While visiting the University of Osaka and one of the earliest hospital medicine groups at National Taiwan University Hospital, I had the opportunity to explore how a nation’s healthcare system impacted physicians and patients outside the U.S. A major takeaway for me was how important it is for physicians and care providers to be an active part of the healthcare system to create change that can influence the way they practice—and ultimately improve patient care.
In East Asia, whenever there was concern about evolving their healthcare models and the way providers take care of patients, physicians often felt limited in their potential impact. Culturally, senior physicians are the ones more apt to network and influence policy changes. The more physicians felt empowered to influence these senior leaders to address these issues with government officials, the better the chances of driving positive change.
As luck would have it, a hospitalist colleague invited me back to National Taiwan University Hospital in December 2015 to share my knowledge of how the specialty can continue to evolve, taking into consideration the challenges of navigating healthcare systems, physician engagement, and burnout. Even though many of their programs are relatively new, I stressed the fact that the more interactive you are with your healthcare system, the better your chances of engaging the right stakeholders and effectively influencing healthcare policy.
While their definition of burnout may differ slightly from ours in the U.S., they wanted to hear about what we experience in the U.S. and how we address it. I was able to share some techniques we are implementing at HealthPartners to minimize burnout and maximize engagement, including regular department meetings, during which there is an open forum for hot topics. This provides the care team with an avenue to express concerns or address important topics affecting their daily practice. We also have an internal website, where our team can access a repository of resources and a discussion board to share challenges, concerns, and best practices. I also emphasized the importance of professional development and investing in staff to improve their professional career and their patient care.
Q: What are some initiatives you are currently working on that you see having a substantial impact in hospital medicine?
A: As part of the Practice Management Committee at SHM, we are exploring opportunities in telemedicine, especially as it relates to rural care. Telemedicine could be the next big step to provide support for rural hospitalists and rural communities. Geographically speaking, the vast majority of the U.S. is rural, and SHM is poised to have a great impact on the clinicians serving these communities.
Another initiative the committee is working on is developing an update to co-management best practices. As hospital medicine has matured, its scope has changed dramatically, and so has the idea of co-management. We must truly embrace opportunities to improve care across specialties. This is especially important as we welcome younger physicians to the specialty who have not had the benefit of witnessing the evolution of the practice. They need to have a firm hold on the varied daily interactions of a hospitalist and their ultimate impact on outcomes.
At HealthPartners, we are actively addressing hospitalist engagement and burnout. We are mindful of how much our health systems have evolved and how much extra work they have asked us to accommodate. To be proactive, we are trying to be much more creative and innovative with our staffing model and our use of scarce resources in order to provide the best patient care possible. Over the last 16 years, we have worked hard to continue to develop our program but, more important, develop our patient care through the development of our physicians, NPs, and PAs. This includes developing a pathway for residents who wish to become hospitalists, introducing vigorous training for PAs during their student and post-graduate years, and providing staff with the professional development resources they need to expand their skills and knowledge base and stay up-to-date on the latest advances in medicine—whether that is through leadership development or skill straining like point-of-care ultrasound.