FPHM: Open for Business

Fellow in Hospital medicine Spotlight

Margaret Fang, MD, FHM

Dr. Fang is assistant professor in residence, division of hospital medicine, and medical director of the anticoagulation clinic at the University of California at San Francisco.

Undergraduate: Northwestern Univer-sity, Evanston, Ill.

Medical school: Feinberg School of Medicine, Northwestern University, Chicago.

Notable: A practicing hospitalist and SHM member since 2003, Dr. Fang was the co-chair and founding member of SHM’s Young Physicians Task Force in 2003. She has been an active member of SHM’s Scientific Abstracts Committee since 2004 and the Research Committee since 2009. She also has been an assistant editor for the Journal of Hospital Medicine since 2006.

FYI: Outside of the hospital, Dr. Fang has developed a strong interest in food and wine, “which is only natural living in the beautiful bay area of San Francisco,” she says. She recently read “The Omnivore’s Dilemma” by Michael Pollan, and has subscribed to Community Supported Agriculture (CSA) ever since. She enjoys being adventurous and creative with her recipes, using locally grown ingredients supplied by the CSA. She indulges her interests in both cooking and eating, “with a bigger emphasis on eating.”

Quotable: “As a hospitalist that is actively involved in clinical research and administration, I get the opportunity to try out a lot of different things and pursue my many interests. SHM tries to embrace all aspects of the hospitalist field, and I am a big advocate of promoting clinical research and quality-improvement projects in our field.”

Comanagement: Done Right, A Powerful Approach to Patient Care

SHM and a panel of experts are taking the concept of teamwork in the hospital to new levels by spearheading a movement that enables hospitalists and surgeons to comanage patient care.

In February, national leaders in medical management of surgical patients in the hospital convened to develop the first guidelines in this new and emerging practice. Soon, those providers will be putting their recommendations to the test.

SHM’s Co-Management Advisory Board, chaired by SHM board member Sylvia McKean, MD, SFHM, conducted a webinar to create consensus around the requirements of a comanagement program and to preview the demonstration project that will be implemented in late summer.

“Comanagement between hospitalist and surgeon is at the cutting edge of hospital medicine,” says Todd Von Deak, SHM vice president of operations and general manager. “There already are some great models for how to structure the relationships and processes necessary to provide the best care possible for surgical patients.”

The advisory board’s guidelines are posted on SHM’s website (www.hospitalmedicine.org/comanagementresources). The resource room includes a white paper, a program building guide, and tips for documentation, coding, and billing. It also provides an outline of the demonstration project. The 11 steps to superior comanagement are:

• Identifying comanagement program champions;
• Consensus meeting(s);
• Identifying patients appropriate for comanagement;
• Determining roles and responsibilities of comanaging physicians and other stakeholders;
• Identifying staffing models;
• Developing service agreements or memos of understanding to clearly define program;
• Developing communication guidelines/standards;
• Addressing financial issues and considerations;
• Developing key metrics;
• Developing any necessary supporting documents; and
• Considering the educational needs of referring services/physicians/ nursing units.