Broad scope of activities
Dr. Shah started practicing pediatric hospital medicine in 2001 during his fellowship training. He joined the faculty at CHOP and the University of Pennsylvania, also in Philadelphia, in 2005. In 2011 he arrived at Cincinnati Children’s Hospital, a facility with more than 600 beds that’s affiliated with the University of Cincinnati, where he is professor in the department of pediatrics and holds the James M. Ewell Endowed Chair, to lead a newly created division of hospital medicine. That division now includes more than 55 physician faculty members, 10 nurse practitioners, and nine 3-year fellows.
Collectively the staff represent a broad scope of clinical and research activities along with consulting and surgical comanagement roles and a unique service staffed by med/peds hospitalists for adult patients who have been followed at the hospital since they were children. “Years ago, those patients would not have survived beyond childhood, but with medical advances, they have. Although they continue to benefit from pediatric expertise, these adults also require internal medicine expertise for their adult health needs,” he explained. Examples include patients with neurologic impairments, dependence on medical technology, or congenital heart defects.
Dr. Shah’s own schedule is 28% clinical. He also serves as the hospital’s chief metrics officer, and his research interests include serious infectious diseases, such as pneumonia and meningitis. He is studying the comparative effectiveness of different antibiotic treatments for community-acquired pneumonia and how to improve outcomes for hospital-acquired pneumonia.
Dr. Shah has tried to be deliberate in leading efforts to grow researchers within the field, both nationally and locally. He serves as the chair of the National Childhood Pneumonia Guidelines Committee of the Infectious Diseases Society of America and the Pediatric Infectious Diseases Society, and he also is vice chair of the Pediatric Research in Inpatient Settings (PRIS) Network, which facilitates multicenter cost-effectiveness studies among its 120 hospital members. For example, a series of studies funded by the Patient- Centered Outcomes Research Institute has demonstrated the comparable effectiveness of oral and intravenous antibiotics for osteomyelitis and complicated pneumonia.
Sustainable positions
When he was asked whether he felt pediatric hospitalists face particular challenges in trying to take their place in the burgeoning field of hospital medicine, Dr. Shah said he and his colleagues don’t really think of it in those terms. “Hospital medicine is such a dynamic field. For example, pediatric hospital medicine has charted its own course by pursuing subspecialty certification and fellowship training. Yet support from the field broadly has been quite strong, and SHM has embraced pediatricians, who serve on its board of directors and on numerous committees.”
SHM’s commitment to supporting pediatric hospital medicine practice and research includes its cosponsorship, with the Academic Pediatric Association and the American Academy of Pediatrics, an annual pediatric hospital medicine educational and research conference, which will next be held July 25-28, 2019, in Seattle. “In my recent meetings with society leaders I have seen exceptional enthusiasm for increasing the presence of pediatric hospitalists in the society’s work. Many pediatric hospitalists already attend SHM’s annual meeting and submit their research, but we all recognize that a strong pediatric presence is important for the society.”
Dr. Shah credits Cincinnati Children’s Hospital for supporting a sustainable work schedule for its hospitalists and for a team-oriented culture that emphasizes both professional and personal development and encourages a diversity of skill sets and perspectives, skills development, and additional training. “Individuals are recognized for their achievements within and beyond the confines of the hospital. The mentorship structure we set up here is incredible. Each faculty member has a primary mentor, a peer mentor, and access to a career development committee. Additionally, there is broad participation in clinical operations, educational scholarship, research, and quality improvement.”
Dr. Shah’s professional interests in academics, research, and infectious diseases trace back in part to a thesis project he did on neonatal infections while in medical school at Yale University, New Haven, Conn. “I was working with basic sciences in a hematology lab under the direction of the neonatologist Dr. Patrick Gallagher, whose research focused on pediatric blood cell membrane disorders.” Dr. Gallagher, who directs the Yale Center for Blood Disorders, had a keen interest in infections in infants, Dr. Shah recalled.
“He would share with me interesting cases from his practice. What particularly captured my attention was realizing how the research I could do might have a direct impact on patients and families.” Thus inspired to do an additional year of medical school training at Yale before graduating in 1998, Dr. Shah used that year to focus on research, including a placement at the Centers for Disease Control and Prevention to investigate infectious disease outbreaks, which offered real-world mysteries to solve.
“When I was a resident, pediatric hospital medicine had not yet been recognized as a specialty. But during my fellowships, most of my work was focused on the inpatient side of medicine,” he said. That made hospital medicine a natural career path.
Dr. Shah describes himself as a devoted soccer fan with season tickets for himself, his wife, and their three children to the Major League Soccer team FC Cincinnati. He’s also a movie buff and a former avid bicyclist who’s now trying to get back into cycling. He encourages readers of The Hospitalist to contact him with input on any aspect of the Journal of Hospital Medicine. Email him at [email protected] and follow him on Twitter: @samirshahmd.
Reference
1. Barrett DJ et al. Pediatric hospital medicine: A proposed new subspecialty. Pediatrics. 2017 March;139(3):e20161823.