Having an established organization with members of differing opinions and backgrounds helps challenge our assumptions. It refines our approach to complex problems, highlights issues or concerns we did not anticipate, and, most importantly, guards against “groupthink”—the tendency to agree with one another all the time. SHM’s board of directors is committed to this type of inclusive leadership.
We do need to be cautious and think quite a bit about this issue in the coming years. The big tent is filling up quickly. It’s becoming more diverse by the week. The concern is that in trying to work at a level that keeps all our constituents happy, we might please no one. If all our activities have to be justified as being relevant to every distinct group that makes up SHM, then we might dilute our effectiveness.
Alternatively, we do not currently have the bandwidth as an organization to initiate in-depth projects in areas relevant to all our members. So far, our approach has been to focus on areas core to every hospitalist: quality and safety, process improvement, leadership, practice management, care transitions, networking, and education.
As unique problems or issues arise that are relevant to only a subset of members, we will weigh the importance. In many cases, we have created task-force groups to clarify and tackle the problem. We provide the support, but the members of the group create the solution. It has worked well so far.
One Voice, One Goal
But can we stick to this strategy as the diversity of membership expands and the number of relevant issues grows? I don’t know. What I do know is that there is strength in numbers, and even though we all have different issues we deem more important, there are times when it helps to come together and speak as one very big, very loud voice.
Older specialties like endocrinology, allergy, and others have split into a variety of organizations and potentially diluted their message. SHM needs to look for creative ways to be relevant to many constituencies within the specialty. In the meantime, we must pay close attention to the big-tent issues. An academic hospitalist in leadership needs to listen to the voices of hospitalists in the community, work to understand them, and support efforts to address problems relevant to them.
In the past, SHM leadership from the community hospitalist setting has worked to help address and solve issues relevant to academic hospitalists. We need to understand and respect the diversity within SHM’s tent, and we need to work to keep us all together. I firmly believe that is the way forward, and I assure you that is the goal of SHM’s leadership.
As President Kennedy said, “If we cannot end now our differences, at least we can help make the world safe for diversity.” I pledge to keep SHM your organization, regardless of how you were trained or where you practice HM. I can’t hope to know all of your important issues, but I can commit to stand ready to hear your concerns and do what SHM has always done—give your request a thoughtful response and all of our energy.
SHM is your organization. Let me know the direction you think SHM should go. Send me an e-mail at [email protected]. TH
Dr. Flanders is president of SHM.