospital Medicine’s LGBTQ+ Task Force and is involved with SHM’s Diversity and Inclusion Special Interest Group.

What challenges have you faced because of your sexual orientation in the different stages of your career, from training to now as a practicing physician?

In my early training, there weren’t a lot of accessible LGBTQ role models to talk about balancing my personal identities with my professional aspirations. Being a double minority as both South Asian and a gay male, made it that much more difficult. “What is it like to work in health care as a gay cismale? Will being out on my personal statement affect my entry into medical school? Should I list my LGBTQ activism activities or not?” Those were important to me.

And did you make your activism known?

Thankfully, I did. I joke that my application might as well have been printed on rainbow paper, if you will. I decided to be out because I wanted to be part of an environment that would accept me for who I was. But it was a difficult decision.

In medical school at UCSF, it’s San Francisco, so they were a little ahead of the game. They had a lot of social networking opportunities with LGBTQ and ally faculty. Those connections were important in helping me explore different fields, and I even got to write my first publication. That said, networking could sometimes be challenging, especially when it came to residency interviews. While many people would talk about family activities and engagements, I’d only been out to my family for a few years. As such, there would be somewhat of a disconnect. On the flip side, there were LGBTQ celebrations and cultural concepts important to me, but I couldn’t always connect on those fronts either.

When it comes to patients, I do have a bit of a higher-pitched voice, and my mannerisms can be gender nonconforming. While it did make me the target of some cruel middle school humor, I’ve come to be proud of myself, mannerisms and all. That said, I have had patients make remarks to me about being gay, whether it be positive or negative. For LGBTQ patients, they’re like, “this is great, I have a gay doctor. They’ll know a bit more about what I’m talking about or be able to relate to the community pressures I face.”

But sometimes homophobic patients can be a bit more cold. I’ve never had anyone say that they don’t want to have me as their physician, but I definitely have patients who disagree with me and say, essentially, “oh well, you don’t know what you’re talking about because you’re gay.” Of course, there have also been comments based on my ethnicity as well.
 

What specific progress could you point to that you’ve seen over the course of your training and your career so far with regard to LGBTQ health care workers’ experience and LGBTQ patients?

When I was in college, there was a case in 2007 where a woman wasn’t able to see her partner or children before dying in a Florida hospital. Since then, there’s been great strides with a 2011 executive order extending hospital visitation rights to LGBTQ families. In 2013, there was the legalization of same-sex marriage. More recently, in June 2020, the Supreme Court extended protections against workplace discrimination to LGBTQ employees.

But there are certain things that continue to be problems, such as the recent Final Rule from the Department of Health & Human Services that fails to protect our LGBTQ patients and friends against discrimination in health care.
 

Can you remember a specific episode with a patient who was in the LGBTQ community that was particularly satisfying or moving?

There are two that I think about. In medical school, I was working in a more conservative area of California, and there was a patient who identified as lesbian. She felt more able to talk about her fears of raising a family in a conservative area. She even said, “I feel you can understand the stuff, I can talk to you a bit more about it freely, which is really nice.” Later on, I was able to see them on another rotation I was on, after she’d had a baby with her partner. I was honored that they considered me a part of their family’s journey.

A couple years ago as an attending hospitalist, I had a gay male patient that came in for hepatitis A treatment. Although we typically think of hepatitis A as a foodborne illness, oral-anal sex (rimming) is also a risk factor. After having an open discussion with him about his sexual practices, I said, “it was probably an STI in your case,” and was able to give him guidelines on how to prevent giving it to anyone else during the recovery period. He was very appreciative, and I was glad to have been there for that patient.
 

What is SHM’s role in regard to improving the care of LGBTQ patients, improving inclusiveness for LGBTQ health professionals?

Continuing to have educational activities, whether it be lectures at the annual conference or online learning modules, will be critical to care for our LGBTQ patients. With regard to membership, we need to make sure that hospitalists feel included and protected. To this end, our Diversity and Inclusion Special Interest Group was working toward having gender-neutral bathrooms and personal pronoun tags for the in-person 2020 annual conference before it was converted to an online format.

Does it ever get tiring for you to work on “social issues” in addition to strictly medical issues?

I will say I definitely experienced a moment in time during residency where I had to take a step back and recenter myself. Sometimes, realizing how much work needs to get done, coupled with the challenges of one’s personal life, can be daunting. That said, I can only stare at a problem so long before needing to work on creating a solution. At the end of the day I didn’t want to run away from these newfound problems of exclusion – I wanted to be a part of the solution.

In my hospital medicine fellowship, I was lucky to have Flora Kisuule, MD, as a mentor who encouraged me to take my prior work with LGBTQ health and leverage it into hospital medicine projects. As such, I was able to combine a topic I was passionate about with my interests in research and teaching so that they work synergistically. After all, the social issues affect our medical histories, just as our medical issues affect our social being. They go hand in hand.

Keshav Khanijow, MD, is a hospitalist at Northwestern Memorial Hospital and assistant professor at Northwestern University, Chicago. Originally from the San Francisco Bay area, he studied anthropology as an undergrad at Johns Hopkins University, Baltimore, then went to medical school at the University of California, San Francisco, followed by internal medicine residency and a hospital medicine fellowship at Johns Hopkins Bayview Medical Center. He came out as gay in 2006 as an undergrad. He is a founding member of the Society of Hospital Medicine’s LGBTQ+ Task Force and is involved with SHM’s Diversity and Inclusion Special Interest Group.

What challenges have you faced because of your sexual orientation in the different stages of your career, from training to now as a practicing physician?

In my early training, there weren’t a lot of accessible LGBTQ role models to talk about balancing my personal identities with my professional aspirations. Being a double minority as both South Asian and a gay male, made it that much more difficult. “What is it like to work in health care as a gay cismale? Will being out on my personal statement affect my entry into medical school? Should I list my LGBTQ activism activities or not?” Those were important to me.

And did you make your activism known?

Thankfully, I did. I joke that my application might as well have been printed on rainbow paper, if you will. I decided to be out because I wanted to be part of an environment that would accept me for who I was. But it was a difficult decision.

In medical school at UCSF, it’s San Francisco, so they were a little ahead of the game. They had a lot of social networking opportunities with LGBTQ and ally faculty. Those connections were important in helping me explore different fields, and I even got to write my first publication. That said, networking could sometimes be challenging, especially when it came to residency interviews. While many people would talk about family activities and engagements, I’d only been out to my family for a few years. As such, there would be somewhat of a disconnect. On the flip side, there were LGBTQ celebrations and cultural concepts important to me, but I couldn’t always connect on those fronts either.

When it comes to patients, I do have a bit of a higher-pitched voice, and my mannerisms can be gender nonconforming. While it did make me the target of some cruel middle school humor, I’ve come to be proud of myself, mannerisms and all. That said, I have had patients make remarks to me about being gay, whether it be positive or negative. For LGBTQ patients, they’re like, “this is great, I have a gay doctor. They’ll know a bit more about what I’m talking about or be able to relate to the community pressures I face.”

But sometimes homophobic patients can be a bit more cold. I’ve never had anyone say that they don’t want to have me as their physician, but I definitely have patients who disagree with me and say, essentially, “oh well, you don’t know what you’re talking about because you’re gay.” Of course, there have also been comments based on my ethnicity as well.
 

What specific progress could you point to that you’ve seen over the course of your training and your career so far with regard to LGBTQ health care workers’ experience and LGBTQ patients?

When I was in college, there was a case in 2007 where a woman wasn’t able to see her partner or children before dying in a Florida hospital. Since then, there’s been great strides with a 2011 executive order extending hospital visitation rights to LGBTQ families. In 2013, there was the legalization of same-sex marriage. More recently, in June 2020, the Supreme Court extended protections against workplace discrimination to LGBTQ employees.

But there are certain things that continue to be problems, such as the recent Final Rule from the Department of Health & Human Services that fails to protect our LGBTQ patients and friends against discrimination in health care.
 

Can you remember a specific episode with a patient who was in the LGBTQ community that was particularly satisfying or moving?

There are two that I think about. In medical school, I was working in a more conservative area of California, and there was a patient who identified as lesbian. She felt more able to talk about her fears of raising a family in a conservative area. She even said, “I feel you can understand the stuff, I can talk to you a bit more about it freely, which is really nice.” Later on, I was able to see them on another rotation I was on, after she’d had a baby with her partner. I was honored that they considered me a part of their family’s journey.

A couple years ago as an attending hospitalist, I had a gay male patient that came in for hepatitis A treatment. Although we typically think of hepatitis A as a foodborne illness, oral-anal sex (rimming) is also a risk factor. After having an open discussion with him about his sexual practices, I said, “it was probably an STI in your case,” and was able to give him guidelines on how to prevent giving it to anyone else during the recovery period. He was very appreciative, and I was glad to have been there for that patient.
 

What is SHM’s role in regard to improving the care of LGBTQ patients, improving inclusiveness for LGBTQ health professionals?

Continuing to have educational activities, whether it be lectures at the annual conference or online learning modules, will be critical to care for our LGBTQ patients. With regard to membership, we need to make sure that hospitalists feel included and protected. To this end, our Diversity and Inclusion Special Interest Group was working toward having gender-neutral bathrooms and personal pronoun tags for the in-person 2020 annual conference before it was converted to an online format.

Does it ever get tiring for you to work on “social issues” in addition to strictly medical issues?

I will say I definitely experienced a moment in time during residency where I had to take a step back and recenter myself. Sometimes, realizing how much work needs to get done, coupled with the challenges of one’s personal life, can be daunting. That said, I can only stare at a problem so long before needing to work on creating a solution. At the end of the day I didn’t want to run away from these newfound problems of exclusion – I wanted to be a part of the solution.

In my hospital medicine fellowship, I was lucky to have Flora Kisuule, MD, as a mentor who encouraged me to take my prior work with LGBTQ health and leverage it into hospital medicine projects. As such, I was able to combine a topic I was passionate about with my interests in research and teaching so that they work synergistically. After all, the social issues affect our medical histories, just as our medical issues affect our social being. They go hand in hand.

Setting the table for over 2 decades

I first met Larry in the spring of 1998 after I had made a presentation to the American College of Physicians’ Board of Regents on the Society for Hospital Medicine’s (then the National Association of Inpatient Physicians) new position statement that referral to hospitalists by primary care physicians should be voluntary. At the time, a number of managed care companies around the United States were compelling primary care physicians to use hospitalists to care for their hospitalized patients apparently because they felt hospitalists could do it more efficiently. SHM became the first professional society to voice the position which in turn was broadly endorsed by physician organizations, including the American Medical Association and the ACP.

Larry sought me out, engaged with me, and handed me his business card. He seemed keen on becoming a part of the rapidly accelerating hospitalist movement and, in retrospect, putting his signature on it. He had recently built and exited from a very large and successful independent physician association during the heyday of California managed care and was eager for a new challenge.

Unlike me, who was just a few years out of residency, Larry was at the height of his professional powers, with the right blend of experience on the one hand and energy on the other to take on a project like SHM.

Larry’s first contribution came in the form of facilitating a 2-day strategic planning meeting with the SHM board in the fall of 1998. John Nelson, MD, had moved to Philadelphia for 3 months to establish the operational foundation of SHM and guide SHM’s first staff member, Angela Musial. One of the most notable achievements during that time was a strategic planning board meeting, which largely set the course for SHM’s early years. Larry was a taskmaster, forcing us to make tough choices about what we wanted to accomplish and to establish concrete goals with timelines and milestones. The adult supervision Larry brought was a new and vital thing for us.

There was a lot at stake in ’97, ‘98, and ‘99. The demand for hospitalists across the nation was skyrocketing and there was a strong need for leadership and bold direction. Academics, community-based hospitalists, pediatricians, entrepreneurs, nonphysician hospital team members, heads of organized medicine, and government and industry leaders were just some of the key stakeholders looking for a seat at the HM table. That table would go on to be set for some 2 decades by Larry Wellikson.

From the beginning, many observers remarked that SHM had established an aggressive agenda. There was an unrelenting need to erect a big tent as a home for diverse stakeholders. John and I and the SHM board were doing all we could to continue to build momentum while also leading our local hospitalist groups and trying to maintain a semblance of balance with our young families back home.

It was against this backdrop, in late 1999, while on yet another flight crisscrossing the country to promote HM and SHM, that John; Bob Wachter, MD (who had by that time replaced John and I as SHM president); and I decided we needed a full-time CEO. By that time, each of us had participated in conversations with Larry. We rapidly decided, with buy-in from the board, that we would offer Larry the position. He accepted and became CEO in January 2000.

To list here all of Larry’s accomplishments since taking the helm at SHM would be impossible. Indeed, all that SHM has achieved is closely tied to Larry. Instead, I would like to call out character traits Larry brought to SHM that are now part of SHM’s DNA and a large part of the reason SHM has been so successful over the past 20 years.


Solution oriented. SHM’s culture has always been to take conditions as they are and work to make things better. There is no place for excessively airing grievances and complaining about “what is being done to us.”

Eschewing the status quo. We can do better. There is too much that needs to be done to wait.

Appropriately irreverent of the norms of the medical establishment. Physicians are by nature careful, plodding, considered, cautious, and methodical. The velocity of change in HM called for a different approach in order to be relevant, one better characterized as the move-fast-and-break-things ethos of a Silicon Valley startup.

Bringing diverse stakeholders to the table. A signature move has been to assemble influential people to lay out the issues before setting a course of action.

Strong bias to action. There is a time to analyze and discuss, but all of this ultimately is in service of taking action to achieve a tangible result.

Working to achieve consensus to a point, then moving forward. Considerable resources have been put into bringing stakeholders together, studying problems, and gaining a common understanding of issues. But this has never been at the expense of taking bold action, even if controversial at times.

Involving industry in creative ways to the benefit of patients. SHM pioneered an approach to use resources gained through industry partnerships to perform national scale improvement activities with groups of hospitalist mentor-experts working with local teams to make care more reliable for patients.

Tirelessly connecting to frontline hospitalists. The lifeblood of SHM is frontline hospitalists. Larry has taken the time to develop relationships with as many as possible, often through personally visiting their communities.

Dr. Whitcomb is chief medical officer at Remedy Partners in Darien, Conn., and cofounder and past president of SHM.

Dynamism

By John Nelson, MD, MHM

You probably know a few people with a magnetic personality. Larry Wellikson is the neodymium variety. Boundless energy, confidence that he has the answer or knows exactly where to find it, and ability to instantly recall every conversation he’s had with you, are traits that have energized his years leading SHM and have led countless people to regard him as friend and mentor.

Watch him at the SHM annual conference. There he goes, fast walking to his next commitment while facing backward to complete from a growing distance the conversation with a person he just bumped into along the way. It is like this for Larry from 6 a.m. until midnight. Like Alexander Hamilton, “the man is nonstop.”

Bill Campbell was the “Trillion Dollar Coach” who had his own success as a business leader, but is best known for mentoring Steve Jobs, the Google founders, and many others who went on to become titans of tech. Larry is hospital medicine’s “Coach,” and has inspired and guided the careers of so many clinicians, administrators, and entrepreneurs in hospital medicine and health care more broadly.

The biggest difference between these two highly effective leaders and mentors might be money; SHM has paid him pretty well, but alas, no stock options.

Larry is a great storyteller, and it doesn’t take long for a conversation with him to arrive at the point where he cites the example of how issues faced by someone else have parallels to your situation, the advice he gave that person, and how things turned out. Mostly this advice is about navigating professional life, but he is also happy to share wisdom about parenting, marriage, money, and sports. And most any other topic.

Larry was very accomplished even prior to connecting with SHM. He had a thriving clinical career, and though he left practice long ago he has maintained a close connection with many people he first met when they were his patients. I was surprised years ago when he drove up a new top-of-the-line Lexus – the two-seater with the solid convertible roof that folded into the trunk with the push of a button. I expressed surprise that he’d buy such a swanky car and he explained that a former patient, now long-time friend, was a Lexus distributor and arranged for Larry to drive it away for something like the cost of a Camry.

He also had terrific success forming and leading a large California independent physician association prior to connecting with SHM. Just ask him to show you the magazine with him on the cover and a glowing article detailing his accomplishments. Seriously, ask him, there’s a good chance he’ll have a copy with him.

When Dr. Win Whitcomb and I were trying to figure out how to start a new medical society and position our field to mature into a real specialty we were lucky enough to connect with many health care leaders who we thought could help. Most tended to pat us on the shoulder and say something along the lines of “good luck with your little hobby, now I have to get back to my important work.” But here was Larry with his impressive resume, having served as one of the leaders who crafted the merger of two giant medical societies (ACP and the American Society of Internal Medicine), keenly interested in our tiny new organization, and excited to serve as facilitator for our first strategic planning session.

SHM got a turbocharger when Larry signed on. For me it has felt like speeding down a highway, top down, radio blasting great music, and happy anticipation of what is around the next corner. I have never been disappointed, and certainly don’t plan to get out of Larry’s car just because he’s retiring as CEO.

Dr. Nelson is cofounder and past president of SHM and principal in Nelson Flores Hospital Medicine Consultants in La Quinta, Calif.

Setting the table for over 2 decades

I first met Larry in the spring of 1998 after I had made a presentation to the American College of Physicians’ Board of Regents on the Society for Hospital Medicine’s (then the National Association of Inpatient Physicians) new position statement that referral to hospitalists by primary care physicians should be voluntary. At the time, a number of managed care companies around the United States were compelling primary care physicians to use hospitalists to care for their hospitalized patients apparently because they felt hospitalists could do it more efficiently. SHM became the first professional society to voice the position which in turn was broadly endorsed by physician organizations, including the American Medical Association and the ACP.

Larry sought me out, engaged with me, and handed me his business card. He seemed keen on becoming a part of the rapidly accelerating hospitalist movement and, in retrospect, putting his signature on it. He had recently built and exited from a very large and successful independent physician association during the heyday of California managed care and was eager for a new challenge.

Unlike me, who was just a few years out of residency, Larry was at the height of his professional powers, with the right blend of experience on the one hand and energy on the other to take on a project like SHM.

Larry’s first contribution came in the form of facilitating a 2-day strategic planning meeting with the SHM board in the fall of 1998. John Nelson, MD, had moved to Philadelphia for 3 months to establish the operational foundation of SHM and guide SHM’s first staff member, Angela Musial. One of the most notable achievements during that time was a strategic planning board meeting, which largely set the course for SHM’s early years. Larry was a taskmaster, forcing us to make tough choices about what we wanted to accomplish and to establish concrete goals with timelines and milestones. The adult supervision Larry brought was a new and vital thing for us.

There was a lot at stake in ’97, ‘98, and ‘99. The demand for hospitalists across the nation was skyrocketing and there was a strong need for leadership and bold direction. Academics, community-based hospitalists, pediatricians, entrepreneurs, nonphysician hospital team members, heads of organized medicine, and government and industry leaders were just some of the key stakeholders looking for a seat at the HM table. That table would go on to be set for some 2 decades by Larry Wellikson.

From the beginning, many observers remarked that SHM had established an aggressive agenda. There was an unrelenting need to erect a big tent as a home for diverse stakeholders. John and I and the SHM board were doing all we could to continue to build momentum while also leading our local hospitalist groups and trying to maintain a semblance of balance with our young families back home.

It was against this backdrop, in late 1999, while on yet another flight crisscrossing the country to promote HM and SHM, that John; Bob Wachter, MD (who had by that time replaced John and I as SHM president); and I decided we needed a full-time CEO. By that time, each of us had participated in conversations with Larry. We rapidly decided, with buy-in from the board, that we would offer Larry the position. He accepted and became CEO in January 2000.

To list here all of Larry’s accomplishments since taking the helm at SHM would be impossible. Indeed, all that SHM has achieved is closely tied to Larry. Instead, I would like to call out character traits Larry brought to SHM that are now part of SHM’s DNA and a large part of the reason SHM has been so successful over the past 20 years.


Solution oriented. SHM’s culture has always been to take conditions as they are and work to make things better. There is no place for excessively airing grievances and complaining about “what is being done to us.”

Eschewing the status quo. We can do better. There is too much that needs to be done to wait.

Appropriately irreverent of the norms of the medical establishment. Physicians are by nature careful, plodding, considered, cautious, and methodical. The velocity of change in HM called for a different approach in order to be relevant, one better characterized as the move-fast-and-break-things ethos of a Silicon Valley startup.

Bringing diverse stakeholders to the table. A signature move has been to assemble influential people to lay out the issues before setting a course of action.

Strong bias to action. There is a time to analyze and discuss, but all of this ultimately is in service of taking action to achieve a tangible result.

Working to achieve consensus to a point, then moving forward. Considerable resources have been put into bringing stakeholders together, studying problems, and gaining a common understanding of issues. But this has never been at the expense of taking bold action, even if controversial at times.

Involving industry in creative ways to the benefit of patients. SHM pioneered an approach to use resources gained through industry partnerships to perform national scale improvement activities with groups of hospitalist mentor-experts working with local teams to make care more reliable for patients.

Tirelessly connecting to frontline hospitalists. The lifeblood of SHM is frontline hospitalists. Larry has taken the time to develop relationships with as many as possible, often through personally visiting their communities.

Dr. Whitcomb is chief medical officer at Remedy Partners in Darien, Conn., and cofounder and past president of SHM.

Dynamism

By John Nelson, MD, MHM

You probably know a few people with a magnetic personality. Larry Wellikson is the neodymium variety. Boundless energy, confidence that he has the answer or knows exactly where to find it, and ability to instantly recall every conversation he’s had with you, are traits that have energized his years leading SHM and have led countless people to regard him as friend and mentor.

Watch him at the SHM annual conference. There he goes, fast walking to his next commitment while facing backward to complete from a growing distance the conversation with a person he just bumped into along the way. It is like this for Larry from 6 a.m. until midnight. Like Alexander Hamilton, “the man is nonstop.”

Bill Campbell was the “Trillion Dollar Coach” who had his own success as a business leader, but is best known for mentoring Steve Jobs, the Google founders, and many others who went on to become titans of tech. Larry is hospital medicine’s “Coach,” and has inspired and guided the careers of so many clinicians, administrators, and entrepreneurs in hospital medicine and health care more broadly.

The biggest difference between these two highly effective leaders and mentors might be money; SHM has paid him pretty well, but alas, no stock options.

Larry is a great storyteller, and it doesn’t take long for a conversation with him to arrive at the point where he cites the example of how issues faced by someone else have parallels to your situation, the advice he gave that person, and how things turned out. Mostly this advice is about navigating professional life, but he is also happy to share wisdom about parenting, marriage, money, and sports. And most any other topic.

Larry was very accomplished even prior to connecting with SHM. He had a thriving clinical career, and though he left practice long ago he has maintained a close connection with many people he first met when they were his patients. I was surprised years ago when he drove up a new top-of-the-line Lexus – the two-seater with the solid convertible roof that folded into the trunk with the push of a button. I expressed surprise that he’d buy such a swanky car and he explained that a former patient, now long-time friend, was a Lexus distributor and arranged for Larry to drive it away for something like the cost of a Camry.

He also had terrific success forming and leading a large California independent physician association prior to connecting with SHM. Just ask him to show you the magazine with him on the cover and a glowing article detailing his accomplishments. Seriously, ask him, there’s a good chance he’ll have a copy with him.

When Dr. Win Whitcomb and I were trying to figure out how to start a new medical society and position our field to mature into a real specialty we were lucky enough to connect with many health care leaders who we thought could help. Most tended to pat us on the shoulder and say something along the lines of “good luck with your little hobby, now I have to get back to my important work.” But here was Larry with his impressive resume, having served as one of the leaders who crafted the merger of two giant medical societies (ACP and the American Society of Internal Medicine), keenly interested in our tiny new organization, and excited to serve as facilitator for our first strategic planning session.

SHM got a turbocharger when Larry signed on. For me it has felt like speeding down a highway, top down, radio blasting great music, and happy anticipation of what is around the next corner. I have never been disappointed, and certainly don’t plan to get out of Larry’s car just because he’s retiring as CEO.

Dr. Nelson is cofounder and past president of SHM and principal in Nelson Flores Hospital Medicine Consultants in La Quinta, Calif.

Setting the table for over 2 decades

I first met Larry in the spring of 1998 after I had made a presentation to the American College of Physicians’ Board of Regents on the Society for Hospital Medicine’s (then the National Association of Inpatient Physicians) new position statement that referral to hospitalists by primary care physicians should be voluntary. At the time, a number of managed care companies around the United States were compelling primary care physicians to use hospitalists to care for their hospitalized patients apparently because they felt hospitalists could do it more efficiently. SHM became the first professional society to voice the position which in turn was broadly endorsed by physician organizations, including the American Medical Association and the ACP.

Larry sought me out, engaged with me, and handed me his business card. He seemed keen on becoming a part of the rapidly accelerating hospitalist movement and, in retrospect, putting his signature on it. He had recently built and exited from a very large and successful independent physician association during the heyday of California managed care and was eager for a new challenge.

Unlike me, who was just a few years out of residency, Larry was at the height of his professional powers, with the right blend of experience on the one hand and energy on the other to take on a project like SHM.

Larry’s first contribution came in the form of facilitating a 2-day strategic planning meeting with the SHM board in the fall of 1998. John Nelson, MD, had moved to Philadelphia for 3 months to establish the operational foundation of SHM and guide SHM’s first staff member, Angela Musial. One of the most notable achievements during that time was a strategic planning board meeting, which largely set the course for SHM’s early years. Larry was a taskmaster, forcing us to make tough choices about what we wanted to accomplish and to establish concrete goals with timelines and milestones. The adult supervision Larry brought was a new and vital thing for us.

There was a lot at stake in ’97, ‘98, and ‘99. The demand for hospitalists across the nation was skyrocketing and there was a strong need for leadership and bold direction. Academics, community-based hospitalists, pediatricians, entrepreneurs, nonphysician hospital team members, heads of organized medicine, and government and industry leaders were just some of the key stakeholders looking for a seat at the HM table. That table would go on to be set for some 2 decades by Larry Wellikson.

From the beginning, many observers remarked that SHM had established an aggressive agenda. There was an unrelenting need to erect a big tent as a home for diverse stakeholders. John and I and the SHM board were doing all we could to continue to build momentum while also leading our local hospitalist groups and trying to maintain a semblance of balance with our young families back home.

It was against this backdrop, in late 1999, while on yet another flight crisscrossing the country to promote HM and SHM, that John; Bob Wachter, MD (who had by that time replaced John and I as SHM president); and I decided we needed a full-time CEO. By that time, each of us had participated in conversations with Larry. We rapidly decided, with buy-in from the board, that we would offer Larry the position. He accepted and became CEO in January 2000.

To list here all of Larry’s accomplishments since taking the helm at SHM would be impossible. Indeed, all that SHM has achieved is closely tied to Larry. Instead, I would like to call out character traits Larry brought to SHM that are now part of SHM’s DNA and a large part of the reason SHM has been so successful over the past 20 years.


Solution oriented. SHM’s culture has always been to take conditions as they are and work to make things better. There is no place for excessively airing grievances and complaining about “what is being done to us.”

Eschewing the status quo. We can do better. There is too much that needs to be done to wait.

Appropriately irreverent of the norms of the medical establishment. Physicians are by nature careful, plodding, considered, cautious, and methodical. The velocity of change in HM called for a different approach in order to be relevant, one better characterized as the move-fast-and-break-things ethos of a Silicon Valley startup.

Bringing diverse stakeholders to the table. A signature move has been to assemble influential people to lay out the issues before setting a course of action.

Strong bias to action. There is a time to analyze and discuss, but all of this ultimately is in service of taking action to achieve a tangible result.

Working to achieve consensus to a point, then moving forward. Considerable resources have been put into bringing stakeholders together, studying problems, and gaining a common understanding of issues. But this has never been at the expense of taking bold action, even if controversial at times.

Involving industry in creative ways to the benefit of patients. SHM pioneered an approach to use resources gained through industry partnerships to perform national scale improvement activities with groups of hospitalist mentor-experts working with local teams to make care more reliable for patients.

Tirelessly connecting to frontline hospitalists. The lifeblood of SHM is frontline hospitalists. Larry has taken the time to develop relationships with as many as possible, often through personally visiting their communities.

Dr. Whitcomb is chief medical officer at Remedy Partners in Darien, Conn., and cofounder and past president of SHM.

Dynamism

By John Nelson, MD, MHM

You probably know a few people with a magnetic personality. Larry Wellikson is the neodymium variety. Boundless energy, confidence that he has the answer or knows exactly where to find it, and ability to instantly recall every conversation he’s had with you, are traits that have energized his years leading SHM and have led countless people to regard him as friend and mentor.

Watch him at the SHM annual conference. There he goes, fast walking to his next commitment while facing backward to complete from a growing distance the conversation with a person he just bumped into along the way. It is like this for Larry from 6 a.m. until midnight. Like Alexander Hamilton, “the man is nonstop.”

Bill Campbell was the “Trillion Dollar Coach” who had his own success as a business leader, but is best known for mentoring Steve Jobs, the Google founders, and many others who went on to become titans of tech. Larry is hospital medicine’s “Coach,” and has inspired and guided the careers of so many clinicians, administrators, and entrepreneurs in hospital medicine and health care more broadly.

The biggest difference between these two highly effective leaders and mentors might be money; SHM has paid him pretty well, but alas, no stock options.

Larry is a great storyteller, and it doesn’t take long for a conversation with him to arrive at the point where he cites the example of how issues faced by someone else have parallels to your situation, the advice he gave that person, and how things turned out. Mostly this advice is about navigating professional life, but he is also happy to share wisdom about parenting, marriage, money, and sports. And most any other topic.

Larry was very accomplished even prior to connecting with SHM. He had a thriving clinical career, and though he left practice long ago he has maintained a close connection with many people he first met when they were his patients. I was surprised years ago when he drove up a new top-of-the-line Lexus – the two-seater with the solid convertible roof that folded into the trunk with the push of a button. I expressed surprise that he’d buy such a swanky car and he explained that a former patient, now long-time friend, was a Lexus distributor and arranged for Larry to drive it away for something like the cost of a Camry.

He also had terrific success forming and leading a large California independent physician association prior to connecting with SHM. Just ask him to show you the magazine with him on the cover and a glowing article detailing his accomplishments. Seriously, ask him, there’s a good chance he’ll have a copy with him.

When Dr. Win Whitcomb and I were trying to figure out how to start a new medical society and position our field to mature into a real specialty we were lucky enough to connect with many health care leaders who we thought could help. Most tended to pat us on the shoulder and say something along the lines of “good luck with your little hobby, now I have to get back to my important work.” But here was Larry with his impressive resume, having served as one of the leaders who crafted the merger of two giant medical societies (ACP and the American Society of Internal Medicine), keenly interested in our tiny new organization, and excited to serve as facilitator for our first strategic planning session.

SHM got a turbocharger when Larry signed on. For me it has felt like speeding down a highway, top down, radio blasting great music, and happy anticipation of what is around the next corner. I have never been disappointed, and certainly don’t plan to get out of Larry’s car just because he’s retiring as CEO.

Dr. Nelson is cofounder and past president of SHM and principal in Nelson Flores Hospital Medicine Consultants in La Quinta, Calif.

PING – you look down at your phone and the words “URGENT – Meeting Today” stare back at you. The elevator door opens, and you step inside – 1 minute, the seemingly perfect amount of time for a quick inbox check.

As a hospitalist, chances are you have experienced this scenario, likely more than once. Email has become a double-edged sword, both a valuable communication tool and a source of stress and frustration.¹ A 2012 McKinsey analysis found that the average professional spends 28% of the day reading and answering emails.² Smartphone technology with email alerts and push notifications constantly diverts hospitalists’ attention away from important and nonurgent responsibilities such as manuscript writing, family time, and personal well-being.³

How can we break this cycle of compulsive connectivity? To keep email from controlling your life, we suggest the “Three Rs” (Resist, Reorganize, and Respond) of email effectiveness.
 

RESIST

The first key to take control of your inbox is to resist the urge to impulsively check and respond to emails. Consider these three solutions to bolster your ability to resist.

• Disable email push notifications. This will reduce the urge to continuously refresh your inbox on the wards.⁴ Excessively checking email can waste as much as 21 minutes per day.²
• Set an email budget.⁵ Schedule one to two appointments each day to handle email.⁶ Consider blocking 30 minutes after rounds and 30 minutes at the end of each day to address emails.
• Correspond at a computer. Limit email correspondence to your laptop or desktop. Access to a full keyboard and larger screen will maximize the efficiency of each email appointment.

REORGANIZE

After implementing these strategies to resist email temptations, reorganize your inbox with the following two-pronged approach.

• Focus your inbox: There are many options for reducing the volume of emails that flood your inbox. Try collaborative tools like Google Docs, Dropbox, Doodle polls, and Slack to shift communication away from email onto platforms optimized to your project’s specific needs. Additionally, email management tools like SaneBox and OtherInbox triage less important messages directly to folders, leaving only must-read-now messages in your inbox.² Lastly, activate spam filters and unsubscribe from mailing lists to eliminate email clutter.
• Commit to concise filing and finding: Archiving emails into a complex array of folders wastes as much as 14 minutes each day. Instead, limit your filing system to two folders: “Action” for email requiring further action and “Reading” for messages to reference at a later date.² Activating “Communication View” on Microsoft Outlook allows rapid review of messages that share the same subject heading.

RESPOND

Finally, once your inbox is reorganized, use the Four Ds for Decision Making model to optimize the way you respond to email.⁶ When you sit down for an email appointment, use the Four Ds, detailed below to avoid reading the same message repeatedly without taking action.

• Delete: Quickly delete any emails that do not directly require your attention or follow-up. Many emails can be immediately deleted without further thought.
• Do: If a task or response to an email will take less than 2 minutes, do it immediately. It will take at least the same amount to retrieve and reread an email as it will to handle it in real time.⁷ Often, this can be accomplished with a quick phone call or email reply.
• Defer: If an email response will take more than 2 minutes, use a system to take action at a later time. Move actionable items from your inbox to a to-do list or calendar appointment and file appropriate emails into the Action or Reading folders, detailed above. This method allows completion of important tasks in a timely manner outside of your fixed email budget. Delaying an email reply can also be advantageous by letting a problem mature, given that some of these issues will resolve without your specific intervention.
• Delegate: This can be difficult for many hospitalists who are accustomed to finishing each task themselves. If someone else can do the task as good as or better than you can, it is wise to delegate whenever possible.

Over the next few weeks, challenge yourself to resist email temptations, reorganize your inbox, and methodically respond to emails. This practice will help structure your day, maximize your efficiency, manage colleagues’ expectations, and create new time windows throughout your on-service weeks.

Dr. Nelson is a hospitalist at Ochsner Medical Center in New Orleans. Dr. Esquivel is a hospitalist and assistant professor at Weill Cornell Medicine, New York. Dr. Hall is a med-peds hospitalist and assistant professor at the University of Kentucky, Lexington.

References

1. MacKinnon R. How you manage your emails may be bad for your health. Science Daily. https://www.sciencedaily.com/releases/2016/01/160104081249.htm. Published Jan 4, 2016.

2. Plummer M. How to spend way less time on email every day. Harvard Business Review. https://hbr.org/2019/01/how-to-spend-way-less-time-on-email-every-day. 2019 Jan 22.

3. Covey SR. The 7 Habits of Highly Effective People: Powerful Lessons in Personal Change. New York: Free Press, 2004.

4. Ericson C. 5 Ways to Take Control of Your Email Inbox. Forbes. https://www.forbes.com/sites/learnvest/2014/03/17/5-ways-to-take-control-of-your-email-inbox/#3711f5946342. 2014 Mar 17.

5. Limit the time you spend on email. Harvard Business Review. https://hbr.org/2014/02/limit-the-time-you-spend-on-email. 2014 Feb 6.

6. McGhee S. Empty your inbox: 4 ways to take control of your email. Internet and Telephone Blog. https://www.itllc.net/it-support-ma/empty-your-inbox-4-ways-to-take-control-of-your-email/.

7. Allen D. Getting Things Done: The Art of Stress-Free Productivity. New York: Penguin Books, 2015.

PING – you look down at your phone and the words “URGENT – Meeting Today” stare back at you. The elevator door opens, and you step inside – 1 minute, the seemingly perfect amount of time for a quick inbox check.

As a hospitalist, chances are you have experienced this scenario, likely more than once. Email has become a double-edged sword, both a valuable communication tool and a source of stress and frustration.¹ A 2012 McKinsey analysis found that the average professional spends 28% of the day reading and answering emails.² Smartphone technology with email alerts and push notifications constantly diverts hospitalists’ attention away from important and nonurgent responsibilities such as manuscript writing, family time, and personal well-being.³

How can we break this cycle of compulsive connectivity? To keep email from controlling your life, we suggest the “Three Rs” (Resist, Reorganize, and Respond) of email effectiveness.
 

RESIST

The first key to take control of your inbox is to resist the urge to impulsively check and respond to emails. Consider these three solutions to bolster your ability to resist.

• Disable email push notifications. This will reduce the urge to continuously refresh your inbox on the wards.⁴ Excessively checking email can waste as much as 21 minutes per day.²
• Set an email budget.⁵ Schedule one to two appointments each day to handle email.⁶ Consider blocking 30 minutes after rounds and 30 minutes at the end of each day to address emails.
• Correspond at a computer. Limit email correspondence to your laptop or desktop. Access to a full keyboard and larger screen will maximize the efficiency of each email appointment.

REORGANIZE

After implementing these strategies to resist email temptations, reorganize your inbox with the following two-pronged approach.

• Focus your inbox: There are many options for reducing the volume of emails that flood your inbox. Try collaborative tools like Google Docs, Dropbox, Doodle polls, and Slack to shift communication away from email onto platforms optimized to your project’s specific needs. Additionally, email management tools like SaneBox and OtherInbox triage less important messages directly to folders, leaving only must-read-now messages in your inbox.² Lastly, activate spam filters and unsubscribe from mailing lists to eliminate email clutter.
• Commit to concise filing and finding: Archiving emails into a complex array of folders wastes as much as 14 minutes each day. Instead, limit your filing system to two folders: “Action” for email requiring further action and “Reading” for messages to reference at a later date.² Activating “Communication View” on Microsoft Outlook allows rapid review of messages that share the same subject heading.

RESPOND

Finally, once your inbox is reorganized, use the Four Ds for Decision Making model to optimize the way you respond to email.⁶ When you sit down for an email appointment, use the Four Ds, detailed below to avoid reading the same message repeatedly without taking action.

• Delete: Quickly delete any emails that do not directly require your attention or follow-up. Many emails can be immediately deleted without further thought.
• Do: If a task or response to an email will take less than 2 minutes, do it immediately. It will take at least the same amount to retrieve and reread an email as it will to handle it in real time.⁷ Often, this can be accomplished with a quick phone call or email reply.
• Defer: If an email response will take more than 2 minutes, use a system to take action at a later time. Move actionable items from your inbox to a to-do list or calendar appointment and file appropriate emails into the Action or Reading folders, detailed above. This method allows completion of important tasks in a timely manner outside of your fixed email budget. Delaying an email reply can also be advantageous by letting a problem mature, given that some of these issues will resolve without your specific intervention.
• Delegate: This can be difficult for many hospitalists who are accustomed to finishing each task themselves. If someone else can do the task as good as or better than you can, it is wise to delegate whenever possible.

Over the next few weeks, challenge yourself to resist email temptations, reorganize your inbox, and methodically respond to emails. This practice will help structure your day, maximize your efficiency, manage colleagues’ expectations, and create new time windows throughout your on-service weeks.

Dr. Nelson is a hospitalist at Ochsner Medical Center in New Orleans. Dr. Esquivel is a hospitalist and assistant professor at Weill Cornell Medicine, New York. Dr. Hall is a med-peds hospitalist and assistant professor at the University of Kentucky, Lexington.

References

1. MacKinnon R. How you manage your emails may be bad for your health. Science Daily. https://www.sciencedaily.com/releases/2016/01/160104081249.htm. Published Jan 4, 2016.

2. Plummer M. How to spend way less time on email every day. Harvard Business Review. https://hbr.org/2019/01/how-to-spend-way-less-time-on-email-every-day. 2019 Jan 22.

3. Covey SR. The 7 Habits of Highly Effective People: Powerful Lessons in Personal Change. New York: Free Press, 2004.

4. Ericson C. 5 Ways to Take Control of Your Email Inbox. Forbes. https://www.forbes.com/sites/learnvest/2014/03/17/5-ways-to-take-control-of-your-email-inbox/#3711f5946342. 2014 Mar 17.

5. Limit the time you spend on email. Harvard Business Review. https://hbr.org/2014/02/limit-the-time-you-spend-on-email. 2014 Feb 6.

6. McGhee S. Empty your inbox: 4 ways to take control of your email. Internet and Telephone Blog. https://www.itllc.net/it-support-ma/empty-your-inbox-4-ways-to-take-control-of-your-email/.

7. Allen D. Getting Things Done: The Art of Stress-Free Productivity. New York: Penguin Books, 2015.

PING – you look down at your phone and the words “URGENT – Meeting Today” stare back at you. The elevator door opens, and you step inside – 1 minute, the seemingly perfect amount of time for a quick inbox check.

As a hospitalist, chances are you have experienced this scenario, likely more than once. Email has become a double-edged sword, both a valuable communication tool and a source of stress and frustration.¹ A 2012 McKinsey analysis found that the average professional spends 28% of the day reading and answering emails.² Smartphone technology with email alerts and push notifications constantly diverts hospitalists’ attention away from important and nonurgent responsibilities such as manuscript writing, family time, and personal well-being.³

How can we break this cycle of compulsive connectivity? To keep email from controlling your life, we suggest the “Three Rs” (Resist, Reorganize, and Respond) of email effectiveness.
 

RESIST

The first key to take control of your inbox is to resist the urge to impulsively check and respond to emails. Consider these three solutions to bolster your ability to resist.

• Disable email push notifications. This will reduce the urge to continuously refresh your inbox on the wards.⁴ Excessively checking email can waste as much as 21 minutes per day.²
• Set an email budget.⁵ Schedule one to two appointments each day to handle email.⁶ Consider blocking 30 minutes after rounds and 30 minutes at the end of each day to address emails.
• Correspond at a computer. Limit email correspondence to your laptop or desktop. Access to a full keyboard and larger screen will maximize the efficiency of each email appointment.

REORGANIZE

After implementing these strategies to resist email temptations, reorganize your inbox with the following two-pronged approach.

• Focus your inbox: There are many options for reducing the volume of emails that flood your inbox. Try collaborative tools like Google Docs, Dropbox, Doodle polls, and Slack to shift communication away from email onto platforms optimized to your project’s specific needs. Additionally, email management tools like SaneBox and OtherInbox triage less important messages directly to folders, leaving only must-read-now messages in your inbox.² Lastly, activate spam filters and unsubscribe from mailing lists to eliminate email clutter.
• Commit to concise filing and finding: Archiving emails into a complex array of folders wastes as much as 14 minutes each day. Instead, limit your filing system to two folders: “Action” for email requiring further action and “Reading” for messages to reference at a later date.² Activating “Communication View” on Microsoft Outlook allows rapid review of messages that share the same subject heading.

RESPOND

Finally, once your inbox is reorganized, use the Four Ds for Decision Making model to optimize the way you respond to email.⁶ When you sit down for an email appointment, use the Four Ds, detailed below to avoid reading the same message repeatedly without taking action.

• Delete: Quickly delete any emails that do not directly require your attention or follow-up. Many emails can be immediately deleted without further thought.
• Do: If a task or response to an email will take less than 2 minutes, do it immediately. It will take at least the same amount to retrieve and reread an email as it will to handle it in real time.⁷ Often, this can be accomplished with a quick phone call or email reply.
• Defer: If an email response will take more than 2 minutes, use a system to take action at a later time. Move actionable items from your inbox to a to-do list or calendar appointment and file appropriate emails into the Action or Reading folders, detailed above. This method allows completion of important tasks in a timely manner outside of your fixed email budget. Delaying an email reply can also be advantageous by letting a problem mature, given that some of these issues will resolve without your specific intervention.
• Delegate: This can be difficult for many hospitalists who are accustomed to finishing each task themselves. If someone else can do the task as good as or better than you can, it is wise to delegate whenever possible.

Over the next few weeks, challenge yourself to resist email temptations, reorganize your inbox, and methodically respond to emails. This practice will help structure your day, maximize your efficiency, manage colleagues’ expectations, and create new time windows throughout your on-service weeks.

Dr. Nelson is a hospitalist at Ochsner Medical Center in New Orleans. Dr. Esquivel is a hospitalist and assistant professor at Weill Cornell Medicine, New York. Dr. Hall is a med-peds hospitalist and assistant professor at the University of Kentucky, Lexington.

References

1. MacKinnon R. How you manage your emails may be bad for your health. Science Daily. https://www.sciencedaily.com/releases/2016/01/160104081249.htm. Published Jan 4, 2016.

2. Plummer M. How to spend way less time on email every day. Harvard Business Review. https://hbr.org/2019/01/how-to-spend-way-less-time-on-email-every-day. 2019 Jan 22.

3. Covey SR. The 7 Habits of Highly Effective People: Powerful Lessons in Personal Change. New York: Free Press, 2004.

4. Ericson C. 5 Ways to Take Control of Your Email Inbox. Forbes. https://www.forbes.com/sites/learnvest/2014/03/17/5-ways-to-take-control-of-your-email-inbox/#3711f5946342. 2014 Mar 17.

5. Limit the time you spend on email. Harvard Business Review. https://hbr.org/2014/02/limit-the-time-you-spend-on-email. 2014 Feb 6.

6. McGhee S. Empty your inbox: 4 ways to take control of your email. Internet and Telephone Blog. https://www.itllc.net/it-support-ma/empty-your-inbox-4-ways-to-take-control-of-your-email/.

7. Allen D. Getting Things Done: The Art of Stress-Free Productivity. New York: Penguin Books, 2015.

Over the last several weeks, hospitals and health systems have focused on the COVID-19 epidemic, preparing and expanding bed capacities for the surge of admissions both in intensive care and medical units. An indirect impact of this has been the reduction in outpatient staffing and resources, with the shifting of staff for inpatient care. Many areas seem to have passed the peak in the number of cases and are now seeing a plateau or downward trend in the admissions to acute care facilities.

During this period, there has been a noticeable downtrend in patients being evaluated in the ED, or admitted for decompensation of chronic conditions like heart failure, COPD and diabetes mellitus, or such acute conditions as stroke and MI. Studies from Italy and Spain, and closer to home from Atlanta and Boston, point to a significant decrease in numbers of ST-elevation myocardial infarction (STEMI) admissions.¹ Duke Health saw a decrease in stroke admissions in their hospitals by 34%.²

One could argue that these patients are in fact presenting with COVID-19 or similar symptoms as is evidenced by the studies linking the severity of SARS-Co-V2 infection to chronic conditions like diabetes mellitus and obesity.² On the other hand, the message of social isolation and avoidance of nonurgent visits could lead to delays in care resulting in patients presenting sicker and in advanced stages.³ Also, this has not been limited to the adult population. For example, reports indicate that visits to WakeMed’s pediatric emergency rooms in Wake County, N.C., were down by 60%.²

We could well be seeing a calm before the storm. While it is anticipated that there may be a second surge of COVID-19 cases, health systems would do well to be prepared for the “third surge,” consisting of patients coming in with chronic medical conditions for which they have been, so far, avoiding follow-up and managing at home, and acute medical conditions with delayed diagnoses. The impact could likely be more in the subset of patients with limited access to health care, including medications and follow-up, resulting in a disproportionate burden on safety-net hospitals.

Compounding this issue would be the economic impact of the current crisis on health systems, their staffing, and resources. Several major organizations have already proposed budget cuts and reduction of the workforce, raising significant concerns about the future of health care workers who put their lives at risk during this pandemic.⁴ There is no guarantee that the federal funding provided by the stimulus packages will save jobs in the health care industry. This problem needs new leadership thinking, and every organization that puts employees over profits margins will have a long-term impact on communities.

Another area of concern is a shift in resources and workflow from ambulatory to inpatient settings for the COVID-19 pandemic, and the need for revamping the ambulatory services with reshifting the workforce. As COVID-19 cases plateau, the resurgence of non-COVID–related admissions will require additional help in inpatient settings. Prioritizing the ambulatory services based on financial benefits versus patient outcomes is also a major challenge to leadership.⁵

Lastly, the current health care crisis has led to significant stress, both emotional and physical, among frontline caregivers, increasing the risk of burnout.⁶ How leadership helps health care workers to cope with these stressors, and the resources they provide, is going to play a key role in long term retention of their talent, and will reflect on the organizational culture. Though it might seem trivial, posttraumatic stress disorder related to this is already obvious, and health care leadership needs to put every effort in providing the resources to help prevent burnout, in partnership with national organizations like the Society of Hospital Medicine and the American College of Physicians.

The expansion of telemedicine has provided a unique opportunity to address several of these issues while maintaining the nonpharmacologic interventions to fight the epidemic, and keeping the cost curve as low as possible.⁷ Extension of these services to all ambulatory service lines, including home health and therapy, is the next big step in the new health care era. Virtual check-ins by physicians, advance practice clinicians, and home care nurses could help alleviate the concerns regarding delays in care of patients with chronic conditions, and help identify those at risk. This would also be of help with staffing shortages, and possibly provide much needed support to frontline providers.

Dr. Prasad is currently medical director of care management and a hospitalist at Advocate Aurora Health in Milwaukee. He was previously quality and utilization officer and chief of the medical staff at Aurora Sinai Medical Center. Dr. Prasad is cochair of SHM’s IT Special Interest Group, sits on the HQPS Committee, and is president of SHM’s Wisconsin Chapter. Dr. Palabindala is the medical director, utilization management and physician advisory services, at the University of Mississippi Medical Center, Jackson. He is an associate professor of medicine and academic hospitalist in the UMMC School of Medicine.

References

1. Wood S. TCTMD. 2020 Apr 2. “The mystery of the missing STEMIs during the COVID-19 pandemic.”

2. Stradling R. The News & Observer. 2020 Apr 21. “Fewer people are going to Triangle [N.C.] emergency rooms, and that could be a bad thing.”

3. Kasanagottu K. USA Today. 2020 Apr 15. “Don’t delay care for chronic illness over coronavirus. It’s bad for you and for hospitals.”

4. Snowbeck C. The Star Tribune. 2020 Apr 11. “Mayo Clinic cutting pay for more than 20,000 workers.”

5. LaPointe J. RevCycle Intelligence. 2020 Mar 31. “How much will the COVID-19 pandemic cost hospitals?”

6. Gavidia M. AJMC. 2020 Mar 31. “Sleep, physician burnout linked amid COVID-19 pandemic.”

7. Hollander JE and Carr BG. N Engl J Med. 2020 Apr 30;382(18):1679-81. “Virtually perfect? Telemedicine for COVID-19.”

Over the last several weeks, hospitals and health systems have focused on the COVID-19 epidemic, preparing and expanding bed capacities for the surge of admissions both in intensive care and medical units. An indirect impact of this has been the reduction in outpatient staffing and resources, with the shifting of staff for inpatient care. Many areas seem to have passed the peak in the number of cases and are now seeing a plateau or downward trend in the admissions to acute care facilities.

During this period, there has been a noticeable downtrend in patients being evaluated in the ED, or admitted for decompensation of chronic conditions like heart failure, COPD and diabetes mellitus, or such acute conditions as stroke and MI. Studies from Italy and Spain, and closer to home from Atlanta and Boston, point to a significant decrease in numbers of ST-elevation myocardial infarction (STEMI) admissions.¹ Duke Health saw a decrease in stroke admissions in their hospitals by 34%.²

One could argue that these patients are in fact presenting with COVID-19 or similar symptoms as is evidenced by the studies linking the severity of SARS-Co-V2 infection to chronic conditions like diabetes mellitus and obesity.² On the other hand, the message of social isolation and avoidance of nonurgent visits could lead to delays in care resulting in patients presenting sicker and in advanced stages.³ Also, this has not been limited to the adult population. For example, reports indicate that visits to WakeMed’s pediatric emergency rooms in Wake County, N.C., were down by 60%.²

We could well be seeing a calm before the storm. While it is anticipated that there may be a second surge of COVID-19 cases, health systems would do well to be prepared for the “third surge,” consisting of patients coming in with chronic medical conditions for which they have been, so far, avoiding follow-up and managing at home, and acute medical conditions with delayed diagnoses. The impact could likely be more in the subset of patients with limited access to health care, including medications and follow-up, resulting in a disproportionate burden on safety-net hospitals.

Compounding this issue would be the economic impact of the current crisis on health systems, their staffing, and resources. Several major organizations have already proposed budget cuts and reduction of the workforce, raising significant concerns about the future of health care workers who put their lives at risk during this pandemic.⁴ There is no guarantee that the federal funding provided by the stimulus packages will save jobs in the health care industry. This problem needs new leadership thinking, and every organization that puts employees over profits margins will have a long-term impact on communities.

Another area of concern is a shift in resources and workflow from ambulatory to inpatient settings for the COVID-19 pandemic, and the need for revamping the ambulatory services with reshifting the workforce. As COVID-19 cases plateau, the resurgence of non-COVID–related admissions will require additional help in inpatient settings. Prioritizing the ambulatory services based on financial benefits versus patient outcomes is also a major challenge to leadership.⁵

Lastly, the current health care crisis has led to significant stress, both emotional and physical, among frontline caregivers, increasing the risk of burnout.⁶ How leadership helps health care workers to cope with these stressors, and the resources they provide, is going to play a key role in long term retention of their talent, and will reflect on the organizational culture. Though it might seem trivial, posttraumatic stress disorder related to this is already obvious, and health care leadership needs to put every effort in providing the resources to help prevent burnout, in partnership with national organizations like the Society of Hospital Medicine and the American College of Physicians.

The expansion of telemedicine has provided a unique opportunity to address several of these issues while maintaining the nonpharmacologic interventions to fight the epidemic, and keeping the cost curve as low as possible.⁷ Extension of these services to all ambulatory service lines, including home health and therapy, is the next big step in the new health care era. Virtual check-ins by physicians, advance practice clinicians, and home care nurses could help alleviate the concerns regarding delays in care of patients with chronic conditions, and help identify those at risk. This would also be of help with staffing shortages, and possibly provide much needed support to frontline providers.

Dr. Prasad is currently medical director of care management and a hospitalist at Advocate Aurora Health in Milwaukee. He was previously quality and utilization officer and chief of the medical staff at Aurora Sinai Medical Center. Dr. Prasad is cochair of SHM’s IT Special Interest Group, sits on the HQPS Committee, and is president of SHM’s Wisconsin Chapter. Dr. Palabindala is the medical director, utilization management and physician advisory services, at the University of Mississippi Medical Center, Jackson. He is an associate professor of medicine and academic hospitalist in the UMMC School of Medicine.

References

1. Wood S. TCTMD. 2020 Apr 2. “The mystery of the missing STEMIs during the COVID-19 pandemic.”

2. Stradling R. The News & Observer. 2020 Apr 21. “Fewer people are going to Triangle [N.C.] emergency rooms, and that could be a bad thing.”

3. Kasanagottu K. USA Today. 2020 Apr 15. “Don’t delay care for chronic illness over coronavirus. It’s bad for you and for hospitals.”

4. Snowbeck C. The Star Tribune. 2020 Apr 11. “Mayo Clinic cutting pay for more than 20,000 workers.”

5. LaPointe J. RevCycle Intelligence. 2020 Mar 31. “How much will the COVID-19 pandemic cost hospitals?”

6. Gavidia M. AJMC. 2020 Mar 31. “Sleep, physician burnout linked amid COVID-19 pandemic.”

7. Hollander JE and Carr BG. N Engl J Med. 2020 Apr 30;382(18):1679-81. “Virtually perfect? Telemedicine for COVID-19.”

Over the last several weeks, hospitals and health systems have focused on the COVID-19 epidemic, preparing and expanding bed capacities for the surge of admissions both in intensive care and medical units. An indirect impact of this has been the reduction in outpatient staffing and resources, with the shifting of staff for inpatient care. Many areas seem to have passed the peak in the number of cases and are now seeing a plateau or downward trend in the admissions to acute care facilities.

During this period, there has been a noticeable downtrend in patients being evaluated in the ED, or admitted for decompensation of chronic conditions like heart failure, COPD and diabetes mellitus, or such acute conditions as stroke and MI. Studies from Italy and Spain, and closer to home from Atlanta and Boston, point to a significant decrease in numbers of ST-elevation myocardial infarction (STEMI) admissions.¹ Duke Health saw a decrease in stroke admissions in their hospitals by 34%.²

One could argue that these patients are in fact presenting with COVID-19 or similar symptoms as is evidenced by the studies linking the severity of SARS-Co-V2 infection to chronic conditions like diabetes mellitus and obesity.² On the other hand, the message of social isolation and avoidance of nonurgent visits could lead to delays in care resulting in patients presenting sicker and in advanced stages.³ Also, this has not been limited to the adult population. For example, reports indicate that visits to WakeMed’s pediatric emergency rooms in Wake County, N.C., were down by 60%.²

We could well be seeing a calm before the storm. While it is anticipated that there may be a second surge of COVID-19 cases, health systems would do well to be prepared for the “third surge,” consisting of patients coming in with chronic medical conditions for which they have been, so far, avoiding follow-up and managing at home, and acute medical conditions with delayed diagnoses. The impact could likely be more in the subset of patients with limited access to health care, including medications and follow-up, resulting in a disproportionate burden on safety-net hospitals.

Compounding this issue would be the economic impact of the current crisis on health systems, their staffing, and resources. Several major organizations have already proposed budget cuts and reduction of the workforce, raising significant concerns about the future of health care workers who put their lives at risk during this pandemic.⁴ There is no guarantee that the federal funding provided by the stimulus packages will save jobs in the health care industry. This problem needs new leadership thinking, and every organization that puts employees over profits margins will have a long-term impact on communities.

Another area of concern is a shift in resources and workflow from ambulatory to inpatient settings for the COVID-19 pandemic, and the need for revamping the ambulatory services with reshifting the workforce. As COVID-19 cases plateau, the resurgence of non-COVID–related admissions will require additional help in inpatient settings. Prioritizing the ambulatory services based on financial benefits versus patient outcomes is also a major challenge to leadership.⁵

Lastly, the current health care crisis has led to significant stress, both emotional and physical, among frontline caregivers, increasing the risk of burnout.⁶ How leadership helps health care workers to cope with these stressors, and the resources they provide, is going to play a key role in long term retention of their talent, and will reflect on the organizational culture. Though it might seem trivial, posttraumatic stress disorder related to this is already obvious, and health care leadership needs to put every effort in providing the resources to help prevent burnout, in partnership with national organizations like the Society of Hospital Medicine and the American College of Physicians.

The expansion of telemedicine has provided a unique opportunity to address several of these issues while maintaining the nonpharmacologic interventions to fight the epidemic, and keeping the cost curve as low as possible.⁷ Extension of these services to all ambulatory service lines, including home health and therapy, is the next big step in the new health care era. Virtual check-ins by physicians, advance practice clinicians, and home care nurses could help alleviate the concerns regarding delays in care of patients with chronic conditions, and help identify those at risk. This would also be of help with staffing shortages, and possibly provide much needed support to frontline providers.

Dr. Prasad is currently medical director of care management and a hospitalist at Advocate Aurora Health in Milwaukee. He was previously quality and utilization officer and chief of the medical staff at Aurora Sinai Medical Center. Dr. Prasad is cochair of SHM’s IT Special Interest Group, sits on the HQPS Committee, and is president of SHM’s Wisconsin Chapter. Dr. Palabindala is the medical director, utilization management and physician advisory services, at the University of Mississippi Medical Center, Jackson. He is an associate professor of medicine and academic hospitalist in the UMMC School of Medicine.

References

1. Wood S. TCTMD. 2020 Apr 2. “The mystery of the missing STEMIs during the COVID-19 pandemic.”

2. Stradling R. The News & Observer. 2020 Apr 21. “Fewer people are going to Triangle [N.C.] emergency rooms, and that could be a bad thing.”

3. Kasanagottu K. USA Today. 2020 Apr 15. “Don’t delay care for chronic illness over coronavirus. It’s bad for you and for hospitals.”

4. Snowbeck C. The Star Tribune. 2020 Apr 11. “Mayo Clinic cutting pay for more than 20,000 workers.”

5. LaPointe J. RevCycle Intelligence. 2020 Mar 31. “How much will the COVID-19 pandemic cost hospitals?”

6. Gavidia M. AJMC. 2020 Mar 31. “Sleep, physician burnout linked amid COVID-19 pandemic.”

7. Hollander JE and Carr BG. N Engl J Med. 2020 Apr 30;382(18):1679-81. “Virtually perfect? Telemedicine for COVID-19.”

Outstanding Service in Hospital Medicine

Efren Manjarrez, MD, SFHM, FACP, is an associate professor of clinical medicine at the University of Miami Miller School of Medicine, where he also serves as a hospitalist in the division of hospital medicine. His high-impact work at his home institution and through SHM has been extensive.

He founded the division of hospital medicine at the University of Miami in 2000 and later served as the division chief and patient safety officer. Dr. Manjarrez served in the prestigious role of course director for HM15 and as co-course director for the Adult Hospital Medicine Boot Camp.

One of his most enduring contributions is as an author of the white paper on hospitalist handoffs, published in the Journal of Hospital Medicine in 2009, which continues to be cited and validated. He was an assistant editor for the Journal of Hospital Medicine and continues to review articles for JHM. Dr. Manjarrez is also a senior fellow in hospital medicine.

Excellence in Research

Shoshana J. Herzig, MD, MPH, is the director of hospital medicine research at Beth Israel Deaconess Medical Center in Boston, where she also serves as a hospitalist. She is also an associate professor of medicine at Harvard Medical School, also in Boston.

She has published nearly 50 original peer-reviewed manuscripts in some of medicine’s top journals. Her impressive research, which primarily focuses on patterns of medication utilization and associated outcomes in hospitalized adults, has been cited more than 1,500 times in the medical literature.

In addition to her work on medication safety, she is also a site PI for the Hospital Medicine Research Network (HOMERuN), a nationwide collaborative of hospital medicine researchers.

Dr. Herzig has been a member of SHM since 2008 and has attended the annual conference every year since. She has served as an RIV abstract judge, was instrumental in developing SHM’s consensus statement on safe opioid prescribing, and has served as an editor for the Journal of Hospital Medicine since 2012 and has been a senior deputy editor since 2015.

Clinical Leadership for Physicians

Karen Smith, MD, MEd, SFHM, is the chief of the division of hospitalist medicine and past president of the medical staff at Children’s National Medical Center in Washington. She also serves as associate professor of pediatrics at the George Washington University School of Medicine. She has consistently worked to create a supportive environment in which to promote wellness among her staff and colleagues.

She was one of three founding faculty members of the division of hospital medicine at Children’s National, and under her leadership, the division has seen substantial growth. It has evolved from a single site to a comprehensive model of services, spanning six community hospitals and a specialty hospital for rehabilitation and subacute care.

To increase morale, Dr. Smith spearheaded the development of a virtual physician lounge. She reserved a conference room once a month and provided free lunch to medical staff members of different specialties. Its success led to the construction of a full-time lounge – all because of Dr. Smith’s perseverance and forward thinking.

She is a past member of SHM’s Pediatrics Committee and Hospital Quality and Patient Safety Committee and is a senior fellow in hospital medicine.

Excellence in Teaching

Kathleen M. Finn, MD, M.Phil, SFHM, is the senior associate program director for resident and faculty development in the Massachusetts General Hospital internal medicine residency program at Harvard Medical School, both in Boston, where she also is an assistant professor of medicine. She has excelled at teaching at all levels and in all kinds of settings, from clinical teaching on inpatient rounds, educating faculty through workshops to serving as course director for Hospital Medicine 2018 in Orlando. She constantly strives to think creatively and to teach in new ways and considers her career to be a synergy of all three domains in medical education: clinical teaching, leadership, and research.

Her interest in improving the art of inpatient teaching has also taken Dr. Finn into the medical education research space, where she has conducted and published several significant studies.

She was the codirector of the Boston chapter of SHM for 18 years and is well known for her dedication to SHM’s annual conference. She gained a reputation on the Annual Conference Committee for coming up with creative topics, including the Great Debate series.

Dr. Finn has previously served on the editorial board for the Journal of Hospital Medicine, where she continues to be a reviewer. She is a senior fellow in hospital medicine.

Excellence in Teaching

Juan Nicolás Lessing, MD, is an assistant professor of medicine within the division of hospital medicine at the Medical School at the University of Colorado at Denver, Aurora. He has dedicated himself to the teaching and study of clinical reasoning processes and has cocreated a resident clinical reasoning curriculum, which has been expended to all residency classes.

Dr. Lessing’s dedication to mentorship has been extraordinary. In fewer than 5 years, he has mentored more than 50 learners, resulting in 54 competitive abstracts, posters, and presentations. He has led more than 24 workshops and consistently sponsors junior colleagues to join him. In summary, he teaches learners how to learn rather than what to learn. Additionally, Dr. Lessing created and facilitated several impactful department-wide sessions on how we can learn from our mistakes to openly discuss missed diagnoses. He served as a co-PI on the LOOP study, a multicenter endeavor to provide real-time feedback to admitting residents on a patient’s clinical course, which was published in the Journal of Hospital Medicine.

Dr. Lessing has been actively involved with SHM since medical school, is a graduate of SHM’s Academic Hospitalist Academy, and serves on the executive board for the Rocky Mountain chapter of SHM.

Clinical Leadership for NPs/PAs

Ilaria Gadalla, DMSc, PA-C, is a hospitalist at Treasure Coast Hospitalists in Port St. Lucia, Fla., and also serves as the physician assistant department chair/program director at South University, where she supervises more than 40 PAs, medical directors, and administrative staff.

She continuously drives innovative projects for NPs and PAs to demonstrate excellence in collaboration by working closely with C-suite administration to expand QI (quality improvement) and education efforts. A prime example is the optimal communication system that she developed within her first week as a hospitalist in the Port St. Lucie area. Nursing, ED, and pharmacy staff had difficulty contacting hospitalists since the EMR would not reflect the assigned hospitalist, so she developed a simple contact sheet that included the hospitalist team each day. This method is still in use today.

Ms. Gadalla is the chair of SHM’s NP/PA special interest group who was integral in drafting the recent white paper on NP/PA integration and optimization.

Excellence in Humanitarian Services

Khaalisha Ajala, MD, MBA, is a hospitalist and associate site director for education at Grady Memorial Hospital in Atlanta. She cares for patients of diverse backgrounds directly and also has a deep-seeded passion for public health and patient education, always demonstrating how to bring this passion to trainee education.

Using her knowledge as an MBA, Dr. Ajala has designed, developed, and now maintains her own nonprofit agency, Heart Beats & Hip-Hop. Through this organization, she has hosted public health fairs to conduct health screenings in less-traditional local settings, where community members who may not have access to care can gain exposure to a health care provider.

More broadly, in the last year, she has made two journeys – one to Thailand and another to Ethiopia – to work with Emory trainees in educational and clinical efforts to help them engage the global community in health improvement. In Thailand, she taught students how to care for patients at risk for trafficking and sexual exploitation. While in Ethiopia, she served as an educator and clinical preceptor to Emory residents in the global health pathway, teaching them to care for high-risk patients at a local hospital.

With her active and unrelenting humanitarian efforts in mind, she was also chosen as a member of the executive council for SHM’s Care for Vulnerable Populations special interest group.

Diversity Leadership

Kimberly D. Manning, MD, FACP, FAAP, is a professor of medicine and the associate vice chair of diversity, equity and inclusion at the Emory University School of Medicine in Atlanta, where she also is a hospitalist at Grady Memorial Hospital. She demonstrates a strong passion for building and strengthening diverse clinical learning environments. This inspired her to promote cultural competency via lectures, curriculum development, and more.

Dr. Manning has designed a new educational modality – Bite-Sized Teaching (abbreviated “BST” and read as “BEAST”-Mode Teaching). This engages trainees as the teachers of their peers. As part of those sessions, Dr. Manning intentionally encourages and engages trainees from all backgrounds, including women, minorities, and trainees with varied ethnic and cultural perspectives.

Her leadership on the Emory Task Force on Diversity, Equity and Inclusion led her to be named the department of medicine’s first associate vice chair of diversity, equity and inclusion. Due in large part to her engagement, the medical school just admitted its largest class of underrepresented minorities, nearly doubling numbers from prior years.

She has received the 2018 AGCME Parker J. Palmer Courage to Teach Award and the 2019 Lifetime Achievement Award by the Association of Black Women Physicians. 

Leadership for Practice Manager

Douglas G. Philpot, MHA, MBA, MHR, FACHE, currently the hospitalist program director at Intermountain Healthcare in Salt Lake City, epitomizes excellence in practice management.

In mid-2018, Intermountain Healthcare transitioned to a new organizational structure that brought all medical and surgical operations under one leadership team. Prior to this reorganization, hospitalist groups were largely divided by the geographies they served, each operating independently.

After the reorganization, it was apparent that staffing structures among groups varied greatly. Dr. Philpot pored over the workload and billing data and determined the most efficient use of how to staff hospitalist providers. He recently created a program that allows all stakeholders to meet and discuss in an unbiased manner how and when to add resources to a given group. As a result, the team is better able to make smart decisions that translate into improved quality, better patient experience, a more engaged hospitalist group and improved financial decisions. This is a model that Intermountain is now looking to apply to other specialties.

Team Award in Quality Improvement

The Michigan Hospital Medicine Safety Consortium has been in place for a decade and has worked together to improve quality and safety for patients across Michigan and the nation. It has been led since its inception by Scott Flanders, MD, a hospitalist at the University of Michigan, Ann Arbor.

At each participating hospital, teams include hospitalists, infectious disease clinicians, interventional radiologists, nephrologists, nurses, pharmacists, administrators, and more. This integration ensures that the team’s work is highly relevant and generalizable for hospitals around the country.

Their initiatives have informed regulatory and guideline writing authorities in the United States and beyond. For example, findings from their venous thromboembolism project demonstrated that the majority of hospitalized patients do not benefit from VTE prophylaxis, but rather, targeted strategies to define those at high risk. In 2016, their work helped to prevent 852 VTEs in Michigan alone. This led to changes in national guidelines that now emphasize deimplementing pharmacologic VTE prophylaxis and focused risk-assessment in U.S. hospitals.

Their antimicrobial use initiative has led to a robust partnership between hospitalists, hospitals, and national partners, such as the Centers for Disease Control and Prevention. Early work has informed a key gap in stewardship – discharge antibiotic prescribing – which has been a focus for SHM, the CDC, and many others. Efforts have already led to a reduction in thousands of unnecessary antibiotic prescriptions in Michigan.

Junior Investigator Award

SHM’s Research Committee presents the Junior Investigator Award to recognize early-career hospitalist researchers who are leading the way in their field. We are pleased to present the HM20 Junior Investigator Award to Valerie Vaughn, MD, MSc.

Dr. Vaughn is an assistant professor and research scientist in the division of hospital medicine at the University of Michigan and Veterans Affairs Ann Arbor Healthcare System.

Her research is focused on engaging hospitalists in antibiotic prescribing, especially at discharge. She is the hospitalist lead for an initiative to improve antibiotic prescribing in 46 hospitals across Michigan. She has already made a national contribution to the field – two manuscripts that have received high praise and have been cited by the Joint Commission and the CDC in their updated recommendations for antibiotic stewardship. She has a grant from the Gordon and Betty Moore Foundation to study the role of diagnostic error in antibiotic overuse and just received a K08 career development award from the Agency for Healthcare Research and Quality to study methods to improve antibiotic prescribing at hospital discharge.

One of Dr. Vaughn’s career goals is to advance hospital medicine through mentoring the next generation of hospitalists. In 2017, she authored a manuscript titled “Mentee Missteps” in JAMA, which has been viewed nearly 40,000 times since publication. She continues to give talks on this topic and mentors clinical hospitalists on research projects to improve quality and safety.

Dr. Vaughn has worked closely with SHM and represents the society at the CDC’s Healthcare Infection Control Practices Advisory Committee quarterly meetings.

Certificate of Leadership in Hospital Medicine

The Certificate of Leadership in Hospital Medicine (CLHM) cultivates leadership skills in the context of specific hospital medicine challenges. This designation informs employers – or potential employers – with confidence that a candidate is equipped and ready to lead teams and grow an organization.

Charmaine Lewis, MD, MPH, FHM, CLHM, is the quality director for New Hanover Hospitalists in Wilmington, N.C., a role she has held for 7 years. She is also clinical assistant professor, department of medicine, University of North Carolina School of Medicine, Chapel Hill, serving as a mentor for internal medicine, surgery, and obstetrics residents completing projects in quality improvement.

While sitting on the CHF and readmissions committees at her institution, Dr. Lewis was asked why patients with heart failure came back to the hospital. This question launched an in-depth search for real-time and accurate data on heart failure patients in her institution. She worked with the Heart Failure Steering Committee to develop a process to close care gaps and document compliance to the ACC/AHA Get with the Guidelines: Heart Failure recommendations. She facilitated order set revisions, smart-phrase documentation in EPIC, and scripted bedside interdisciplinary rounding to facilitate compliance prior to patient discharge. She also created an end-user friendly dashboard to report compliance with medical leaders, and eventually this project was selected by the department of medicine as their annual quality goal.  The project has led to the improvement of CHF GWTG Composite Bundle compliance from 76% to 93%, and compliance with use of aldosterone antagonists from 22% to 85%.

Outstanding Service in Hospital Medicine

Efren Manjarrez, MD, SFHM, FACP, is an associate professor of clinical medicine at the University of Miami Miller School of Medicine, where he also serves as a hospitalist in the division of hospital medicine. His high-impact work at his home institution and through SHM has been extensive.

He founded the division of hospital medicine at the University of Miami in 2000 and later served as the division chief and patient safety officer. Dr. Manjarrez served in the prestigious role of course director for HM15 and as co-course director for the Adult Hospital Medicine Boot Camp.

One of his most enduring contributions is as an author of the white paper on hospitalist handoffs, published in the Journal of Hospital Medicine in 2009, which continues to be cited and validated. He was an assistant editor for the Journal of Hospital Medicine and continues to review articles for JHM. Dr. Manjarrez is also a senior fellow in hospital medicine.

Excellence in Research

Shoshana J. Herzig, MD, MPH, is the director of hospital medicine research at Beth Israel Deaconess Medical Center in Boston, where she also serves as a hospitalist. She is also an associate professor of medicine at Harvard Medical School, also in Boston.

She has published nearly 50 original peer-reviewed manuscripts in some of medicine’s top journals. Her impressive research, which primarily focuses on patterns of medication utilization and associated outcomes in hospitalized adults, has been cited more than 1,500 times in the medical literature.

In addition to her work on medication safety, she is also a site PI for the Hospital Medicine Research Network (HOMERuN), a nationwide collaborative of hospital medicine researchers.

Dr. Herzig has been a member of SHM since 2008 and has attended the annual conference every year since. She has served as an RIV abstract judge, was instrumental in developing SHM’s consensus statement on safe opioid prescribing, and has served as an editor for the Journal of Hospital Medicine since 2012 and has been a senior deputy editor since 2015.

Clinical Leadership for Physicians

Karen Smith, MD, MEd, SFHM, is the chief of the division of hospitalist medicine and past president of the medical staff at Children’s National Medical Center in Washington. She also serves as associate professor of pediatrics at the George Washington University School of Medicine. She has consistently worked to create a supportive environment in which to promote wellness among her staff and colleagues.

She was one of three founding faculty members of the division of hospital medicine at Children’s National, and under her leadership, the division has seen substantial growth. It has evolved from a single site to a comprehensive model of services, spanning six community hospitals and a specialty hospital for rehabilitation and subacute care.

To increase morale, Dr. Smith spearheaded the development of a virtual physician lounge. She reserved a conference room once a month and provided free lunch to medical staff members of different specialties. Its success led to the construction of a full-time lounge – all because of Dr. Smith’s perseverance and forward thinking.

She is a past member of SHM’s Pediatrics Committee and Hospital Quality and Patient Safety Committee and is a senior fellow in hospital medicine.

Excellence in Teaching

Kathleen M. Finn, MD, M.Phil, SFHM, is the senior associate program director for resident and faculty development in the Massachusetts General Hospital internal medicine residency program at Harvard Medical School, both in Boston, where she also is an assistant professor of medicine. She has excelled at teaching at all levels and in all kinds of settings, from clinical teaching on inpatient rounds, educating faculty through workshops to serving as course director for Hospital Medicine 2018 in Orlando. She constantly strives to think creatively and to teach in new ways and considers her career to be a synergy of all three domains in medical education: clinical teaching, leadership, and research.

Her interest in improving the art of inpatient teaching has also taken Dr. Finn into the medical education research space, where she has conducted and published several significant studies.

She was the codirector of the Boston chapter of SHM for 18 years and is well known for her dedication to SHM’s annual conference. She gained a reputation on the Annual Conference Committee for coming up with creative topics, including the Great Debate series.

Dr. Finn has previously served on the editorial board for the Journal of Hospital Medicine, where she continues to be a reviewer. She is a senior fellow in hospital medicine.

Excellence in Teaching

Juan Nicolás Lessing, MD, is an assistant professor of medicine within the division of hospital medicine at the Medical School at the University of Colorado at Denver, Aurora. He has dedicated himself to the teaching and study of clinical reasoning processes and has cocreated a resident clinical reasoning curriculum, which has been expended to all residency classes.

Dr. Lessing’s dedication to mentorship has been extraordinary. In fewer than 5 years, he has mentored more than 50 learners, resulting in 54 competitive abstracts, posters, and presentations. He has led more than 24 workshops and consistently sponsors junior colleagues to join him. In summary, he teaches learners how to learn rather than what to learn. Additionally, Dr. Lessing created and facilitated several impactful department-wide sessions on how we can learn from our mistakes to openly discuss missed diagnoses. He served as a co-PI on the LOOP study, a multicenter endeavor to provide real-time feedback to admitting residents on a patient’s clinical course, which was published in the Journal of Hospital Medicine.

Dr. Lessing has been actively involved with SHM since medical school, is a graduate of SHM’s Academic Hospitalist Academy, and serves on the executive board for the Rocky Mountain chapter of SHM.

Clinical Leadership for NPs/PAs

Ilaria Gadalla, DMSc, PA-C, is a hospitalist at Treasure Coast Hospitalists in Port St. Lucia, Fla., and also serves as the physician assistant department chair/program director at South University, where she supervises more than 40 PAs, medical directors, and administrative staff.

She continuously drives innovative projects for NPs and PAs to demonstrate excellence in collaboration by working closely with C-suite administration to expand QI (quality improvement) and education efforts. A prime example is the optimal communication system that she developed within her first week as a hospitalist in the Port St. Lucie area. Nursing, ED, and pharmacy staff had difficulty contacting hospitalists since the EMR would not reflect the assigned hospitalist, so she developed a simple contact sheet that included the hospitalist team each day. This method is still in use today.

Ms. Gadalla is the chair of SHM’s NP/PA special interest group who was integral in drafting the recent white paper on NP/PA integration and optimization.

Excellence in Humanitarian Services

Khaalisha Ajala, MD, MBA, is a hospitalist and associate site director for education at Grady Memorial Hospital in Atlanta. She cares for patients of diverse backgrounds directly and also has a deep-seeded passion for public health and patient education, always demonstrating how to bring this passion to trainee education.

Using her knowledge as an MBA, Dr. Ajala has designed, developed, and now maintains her own nonprofit agency, Heart Beats & Hip-Hop. Through this organization, she has hosted public health fairs to conduct health screenings in less-traditional local settings, where community members who may not have access to care can gain exposure to a health care provider.

More broadly, in the last year, she has made two journeys – one to Thailand and another to Ethiopia – to work with Emory trainees in educational and clinical efforts to help them engage the global community in health improvement. In Thailand, she taught students how to care for patients at risk for trafficking and sexual exploitation. While in Ethiopia, she served as an educator and clinical preceptor to Emory residents in the global health pathway, teaching them to care for high-risk patients at a local hospital.

With her active and unrelenting humanitarian efforts in mind, she was also chosen as a member of the executive council for SHM’s Care for Vulnerable Populations special interest group.

Diversity Leadership

Kimberly D. Manning, MD, FACP, FAAP, is a professor of medicine and the associate vice chair of diversity, equity and inclusion at the Emory University School of Medicine in Atlanta, where she also is a hospitalist at Grady Memorial Hospital. She demonstrates a strong passion for building and strengthening diverse clinical learning environments. This inspired her to promote cultural competency via lectures, curriculum development, and more.

Dr. Manning has designed a new educational modality – Bite-Sized Teaching (abbreviated “BST” and read as “BEAST”-Mode Teaching). This engages trainees as the teachers of their peers. As part of those sessions, Dr. Manning intentionally encourages and engages trainees from all backgrounds, including women, minorities, and trainees with varied ethnic and cultural perspectives.

Her leadership on the Emory Task Force on Diversity, Equity and Inclusion led her to be named the department of medicine’s first associate vice chair of diversity, equity and inclusion. Due in large part to her engagement, the medical school just admitted its largest class of underrepresented minorities, nearly doubling numbers from prior years.

She has received the 2018 AGCME Parker J. Palmer Courage to Teach Award and the 2019 Lifetime Achievement Award by the Association of Black Women Physicians. 

Leadership for Practice Manager

Douglas G. Philpot, MHA, MBA, MHR, FACHE, currently the hospitalist program director at Intermountain Healthcare in Salt Lake City, epitomizes excellence in practice management.

In mid-2018, Intermountain Healthcare transitioned to a new organizational structure that brought all medical and surgical operations under one leadership team. Prior to this reorganization, hospitalist groups were largely divided by the geographies they served, each operating independently.

After the reorganization, it was apparent that staffing structures among groups varied greatly. Dr. Philpot pored over the workload and billing data and determined the most efficient use of how to staff hospitalist providers. He recently created a program that allows all stakeholders to meet and discuss in an unbiased manner how and when to add resources to a given group. As a result, the team is better able to make smart decisions that translate into improved quality, better patient experience, a more engaged hospitalist group and improved financial decisions. This is a model that Intermountain is now looking to apply to other specialties.

Team Award in Quality Improvement

The Michigan Hospital Medicine Safety Consortium has been in place for a decade and has worked together to improve quality and safety for patients across Michigan and the nation. It has been led since its inception by Scott Flanders, MD, a hospitalist at the University of Michigan, Ann Arbor.

At each participating hospital, teams include hospitalists, infectious disease clinicians, interventional radiologists, nephrologists, nurses, pharmacists, administrators, and more. This integration ensures that the team’s work is highly relevant and generalizable for hospitals around the country.

Their initiatives have informed regulatory and guideline writing authorities in the United States and beyond. For example, findings from their venous thromboembolism project demonstrated that the majority of hospitalized patients do not benefit from VTE prophylaxis, but rather, targeted strategies to define those at high risk. In 2016, their work helped to prevent 852 VTEs in Michigan alone. This led to changes in national guidelines that now emphasize deimplementing pharmacologic VTE prophylaxis and focused risk-assessment in U.S. hospitals.

Their antimicrobial use initiative has led to a robust partnership between hospitalists, hospitals, and national partners, such as the Centers for Disease Control and Prevention. Early work has informed a key gap in stewardship – discharge antibiotic prescribing – which has been a focus for SHM, the CDC, and many others. Efforts have already led to a reduction in thousands of unnecessary antibiotic prescriptions in Michigan.

Junior Investigator Award

SHM’s Research Committee presents the Junior Investigator Award to recognize early-career hospitalist researchers who are leading the way in their field. We are pleased to present the HM20 Junior Investigator Award to Valerie Vaughn, MD, MSc.

Dr. Vaughn is an assistant professor and research scientist in the division of hospital medicine at the University of Michigan and Veterans Affairs Ann Arbor Healthcare System.

Her research is focused on engaging hospitalists in antibiotic prescribing, especially at discharge. She is the hospitalist lead for an initiative to improve antibiotic prescribing in 46 hospitals across Michigan. She has already made a national contribution to the field – two manuscripts that have received high praise and have been cited by the Joint Commission and the CDC in their updated recommendations for antibiotic stewardship. She has a grant from the Gordon and Betty Moore Foundation to study the role of diagnostic error in antibiotic overuse and just received a K08 career development award from the Agency for Healthcare Research and Quality to study methods to improve antibiotic prescribing at hospital discharge.

One of Dr. Vaughn’s career goals is to advance hospital medicine through mentoring the next generation of hospitalists. In 2017, she authored a manuscript titled “Mentee Missteps” in JAMA, which has been viewed nearly 40,000 times since publication. She continues to give talks on this topic and mentors clinical hospitalists on research projects to improve quality and safety.

Dr. Vaughn has worked closely with SHM and represents the society at the CDC’s Healthcare Infection Control Practices Advisory Committee quarterly meetings.

Certificate of Leadership in Hospital Medicine

The Certificate of Leadership in Hospital Medicine (CLHM) cultivates leadership skills in the context of specific hospital medicine challenges. This designation informs employers – or potential employers – with confidence that a candidate is equipped and ready to lead teams and grow an organization.

Charmaine Lewis, MD, MPH, FHM, CLHM, is the quality director for New Hanover Hospitalists in Wilmington, N.C., a role she has held for 7 years. She is also clinical assistant professor, department of medicine, University of North Carolina School of Medicine, Chapel Hill, serving as a mentor for internal medicine, surgery, and obstetrics residents completing projects in quality improvement.

While sitting on the CHF and readmissions committees at her institution, Dr. Lewis was asked why patients with heart failure came back to the hospital. This question launched an in-depth search for real-time and accurate data on heart failure patients in her institution. She worked with the Heart Failure Steering Committee to develop a process to close care gaps and document compliance to the ACC/AHA Get with the Guidelines: Heart Failure recommendations. She facilitated order set revisions, smart-phrase documentation in EPIC, and scripted bedside interdisciplinary rounding to facilitate compliance prior to patient discharge. She also created an end-user friendly dashboard to report compliance with medical leaders, and eventually this project was selected by the department of medicine as their annual quality goal.  The project has led to the improvement of CHF GWTG Composite Bundle compliance from 76% to 93%, and compliance with use of aldosterone antagonists from 22% to 85%.

Outstanding Service in Hospital Medicine

Efren Manjarrez, MD, SFHM, FACP, is an associate professor of clinical medicine at the University of Miami Miller School of Medicine, where he also serves as a hospitalist in the division of hospital medicine. His high-impact work at his home institution and through SHM has been extensive.

He founded the division of hospital medicine at the University of Miami in 2000 and later served as the division chief and patient safety officer. Dr. Manjarrez served in the prestigious role of course director for HM15 and as co-course director for the Adult Hospital Medicine Boot Camp.

One of his most enduring contributions is as an author of the white paper on hospitalist handoffs, published in the Journal of Hospital Medicine in 2009, which continues to be cited and validated. He was an assistant editor for the Journal of Hospital Medicine and continues to review articles for JHM. Dr. Manjarrez is also a senior fellow in hospital medicine.

Excellence in Research

Shoshana J. Herzig, MD, MPH, is the director of hospital medicine research at Beth Israel Deaconess Medical Center in Boston, where she also serves as a hospitalist. She is also an associate professor of medicine at Harvard Medical School, also in Boston.

She has published nearly 50 original peer-reviewed manuscripts in some of medicine’s top journals. Her impressive research, which primarily focuses on patterns of medication utilization and associated outcomes in hospitalized adults, has been cited more than 1,500 times in the medical literature.

In addition to her work on medication safety, she is also a site PI for the Hospital Medicine Research Network (HOMERuN), a nationwide collaborative of hospital medicine researchers.

Dr. Herzig has been a member of SHM since 2008 and has attended the annual conference every year since. She has served as an RIV abstract judge, was instrumental in developing SHM’s consensus statement on safe opioid prescribing, and has served as an editor for the Journal of Hospital Medicine since 2012 and has been a senior deputy editor since 2015.

Clinical Leadership for Physicians

Karen Smith, MD, MEd, SFHM, is the chief of the division of hospitalist medicine and past president of the medical staff at Children’s National Medical Center in Washington. She also serves as associate professor of pediatrics at the George Washington University School of Medicine. She has consistently worked to create a supportive environment in which to promote wellness among her staff and colleagues.

She was one of three founding faculty members of the division of hospital medicine at Children’s National, and under her leadership, the division has seen substantial growth. It has evolved from a single site to a comprehensive model of services, spanning six community hospitals and a specialty hospital for rehabilitation and subacute care.

To increase morale, Dr. Smith spearheaded the development of a virtual physician lounge. She reserved a conference room once a month and provided free lunch to medical staff members of different specialties. Its success led to the construction of a full-time lounge – all because of Dr. Smith’s perseverance and forward thinking.

She is a past member of SHM’s Pediatrics Committee and Hospital Quality and Patient Safety Committee and is a senior fellow in hospital medicine.

Excellence in Teaching

Kathleen M. Finn, MD, M.Phil, SFHM, is the senior associate program director for resident and faculty development in the Massachusetts General Hospital internal medicine residency program at Harvard Medical School, both in Boston, where she also is an assistant professor of medicine. She has excelled at teaching at all levels and in all kinds of settings, from clinical teaching on inpatient rounds, educating faculty through workshops to serving as course director for Hospital Medicine 2018 in Orlando. She constantly strives to think creatively and to teach in new ways and considers her career to be a synergy of all three domains in medical education: clinical teaching, leadership, and research.

Her interest in improving the art of inpatient teaching has also taken Dr. Finn into the medical education research space, where she has conducted and published several significant studies.

She was the codirector of the Boston chapter of SHM for 18 years and is well known for her dedication to SHM’s annual conference. She gained a reputation on the Annual Conference Committee for coming up with creative topics, including the Great Debate series.

Dr. Finn has previously served on the editorial board for the Journal of Hospital Medicine, where she continues to be a reviewer. She is a senior fellow in hospital medicine.

Excellence in Teaching

Juan Nicolás Lessing, MD, is an assistant professor of medicine within the division of hospital medicine at the Medical School at the University of Colorado at Denver, Aurora. He has dedicated himself to the teaching and study of clinical reasoning processes and has cocreated a resident clinical reasoning curriculum, which has been expended to all residency classes.

Dr. Lessing’s dedication to mentorship has been extraordinary. In fewer than 5 years, he has mentored more than 50 learners, resulting in 54 competitive abstracts, posters, and presentations. He has led more than 24 workshops and consistently sponsors junior colleagues to join him. In summary, he teaches learners how to learn rather than what to learn. Additionally, Dr. Lessing created and facilitated several impactful department-wide sessions on how we can learn from our mistakes to openly discuss missed diagnoses. He served as a co-PI on the LOOP study, a multicenter endeavor to provide real-time feedback to admitting residents on a patient’s clinical course, which was published in the Journal of Hospital Medicine.

Dr. Lessing has been actively involved with SHM since medical school, is a graduate of SHM’s Academic Hospitalist Academy, and serves on the executive board for the Rocky Mountain chapter of SHM.

Clinical Leadership for NPs/PAs

Ilaria Gadalla, DMSc, PA-C, is a hospitalist at Treasure Coast Hospitalists in Port St. Lucia, Fla., and also serves as the physician assistant department chair/program director at South University, where she supervises more than 40 PAs, medical directors, and administrative staff.

She continuously drives innovative projects for NPs and PAs to demonstrate excellence in collaboration by working closely with C-suite administration to expand QI (quality improvement) and education efforts. A prime example is the optimal communication system that she developed within her first week as a hospitalist in the Port St. Lucie area. Nursing, ED, and pharmacy staff had difficulty contacting hospitalists since the EMR would not reflect the assigned hospitalist, so she developed a simple contact sheet that included the hospitalist team each day. This method is still in use today.

Ms. Gadalla is the chair of SHM’s NP/PA special interest group who was integral in drafting the recent white paper on NP/PA integration and optimization.

Excellence in Humanitarian Services

Khaalisha Ajala, MD, MBA, is a hospitalist and associate site director for education at Grady Memorial Hospital in Atlanta. She cares for patients of diverse backgrounds directly and also has a deep-seeded passion for public health and patient education, always demonstrating how to bring this passion to trainee education.

Using her knowledge as an MBA, Dr. Ajala has designed, developed, and now maintains her own nonprofit agency, Heart Beats & Hip-Hop. Through this organization, she has hosted public health fairs to conduct health screenings in less-traditional local settings, where community members who may not have access to care can gain exposure to a health care provider.

More broadly, in the last year, she has made two journeys – one to Thailand and another to Ethiopia – to work with Emory trainees in educational and clinical efforts to help them engage the global community in health improvement. In Thailand, she taught students how to care for patients at risk for trafficking and sexual exploitation. While in Ethiopia, she served as an educator and clinical preceptor to Emory residents in the global health pathway, teaching them to care for high-risk patients at a local hospital.

With her active and unrelenting humanitarian efforts in mind, she was also chosen as a member of the executive council for SHM’s Care for Vulnerable Populations special interest group.

Diversity Leadership

Kimberly D. Manning, MD, FACP, FAAP, is a professor of medicine and the associate vice chair of diversity, equity and inclusion at the Emory University School of Medicine in Atlanta, where she also is a hospitalist at Grady Memorial Hospital. She demonstrates a strong passion for building and strengthening diverse clinical learning environments. This inspired her to promote cultural competency via lectures, curriculum development, and more.

Dr. Manning has designed a new educational modality – Bite-Sized Teaching (abbreviated “BST” and read as “BEAST”-Mode Teaching). This engages trainees as the teachers of their peers. As part of those sessions, Dr. Manning intentionally encourages and engages trainees from all backgrounds, including women, minorities, and trainees with varied ethnic and cultural perspectives.

Her leadership on the Emory Task Force on Diversity, Equity and Inclusion led her to be named the department of medicine’s first associate vice chair of diversity, equity and inclusion. Due in large part to her engagement, the medical school just admitted its largest class of underrepresented minorities, nearly doubling numbers from prior years.

She has received the 2018 AGCME Parker J. Palmer Courage to Teach Award and the 2019 Lifetime Achievement Award by the Association of Black Women Physicians. 

Leadership for Practice Manager

Douglas G. Philpot, MHA, MBA, MHR, FACHE, currently the hospitalist program director at Intermountain Healthcare in Salt Lake City, epitomizes excellence in practice management.

In mid-2018, Intermountain Healthcare transitioned to a new organizational structure that brought all medical and surgical operations under one leadership team. Prior to this reorganization, hospitalist groups were largely divided by the geographies they served, each operating independently.

After the reorganization, it was apparent that staffing structures among groups varied greatly. Dr. Philpot pored over the workload and billing data and determined the most efficient use of how to staff hospitalist providers. He recently created a program that allows all stakeholders to meet and discuss in an unbiased manner how and when to add resources to a given group. As a result, the team is better able to make smart decisions that translate into improved quality, better patient experience, a more engaged hospitalist group and improved financial decisions. This is a model that Intermountain is now looking to apply to other specialties.

Team Award in Quality Improvement

The Michigan Hospital Medicine Safety Consortium has been in place for a decade and has worked together to improve quality and safety for patients across Michigan and the nation. It has been led since its inception by Scott Flanders, MD, a hospitalist at the University of Michigan, Ann Arbor.

At each participating hospital, teams include hospitalists, infectious disease clinicians, interventional radiologists, nephrologists, nurses, pharmacists, administrators, and more. This integration ensures that the team’s work is highly relevant and generalizable for hospitals around the country.

Their initiatives have informed regulatory and guideline writing authorities in the United States and beyond. For example, findings from their venous thromboembolism project demonstrated that the majority of hospitalized patients do not benefit from VTE prophylaxis, but rather, targeted strategies to define those at high risk. In 2016, their work helped to prevent 852 VTEs in Michigan alone. This led to changes in national guidelines that now emphasize deimplementing pharmacologic VTE prophylaxis and focused risk-assessment in U.S. hospitals.

Their antimicrobial use initiative has led to a robust partnership between hospitalists, hospitals, and national partners, such as the Centers for Disease Control and Prevention. Early work has informed a key gap in stewardship – discharge antibiotic prescribing – which has been a focus for SHM, the CDC, and many others. Efforts have already led to a reduction in thousands of unnecessary antibiotic prescriptions in Michigan.

Junior Investigator Award

SHM’s Research Committee presents the Junior Investigator Award to recognize early-career hospitalist researchers who are leading the way in their field. We are pleased to present the HM20 Junior Investigator Award to Valerie Vaughn, MD, MSc.

Dr. Vaughn is an assistant professor and research scientist in the division of hospital medicine at the University of Michigan and Veterans Affairs Ann Arbor Healthcare System.

Her research is focused on engaging hospitalists in antibiotic prescribing, especially at discharge. She is the hospitalist lead for an initiative to improve antibiotic prescribing in 46 hospitals across Michigan. She has already made a national contribution to the field – two manuscripts that have received high praise and have been cited by the Joint Commission and the CDC in their updated recommendations for antibiotic stewardship. She has a grant from the Gordon and Betty Moore Foundation to study the role of diagnostic error in antibiotic overuse and just received a K08 career development award from the Agency for Healthcare Research and Quality to study methods to improve antibiotic prescribing at hospital discharge.

One of Dr. Vaughn’s career goals is to advance hospital medicine through mentoring the next generation of hospitalists. In 2017, she authored a manuscript titled “Mentee Missteps” in JAMA, which has been viewed nearly 40,000 times since publication. She continues to give talks on this topic and mentors clinical hospitalists on research projects to improve quality and safety.

Dr. Vaughn has worked closely with SHM and represents the society at the CDC’s Healthcare Infection Control Practices Advisory Committee quarterly meetings.

Certificate of Leadership in Hospital Medicine

The Certificate of Leadership in Hospital Medicine (CLHM) cultivates leadership skills in the context of specific hospital medicine challenges. This designation informs employers – or potential employers – with confidence that a candidate is equipped and ready to lead teams and grow an organization.

Charmaine Lewis, MD, MPH, FHM, CLHM, is the quality director for New Hanover Hospitalists in Wilmington, N.C., a role she has held for 7 years. She is also clinical assistant professor, department of medicine, University of North Carolina School of Medicine, Chapel Hill, serving as a mentor for internal medicine, surgery, and obstetrics residents completing projects in quality improvement.

While sitting on the CHF and readmissions committees at her institution, Dr. Lewis was asked why patients with heart failure came back to the hospital. This question launched an in-depth search for real-time and accurate data on heart failure patients in her institution. She worked with the Heart Failure Steering Committee to develop a process to close care gaps and document compliance to the ACC/AHA Get with the Guidelines: Heart Failure recommendations. She facilitated order set revisions, smart-phrase documentation in EPIC, and scripted bedside interdisciplinary rounding to facilitate compliance prior to patient discharge. She also created an end-user friendly dashboard to report compliance with medical leaders, and eventually this project was selected by the department of medicine as their annual quality goal.  The project has led to the improvement of CHF GWTG Composite Bundle compliance from 76% to 93%, and compliance with use of aldosterone antagonists from 22% to 85%.

Pediatric hospitalists Linda Bloom, MD, Corina Sandru, MD, and Ilana Price MD, all from Reading Hospital – Tower Health (West Reading, Pa.) recently earned board certification in pediatric hospital medicine from the American Board of Pediatrics. This was the first certification of its kind given by the ABP.

Sitting for the board certification exam required ABP certification and meeting the training requirements set for pediatric hospital medicine, which was recognized as a subspecialty in 2016.

Felipe Castorena, MD, recently received the Humanitarian Award at the Northwell Health Hospital Medicine Academic Summit. Dr. Castorena was honored for the volunteer work he did with underserved communities in the Dominican Republic in October 2018.

Dr. Castorena worked with the Dr. Almanzar Foundation, providing medical care that included vaccine administration, surgery, and general checkups. A native of Mexico, Dr. Castorena is a hospitalist at Phelps Hospital in Sleepy Hollow, N.Y.

Alteon Health has named Frank Kelley, MD, as one of three 2019 Facility Medical Directors of the Year. Dr. Kelley serves as director of hospital medicine at University Hospitals Portage Medical Center (Ravenna, Ohio). Alteon began managing the Portage hospitalist program in 2006.

Dr. Kelley was recognized for exhibiting “exemplary leadership and professionalism … mentoring their physicians and advance practice providers while improving department performance.” He is one of three winners among Alteon’s 125 clinical sites.

Amina Ahmed, MD, recently was named chief medical officer for CareOne, New Jersey’s largest family-owned-and-operated senior-living/post–acute care operator.

A board-certified internist, Dr. Ahmed most recently was chief of hospitalist medicine and post–acute care at Summit Medical Group (Berkeley Heights, N.J.).

Ikenna Ibe, MD, has been promoted to vice president of medical affairs and chief medical officer at Virginia Commonwealth University Health Community Memorial Hospital (Richmond, Va.). Dr. Ibe will be charged with creating a stronger connect between staff at VCU Health CMH and the clinical programs at VCU Medical Center’s main campus.

Dr. Ibe has been medical director of the hospitalist group since starting at VCU Health CMH in 2018. He will continue to care for patients and guide the hospitalist program while in his new role until his replacement is found. He previously directed the hospitalist program at Richmond’s St. Mary’s Hospital.

The medical staff at Saint Thomas Rutherford Hospital (Murfreesboro, Tenn.) has voted David Sellers, MD, to be chief of staff for a 2-year term that began in January 2020.

Dr. Sellers is the lead hospitalist at Ascension Saint Thomas Rutherford. Dr. Sellers, as chief of staff, will chair the hospital’s Medical Executive Committee, as well as serving as the staff’s advocate at overall board meetings. In addition, he will seek continuing education opportunities for staff, and safeguard that the staff aligns along board policies.

Angela Shippy, MD, FHM, has been promoted to senior vice president and chief medical officer at Memorial Hermann Health System (Houston). In addition, Dr. Shippy will continue to execute her duties as the system’s chief quality officer, a position she has held for the past 5 years.

Dr. Shippy has worked in management throughout her career, serving as chief medical officer at HCA Healthcare’s Gulf Coast Division and as vice president of medical affairs at St. Luke’s Episcopal Hospital, where she also was a hospitalist.

Munir Ahmed, MD, an internist with a quarter century’s worth of experience in Cape Cod, Mass., has been named chief transformation officer with Community Health Center of Cape Cod. Dr. Ahmed will be tasked with creating improvements in clinical outcomes and expanding the facility’s use of emerging technology.

Dr. Ahmed previously worked as a hospitalist and internist at Cape Cod Hospital (East Sandwich, Mass.), where he specialized in hypertension, diabetes, geriatrics, hospice, and palliative care.

A new obstetrics hospitalist program is coming to Bayhealth Kent Campus (Dover, Del.), which has partnered with the national OB Hospitalist Group (Greenville, S.C.). The OB hospitalists will cover labor and delivery, as well as emergency and trauma, 24 hours a day, 7 days a week.

The program will be advantageous for Bayhealth patients who may not have a primary doctor, as the hospitalists will work to ensure safe deliveries and perform C-sections as needed.

The OB Hospitalist Group is the nation’s largest and only dedicated ob.gyn. hospitalist provider with more than 1,000 clinicians in close to 200 facilities across 33 states.

Pediatric hospitalists Linda Bloom, MD, Corina Sandru, MD, and Ilana Price MD, all from Reading Hospital – Tower Health (West Reading, Pa.) recently earned board certification in pediatric hospital medicine from the American Board of Pediatrics. This was the first certification of its kind given by the ABP.

Sitting for the board certification exam required ABP certification and meeting the training requirements set for pediatric hospital medicine, which was recognized as a subspecialty in 2016.

Felipe Castorena, MD, recently received the Humanitarian Award at the Northwell Health Hospital Medicine Academic Summit. Dr. Castorena was honored for the volunteer work he did with underserved communities in the Dominican Republic in October 2018.

Dr. Castorena worked with the Dr. Almanzar Foundation, providing medical care that included vaccine administration, surgery, and general checkups. A native of Mexico, Dr. Castorena is a hospitalist at Phelps Hospital in Sleepy Hollow, N.Y.

Alteon Health has named Frank Kelley, MD, as one of three 2019 Facility Medical Directors of the Year. Dr. Kelley serves as director of hospital medicine at University Hospitals Portage Medical Center (Ravenna, Ohio). Alteon began managing the Portage hospitalist program in 2006.

Dr. Kelley was recognized for exhibiting “exemplary leadership and professionalism … mentoring their physicians and advance practice providers while improving department performance.” He is one of three winners among Alteon’s 125 clinical sites.

Amina Ahmed, MD, recently was named chief medical officer for CareOne, New Jersey’s largest family-owned-and-operated senior-living/post–acute care operator.

A board-certified internist, Dr. Ahmed most recently was chief of hospitalist medicine and post–acute care at Summit Medical Group (Berkeley Heights, N.J.).

Ikenna Ibe, MD, has been promoted to vice president of medical affairs and chief medical officer at Virginia Commonwealth University Health Community Memorial Hospital (Richmond, Va.). Dr. Ibe will be charged with creating a stronger connect between staff at VCU Health CMH and the clinical programs at VCU Medical Center’s main campus.

Dr. Ibe has been medical director of the hospitalist group since starting at VCU Health CMH in 2018. He will continue to care for patients and guide the hospitalist program while in his new role until his replacement is found. He previously directed the hospitalist program at Richmond’s St. Mary’s Hospital.

The medical staff at Saint Thomas Rutherford Hospital (Murfreesboro, Tenn.) has voted David Sellers, MD, to be chief of staff for a 2-year term that began in January 2020.

Dr. Sellers is the lead hospitalist at Ascension Saint Thomas Rutherford. Dr. Sellers, as chief of staff, will chair the hospital’s Medical Executive Committee, as well as serving as the staff’s advocate at overall board meetings. In addition, he will seek continuing education opportunities for staff, and safeguard that the staff aligns along board policies.

Angela Shippy, MD, FHM, has been promoted to senior vice president and chief medical officer at Memorial Hermann Health System (Houston). In addition, Dr. Shippy will continue to execute her duties as the system’s chief quality officer, a position she has held for the past 5 years.

Dr. Shippy has worked in management throughout her career, serving as chief medical officer at HCA Healthcare’s Gulf Coast Division and as vice president of medical affairs at St. Luke’s Episcopal Hospital, where she also was a hospitalist.

Munir Ahmed, MD, an internist with a quarter century’s worth of experience in Cape Cod, Mass., has been named chief transformation officer with Community Health Center of Cape Cod. Dr. Ahmed will be tasked with creating improvements in clinical outcomes and expanding the facility’s use of emerging technology.

Dr. Ahmed previously worked as a hospitalist and internist at Cape Cod Hospital (East Sandwich, Mass.), where he specialized in hypertension, diabetes, geriatrics, hospice, and palliative care.

A new obstetrics hospitalist program is coming to Bayhealth Kent Campus (Dover, Del.), which has partnered with the national OB Hospitalist Group (Greenville, S.C.). The OB hospitalists will cover labor and delivery, as well as emergency and trauma, 24 hours a day, 7 days a week.

The program will be advantageous for Bayhealth patients who may not have a primary doctor, as the hospitalists will work to ensure safe deliveries and perform C-sections as needed.

The OB Hospitalist Group is the nation’s largest and only dedicated ob.gyn. hospitalist provider with more than 1,000 clinicians in close to 200 facilities across 33 states.

Pediatric hospitalists Linda Bloom, MD, Corina Sandru, MD, and Ilana Price MD, all from Reading Hospital – Tower Health (West Reading, Pa.) recently earned board certification in pediatric hospital medicine from the American Board of Pediatrics. This was the first certification of its kind given by the ABP.

Sitting for the board certification exam required ABP certification and meeting the training requirements set for pediatric hospital medicine, which was recognized as a subspecialty in 2016.

Felipe Castorena, MD, recently received the Humanitarian Award at the Northwell Health Hospital Medicine Academic Summit. Dr. Castorena was honored for the volunteer work he did with underserved communities in the Dominican Republic in October 2018.

Dr. Castorena worked with the Dr. Almanzar Foundation, providing medical care that included vaccine administration, surgery, and general checkups. A native of Mexico, Dr. Castorena is a hospitalist at Phelps Hospital in Sleepy Hollow, N.Y.

Alteon Health has named Frank Kelley, MD, as one of three 2019 Facility Medical Directors of the Year. Dr. Kelley serves as director of hospital medicine at University Hospitals Portage Medical Center (Ravenna, Ohio). Alteon began managing the Portage hospitalist program in 2006.

Dr. Kelley was recognized for exhibiting “exemplary leadership and professionalism … mentoring their physicians and advance practice providers while improving department performance.” He is one of three winners among Alteon’s 125 clinical sites.

Amina Ahmed, MD, recently was named chief medical officer for CareOne, New Jersey’s largest family-owned-and-operated senior-living/post–acute care operator.

A board-certified internist, Dr. Ahmed most recently was chief of hospitalist medicine and post–acute care at Summit Medical Group (Berkeley Heights, N.J.).

Ikenna Ibe, MD, has been promoted to vice president of medical affairs and chief medical officer at Virginia Commonwealth University Health Community Memorial Hospital (Richmond, Va.). Dr. Ibe will be charged with creating a stronger connect between staff at VCU Health CMH and the clinical programs at VCU Medical Center’s main campus.

Dr. Ibe has been medical director of the hospitalist group since starting at VCU Health CMH in 2018. He will continue to care for patients and guide the hospitalist program while in his new role until his replacement is found. He previously directed the hospitalist program at Richmond’s St. Mary’s Hospital.

The medical staff at Saint Thomas Rutherford Hospital (Murfreesboro, Tenn.) has voted David Sellers, MD, to be chief of staff for a 2-year term that began in January 2020.

Dr. Sellers is the lead hospitalist at Ascension Saint Thomas Rutherford. Dr. Sellers, as chief of staff, will chair the hospital’s Medical Executive Committee, as well as serving as the staff’s advocate at overall board meetings. In addition, he will seek continuing education opportunities for staff, and safeguard that the staff aligns along board policies.

Angela Shippy, MD, FHM, has been promoted to senior vice president and chief medical officer at Memorial Hermann Health System (Houston). In addition, Dr. Shippy will continue to execute her duties as the system’s chief quality officer, a position she has held for the past 5 years.

Dr. Shippy has worked in management throughout her career, serving as chief medical officer at HCA Healthcare’s Gulf Coast Division and as vice president of medical affairs at St. Luke’s Episcopal Hospital, where she also was a hospitalist.

Munir Ahmed, MD, an internist with a quarter century’s worth of experience in Cape Cod, Mass., has been named chief transformation officer with Community Health Center of Cape Cod. Dr. Ahmed will be tasked with creating improvements in clinical outcomes and expanding the facility’s use of emerging technology.

Dr. Ahmed previously worked as a hospitalist and internist at Cape Cod Hospital (East Sandwich, Mass.), where he specialized in hypertension, diabetes, geriatrics, hospice, and palliative care.

A new obstetrics hospitalist program is coming to Bayhealth Kent Campus (Dover, Del.), which has partnered with the national OB Hospitalist Group (Greenville, S.C.). The OB hospitalists will cover labor and delivery, as well as emergency and trauma, 24 hours a day, 7 days a week.

The program will be advantageous for Bayhealth patients who may not have a primary doctor, as the hospitalists will work to ensure safe deliveries and perform C-sections as needed.

The OB Hospitalist Group is the nation’s largest and only dedicated ob.gyn. hospitalist provider with more than 1,000 clinicians in close to 200 facilities across 33 states.

SHM is entering an exciting new chapter in its history because we will soon see Dr. Eric Howell take the reins from Dr. Larry Wellikson as CEO, as we watch Dr. Danielle Scheurer assume the role of president from Dr. Chris Frost, and as a side note, I will try to fill Dr. Scheurer’s shoes as physician editor of The Hospitalist.

This changing of the guard of SHM’s leadership will take place amid the backdrop of an acrimonious presidential election and the emergence of a novel coronavirus that threatens to upend the typical routines of our social and professional lives.

Without a doubt, our leaders, whether national, regional, or local, will be at the helm during one of the most uncertain times in the history of modern health care. Will we see a U.S. President who is a proponent of supporting the Affordable Care Act? Will we see further erosion of Obamacare under a second term of President Trump? Will we see rural hospitals continue to close or shrink¹ as their margins get squeezed by skyrocketing denials for inpatient status in favor of observation or outpatient status?²

Forces that seem beyond our control threaten to drastically alter our professions and even our livelihoods. In the space of the few weeks during which I began and finished this piece, every day brought a whole new world of changes in my hospital, town, state, and country. No leader can predict the future with any semblance of certitude.

In the face of these swirling winds of uncertainty, what is clear is that maintaining our commitment as hospitalists to providing evidence-based, high-quality care to our patients while providing support to our colleagues in the health care industry will greatly benefit from collaborating effectively under the “big tent” philosophy of SHM. Over my career, I have benefited from great role models and colleagues as my career took me from primary care med-peds to the “new” field of hospital medicine as a med-peds hospitalist, to a leadership role in pediatric hospital medicine. I have also benefited from “learning opportunities,” as I have made my fair share of mistakes in efforts to improve systems of care. Nearly all of these mistakes share a common thread – not collaborating effectively with critical stakeholders, both within and outside of my institution.³ As this pandemic progresses, I am (and likely you are) witnessing your leaders succeed or fail based on their ability to collaborate across the institution.

As a field, we risk making similar errors by being too narrowly focused as we strive to improve the care of our patients. Recently, Dr. Russell Buhr and his colleagues at the University of California, Los Angeles, demonstrated that a majority of 30-day readmissions for chronic obstructive pulmonary disease (COPD) are due to non-COPD diagnoses.⁴ As we discharge our COPD patients, we may be satisfied that we’ve “tuned up” our patient’s COPD, but have we adequately arranged for appropriate ongoing care of their other medical problems? This requires an activity undertaken less and less these days in medicine – a conversation between hospitalists and outpatient medical providers. The coronavirus disease 2019 (COVID-19) pandemic has made this more challenging, but I can assure you that you can neither transmit nor catch the coronavirus from a phone call.

Perhaps we can learn from our hospitalist colleagues trained in family medicine. A recent study found that hospitalists in a team made up of family medicine–trained physicians in an academic health center achieved a 33% shorter length of stay for patients from the family medicine clinic, after adjustment for disease, demographics, and disease severity.⁵ The conclusion of the authors was that this was likely caused by greater familiarity with outpatient resources. I would conjecture that family medicine hospitalists were also more likely to have a conversation with a patient’s outpatient primary care provider (PCP).

Of course, I am the first to admit that chatting with a PCP is not as easy as it used to be – when we could bump into each other in the doctor’s lounge drinking coffee or in radiology while pulling x-ray films (remember those?) – and in the age of COVID-19, these interactions are even less likely. It can take considerable time and effort to get PCP colleagues on the phone unless you’re chummy enough to have their cell phone numbers. And time is a resource in short supply because most hospital medicine groups are understaffed – in the 2018 SHM State of Hospital Medicine (SoHM) Report, 66.4% of responding groups had open positions, with a median of 12% understaffing reported. The 2020 SoHM report is being compiled as we speak, but I suspect this situation will not have improved, and as the pandemic strikes, staffing models have been completely blown up.

To dig ourselves out of this staffing hole and still stay under (or not too over) budget, bringing more advanced practice providers (APP) into our groups/divisions will be needed. We must recognize, however, that APPs can’t just be hired rapidly and thrown into the schedule. As Tracy Cardin, ACNP-BC, SFHM, stated in her December 2019 blog post on the Hospital Leader website, leaders need to implement consistent onboarding, training, and support of APPs, just as they would for any other hospitalist in their group.⁶ Physician hospitalists need to develop and maintain proven competency in effectively interacting with APPs practicing at the top of their skills and productivity. No time has ever proven the need to allow APPs to practice at the top of their skills than the age of COVID-19.⁷

But if your “field” doesn’t even recognize you at all? That is the fate of many providers left behind by the field of pediatric hospital medicine. Over the past year, we have seen PHM attain a great achievement in its recognition as a board-certified subspecialty established by the American Board of Pediatrics (ABP), only to have the process beset by allegations of gender and maternal bias. While a groundswell of opposition from pediatric hospitalists triggered by the exclusion of applicants to the Practice Pathway to board certification led the ABP to remove the practice interruption criteria, other potential sources of gender and maternal bias remain.⁸

This does not even address pediatric hospitalists trained in family medicine who cannot be eligible for PHM board certification through experience or fellowship, med-peds trained pediatric hospitalists who cannot quality because of insufficient time spent on pediatric inpatient care, newborn hospitalists (who do not qualify), and APPs specialized in pediatric inpatient care. While it is completely understandable that the ABP cannot provide a certification pathway for all of these groups, this still leaves a gap for these providers when it comes to being in a professional community that supports their professional development, ongoing education, and training. Fortunately, leaders of the three societies that have significant numbers of pediatric hospitalists – SHM, American Academy of Pediatrics, and Academic Pediatric Association – are working to develop a PHM designation outside of the ABP board certification pathway that will extend the professional community to those left out of board certification.

As we move bravely into this new era of SHM, our clarion call is to collaborate whenever and wherever we can, with our practice administrators, APPs, outpatient providers, subspecialist providers, and patient/family advocates – pandemic or no pandemic. In fact, what this pandemic has shown us is that rapid cycle, fully 360-degree collaboration is the only way hospitalists and hospital leaders will weather the storms of changing reimbursement, pandemics, or politics. This will be our challenge for the next decade, to ensure that SHM collaboratively moves beyond the confines of the hospital ward.
 

Dr. Chang is chief of pediatric hospital medicine at Baystate Children’s Hospital in Springfield, Mass., and associate professor of pediatrics at the University of Massachusetts, also in Springfield.

References

1. Frakt A. A Sense of Alarm as Rural Hospitals Keep Closing. The New York Times. 2018. https://www.nytimes.com/2018/10/29/upshot/a-sense-of-alarm-as-rural-hospitals-keep-closing.html. Accessed February 28, 2020.

2. Poonacha TK, Chamoun F. The burden of prior authorizations and denials in health care. Medpage Today’s KevinMD. 2019. https://www.kevinmd.com/blog/2019/12/the-burden-of-prior-authorizations-and-denials-in-health-care.html. Accessed February 28, 2020.

3. 10 reasons healthcare leaders fail and how to prevent them. Becker’s Hospital Review. 2015. https://www.beckershospitalreview.com/hospital-management-administration/10-reasons-healthcare-leaders-fail-and-how-to-prevent-them.html. Accessed March 15, 2020

4. Buhr RG et al. Comorbidity and thirty-day hospital readmission odds in chronic obstructive pulmonary disease: a comparison of the Charlson and Elixhauser comorbidity indices. BMC Health Serv Res. 2019;19:701.

5. Garrison GM et al. Family medicine patients have shorter length of stay when cared for on a family medicine inpatient service. J Prim Care Community Health. 2019. doi: 10.1177/2150132719840517.

6. Cardin T. Work the Program for NP/PAs, and the Program Will Work. The Hospital Leader: Official Blog of SHM. 2019. https://thehospitalleader.org/work-the-program-for-np-pas-and-the-program-will-work/

7. Mittman DE. More physician assistants are ready to help with COVID-19 – now governors must empower them. The Hill. 2020. https://thehill.com/opinion/healthcare/489985-more-physician-assistants-are-ready-to-help-with-covid-19-now-governors. Accessed March 31, 2020.

8. Gold JM et al. Collective action and effective dialogue to address gender bias in medicine. J Hosp Med. 2019;14:630-2.

SHM is entering an exciting new chapter in its history because we will soon see Dr. Eric Howell take the reins from Dr. Larry Wellikson as CEO, as we watch Dr. Danielle Scheurer assume the role of president from Dr. Chris Frost, and as a side note, I will try to fill Dr. Scheurer’s shoes as physician editor of The Hospitalist.

This changing of the guard of SHM’s leadership will take place amid the backdrop of an acrimonious presidential election and the emergence of a novel coronavirus that threatens to upend the typical routines of our social and professional lives.

Without a doubt, our leaders, whether national, regional, or local, will be at the helm during one of the most uncertain times in the history of modern health care. Will we see a U.S. President who is a proponent of supporting the Affordable Care Act? Will we see further erosion of Obamacare under a second term of President Trump? Will we see rural hospitals continue to close or shrink¹ as their margins get squeezed by skyrocketing denials for inpatient status in favor of observation or outpatient status?²

Forces that seem beyond our control threaten to drastically alter our professions and even our livelihoods. In the space of the few weeks during which I began and finished this piece, every day brought a whole new world of changes in my hospital, town, state, and country. No leader can predict the future with any semblance of certitude.

In the face of these swirling winds of uncertainty, what is clear is that maintaining our commitment as hospitalists to providing evidence-based, high-quality care to our patients while providing support to our colleagues in the health care industry will greatly benefit from collaborating effectively under the “big tent” philosophy of SHM. Over my career, I have benefited from great role models and colleagues as my career took me from primary care med-peds to the “new” field of hospital medicine as a med-peds hospitalist, to a leadership role in pediatric hospital medicine. I have also benefited from “learning opportunities,” as I have made my fair share of mistakes in efforts to improve systems of care. Nearly all of these mistakes share a common thread – not collaborating effectively with critical stakeholders, both within and outside of my institution.³ As this pandemic progresses, I am (and likely you are) witnessing your leaders succeed or fail based on their ability to collaborate across the institution.

As a field, we risk making similar errors by being too narrowly focused as we strive to improve the care of our patients. Recently, Dr. Russell Buhr and his colleagues at the University of California, Los Angeles, demonstrated that a majority of 30-day readmissions for chronic obstructive pulmonary disease (COPD) are due to non-COPD diagnoses.⁴ As we discharge our COPD patients, we may be satisfied that we’ve “tuned up” our patient’s COPD, but have we adequately arranged for appropriate ongoing care of their other medical problems? This requires an activity undertaken less and less these days in medicine – a conversation between hospitalists and outpatient medical providers. The coronavirus disease 2019 (COVID-19) pandemic has made this more challenging, but I can assure you that you can neither transmit nor catch the coronavirus from a phone call.

Perhaps we can learn from our hospitalist colleagues trained in family medicine. A recent study found that hospitalists in a team made up of family medicine–trained physicians in an academic health center achieved a 33% shorter length of stay for patients from the family medicine clinic, after adjustment for disease, demographics, and disease severity.⁵ The conclusion of the authors was that this was likely caused by greater familiarity with outpatient resources. I would conjecture that family medicine hospitalists were also more likely to have a conversation with a patient’s outpatient primary care provider (PCP).

Of course, I am the first to admit that chatting with a PCP is not as easy as it used to be – when we could bump into each other in the doctor’s lounge drinking coffee or in radiology while pulling x-ray films (remember those?) – and in the age of COVID-19, these interactions are even less likely. It can take considerable time and effort to get PCP colleagues on the phone unless you’re chummy enough to have their cell phone numbers. And time is a resource in short supply because most hospital medicine groups are understaffed – in the 2018 SHM State of Hospital Medicine (SoHM) Report, 66.4% of responding groups had open positions, with a median of 12% understaffing reported. The 2020 SoHM report is being compiled as we speak, but I suspect this situation will not have improved, and as the pandemic strikes, staffing models have been completely blown up.

To dig ourselves out of this staffing hole and still stay under (or not too over) budget, bringing more advanced practice providers (APP) into our groups/divisions will be needed. We must recognize, however, that APPs can’t just be hired rapidly and thrown into the schedule. As Tracy Cardin, ACNP-BC, SFHM, stated in her December 2019 blog post on the Hospital Leader website, leaders need to implement consistent onboarding, training, and support of APPs, just as they would for any other hospitalist in their group.⁶ Physician hospitalists need to develop and maintain proven competency in effectively interacting with APPs practicing at the top of their skills and productivity. No time has ever proven the need to allow APPs to practice at the top of their skills than the age of COVID-19.⁷

But if your “field” doesn’t even recognize you at all? That is the fate of many providers left behind by the field of pediatric hospital medicine. Over the past year, we have seen PHM attain a great achievement in its recognition as a board-certified subspecialty established by the American Board of Pediatrics (ABP), only to have the process beset by allegations of gender and maternal bias. While a groundswell of opposition from pediatric hospitalists triggered by the exclusion of applicants to the Practice Pathway to board certification led the ABP to remove the practice interruption criteria, other potential sources of gender and maternal bias remain.⁸

This does not even address pediatric hospitalists trained in family medicine who cannot be eligible for PHM board certification through experience or fellowship, med-peds trained pediatric hospitalists who cannot quality because of insufficient time spent on pediatric inpatient care, newborn hospitalists (who do not qualify), and APPs specialized in pediatric inpatient care. While it is completely understandable that the ABP cannot provide a certification pathway for all of these groups, this still leaves a gap for these providers when it comes to being in a professional community that supports their professional development, ongoing education, and training. Fortunately, leaders of the three societies that have significant numbers of pediatric hospitalists – SHM, American Academy of Pediatrics, and Academic Pediatric Association – are working to develop a PHM designation outside of the ABP board certification pathway that will extend the professional community to those left out of board certification.

As we move bravely into this new era of SHM, our clarion call is to collaborate whenever and wherever we can, with our practice administrators, APPs, outpatient providers, subspecialist providers, and patient/family advocates – pandemic or no pandemic. In fact, what this pandemic has shown us is that rapid cycle, fully 360-degree collaboration is the only way hospitalists and hospital leaders will weather the storms of changing reimbursement, pandemics, or politics. This will be our challenge for the next decade, to ensure that SHM collaboratively moves beyond the confines of the hospital ward.
 

Dr. Chang is chief of pediatric hospital medicine at Baystate Children’s Hospital in Springfield, Mass., and associate professor of pediatrics at the University of Massachusetts, also in Springfield.

References

1. Frakt A. A Sense of Alarm as Rural Hospitals Keep Closing. The New York Times. 2018. https://www.nytimes.com/2018/10/29/upshot/a-sense-of-alarm-as-rural-hospitals-keep-closing.html. Accessed February 28, 2020.

2. Poonacha TK, Chamoun F. The burden of prior authorizations and denials in health care. Medpage Today’s KevinMD. 2019. https://www.kevinmd.com/blog/2019/12/the-burden-of-prior-authorizations-and-denials-in-health-care.html. Accessed February 28, 2020.

3. 10 reasons healthcare leaders fail and how to prevent them. Becker’s Hospital Review. 2015. https://www.beckershospitalreview.com/hospital-management-administration/10-reasons-healthcare-leaders-fail-and-how-to-prevent-them.html. Accessed March 15, 2020

4. Buhr RG et al. Comorbidity and thirty-day hospital readmission odds in chronic obstructive pulmonary disease: a comparison of the Charlson and Elixhauser comorbidity indices. BMC Health Serv Res. 2019;19:701.

5. Garrison GM et al. Family medicine patients have shorter length of stay when cared for on a family medicine inpatient service. J Prim Care Community Health. 2019. doi: 10.1177/2150132719840517.

6. Cardin T. Work the Program for NP/PAs, and the Program Will Work. The Hospital Leader: Official Blog of SHM. 2019. https://thehospitalleader.org/work-the-program-for-np-pas-and-the-program-will-work/

7. Mittman DE. More physician assistants are ready to help with COVID-19 – now governors must empower them. The Hill. 2020. https://thehill.com/opinion/healthcare/489985-more-physician-assistants-are-ready-to-help-with-covid-19-now-governors. Accessed March 31, 2020.

8. Gold JM et al. Collective action and effective dialogue to address gender bias in medicine. J Hosp Med. 2019;14:630-2.

SHM is entering an exciting new chapter in its history because we will soon see Dr. Eric Howell take the reins from Dr. Larry Wellikson as CEO, as we watch Dr. Danielle Scheurer assume the role of president from Dr. Chris Frost, and as a side note, I will try to fill Dr. Scheurer’s shoes as physician editor of The Hospitalist.

This changing of the guard of SHM’s leadership will take place amid the backdrop of an acrimonious presidential election and the emergence of a novel coronavirus that threatens to upend the typical routines of our social and professional lives.

Without a doubt, our leaders, whether national, regional, or local, will be at the helm during one of the most uncertain times in the history of modern health care. Will we see a U.S. President who is a proponent of supporting the Affordable Care Act? Will we see further erosion of Obamacare under a second term of President Trump? Will we see rural hospitals continue to close or shrink¹ as their margins get squeezed by skyrocketing denials for inpatient status in favor of observation or outpatient status?²

Forces that seem beyond our control threaten to drastically alter our professions and even our livelihoods. In the space of the few weeks during which I began and finished this piece, every day brought a whole new world of changes in my hospital, town, state, and country. No leader can predict the future with any semblance of certitude.

In the face of these swirling winds of uncertainty, what is clear is that maintaining our commitment as hospitalists to providing evidence-based, high-quality care to our patients while providing support to our colleagues in the health care industry will greatly benefit from collaborating effectively under the “big tent” philosophy of SHM. Over my career, I have benefited from great role models and colleagues as my career took me from primary care med-peds to the “new” field of hospital medicine as a med-peds hospitalist, to a leadership role in pediatric hospital medicine. I have also benefited from “learning opportunities,” as I have made my fair share of mistakes in efforts to improve systems of care. Nearly all of these mistakes share a common thread – not collaborating effectively with critical stakeholders, both within and outside of my institution.³ As this pandemic progresses, I am (and likely you are) witnessing your leaders succeed or fail based on their ability to collaborate across the institution.

As a field, we risk making similar errors by being too narrowly focused as we strive to improve the care of our patients. Recently, Dr. Russell Buhr and his colleagues at the University of California, Los Angeles, demonstrated that a majority of 30-day readmissions for chronic obstructive pulmonary disease (COPD) are due to non-COPD diagnoses.⁴ As we discharge our COPD patients, we may be satisfied that we’ve “tuned up” our patient’s COPD, but have we adequately arranged for appropriate ongoing care of their other medical problems? This requires an activity undertaken less and less these days in medicine – a conversation between hospitalists and outpatient medical providers. The coronavirus disease 2019 (COVID-19) pandemic has made this more challenging, but I can assure you that you can neither transmit nor catch the coronavirus from a phone call.

Perhaps we can learn from our hospitalist colleagues trained in family medicine. A recent study found that hospitalists in a team made up of family medicine–trained physicians in an academic health center achieved a 33% shorter length of stay for patients from the family medicine clinic, after adjustment for disease, demographics, and disease severity.⁵ The conclusion of the authors was that this was likely caused by greater familiarity with outpatient resources. I would conjecture that family medicine hospitalists were also more likely to have a conversation with a patient’s outpatient primary care provider (PCP).

Of course, I am the first to admit that chatting with a PCP is not as easy as it used to be – when we could bump into each other in the doctor’s lounge drinking coffee or in radiology while pulling x-ray films (remember those?) – and in the age of COVID-19, these interactions are even less likely. It can take considerable time and effort to get PCP colleagues on the phone unless you’re chummy enough to have their cell phone numbers. And time is a resource in short supply because most hospital medicine groups are understaffed – in the 2018 SHM State of Hospital Medicine (SoHM) Report, 66.4% of responding groups had open positions, with a median of 12% understaffing reported. The 2020 SoHM report is being compiled as we speak, but I suspect this situation will not have improved, and as the pandemic strikes, staffing models have been completely blown up.

To dig ourselves out of this staffing hole and still stay under (or not too over) budget, bringing more advanced practice providers (APP) into our groups/divisions will be needed. We must recognize, however, that APPs can’t just be hired rapidly and thrown into the schedule. As Tracy Cardin, ACNP-BC, SFHM, stated in her December 2019 blog post on the Hospital Leader website, leaders need to implement consistent onboarding, training, and support of APPs, just as they would for any other hospitalist in their group.⁶ Physician hospitalists need to develop and maintain proven competency in effectively interacting with APPs practicing at the top of their skills and productivity. No time has ever proven the need to allow APPs to practice at the top of their skills than the age of COVID-19.⁷

But if your “field” doesn’t even recognize you at all? That is the fate of many providers left behind by the field of pediatric hospital medicine. Over the past year, we have seen PHM attain a great achievement in its recognition as a board-certified subspecialty established by the American Board of Pediatrics (ABP), only to have the process beset by allegations of gender and maternal bias. While a groundswell of opposition from pediatric hospitalists triggered by the exclusion of applicants to the Practice Pathway to board certification led the ABP to remove the practice interruption criteria, other potential sources of gender and maternal bias remain.⁸

This does not even address pediatric hospitalists trained in family medicine who cannot be eligible for PHM board certification through experience or fellowship, med-peds trained pediatric hospitalists who cannot quality because of insufficient time spent on pediatric inpatient care, newborn hospitalists (who do not qualify), and APPs specialized in pediatric inpatient care. While it is completely understandable that the ABP cannot provide a certification pathway for all of these groups, this still leaves a gap for these providers when it comes to being in a professional community that supports their professional development, ongoing education, and training. Fortunately, leaders of the three societies that have significant numbers of pediatric hospitalists – SHM, American Academy of Pediatrics, and Academic Pediatric Association – are working to develop a PHM designation outside of the ABP board certification pathway that will extend the professional community to those left out of board certification.

As we move bravely into this new era of SHM, our clarion call is to collaborate whenever and wherever we can, with our practice administrators, APPs, outpatient providers, subspecialist providers, and patient/family advocates – pandemic or no pandemic. In fact, what this pandemic has shown us is that rapid cycle, fully 360-degree collaboration is the only way hospitalists and hospital leaders will weather the storms of changing reimbursement, pandemics, or politics. This will be our challenge for the next decade, to ensure that SHM collaboratively moves beyond the confines of the hospital ward.
 

Dr. Chang is chief of pediatric hospital medicine at Baystate Children’s Hospital in Springfield, Mass., and associate professor of pediatrics at the University of Massachusetts, also in Springfield.

References

1. Frakt A. A Sense of Alarm as Rural Hospitals Keep Closing. The New York Times. 2018. https://www.nytimes.com/2018/10/29/upshot/a-sense-of-alarm-as-rural-hospitals-keep-closing.html. Accessed February 28, 2020.

2. Poonacha TK, Chamoun F. The burden of prior authorizations and denials in health care. Medpage Today’s KevinMD. 2019. https://www.kevinmd.com/blog/2019/12/the-burden-of-prior-authorizations-and-denials-in-health-care.html. Accessed February 28, 2020.

3. 10 reasons healthcare leaders fail and how to prevent them. Becker’s Hospital Review. 2015. https://www.beckershospitalreview.com/hospital-management-administration/10-reasons-healthcare-leaders-fail-and-how-to-prevent-them.html. Accessed March 15, 2020

4. Buhr RG et al. Comorbidity and thirty-day hospital readmission odds in chronic obstructive pulmonary disease: a comparison of the Charlson and Elixhauser comorbidity indices. BMC Health Serv Res. 2019;19:701.

5. Garrison GM et al. Family medicine patients have shorter length of stay when cared for on a family medicine inpatient service. J Prim Care Community Health. 2019. doi: 10.1177/2150132719840517.

6. Cardin T. Work the Program for NP/PAs, and the Program Will Work. The Hospital Leader: Official Blog of SHM. 2019. https://thehospitalleader.org/work-the-program-for-np-pas-and-the-program-will-work/

7. Mittman DE. More physician assistants are ready to help with COVID-19 – now governors must empower them. The Hill. 2020. https://thehill.com/opinion/healthcare/489985-more-physician-assistants-are-ready-to-help-with-covid-19-now-governors. Accessed March 31, 2020.

8. Gold JM et al. Collective action and effective dialogue to address gender bias in medicine. J Hosp Med. 2019;14:630-2.

Given the unpredictability and wide range of patients and conditions physicians see in a hospital setting, keeping current with the latest trends and methods is essential. Until now, options for maintaining certification in Hospital Medicine were limited to ABIM’s 10-year, traditional Maintenance of Certification (MOC) exam taken at a testing center. Beginning this year hospitalists will have a choice for how they maintain their certification with the introduction of the Knowledge Check-In (KCI) in Focused Practice in Hospital Medicine (FPHM). Physicians who are currently certified in Internal Medicine can also use the KCI to earn their FPHM certificate once they have been admitted into the FPHM program.
 

KCI for hospitalists

The KCI is a shorter, lower stakes assessment option that takes about three hours to complete. Similar to the traditional 10-year MOC exam, it includes access to UpToDate® without the need for a personal subscription. Physicians can choose to take the KCI at a test center or online, such as from their home or workplace. The test center experience resembles that of the traditional 10-year MOC exam, with the main difference being the shorter testing format.

Since this is the first year the KCI is offered in FPHM, it is considered to be “no consequences,” meaning that if a physician is unsuccessful they will continue to be publicly reported as certified as long as they are meeting all other MOC requirements, and their next assessment will be due two years later. However, the “no consequences” feature does not apply to physicians who are already in a grace period. Please refer to ABIM’s policy on Traditional 10-Year MOC Exam Grace Period.

The longitudinal assessment option

Responding to feedback from the community for an MOC program that is lower-stakes and more closely aligned with how physicians practice, in August 2019 ABIM announced it would develop a longitudinal assessment pathway for physicians to acquire and demonstrate current knowledge. Longitudinal assessment is a process that involves the administration of shorter assessments of specific content, such as medical knowledge, repeatedly over a period of time. A critical component of longitudinal is that it integrates education into the assessment experience.
 

What features can you expect with longitudinal assessment?

The new assessment pathway is anticipated to launch in 2022 in as many specialties as possible. As the program is being developed ABIM is engaging with the community to ensure it will meet their needs, and physicians are encouraged to join its Community Insights Network by visiting abim.org. With the new longitudinal assessment option physicians will be able to:

• Answer a question at any place or time
• Receive immediate feedback 
• See references and rationales for each answer
• Access all the resources they use in practice, such as journals or websites

The traditional MOC Exam that is taken every 10 years will also remain an option, as some physicians have expressed a preference for a point-in-time exam taken less frequently.

What should you do now?

All current ABIM MOC program requirements and policies remain in effect while the new longitudinal assessment is being developed and ABIM will communicate any program changes as well as more details on the program in advance of implementation. If you have an assessment due in 2020 or 2021, you can choose from the assessment options currently available in your discipline.

Registration for all 2020 MOC assessments opened December 1, 2019. Be sure to check ABIM’s website to see exam dates – and registration dates – for FPHM and any other certificates you are maintaining.

You can also find all of your MOC program requirements and deadlines by signing into your Physician Portal at abim.org.
 

Dr. Gupta is a member of ABIM’s Internal Medicine Board and a full-time hospitalist with Apogee Physicians. As a medical director, he currently runs the Hospitalist Program at Texas Health Arlington Memorial Hospital. He is also president of the SHM North Central Texas Chapter.

Given the unpredictability and wide range of patients and conditions physicians see in a hospital setting, keeping current with the latest trends and methods is essential. Until now, options for maintaining certification in Hospital Medicine were limited to ABIM’s 10-year, traditional Maintenance of Certification (MOC) exam taken at a testing center. Beginning this year hospitalists will have a choice for how they maintain their certification with the introduction of the Knowledge Check-In (KCI) in Focused Practice in Hospital Medicine (FPHM). Physicians who are currently certified in Internal Medicine can also use the KCI to earn their FPHM certificate once they have been admitted into the FPHM program.
 

KCI for hospitalists

The KCI is a shorter, lower stakes assessment option that takes about three hours to complete. Similar to the traditional 10-year MOC exam, it includes access to UpToDate® without the need for a personal subscription. Physicians can choose to take the KCI at a test center or online, such as from their home or workplace. The test center experience resembles that of the traditional 10-year MOC exam, with the main difference being the shorter testing format.

Since this is the first year the KCI is offered in FPHM, it is considered to be “no consequences,” meaning that if a physician is unsuccessful they will continue to be publicly reported as certified as long as they are meeting all other MOC requirements, and their next assessment will be due two years later. However, the “no consequences” feature does not apply to physicians who are already in a grace period. Please refer to ABIM’s policy on Traditional 10-Year MOC Exam Grace Period.

The longitudinal assessment option

Responding to feedback from the community for an MOC program that is lower-stakes and more closely aligned with how physicians practice, in August 2019 ABIM announced it would develop a longitudinal assessment pathway for physicians to acquire and demonstrate current knowledge. Longitudinal assessment is a process that involves the administration of shorter assessments of specific content, such as medical knowledge, repeatedly over a period of time. A critical component of longitudinal is that it integrates education into the assessment experience.
 

What features can you expect with longitudinal assessment?

The new assessment pathway is anticipated to launch in 2022 in as many specialties as possible. As the program is being developed ABIM is engaging with the community to ensure it will meet their needs, and physicians are encouraged to join its Community Insights Network by visiting abim.org. With the new longitudinal assessment option physicians will be able to:

• Answer a question at any place or time
• Receive immediate feedback 
• See references and rationales for each answer
• Access all the resources they use in practice, such as journals or websites

The traditional MOC Exam that is taken every 10 years will also remain an option, as some physicians have expressed a preference for a point-in-time exam taken less frequently.

What should you do now?

All current ABIM MOC program requirements and policies remain in effect while the new longitudinal assessment is being developed and ABIM will communicate any program changes as well as more details on the program in advance of implementation. If you have an assessment due in 2020 or 2021, you can choose from the assessment options currently available in your discipline.

Registration for all 2020 MOC assessments opened December 1, 2019. Be sure to check ABIM’s website to see exam dates – and registration dates – for FPHM and any other certificates you are maintaining.

You can also find all of your MOC program requirements and deadlines by signing into your Physician Portal at abim.org.
 

Dr. Gupta is a member of ABIM’s Internal Medicine Board and a full-time hospitalist with Apogee Physicians. As a medical director, he currently runs the Hospitalist Program at Texas Health Arlington Memorial Hospital. He is also president of the SHM North Central Texas Chapter.

Given the unpredictability and wide range of patients and conditions physicians see in a hospital setting, keeping current with the latest trends and methods is essential. Until now, options for maintaining certification in Hospital Medicine were limited to ABIM’s 10-year, traditional Maintenance of Certification (MOC) exam taken at a testing center. Beginning this year hospitalists will have a choice for how they maintain their certification with the introduction of the Knowledge Check-In (KCI) in Focused Practice in Hospital Medicine (FPHM). Physicians who are currently certified in Internal Medicine can also use the KCI to earn their FPHM certificate once they have been admitted into the FPHM program.
 

KCI for hospitalists

The KCI is a shorter, lower stakes assessment option that takes about three hours to complete. Similar to the traditional 10-year MOC exam, it includes access to UpToDate® without the need for a personal subscription. Physicians can choose to take the KCI at a test center or online, such as from their home or workplace. The test center experience resembles that of the traditional 10-year MOC exam, with the main difference being the shorter testing format.

Since this is the first year the KCI is offered in FPHM, it is considered to be “no consequences,” meaning that if a physician is unsuccessful they will continue to be publicly reported as certified as long as they are meeting all other MOC requirements, and their next assessment will be due two years later. However, the “no consequences” feature does not apply to physicians who are already in a grace period. Please refer to ABIM’s policy on Traditional 10-Year MOC Exam Grace Period.

The longitudinal assessment option

Responding to feedback from the community for an MOC program that is lower-stakes and more closely aligned with how physicians practice, in August 2019 ABIM announced it would develop a longitudinal assessment pathway for physicians to acquire and demonstrate current knowledge. Longitudinal assessment is a process that involves the administration of shorter assessments of specific content, such as medical knowledge, repeatedly over a period of time. A critical component of longitudinal is that it integrates education into the assessment experience.
 

What features can you expect with longitudinal assessment?

The new assessment pathway is anticipated to launch in 2022 in as many specialties as possible. As the program is being developed ABIM is engaging with the community to ensure it will meet their needs, and physicians are encouraged to join its Community Insights Network by visiting abim.org. With the new longitudinal assessment option physicians will be able to:

• Answer a question at any place or time
• Receive immediate feedback 
• See references and rationales for each answer
• Access all the resources they use in practice, such as journals or websites

The traditional MOC Exam that is taken every 10 years will also remain an option, as some physicians have expressed a preference for a point-in-time exam taken less frequently.

What should you do now?

All current ABIM MOC program requirements and policies remain in effect while the new longitudinal assessment is being developed and ABIM will communicate any program changes as well as more details on the program in advance of implementation. If you have an assessment due in 2020 or 2021, you can choose from the assessment options currently available in your discipline.

Registration for all 2020 MOC assessments opened December 1, 2019. Be sure to check ABIM’s website to see exam dates – and registration dates – for FPHM and any other certificates you are maintaining.

You can also find all of your MOC program requirements and deadlines by signing into your Physician Portal at abim.org.
 

Dr. Gupta is a member of ABIM’s Internal Medicine Board and a full-time hospitalist with Apogee Physicians. As a medical director, he currently runs the Hospitalist Program at Texas Health Arlington Memorial Hospital. He is also president of the SHM North Central Texas Chapter.

As I transition out of the role of medical editor for The Hospitalist, and into the role of president of the Society of Hospital Medicine, it is a bittersweet but exciting transition.

In the relatively short time I have served as editor, so much has changed in our hospitalist community! In the last 4 years alone, we have increased:

• Membership from 14,000 to 20,000

• Chapters from 46 to 68

• Special Interest Groups from 8 to 22

• Subscribers to The Hospitalist from 15,000 to 30,000.

This is all a testimony to the engagement of our membership. SHM is clearly no ordinary specialty society; it is full of incredibly intelligent, invested, and talented members, who actively participate in the society for the betterment of their local teams and patients. It is such a privilege to lead this amazing team.

As for The Hospitalist, I would like to warmly welcome Weijen Chang, MD, FACP, SFHM, as the incoming editor. Weijen served as the pediatrics editor for many years and has been extensively involved on The Hospitalist’s editorial advisory board for even longer. He also has a broad track record of experience as a hospitalist in many settings; that combined with an inquisitive mind and curious spirit makes him the ideal editor for The Hospitalist. He brings energy and enthusiasm and will serve us very well.

While I will miss being intimately involved with The Hospitalist, I am very much looking forward to serving in the role of SHM president starting in April. During this pivotal year, SHM will transition from our one-and-only CEO, Larry Wellikson, MD, MHM, to our newly minted CEO Eric Howell, MD, MHM, who will officially transition in July 2020.

This is a very exciting time in the history of SHM, as we refocus on our mission, vision, values, and core activities. As a membership organization, our primary focus has been, and will always be, serving our member’s needs! As a “Big Tent” organization, we have always supported a broad and diverse set of members, ranging far beyond physician hospitalists, to trainees, medical students, nurse practitioners, physician assistants, practice administrators, and other hospital-based specialists. Being in such a dynamic industry, our diverse members needs are constantly and rapidly changing along with the dramatic transformations in the landscape, including profound shifts in care and reimbursement models that could change the very definition of a hospitalist.

While we continuously scour the landscape and anticipate our members’ needs, we will never lose sight of our core mission, which is to promote exceptional care for hospitalized patients. We will continue to do this by supporting all of our members with tools and materials to help them be the very best they can, for all of our patients. As a humble and servant leader, I am prepared to meet the demands and challenges of the year ahead, with energy and focus, and fulfill the needs of our members, so that together, we can make health care better for those we serve.

Thank you in advance for allowing me the great pleasure of serving this amazing and innovative organization!
 

Dr. Scheurer is chief quality officer and professor of medicine at the Medical University of South Carolina, Charleston. She is the outgoing medical editor of The Hospitalist, and president-elect of SHM.

As I transition out of the role of medical editor for The Hospitalist, and into the role of president of the Society of Hospital Medicine, it is a bittersweet but exciting transition.

In the relatively short time I have served as editor, so much has changed in our hospitalist community! In the last 4 years alone, we have increased:

• Membership from 14,000 to 20,000

• Chapters from 46 to 68

• Special Interest Groups from 8 to 22

• Subscribers to The Hospitalist from 15,000 to 30,000.

This is all a testimony to the engagement of our membership. SHM is clearly no ordinary specialty society; it is full of incredibly intelligent, invested, and talented members, who actively participate in the society for the betterment of their local teams and patients. It is such a privilege to lead this amazing team.

As for The Hospitalist, I would like to warmly welcome Weijen Chang, MD, FACP, SFHM, as the incoming editor. Weijen served as the pediatrics editor for many years and has been extensively involved on The Hospitalist’s editorial advisory board for even longer. He also has a broad track record of experience as a hospitalist in many settings; that combined with an inquisitive mind and curious spirit makes him the ideal editor for The Hospitalist. He brings energy and enthusiasm and will serve us very well.

While I will miss being intimately involved with The Hospitalist, I am very much looking forward to serving in the role of SHM president starting in April. During this pivotal year, SHM will transition from our one-and-only CEO, Larry Wellikson, MD, MHM, to our newly minted CEO Eric Howell, MD, MHM, who will officially transition in July 2020.

This is a very exciting time in the history of SHM, as we refocus on our mission, vision, values, and core activities. As a membership organization, our primary focus has been, and will always be, serving our member’s needs! As a “Big Tent” organization, we have always supported a broad and diverse set of members, ranging far beyond physician hospitalists, to trainees, medical students, nurse practitioners, physician assistants, practice administrators, and other hospital-based specialists. Being in such a dynamic industry, our diverse members needs are constantly and rapidly changing along with the dramatic transformations in the landscape, including profound shifts in care and reimbursement models that could change the very definition of a hospitalist.

While we continuously scour the landscape and anticipate our members’ needs, we will never lose sight of our core mission, which is to promote exceptional care for hospitalized patients. We will continue to do this by supporting all of our members with tools and materials to help them be the very best they can, for all of our patients. As a humble and servant leader, I am prepared to meet the demands and challenges of the year ahead, with energy and focus, and fulfill the needs of our members, so that together, we can make health care better for those we serve.

Thank you in advance for allowing me the great pleasure of serving this amazing and innovative organization!
 

Dr. Scheurer is chief quality officer and professor of medicine at the Medical University of South Carolina, Charleston. She is the outgoing medical editor of The Hospitalist, and president-elect of SHM.

As I transition out of the role of medical editor for The Hospitalist, and into the role of president of the Society of Hospital Medicine, it is a bittersweet but exciting transition.

In the relatively short time I have served as editor, so much has changed in our hospitalist community! In the last 4 years alone, we have increased:

• Membership from 14,000 to 20,000

• Chapters from 46 to 68

• Special Interest Groups from 8 to 22

• Subscribers to The Hospitalist from 15,000 to 30,000.

This is all a testimony to the engagement of our membership. SHM is clearly no ordinary specialty society; it is full of incredibly intelligent, invested, and talented members, who actively participate in the society for the betterment of their local teams and patients. It is such a privilege to lead this amazing team.

As for The Hospitalist, I would like to warmly welcome Weijen Chang, MD, FACP, SFHM, as the incoming editor. Weijen served as the pediatrics editor for many years and has been extensively involved on The Hospitalist’s editorial advisory board for even longer. He also has a broad track record of experience as a hospitalist in many settings; that combined with an inquisitive mind and curious spirit makes him the ideal editor for The Hospitalist. He brings energy and enthusiasm and will serve us very well.

While I will miss being intimately involved with The Hospitalist, I am very much looking forward to serving in the role of SHM president starting in April. During this pivotal year, SHM will transition from our one-and-only CEO, Larry Wellikson, MD, MHM, to our newly minted CEO Eric Howell, MD, MHM, who will officially transition in July 2020.

This is a very exciting time in the history of SHM, as we refocus on our mission, vision, values, and core activities. As a membership organization, our primary focus has been, and will always be, serving our member’s needs! As a “Big Tent” organization, we have always supported a broad and diverse set of members, ranging far beyond physician hospitalists, to trainees, medical students, nurse practitioners, physician assistants, practice administrators, and other hospital-based specialists. Being in such a dynamic industry, our diverse members needs are constantly and rapidly changing along with the dramatic transformations in the landscape, including profound shifts in care and reimbursement models that could change the very definition of a hospitalist.

While we continuously scour the landscape and anticipate our members’ needs, we will never lose sight of our core mission, which is to promote exceptional care for hospitalized patients. We will continue to do this by supporting all of our members with tools and materials to help them be the very best they can, for all of our patients. As a humble and servant leader, I am prepared to meet the demands and challenges of the year ahead, with energy and focus, and fulfill the needs of our members, so that together, we can make health care better for those we serve.

Thank you in advance for allowing me the great pleasure of serving this amazing and innovative organization!
 

Dr. Scheurer is chief quality officer and professor of medicine at the Medical University of South Carolina, Charleston. She is the outgoing medical editor of The Hospitalist, and president-elect of SHM.