SHM is also actively participating in quality and team-based initiatives with the endocrine societies and the cardiology communities. This will lead to a new way of managing care in diabetes, heart failure, coronary artery disease, and deep vein thrombosis and pulmonary embolism.
On a national level President Bush has appointed David Brailler as the “health IT czar” with the charge to expand and integrate the information capabilities in health care. This coupled with the work being done at the National Quality Forum by Ken Kizer and others will lead to practical front line applications of standards of care and the ability to measure our performance in the reality of today’s hospital.
And even the payers are getting into the mix. The new buzz words are “pay for performance” and it is all the rage. CMS and others are well into beta test programs to see just how this would play out. Peer pressure and restriction of privileges have been the only concrete drivers to improve quality in the past. The prospect that demonstrable, measurable better care will translate into more compensation or greater market share is being tested in today’s hospital.
This is not a pipe dream or a Ralph Waldo Emerson essay. These initiatives are being driven by capable action oriented leaders who have a history of making change happen. And hospitalists, who for the most part are in the beginning of a 20 to 30-year professional career, are primed to play significant roles in this changing dynamic.
In the most basic way, today’s 12,000 hospitalists and the next 20,000 who will join us in the coming years must be much more than just willing participants to make this fly. Sure hospitalists will be the effector arm of health system change in their hospitals, but hospitalists must have
the skills and the vision to help shape this better day in health care. Hospitalists need to embrace the patient-centered, performance-driven acute care system. Hospitalists need to demand care delivered by teams and have the leadership skills to help these teams manage and lead change.
This wasn’t taught in medical school or residency, but that doesn’t matter. Hospital medicine as a new specialty has arrived coincident to (or by design at) a special moment in health care. Our patients have expectations of excellent care. There are plenty of resources available to do the best job. We just aren’t organized to be the best that we can be. But this will all be sorted out in the coming years. It is an exciting time to be a health professional, and hospitalists are at the center. And SHM has the vision and will have the programs to help our hospitalists be an important part in creating this new era of health care.