Hopefully, many of you were able to attend the Society of Hospital Medicine’s annual meeting this year in San Diego. (I know at least 4,000 of you made it!) Each year, the annual meeting is a time of catching up with hospitalists from around the country (many of whom I only see once a year) and catching up on what is going on in the medical industry.
This year was not particularly unique in that many sessions focused on the myriad challenges we should expect to see in the medical industry in the coming years. There was much discussion about future payment models; although there is ongoing ambiguity about exactly how these models are going to be operationalized, there is certainly no ambiguity that the Centers for Medicare & Medicaid Services (CMS) is hard driving the amount of payments that will be tied to some form of alternative payment model (50% by 2018).
We also heard about ongoing challenges in quality and safety, where a stunning number of patients continue to suffer preventable harm on a daily basis within our hospital walls. And we heard much about the ongoing and mounting opiate abuse epidemic. All of these are monumentally difficult challenges that remain unsolved and without a clear path forward to resolution.
Contrast that with the message from the U.S. Surgeon General during the opening plenary of the annual meeting. Vivek Murthy, MD, was named Surgeon General at a time in the U.S. when all of the above challenges are being added to the abounding issues of chronic disease, mental illness, and extraordinary healthcare costs. He is the highest leader in the nation ordained with trying to improve the health of all Americans at a time when we have never been unhealthier. But despite these monumental challenges, his message was not about the average American body mass index (BMI), smoking status, or heroin addiction. Much different, his message was chock full of amazing stories of community engagement and resilience, focused on innovation and fresh thinking, and about creative problem-solving despite lean and unforgiving budgets.
What Dr. Murthy offered were endless stories of hope and goodness, which he was able to find in each and every city he has visited in his short time as the nation’s “top doc.”
During his tenure, he has visited innumerable communities and engaged with locals in listening sessions. His takeaway from these sessions is “you wouldn’t believe how much good is out there.” One of his many stories was of a hospital and a YMCA that joined forces to improve the health and well-being of the hospital patients, employees, and entire community. This was at a time when both were struggling with lean budgets and stagnant progress in healthy living.
This pragmatic optimism reminds me a bit of one of my life mentors, my Aunt Karen. She is extremely realistic and grounded and knows in great detail the trials and tribulations of being alive for 66 years (including being a 10-year survivor of recurrent ovarian rhabdomyosarcoma). What Aunt Karen does that is so uniquely different than anyone else I know is that she creates goodness. I did not fully understand this until a few years ago, but I noticed that she goes out of her way to create extreme goodness out of extreme ordinariness. I have often joked that she purposely befriends pregnant women just to have an excuse to host a baby shower. She goes overboard to make any and every excuse to celebrate relatively ordinary life milestones (anniversaries, Valentine’s Day, St. Patrick’s Day). In her words, “you have to have a buffer for the funerals.”