Does SHM’s leadership reflect the gender, race, religion, ethnicity, and sexual-preference diversity of the 30,000-plus hospitalists practicing in the U.S.? I don’t know the answer, but I suspect that whatever measure of diversity we have reflected in our organizational leadership, it could be better. I am very pleased with the initiation of the Diversity Task Force, which will ensure that SHM is developing leaders from these constituencies within its committees such that, in the coming years, there is meaningful integration of these diversities into the SHM leadership.
If SHM is to fulfill its destiny of changing American healthcare, it will do so only as a part of collaboration with other national organizations and entities. What comes next is too big for one physician organization to enact alone. One such organization is the Veterans Administration healthcare system, and I am pleased that we have started this journey by establishing the VA Affairs Committee. I look forward to seeing what will come of SHM’s collaboration with the VA. I believe that in 10 years’ time, both entities will count themselves fortunate for having engaged in this collaborative journey together.
Academics
From the outset, SHM’s attention to academics was about the pipeline, for despite our diverse practice patterns, we all share one common denominator in that we are where we are today as a product of our training. Much has been said about whether there will be a sufficient number of students and residents entering the practice of HM. But the question is about quality, not quantity. For HM to be sustainable, the best and brightest of our medical students and residents must select HM as a lifelong career, not as a year between residency and subspecialty fellowship. Career decisions are based upon mentors and role models, and the only solution is to ensure that our students and residents are regularly interacting with hospitalists as role models in their medical schools and residencies.
This was the second year for the Academic Hospitalist Academy: an initiative critical to ensuring that the hospitalists with whom our students and residents interact have the educational and leadership skills to be effective as role models. The work by the Academic Practice and Promotion Committee will soon yield a position paper that will establish the benchmarks for hospitalist promotions, empowering chairs and promotion committees to sustain hospitalists within the academic infrastructure. This is the second year of funding young investigators in HM, and SHM’s inclusion in the GEMSTAR program will enable further funding to ensure that the specialty is creating new knowledge.
And, as noted above, the new Pipeline Committee already has been effective in establishing a relationship with the Alliance for Academic Internal Medicine (professors, clerkship directors, residency directors). The collaborative venture, the Quality and Safety Educators Academy (QSEA), will come to fruition early in 2012, further integrating hospitalists as mentors in the educational infrastructure.
And even as you read this, I will be representing SHM in a joint collaborative with AAIM, ABIM, SGIM, and ACP regarding the “milestones project” as a new model of establishing resident competency, ensuring that the knowledge and skills requisite for being a hospitalist will be acquired in residency training in years to come.
Practice Management
After 48 trips over the course of the year, I can tell you that despite how far we have come as a profession, there remains remarkable heterogeneity as to how hospitalist groups are structured. And yet there are common principles that underlie the high-performing teams, principles captured in the work of the Practice Management and Practice Analysis committees. This valuable SHM service as the clearinghouse of best practices must continue to grow.