Practice Economics

Society of Hospital Medicine (SHM) Epitomizes Professional Diversity


Dr. Howell

I just got back from a trip to SHM headquarters in Philadelphia, and all I can say is “wow.” I was visiting there for a meeting with the staff, many SHM members and committee leaders, and the SHM board of directors. The first day we all went into a big, modern, beautiful room at SHM headquarters—there must have been more than 100 people—and we went around the room and introduced ourselves. The diversity of the staff that support our society, and the diversity of the members there, was truly breathtaking. What I saw was a microcosm of our society and our specialty.

Looking around the room, it was easy to see some aspects of our diverse organization: both genders and a variety of ethnicities and age groups were well represented. These traditional measures of diversity are critical to a healthy environment, in my opinion, and the data bear out the idea that a diverse workforce can reduce turnover and be more creative and qualified.1,2 Our diversity is not an accident. It is part of a larger, deliberate strategy by SHM to be “the home” for healthcare professionals who provide hospital-based patient care. SHM embraces diversity, whether it’s skin deep or deeply cognitive.

Although we are continually working to enrich the traditional aspects of diversity, we are also very hard at work to make SHM a place of professional diversity.

Open and Inclusive

Over the past several years, SHM has worked hard to be openly inclusive. Many of the committees and sections within the society have been developed specifically to embrace important aspects of hospital medicine that have special or common interests, characteristics, or needs. Examples include the international section, med-peds section, administrators’ committee, and the nurse practitioner and physician assistant committee. These venues allow individuals under a Big Tent to find others with similar interests or training, so that they can address unique aspects of hospital medicine as it relates directly to them. SHM’s virtual world is following our committee and section structure, which has some of the most actively growing HMXchange communities coming from the “administrators” community and the “NP/PA” community.

SHM has put its money where its mouth is, dedicating significant resources for educational programs that will help benefit professionals with a variety of backgrounds. Some are focused on the special needs of our diverse physician population, including the Academic Hospitalist Academy, the Quality and Safety Educators Academy, and the Pediatric Hospital Medicine annual meeting (through a partnership with the American Academy of Pediatrics, the AAP Section on Hospital Medicine, and the Academic Pediatric Association). Other events are focused specifically on helping our non-physician colleagues, like the boot camp that is presented in collaboration with the American Academy of Physician Assistants and American Association of Nurse Practitioners. The SHM Leadership Academies attract a venerable alphabet soup of professional designations, including many MDs and DOs, of course, but also increasing numbers of PAs and NPs, a growing number of administrators, and now even a few ED and OB docs! Now that’s a Big Tent.

My understanding is that these events are always popular and often sold out.

Maybe the most powerful evidence that our Big Tent philosophy is working is found in the relationships SHM has forged with other hospital-based specialties, like obstetrics, neurology, and surgery. The president of the Society of OB/GYN Hospitalists ( has attended the SHM annual meeting and at least one of the Leadership Academies. Although “traditional” hospitalists like me may not be able to help in the OR or birthing suite, we have a lot of experience in quality improvement, leadership, and, of course, addressing the needs of a new and growing professional segment. The emergence and growth of these “specialty hospitalists” offers a unique opportunity for traditional hospitalists to partner with our subspecialty colleagues in a new way, so that together we can continue to improve patient care within the hospital across multiple disciplines.

There is no Big Tent so large that physicians, or even internists, will ever be in jeopardy. We occupy plenty of space under this Big Tent and still have lots of room to spare for our colleagues. In welcoming others, we all strengthen our own standing, by elevating the entire field.

What’s Ahead?

Based on the data I recently saw while at SHM headquarters, the Big Tent philosophy is a measurable success. Membership for NPs, PAs, and administrators is growing, with nearly 200 new members in those categories combined. Incredibly, we have ED physicians joining our organization—albeit, at a number dwarfed by internists—and the relationships with the specialty hospitalists are moving forward in a meaningful way. Looking at committees and committee chairs, there is plenty of ethnic, professional, and gender diversity.

What does all of this focus outside of internal medicine and physician groups mean for us internists? Will we be left behind? Fret not. Physicians make up more than 85% of our 12,000-plus members, with internists outnumbering—by a huge number—all of the other segments of our society combined. There is no Big Tent so large that physicians, or even internists, will ever be in jeopardy. We occupy plenty of space under this Big Tent and still have lots of room to spare for our colleagues. In welcoming others, we all strengthen our own standing, by elevating the entire field.

As a terrific mentor once said, a rising tide floats all boats. And the way to raise the tide of hospital medicine can be through partnerships whose gravity is a strong pull on the hospital medicine tide, as the moon pulls the ocean’s tides.

One area in which our society plans to place more effort in expanding the Big Tent is with trainees. Students and housestaff are one of the smallest groups in our organization, with the smallest growth. Those statistics are cause for concern. The need for future hospitalist growth, both in numbers and skill set, makes attracting this segment of paramount importance, in my view.

Fortunately, SHM is developing a strategy to make our society a valuable home to trainees. I have touched on those strategies previously, including a Physicians in Training Committee, free membership for students, $100 memberships for housestaff, and our “1,000 Challenge” to recruit 1,000 students and housestaff in the coming months.

In Sum

I am a firm believer in professional and personal diversity. I am proud to work in a society that also embraces this philosophy, places real value on it, and works hard to be inclusive. So, the next time you meet an NP, PA, student, or even a hospital-based OB physician, bring them under the SHM Big Tent, and encourage them to join us in making the hospital world a better place. They, we, and our patients will be better off for it.

Dr. Howell is president of SHM, chief of the division of hospital medicine at Johns Hopkins Bayview in Baltimore, and spends a significant part of his time and research on hospital operations. Email questions or comments to [email protected].


  1. Egan ME. Global diversity and inclusion: Fostering innovation through a diverse workforce. Forbes Insights. Forbes website. Available at: Accessed October 23, 2013.
  2. Kerby S, Burns C. The top 10 economic facts of diversity in the workplace. Center for American Progress website. Available at: Accessed October 23, 2013.

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