When it comes to potential credentialing in hospital medicine, there is not a clear path to create a certification in hospital medicine. The solution for the 80% of hospitalists trained in internal medicine may very well be through the American Board of Internal Medicine (ABIM), but the pediatric and family practice solution will need to involve the American Board of Pediatrics (ABP) and the American Board of Family Medicine (ABFP), respectively. And this doesn’t even begin to address the credentialing needs of the nonphysicians.
Further, as SHM looks to represent all of the diverse elements that form the fabric of hospital medicine, we need to be in touch with the American College of Physicians, the American Academy of Pediatrics, the American Academy of Family Physicians, the Society of General Internal Medicine, the Ambulatory Pediatric Association, the American Association of Critical Care Nurses, the American Society of Health System Pharmacists, the American
Academy of Physicians Assistants, the American Academy of Nurse Practitioners, and many other important substantial medical professional societies; members of each believe that their organization relates to a segment of hospital medicine.
DIVERSITY CREATES NEW SOLUTIONS
The good part of this diversity is that as SHM helps to build this new specialty we are able to include so many unique vantage points. This strategy of inclusion allows for new ideas to percolate to the surface and leads to innovation and creativity. In fashioning the hospital of the future, “old think” must not rule the day. One way to change the outcome is to change those who are at the table.
If hospital medicine is to be part of the process of creating a hospital that is patient-centered, relies on measurable quality improvement, and delivers care by teams of healthcare professionals, then we need to open the tent and let in different perspectives. In SHM’s ongoing quality improvement efforts in heart failure and glycemic control, this is our approach—with meaningful input from hospitalists, subspecialists, nurses, pharmacists, and many other stakeholders in hospital medicine. This will lead to a different and—let’s hope—better outcome.
LABORISTS AND SURGICALISTS
And there are more wrinkles in the hospitalist world all the time. Recently USA Today wrote a story about “laborists” as hospitals try to solve access to obstetrical services by having contracted laborists on site 24/7. Some hospitals have to be creative when their community surgeons aren’t available for trauma care and some hospitals have contracted with orthopedists and general surgeons as “surgicalists.”
Are these the latest additions to the roll call of hospital medicine or just a footnote or an asterisk? Time and the marketplace will tell.
Besides the basic training for hospitalists there are many variations determined by site of practice and employment model. Whether we are talking about the differences between academic
hospital medicine or that practiced in community hospitals, or the uniqueness of a small group of hospitalists at only one hospital or a large multistate group of hospitalists in 10 states with 400 hospitalists, we are all part of hospital medicine.
In the end, hospital medicine is defined more by its common goals and its common values regardless of initial training or mode of practice. At this time in healthcare, many are looking for healthcare professionals to have the skills and the energy to create the hospital
of the future that will be a better place to work and to get the best care. SHM is committed to harnessing the diversity of our specialty to do our part to create a better future. With your help, we can get there. TH