Does Anyone Care About? Larry Wellikson, MD CEO Society of lwellikson@hospitalmedicine.org is Young 140 120 100 80 60 40 20 0 Hospital Medicine Emergency Medicine Internal Medicine Years If Medical Societies Were Music Emergency Medicine The Beatles Internal Medicine Ludwig von Beethoven 1
And Would BE American Idol If Medical Specialties Were Athletics Emergency Medicine Internal Medicine Modern Olympics Original Olympics And Would Be the X Games 2
Congressional 9/11 Report Operational Management Earlier in this report we detailed various missed opportunities to thwart the 9/11 plot. Information was not shared, sometimes inadvertently or because of legal misunderstandings. Analysis was not pooled. Effective operations were not launched. Often the handoffs of information were lost across the divide separating the foreign and domestic agencies of the government. However the specific problems are labeled, we believe the symptoms of the government s broader inability to adapt how it manages problems to the new challenges of the twenty-first century. The agencies are like a set of specialists in a hospital, each ordering tests, looking for symptoms, and prescribing medications. What is missing is the attending physician who makes sure they work as a team. They Needed a Hospitalist page 353 of the 9/11 report Section 11.4 AHA 2005 Survey 1,969 (40%) of 4,936 community hospitals have hospitalists Grew from 29% over 2 year period 2003-2005 50-55% is a reasonable estimate for 2007 That translates into >2,600 hospitals with hospitalists The larger the hospital the more likely to have hospitalists 21% of hospitals <100 beds have hospitalists 87% of hospitals >500 Beds have hospitalists >16,000 hospitalists at community hospitals Grew 40% over 2 year period 2003-2005 20,000 23,000 hospitalists is a reasonable estimate for 2007 AHA 2005 Survey Allergy 4,156 Pulmonary 9,791 Gastroenterology 11,704 Neurology 13,293 16,383 Cardiology 22,302 Emergency Medicine 26,634 0 5,000 10,000 15,000 20,000 25,000 30,000 # of physicians Specialty Numbers (except ) from AMA s Physician Characteristics and Distribution in the US, 2005 edition 3
Who Cares What Hospitalists Think? National Quality Forum (NQF) Joint Commission Institute for Healthcare Improvement (IHI) American Board of Internal Medicine (ABIM) Hospital Quality Alliance (HQA) Agency for Healthcare Research & Quality (AHRQ) Centers for Disease Control (CDC) The Hartford Foundation Who Wants to Partner with SHM? Internal Medicine-ABIM, ACP, AAIM, SGIM Pediatrics-AAP, APA Critical Care-ACCP, SCCM Emergency Medicine-ACEP Specialists- AACE, ADA, ACC Geriatrics-AGS Palliative Care Organizations Nursing/Pharmacy-AACN, ASHP, CMSA C-Suite-AHA, ACHE Who Cares that Hospitalists Are There? PCPs Surgeons Orthopedists Subspecialists Emergency Physicians Intensivists Hospitalized Patients 4
Who Cares that Hospitalists Care About What They Care About? Nurses Pharmacists Case Managers Social Workers Hospital CEOs, CMOs, VPMAs Expectations of Save Money Reduce LOS, Reduce Use of Resources Provide Measurable Quality Improvement Standards & Compliance Do Things No One Else Will Uncompensated Care Committee Service Expectations of Improve Efficiency of Hospital Throughput & Early Discharge Uncrowdthe ED Open ICU beds Create a Seamless Continuity From Inpatient to Outpatient From ED to Floor From ICU to Floor 5
Expectations of Make Other Physicians Lives Better Retain & Recruit Medical Staff Physicians Educate Medical Students, Residents, Nurses, Pharmacists Create a Real Team Better Use of Talent Retention of Nurses and others Change is the Price of Survival Winston Churchill Hospital of the Future Patient Centered Measurable Quality Performance Care Delivered by True Teams 6
SHM Defining Survey of Hospitalist Productivity & Compensation Proving Hospitalist Value to C-Suite Hospitalists Role in Quality Improvement Advocacy Efforts Communications & Media Core Competencies in Certification in SHM Defining 2005-06 Survey of Hospitalist Productivity & Compensation Most Quoted Information Source 2007 Survey starts in Fall 2007 Proving Hospitalist Value to C-Suite Value Added Monograph Book in Partnership with ACHE Workshop at 2007 ACHE Congress Hospitalist Role in Throughput and QI AHA Leadership Summit Positioning Hospitalists as Leaders in Quality Improvement Development of Resource Rooms with QI Tools Expanding new Heart Failure resources New ACS resources in development National Expert Panel on Observation Units and management of Acute Heart Failure Setting Strategies for IMPLEMENTATION, not just Education and Guideline Development Mentored Implementation of Quality Improvement IHI partnerships AHA partnerships New QI Teamwork Award in 2008 7
Advocacy Development of White Paper Differences between traditional IM, Pediatrics, Family Practice, Emergency Physicians Used to Talk to CMS, AHRQ, Congress First Legislative Day May 3, 2006 in DC Over 100 hospitalists lobby Congress PPC went back to Congress in 2007 National QI Efforts & Pay For Performance NQF, JCAHO, AMA Consortium, HQA, AHRQ CMS Experts will be available on June 5 for a national call hospitalists on Physician Reporting SHM Lead Organization of National Coalition for DVT Awareness Communications The Hospitalist newsmagazine-new Format Journal of (JHM) Moves HM from Service to Academic Specialty Web Based Discussions Groups Monthly e-newsletter NEW Online Career Center Largest Hospitalist Site with >175 Fresh Jobs Medscape Web Pages as Unique Specialty Certification in Core Competencies Very Important Basis for the Uniqueness of Hospital Medicine Draft Plan for Recognition of HM No additional formal training required Part of Maintenance of Certification (MOC) Similar to Current General MOC in IM SEPs, PIMs, and Test ALL Specific to HM Candidates Eligible Within 3 years of HM Practice SHM Plans to Move on to Peds, FP, DO issues 8
Get Connected to SHM Leadership Academies All Five Academies have SOLD OUT Next Academy: November 5-8, 2007 San Antonio National Web based Discussion Groups SHM s Committees and Task Forces Submit an Article for JHM or The Hospitalist Future is Bright Size Growth Influence & Reach Energy Large Tent Diversity & Unity Strength Possibilities are Almost Limitless 9