From the Society

Danielle Scheurer, MD, MSRC, SFHM, is the chief quality officer and professor of medicine at the Medical University of South Carolina, Charleston. She is the outgoing medical editor of The Hospitalist, and the new president of the Society of Hospital Medicine. She assumes the role from immediate past-president Christopher Frost, MD, SFHM.

Brennan Wesley, Medical University of South Carolina

As a hospitalist for 17 years, Dr. Scheurer has practiced in both academic tertiary care, as well as community hospital settings. As a chief quality officer, she has worked to improve quality and safety in all health care settings, including ambulatory care, nursing homes, home health, and surgical centers. She brings a broad experience in the medical industry to the SHM presidency.
 

At what point in your education/training did you decide to practice hospital medicine?

I always loved inpatient medicine throughout my entire meds-peds residency training at Duke University in Durham, N.C. I honestly never had a doubt that hospital medicine was going to be my career. What appeals to me is that each hour and each day is different, which is invigorating.

What are your favorite aspects of clinical practice and of your administrative duties?

I like doing both administrative work and clinical work because I believe having a view of both worlds helps me to be a better physician and a better administrator. It greatly helps me bring realistic solutions to the front lines since I have a good understanding of what needs to be done, but also what is likely to actually work.

As president of SHM over the next year, what are your primary goals?

My primary goal is to deeply connect with the SHM membership and understand what their needs are. There is enormous change happening in the medical industry, and SHM should be a conduit for information sharing, resources, and most importantly, answers to all our difficult problems. Hospitalists are critical to success for our hospitals and our communities during the COVID-19 pandemic. We must be able to give and receive information quickly and seamlessly to effectively help each other across the country and the world. SHM must be seen as a critical convener, especially in times of crisis.

Additionally, SHM has always fostered a “big tent” philosophy, so we will continue to explore ways to expand membership beyond “the core” of internal medicine, family medicine, and pediatrics and reach a better understanding of what our constituents need and how we can add value to their work lives and careers. In addition to expanding membership within our borders, other expansions already include working with international chapters and members with an “all teach, all learn” attitude to better understand mutually beneficial partnerships with international members. Through all these expansions, we will come closer to truly realizing our mission at SHM, which is to “promote exceptional care for hospitalized patients.”
 

You mention COVID-19. What resources is SHM offering to members?

We have opened up the SHM Learning Portal to help members and non-members address upcoming challenges, such as expanding ICU coverage or cross-training providers for hospital medicine. Several modules in SHM’s “Critical Care for the Hospitalist” series may be especially relevant during the COVID-19 crisis:

• Fluid Resuscitation in the Critically Ill
• Mechanical Ventilation Part I – The Basics
• Mechanical Ventilation Part II – Beyond the Basics
• Mechanical Ventilation Part III – ARDS

Finally, in this time when so many hospitalists are busy dealing with COVID-19, SHM is committed to offering valuable resources and is in the process of offering new material, including Twitter chats, webinars, blogs, and podcasts to help hospitalists share best practices. Please bookmark SHM’s compilation of COVID-19 resources at hospitalmedicine.org/coronavirus.

We also continue to forge ahead with our publications, The Hospitalist and the Journal of Hospital Medicine, by adding online content as it becomes available. Visit the COVID-19 news feed on The Hospitalist website at www.the-hospitalist.org/hospitalist/coronavirus-updates.

In this trying time, we can still connect as a community and continue to learn from each other. We encourage you to use SHM’s online community, HMX, to share resources and crowd-source solutions. Ideas for SHM resources can be submitted via email at [email protected].
 

What are some of the current challenges for hospital medicine?

The demands placed on hospitalists are greater than ever. With shortening length of stay, rising acuity and complexity, increasing administrative burdens, and high emphasis on care transitions, our skills (and our patience) need to rise to these increasing demands. As a member-based society, SHM (and the board of directors) seeks to ensure we are helping hospitalists be the very best they can be, regardless of hospitalist type or practice setting.

The good news is that we are still in high demand. Within the medical industry, there has been an explosive growth in the need for hospitalists, and we can now be found in almost every hospital setting in the United States. But as a current commodity, it is imperative that we continue to prove the value we are adding to our patients and their families, the systems in which we work, and the industry as a whole.
 

How will hospital medicine change in the next decade?

I believe one of the biggest changes we will see is the shift to ambulatory settings and the use of telehealth, and we all need to gain significant comfort with both to be effective.
 

Do you have any advice for students and residents interested in hospital medicine?

It is an incredibly dynamic and invigorating career; I can’t imagine doing anything else.

Danielle Scheurer, MD, MSRC, SFHM, is the chief quality officer and professor of medicine at the Medical University of South Carolina, Charleston. She is the outgoing medical editor of The Hospitalist, and the new president of the Society of Hospital Medicine. She assumes the role from immediate past-president Christopher Frost, MD, SFHM.

Brennan Wesley, Medical University of South Carolina

As a hospitalist for 17 years, Dr. Scheurer has practiced in both academic tertiary care, as well as community hospital settings. As a chief quality officer, she has worked to improve quality and safety in all health care settings, including ambulatory care, nursing homes, home health, and surgical centers. She brings a broad experience in the medical industry to the SHM presidency.
 

At what point in your education/training did you decide to practice hospital medicine?

I always loved inpatient medicine throughout my entire meds-peds residency training at Duke University in Durham, N.C. I honestly never had a doubt that hospital medicine was going to be my career. What appeals to me is that each hour and each day is different, which is invigorating.

What are your favorite aspects of clinical practice and of your administrative duties?

I like doing both administrative work and clinical work because I believe having a view of both worlds helps me to be a better physician and a better administrator. It greatly helps me bring realistic solutions to the front lines since I have a good understanding of what needs to be done, but also what is likely to actually work.

As president of SHM over the next year, what are your primary goals?

My primary goal is to deeply connect with the SHM membership and understand what their needs are. There is enormous change happening in the medical industry, and SHM should be a conduit for information sharing, resources, and most importantly, answers to all our difficult problems. Hospitalists are critical to success for our hospitals and our communities during the COVID-19 pandemic. We must be able to give and receive information quickly and seamlessly to effectively help each other across the country and the world. SHM must be seen as a critical convener, especially in times of crisis.

Additionally, SHM has always fostered a “big tent” philosophy, so we will continue to explore ways to expand membership beyond “the core” of internal medicine, family medicine, and pediatrics and reach a better understanding of what our constituents need and how we can add value to their work lives and careers. In addition to expanding membership within our borders, other expansions already include working with international chapters and members with an “all teach, all learn” attitude to better understand mutually beneficial partnerships with international members. Through all these expansions, we will come closer to truly realizing our mission at SHM, which is to “promote exceptional care for hospitalized patients.”
 

You mention COVID-19. What resources is SHM offering to members?

We have opened up the SHM Learning Portal to help members and non-members address upcoming challenges, such as expanding ICU coverage or cross-training providers for hospital medicine. Several modules in SHM’s “Critical Care for the Hospitalist” series may be especially relevant during the COVID-19 crisis:

• Fluid Resuscitation in the Critically Ill
• Mechanical Ventilation Part I – The Basics
• Mechanical Ventilation Part II – Beyond the Basics
• Mechanical Ventilation Part III – ARDS

Finally, in this time when so many hospitalists are busy dealing with COVID-19, SHM is committed to offering valuable resources and is in the process of offering new material, including Twitter chats, webinars, blogs, and podcasts to help hospitalists share best practices. Please bookmark SHM’s compilation of COVID-19 resources at hospitalmedicine.org/coronavirus.

We also continue to forge ahead with our publications, The Hospitalist and the Journal of Hospital Medicine, by adding online content as it becomes available. Visit the COVID-19 news feed on The Hospitalist website at www.the-hospitalist.org/hospitalist/coronavirus-updates.

In this trying time, we can still connect as a community and continue to learn from each other. We encourage you to use SHM’s online community, HMX, to share resources and crowd-source solutions. Ideas for SHM resources can be submitted via email at [email protected].
 

What are some of the current challenges for hospital medicine?

The demands placed on hospitalists are greater than ever. With shortening length of stay, rising acuity and complexity, increasing administrative burdens, and high emphasis on care transitions, our skills (and our patience) need to rise to these increasing demands. As a member-based society, SHM (and the board of directors) seeks to ensure we are helping hospitalists be the very best they can be, regardless of hospitalist type or practice setting.

The good news is that we are still in high demand. Within the medical industry, there has been an explosive growth in the need for hospitalists, and we can now be found in almost every hospital setting in the United States. But as a current commodity, it is imperative that we continue to prove the value we are adding to our patients and their families, the systems in which we work, and the industry as a whole.
 

How will hospital medicine change in the next decade?

I believe one of the biggest changes we will see is the shift to ambulatory settings and the use of telehealth, and we all need to gain significant comfort with both to be effective.
 

Do you have any advice for students and residents interested in hospital medicine?

It is an incredibly dynamic and invigorating career; I can’t imagine doing anything else.

Danielle Scheurer, MD, MSRC, SFHM, is the chief quality officer and professor of medicine at the Medical University of South Carolina, Charleston. She is the outgoing medical editor of The Hospitalist, and the new president of the Society of Hospital Medicine. She assumes the role from immediate past-president Christopher Frost, MD, SFHM.

Brennan Wesley, Medical University of South Carolina

As a hospitalist for 17 years, Dr. Scheurer has practiced in both academic tertiary care, as well as community hospital settings. As a chief quality officer, she has worked to improve quality and safety in all health care settings, including ambulatory care, nursing homes, home health, and surgical centers. She brings a broad experience in the medical industry to the SHM presidency.
 

At what point in your education/training did you decide to practice hospital medicine?

I always loved inpatient medicine throughout my entire meds-peds residency training at Duke University in Durham, N.C. I honestly never had a doubt that hospital medicine was going to be my career. What appeals to me is that each hour and each day is different, which is invigorating.

What are your favorite aspects of clinical practice and of your administrative duties?

I like doing both administrative work and clinical work because I believe having a view of both worlds helps me to be a better physician and a better administrator. It greatly helps me bring realistic solutions to the front lines since I have a good understanding of what needs to be done, but also what is likely to actually work.

As president of SHM over the next year, what are your primary goals?

My primary goal is to deeply connect with the SHM membership and understand what their needs are. There is enormous change happening in the medical industry, and SHM should be a conduit for information sharing, resources, and most importantly, answers to all our difficult problems. Hospitalists are critical to success for our hospitals and our communities during the COVID-19 pandemic. We must be able to give and receive information quickly and seamlessly to effectively help each other across the country and the world. SHM must be seen as a critical convener, especially in times of crisis.

Additionally, SHM has always fostered a “big tent” philosophy, so we will continue to explore ways to expand membership beyond “the core” of internal medicine, family medicine, and pediatrics and reach a better understanding of what our constituents need and how we can add value to their work lives and careers. In addition to expanding membership within our borders, other expansions already include working with international chapters and members with an “all teach, all learn” attitude to better understand mutually beneficial partnerships with international members. Through all these expansions, we will come closer to truly realizing our mission at SHM, which is to “promote exceptional care for hospitalized patients.”
 

You mention COVID-19. What resources is SHM offering to members?

We have opened up the SHM Learning Portal to help members and non-members address upcoming challenges, such as expanding ICU coverage or cross-training providers for hospital medicine. Several modules in SHM’s “Critical Care for the Hospitalist” series may be especially relevant during the COVID-19 crisis:

• Fluid Resuscitation in the Critically Ill
• Mechanical Ventilation Part I – The Basics
• Mechanical Ventilation Part II – Beyond the Basics
• Mechanical Ventilation Part III – ARDS

Finally, in this time when so many hospitalists are busy dealing with COVID-19, SHM is committed to offering valuable resources and is in the process of offering new material, including Twitter chats, webinars, blogs, and podcasts to help hospitalists share best practices. Please bookmark SHM’s compilation of COVID-19 resources at hospitalmedicine.org/coronavirus.

We also continue to forge ahead with our publications, The Hospitalist and the Journal of Hospital Medicine, by adding online content as it becomes available. Visit the COVID-19 news feed on The Hospitalist website at www.the-hospitalist.org/hospitalist/coronavirus-updates.

In this trying time, we can still connect as a community and continue to learn from each other. We encourage you to use SHM’s online community, HMX, to share resources and crowd-source solutions. Ideas for SHM resources can be submitted via email at [email protected].
 

What are some of the current challenges for hospital medicine?

The demands placed on hospitalists are greater than ever. With shortening length of stay, rising acuity and complexity, increasing administrative burdens, and high emphasis on care transitions, our skills (and our patience) need to rise to these increasing demands. As a member-based society, SHM (and the board of directors) seeks to ensure we are helping hospitalists be the very best they can be, regardless of hospitalist type or practice setting.

The good news is that we are still in high demand. Within the medical industry, there has been an explosive growth in the need for hospitalists, and we can now be found in almost every hospital setting in the United States. But as a current commodity, it is imperative that we continue to prove the value we are adding to our patients and their families, the systems in which we work, and the industry as a whole.
 

How will hospital medicine change in the next decade?

I believe one of the biggest changes we will see is the shift to ambulatory settings and the use of telehealth, and we all need to gain significant comfort with both to be effective.
 

Do you have any advice for students and residents interested in hospital medicine?

It is an incredibly dynamic and invigorating career; I can’t imagine doing anything else.

In mid-March, the Society of Hospital Medicine board of directors concluded that it was impossible for SHM to move forward with Hospital Medicine 2020 because of the continued spread of virus that causes Coronavirus Disease 2019 (COVID-19).

Given the most recent information available from the Centers for Disease Control & Prevention and the World Health Organization about the evolving global pandemic and the number of institutions that had travel bans in place, SHM leadership concluded that canceling the Annual Conference was the only path forward.

“Canceling the conference during this unprecedented time is the right thing to do,” said Benji K. Mathews, MD, SFHM, CLHM, course director for HM20. “With the evolving circumstances out of our control, there were risks to our community as it would have gathered, communities we connect with on our travels, and our home communities and hospitals – canceling was the best way to mitigate these risks. Through it all, I couldn’t have asked for a better leadership team and the larger SHM community for their support.”

Because hospitalists are on the front lines of patient care at their institutions, they will be needed more than ever as the pandemic continues to grow in order to manage care of hospitalized patients with COVID-19 and other illnesses. As the only medical society dedicated to hospital medicine, SHM will continue to support hospitalists with resources and research specific to COVID-19 and its impact on the practice of hospital medicine.

SHM is aware that this necessary cancellation impacts many from both a financial and logistical perspective. As such, SHM will refund all conference registration fees for HM20 in full. SHM is also providing the opportunity to defer your HM20 registration to HM21, taking place May 4-7, 2021 in Las Vegas, or Pediatric Hospital Medicine 2020, taking place July 23-26, 2020 in Lake Buena Vista, Fla.

For accommodation or travel cancellations, SHM requests that individuals please refer to their respective hotel or carrier’s customer service team and related cancellation policies.

To provide the world-class education that conference attendees have come to expect from SHM over the years, the SHM team is exploring virtual options to offer select content originally anticipated at HM20. SHM also offers online education via the SHM Learning Portal and the new SHM Education app.

Visit shmannualconference.org/faqs for a full list of FAQs. For additional questions, please contact [email protected].

SHM will continue to monitor the COVID-19 pandemic and provide hospitalists with useful resources in this time of need at hospitalmedicine.org/coronavirus. For news coverage of COVID-19, visit https://www.the-hospitalist.org/hospitalist/coronavirus-updates.

In mid-March, the Society of Hospital Medicine board of directors concluded that it was impossible for SHM to move forward with Hospital Medicine 2020 because of the continued spread of virus that causes Coronavirus Disease 2019 (COVID-19).

Given the most recent information available from the Centers for Disease Control & Prevention and the World Health Organization about the evolving global pandemic and the number of institutions that had travel bans in place, SHM leadership concluded that canceling the Annual Conference was the only path forward.

“Canceling the conference during this unprecedented time is the right thing to do,” said Benji K. Mathews, MD, SFHM, CLHM, course director for HM20. “With the evolving circumstances out of our control, there were risks to our community as it would have gathered, communities we connect with on our travels, and our home communities and hospitals – canceling was the best way to mitigate these risks. Through it all, I couldn’t have asked for a better leadership team and the larger SHM community for their support.”

Because hospitalists are on the front lines of patient care at their institutions, they will be needed more than ever as the pandemic continues to grow in order to manage care of hospitalized patients with COVID-19 and other illnesses. As the only medical society dedicated to hospital medicine, SHM will continue to support hospitalists with resources and research specific to COVID-19 and its impact on the practice of hospital medicine.

SHM is aware that this necessary cancellation impacts many from both a financial and logistical perspective. As such, SHM will refund all conference registration fees for HM20 in full. SHM is also providing the opportunity to defer your HM20 registration to HM21, taking place May 4-7, 2021 in Las Vegas, or Pediatric Hospital Medicine 2020, taking place July 23-26, 2020 in Lake Buena Vista, Fla.

For accommodation or travel cancellations, SHM requests that individuals please refer to their respective hotel or carrier’s customer service team and related cancellation policies.

To provide the world-class education that conference attendees have come to expect from SHM over the years, the SHM team is exploring virtual options to offer select content originally anticipated at HM20. SHM also offers online education via the SHM Learning Portal and the new SHM Education app.

Visit shmannualconference.org/faqs for a full list of FAQs. For additional questions, please contact [email protected].

SHM will continue to monitor the COVID-19 pandemic and provide hospitalists with useful resources in this time of need at hospitalmedicine.org/coronavirus. For news coverage of COVID-19, visit https://www.the-hospitalist.org/hospitalist/coronavirus-updates.

In mid-March, the Society of Hospital Medicine board of directors concluded that it was impossible for SHM to move forward with Hospital Medicine 2020 because of the continued spread of virus that causes Coronavirus Disease 2019 (COVID-19).

Given the most recent information available from the Centers for Disease Control & Prevention and the World Health Organization about the evolving global pandemic and the number of institutions that had travel bans in place, SHM leadership concluded that canceling the Annual Conference was the only path forward.

“Canceling the conference during this unprecedented time is the right thing to do,” said Benji K. Mathews, MD, SFHM, CLHM, course director for HM20. “With the evolving circumstances out of our control, there were risks to our community as it would have gathered, communities we connect with on our travels, and our home communities and hospitals – canceling was the best way to mitigate these risks. Through it all, I couldn’t have asked for a better leadership team and the larger SHM community for their support.”

Because hospitalists are on the front lines of patient care at their institutions, they will be needed more than ever as the pandemic continues to grow in order to manage care of hospitalized patients with COVID-19 and other illnesses. As the only medical society dedicated to hospital medicine, SHM will continue to support hospitalists with resources and research specific to COVID-19 and its impact on the practice of hospital medicine.

SHM is aware that this necessary cancellation impacts many from both a financial and logistical perspective. As such, SHM will refund all conference registration fees for HM20 in full. SHM is also providing the opportunity to defer your HM20 registration to HM21, taking place May 4-7, 2021 in Las Vegas, or Pediatric Hospital Medicine 2020, taking place July 23-26, 2020 in Lake Buena Vista, Fla.

For accommodation or travel cancellations, SHM requests that individuals please refer to their respective hotel or carrier’s customer service team and related cancellation policies.

To provide the world-class education that conference attendees have come to expect from SHM over the years, the SHM team is exploring virtual options to offer select content originally anticipated at HM20. SHM also offers online education via the SHM Learning Portal and the new SHM Education app.

Visit shmannualconference.org/faqs for a full list of FAQs. For additional questions, please contact [email protected].

SHM will continue to monitor the COVID-19 pandemic and provide hospitalists with useful resources in this time of need at hospitalmedicine.org/coronavirus. For news coverage of COVID-19, visit https://www.the-hospitalist.org/hospitalist/coronavirus-updates.

It’s already been a few years since I exited the Society of Hospital Medicine’s Board of Directors (2 years, or maybe 3 – I’ve already lost count), and sitting in my proverbial rocking chair in the Old Hospitalists’ Home, I heard, as many of you did, that Larry Wellikson, MD, MHM, the first and only CEO in the Society’s history, is stepping down soon.

With all the idle time that I find myself with these days, I have had the opportunity to ruminate on what Larry has brought to SHM in his 2 decades of leadership. And among the many answers, two stand out for me.

The first is Larry’s deep appreciation of the value of relationships that he has developed and nurtured, an attribute which he has imprinted on many of us who have worked with him over the years. Although Larry speaks of the camaraderie of the first years of SHM and the bonds that he, Bob Wachter, Win Whitcomb, and John Nelson established, he also has kept in touch with a vast network of hospitalists over the last 20-plus years.

Go to lunch with Larry, and be amazed at how much he knows about the goings-on of many of our colleagues. The fondness that Larry has for the people in his life is without parallel. These aren’t just professional colleagues who have impacted him in some way – for Larry, every one of these is a true lifetime friendship, and he continues to establish new ones every year. He makes each of his friends feel truly special to him.

The second is the critical value of and need for change and disruption. The specialty of hospital medicine was, from its beginning, disruptive, and from his career as a physician executive, Larry understood and has brought to SHM an understanding of the necessity of disruption to encourage growth and fresh thinking. If one steps back and looks at, for example, the composition of the Board over the years, or the Journal of Hospital Medicine’s editorial staff, or of our committees, one sees a pattern – a commitment to continuously bringing on young leaders who are still on the early and ascending part of their career paths.

Other organizations identify Board candidates at the peak of their careers, but at SHM, many of us were elected when we had just enough experience to contribute but then continued to grow in our careers after finishing our terms. I joined the Board in 2012 (I think) and while I would probably be a more seasoned and stately Board member if I joined at this point in my life, I would also have less new and novel to offer – and therefore be less effective for what the Society needs. While SHM respects its past leaders, it does not revere them. Our past is important, but our present and future are more important. Larry brought that mentality to SHM.

Ironically, the one position within SHM which has not, until this year, been subject to that same kind of transition is the CEO position itself. And this year, that domino will fall as well. While transitions are hard, change is good – and I am confident that our Society’s commitment to seeking out new, talented leaders, and making transitions at all levels – Board, committees, chapters, speakers – with the intent of bringing new perspectives and creativity, is firmly entrenched in our culture. And Larry can join me in the rocking chair as we relive our common SHM experiences together – and create new memories as well.

Congratulations Larry, and thank you.

Dr. Harte is a past president of SHM, and president of Cleveland Clinic Akron (Ohio) General and the Southern Region. He formerly served as president of Cleveland Clinic Hillcrest Hospital and Cleveland Clinic South Pointe Hospital.

It’s already been a few years since I exited the Society of Hospital Medicine’s Board of Directors (2 years, or maybe 3 – I’ve already lost count), and sitting in my proverbial rocking chair in the Old Hospitalists’ Home, I heard, as many of you did, that Larry Wellikson, MD, MHM, the first and only CEO in the Society’s history, is stepping down soon.

With all the idle time that I find myself with these days, I have had the opportunity to ruminate on what Larry has brought to SHM in his 2 decades of leadership. And among the many answers, two stand out for me.

The first is Larry’s deep appreciation of the value of relationships that he has developed and nurtured, an attribute which he has imprinted on many of us who have worked with him over the years. Although Larry speaks of the camaraderie of the first years of SHM and the bonds that he, Bob Wachter, Win Whitcomb, and John Nelson established, he also has kept in touch with a vast network of hospitalists over the last 20-plus years.

Go to lunch with Larry, and be amazed at how much he knows about the goings-on of many of our colleagues. The fondness that Larry has for the people in his life is without parallel. These aren’t just professional colleagues who have impacted him in some way – for Larry, every one of these is a true lifetime friendship, and he continues to establish new ones every year. He makes each of his friends feel truly special to him.

The second is the critical value of and need for change and disruption. The specialty of hospital medicine was, from its beginning, disruptive, and from his career as a physician executive, Larry understood and has brought to SHM an understanding of the necessity of disruption to encourage growth and fresh thinking. If one steps back and looks at, for example, the composition of the Board over the years, or the Journal of Hospital Medicine’s editorial staff, or of our committees, one sees a pattern – a commitment to continuously bringing on young leaders who are still on the early and ascending part of their career paths.

Other organizations identify Board candidates at the peak of their careers, but at SHM, many of us were elected when we had just enough experience to contribute but then continued to grow in our careers after finishing our terms. I joined the Board in 2012 (I think) and while I would probably be a more seasoned and stately Board member if I joined at this point in my life, I would also have less new and novel to offer – and therefore be less effective for what the Society needs. While SHM respects its past leaders, it does not revere them. Our past is important, but our present and future are more important. Larry brought that mentality to SHM.

Ironically, the one position within SHM which has not, until this year, been subject to that same kind of transition is the CEO position itself. And this year, that domino will fall as well. While transitions are hard, change is good – and I am confident that our Society’s commitment to seeking out new, talented leaders, and making transitions at all levels – Board, committees, chapters, speakers – with the intent of bringing new perspectives and creativity, is firmly entrenched in our culture. And Larry can join me in the rocking chair as we relive our common SHM experiences together – and create new memories as well.

Congratulations Larry, and thank you.

Dr. Harte is a past president of SHM, and president of Cleveland Clinic Akron (Ohio) General and the Southern Region. He formerly served as president of Cleveland Clinic Hillcrest Hospital and Cleveland Clinic South Pointe Hospital.

It’s already been a few years since I exited the Society of Hospital Medicine’s Board of Directors (2 years, or maybe 3 – I’ve already lost count), and sitting in my proverbial rocking chair in the Old Hospitalists’ Home, I heard, as many of you did, that Larry Wellikson, MD, MHM, the first and only CEO in the Society’s history, is stepping down soon.

With all the idle time that I find myself with these days, I have had the opportunity to ruminate on what Larry has brought to SHM in his 2 decades of leadership. And among the many answers, two stand out for me.

The first is Larry’s deep appreciation of the value of relationships that he has developed and nurtured, an attribute which he has imprinted on many of us who have worked with him over the years. Although Larry speaks of the camaraderie of the first years of SHM and the bonds that he, Bob Wachter, Win Whitcomb, and John Nelson established, he also has kept in touch with a vast network of hospitalists over the last 20-plus years.

Go to lunch with Larry, and be amazed at how much he knows about the goings-on of many of our colleagues. The fondness that Larry has for the people in his life is without parallel. These aren’t just professional colleagues who have impacted him in some way – for Larry, every one of these is a true lifetime friendship, and he continues to establish new ones every year. He makes each of his friends feel truly special to him.

The second is the critical value of and need for change and disruption. The specialty of hospital medicine was, from its beginning, disruptive, and from his career as a physician executive, Larry understood and has brought to SHM an understanding of the necessity of disruption to encourage growth and fresh thinking. If one steps back and looks at, for example, the composition of the Board over the years, or the Journal of Hospital Medicine’s editorial staff, or of our committees, one sees a pattern – a commitment to continuously bringing on young leaders who are still on the early and ascending part of their career paths.

Other organizations identify Board candidates at the peak of their careers, but at SHM, many of us were elected when we had just enough experience to contribute but then continued to grow in our careers after finishing our terms. I joined the Board in 2012 (I think) and while I would probably be a more seasoned and stately Board member if I joined at this point in my life, I would also have less new and novel to offer – and therefore be less effective for what the Society needs. While SHM respects its past leaders, it does not revere them. Our past is important, but our present and future are more important. Larry brought that mentality to SHM.

Ironically, the one position within SHM which has not, until this year, been subject to that same kind of transition is the CEO position itself. And this year, that domino will fall as well. While transitions are hard, change is good – and I am confident that our Society’s commitment to seeking out new, talented leaders, and making transitions at all levels – Board, committees, chapters, speakers – with the intent of bringing new perspectives and creativity, is firmly entrenched in our culture. And Larry can join me in the rocking chair as we relive our common SHM experiences together – and create new memories as well.

Congratulations Larry, and thank you.

Dr. Harte is a past president of SHM, and president of Cleveland Clinic Akron (Ohio) General and the Southern Region. He formerly served as president of Cleveland Clinic Hillcrest Hospital and Cleveland Clinic South Pointe Hospital.

The Society of Hospital Medicine (SHM) has canceled its annual conference, scheduled for mid-April, joining a growing list of events shuttered by coronavirus (COVID-19) concerns.

In a March 13 announcement, SHM said it would be impossible for the society to host the Hospital Medicine 2020 conference amid the escalating health concerns regarding the global COVID-19 outbreak. For more information about the cancellation and the society’s refund policies, see the SHM website for a list of frequently answered questions.




 

The Society of Hospital Medicine (SHM) has canceled its annual conference, scheduled for mid-April, joining a growing list of events shuttered by coronavirus (COVID-19) concerns.

In a March 13 announcement, SHM said it would be impossible for the society to host the Hospital Medicine 2020 conference amid the escalating health concerns regarding the global COVID-19 outbreak. For more information about the cancellation and the society’s refund policies, see the SHM website for a list of frequently answered questions.




 

The Society of Hospital Medicine (SHM) has canceled its annual conference, scheduled for mid-April, joining a growing list of events shuttered by coronavirus (COVID-19) concerns.

In a March 13 announcement, SHM said it would be impossible for the society to host the Hospital Medicine 2020 conference amid the escalating health concerns regarding the global COVID-19 outbreak. For more information about the cancellation and the society’s refund policies, see the SHM website for a list of frequently answered questions.




 

Match Day is the celebration of the National Resident Matching Program® (NRMP®) results, which seals the fate not only of future medical professionals, but of the program placements dedicated to supporting the acceleration of their careers.

OHSU/Kristyna Wentz-Graff

Daniel Ricotta, MD, FHM, an academic hospitalist at Beth Israel Deaconess Medical Center (BIDMC) in Boston, and an active SHM member since 2013, offers unique insight into the value of understanding both sides of this interview table.

As the associate program director of BIDMC’s Internal Medicine Residency Program and the director of Simulation Education at the Carl J. Shapiro Center for Education & Research, Dr. Ricotta is able to act on his passions for medical education and clinical care.

“I was attracted to the breadth of medicine and enjoyed learning everything,” Dr. Ricotta said. “I knew I wanted to do academic medicine and education, and I was able to get involved by working with students and residents early on in my career.”

A natural fit for his current roles, Dr. Ricotta has gained a unique perspective on the match process and how it has evolved since he began his residency nine years ago.

Preparing for Match Day includes an extensive checklist of life-altering to-dos that shape your career trajectory. Medical students must have noteworthy CV points, scholarly recommendations, stand-out interviews, and a thoughtful rank list – among many other things to consider throughout the course of the match. Dr. Ricotta said that while this application process has generally remained the same since his participation, he has noticed that the students themselves have changed.

“Students going into residency are more mature and further along professionally,” he explained. “I’ve seen more students go on to do something else for a while and have gained more experience. They’re taking time off for research or getting dual degrees.”

Additionally, according to Dr. Ricotta, students are applying to double the number of programs than in years past, and are even using technology to their benefit. Because interview slots are limited, some students set up “bot automation” to help lock in interviews.

Amidst what can feel like a free-for-all, Dr. Ricotta reminds his students that the match process is a two-sided relationship.

“I certainly didn’t realize how much work goes into recruitment when I was a student,” Dr. Ricotta admitted. “What students don’t think about is the amount of care that goes into trying to match students who share similar values, the mission, or are a good cultural fit.”

He went on to emphasize the importance of environmental compatibility.

“Go somewhere that you feel you will fit in. Where you will thrive,” he said. “Go somewhere that has a mission that resonates with your mission and think about your fellow applicants and potential mentorship. Could you see yourself being their classmate? Does this program have people there who can help you to achieve your goals?”

Keeping in mind questions like these, it is no surprise that because of hospital medicine’s scheduling flexibility and hands-on learning opportunities that more and more students are interested in exploring this specialty.

“What is amazing about hospital medicine is the ample opportunity for you to get involved earlier in your career and build from that,” he said. “There is more face time with patients, more training for medical students available, countless academic opportunities in research and scholarships, and even conferences.”

Because of the multiple career pathways available in hospital medicine, SHM aims to provide students and residents with professional tools and opportunities as early as possible to allow them to get a preview of what they can expect as a hospitalist – no matter which path they choose.

“SHM is about getting involved,” said Dr. Ricotta. “SHM encourages residents to become actively incorporated into the community through chapters, conferences, and other networking opportunities on both local and national levels. That’s really difficult to do as a resident.”

Whether you’re waiting on the NRMP® results this year or you are in the beginning stages of gathering your application materials, one thing is clear according to Dr. Ricotta, you’re not just an applicant number.

Are you a student interested in exploring a career in hospital medicine? SHM supports educational and professional needs at all stages of your career. When you join SHM during your residency training, you receive access to programs, resources, and opportunities that will enhance your skills and raise your professional profile. For more information about our Residents & Fellows membership opportunity, please visit: hospitalmedicine.org/residents.

Ms. Cowan is a marketing communications specialist at the Society of Hospital Medicine.

Match Day is the celebration of the National Resident Matching Program® (NRMP®) results, which seals the fate not only of future medical professionals, but of the program placements dedicated to supporting the acceleration of their careers.

OHSU/Kristyna Wentz-Graff

Daniel Ricotta, MD, FHM, an academic hospitalist at Beth Israel Deaconess Medical Center (BIDMC) in Boston, and an active SHM member since 2013, offers unique insight into the value of understanding both sides of this interview table.

As the associate program director of BIDMC’s Internal Medicine Residency Program and the director of Simulation Education at the Carl J. Shapiro Center for Education & Research, Dr. Ricotta is able to act on his passions for medical education and clinical care.

“I was attracted to the breadth of medicine and enjoyed learning everything,” Dr. Ricotta said. “I knew I wanted to do academic medicine and education, and I was able to get involved by working with students and residents early on in my career.”

A natural fit for his current roles, Dr. Ricotta has gained a unique perspective on the match process and how it has evolved since he began his residency nine years ago.

Preparing for Match Day includes an extensive checklist of life-altering to-dos that shape your career trajectory. Medical students must have noteworthy CV points, scholarly recommendations, stand-out interviews, and a thoughtful rank list – among many other things to consider throughout the course of the match. Dr. Ricotta said that while this application process has generally remained the same since his participation, he has noticed that the students themselves have changed.

“Students going into residency are more mature and further along professionally,” he explained. “I’ve seen more students go on to do something else for a while and have gained more experience. They’re taking time off for research or getting dual degrees.”

Additionally, according to Dr. Ricotta, students are applying to double the number of programs than in years past, and are even using technology to their benefit. Because interview slots are limited, some students set up “bot automation” to help lock in interviews.

Amidst what can feel like a free-for-all, Dr. Ricotta reminds his students that the match process is a two-sided relationship.

“I certainly didn’t realize how much work goes into recruitment when I was a student,” Dr. Ricotta admitted. “What students don’t think about is the amount of care that goes into trying to match students who share similar values, the mission, or are a good cultural fit.”

He went on to emphasize the importance of environmental compatibility.

“Go somewhere that you feel you will fit in. Where you will thrive,” he said. “Go somewhere that has a mission that resonates with your mission and think about your fellow applicants and potential mentorship. Could you see yourself being their classmate? Does this program have people there who can help you to achieve your goals?”

Keeping in mind questions like these, it is no surprise that because of hospital medicine’s scheduling flexibility and hands-on learning opportunities that more and more students are interested in exploring this specialty.

“What is amazing about hospital medicine is the ample opportunity for you to get involved earlier in your career and build from that,” he said. “There is more face time with patients, more training for medical students available, countless academic opportunities in research and scholarships, and even conferences.”

Because of the multiple career pathways available in hospital medicine, SHM aims to provide students and residents with professional tools and opportunities as early as possible to allow them to get a preview of what they can expect as a hospitalist – no matter which path they choose.

“SHM is about getting involved,” said Dr. Ricotta. “SHM encourages residents to become actively incorporated into the community through chapters, conferences, and other networking opportunities on both local and national levels. That’s really difficult to do as a resident.”

Whether you’re waiting on the NRMP® results this year or you are in the beginning stages of gathering your application materials, one thing is clear according to Dr. Ricotta, you’re not just an applicant number.

Are you a student interested in exploring a career in hospital medicine? SHM supports educational and professional needs at all stages of your career. When you join SHM during your residency training, you receive access to programs, resources, and opportunities that will enhance your skills and raise your professional profile. For more information about our Residents & Fellows membership opportunity, please visit: hospitalmedicine.org/residents.

Ms. Cowan is a marketing communications specialist at the Society of Hospital Medicine.

Match Day is the celebration of the National Resident Matching Program® (NRMP®) results, which seals the fate not only of future medical professionals, but of the program placements dedicated to supporting the acceleration of their careers.

OHSU/Kristyna Wentz-Graff

Daniel Ricotta, MD, FHM, an academic hospitalist at Beth Israel Deaconess Medical Center (BIDMC) in Boston, and an active SHM member since 2013, offers unique insight into the value of understanding both sides of this interview table.

As the associate program director of BIDMC’s Internal Medicine Residency Program and the director of Simulation Education at the Carl J. Shapiro Center for Education & Research, Dr. Ricotta is able to act on his passions for medical education and clinical care.

“I was attracted to the breadth of medicine and enjoyed learning everything,” Dr. Ricotta said. “I knew I wanted to do academic medicine and education, and I was able to get involved by working with students and residents early on in my career.”

A natural fit for his current roles, Dr. Ricotta has gained a unique perspective on the match process and how it has evolved since he began his residency nine years ago.

Preparing for Match Day includes an extensive checklist of life-altering to-dos that shape your career trajectory. Medical students must have noteworthy CV points, scholarly recommendations, stand-out interviews, and a thoughtful rank list – among many other things to consider throughout the course of the match. Dr. Ricotta said that while this application process has generally remained the same since his participation, he has noticed that the students themselves have changed.

“Students going into residency are more mature and further along professionally,” he explained. “I’ve seen more students go on to do something else for a while and have gained more experience. They’re taking time off for research or getting dual degrees.”

Additionally, according to Dr. Ricotta, students are applying to double the number of programs than in years past, and are even using technology to their benefit. Because interview slots are limited, some students set up “bot automation” to help lock in interviews.

Amidst what can feel like a free-for-all, Dr. Ricotta reminds his students that the match process is a two-sided relationship.

“I certainly didn’t realize how much work goes into recruitment when I was a student,” Dr. Ricotta admitted. “What students don’t think about is the amount of care that goes into trying to match students who share similar values, the mission, or are a good cultural fit.”

He went on to emphasize the importance of environmental compatibility.

“Go somewhere that you feel you will fit in. Where you will thrive,” he said. “Go somewhere that has a mission that resonates with your mission and think about your fellow applicants and potential mentorship. Could you see yourself being their classmate? Does this program have people there who can help you to achieve your goals?”

Keeping in mind questions like these, it is no surprise that because of hospital medicine’s scheduling flexibility and hands-on learning opportunities that more and more students are interested in exploring this specialty.

“What is amazing about hospital medicine is the ample opportunity for you to get involved earlier in your career and build from that,” he said. “There is more face time with patients, more training for medical students available, countless academic opportunities in research and scholarships, and even conferences.”

Because of the multiple career pathways available in hospital medicine, SHM aims to provide students and residents with professional tools and opportunities as early as possible to allow them to get a preview of what they can expect as a hospitalist – no matter which path they choose.

“SHM is about getting involved,” said Dr. Ricotta. “SHM encourages residents to become actively incorporated into the community through chapters, conferences, and other networking opportunities on both local and national levels. That’s really difficult to do as a resident.”

Whether you’re waiting on the NRMP® results this year or you are in the beginning stages of gathering your application materials, one thing is clear according to Dr. Ricotta, you’re not just an applicant number.

Are you a student interested in exploring a career in hospital medicine? SHM supports educational and professional needs at all stages of your career. When you join SHM during your residency training, you receive access to programs, resources, and opportunities that will enhance your skills and raise your professional profile. For more information about our Residents & Fellows membership opportunity, please visit: hospitalmedicine.org/residents.

Ms. Cowan is a marketing communications specialist at the Society of Hospital Medicine.

Charu Puri, MD, FHM, is a hospitalist and medical informaticist at Sutter East Bay Medical Group in Oakland, Calif. She also serves as medical director for onboarding, mentoring, and physician development.

Dr. Puri has been a member of the Society of Hospital Medicine since 2009, and attended the Society’s Leadership Academy, where she was inspired to create a mentorship program at her own institution. She is a member of the San Francisco Bay chapter of SHM and serves on the Performance Measurement and Reporting Committee.
 

At what point in your education/training did you decide to practice hospital medicine? What about hospital medicine appealed to you?

It was early on in my residency that it became clear to me that I wanted to pursue the hospitalist track. It was a natural fit, and I gravitated toward the hospitalist side of medicine. What appealed to me most was that we had the opportunity and privilege to provide care to patients in their most vulnerable state and experience the effects of that care in real time. I found that very gratifying.

There is also a sense of community and camaraderie that comes with working in a hospital setting. Everyone is working together, trying to help patients. The collegiality and the relationships that develop are very rewarding. I have been fortunate enough to have built strong friendships with the hospitalists in my group as well as colleagues from other disciplines in medicine that work in the hospital.
 

What is your current role at Sutter Health?

Alta Bates Summit Medical Center is part of the larger Sutter Health system. I have an administrative role with my medical group in addition to the clinical work I do at the medical center, although first and foremost I identify myself as a hospitalist. About 5 years ago I took on a role in clinical informatics, when our hospital implemented an EHR. Since then I have been working as an inpatient physician informaticist. Most recently I took on a new role as medical director for onboarding, mentoring, and physician development in my medical group.

How do you balance the different duties of your various roles?

I am full time in my administration role, between my informatics role and my onboarding role. I technically don’t have to do clinical shifts if I don’t want to, but it’s important to me to continue clinical practice and maintain my skills and connection to the hospital and colleagues. I do about four clinical shifts a month, and plan to continue doing that. In our group you must do 14 shifts a month to be considered full time, so what I do could be considered about one-third of that.

What are your favorite areas of clinical practice and/or research?

I haven’t had a lot of research experience. My residency program was a community-based program, and my current setting is a community hospital. I haven’t been involved much in the academic side of hospital medicine. As far as clinical practices goes, I think it’s the diversity of hospital medicine that appeals to me. You really get to be a jack of all trades, and experience all the different disciplines of medicine. I like the variety.

Both my informatics and onboarding roles came out of a need that I identified, and just began doing the work before there was an official role. When we implemented our EHR, it was essential to get our doctors organized to make sure they were ready to take care of patients that first day of go live. By the time our hospital went live on the EHR, I had a good understanding of how it worked, and so I was able to create a miniature curriculum for our physicians – templates, order sets, workflows, etc. – to help ensure everything went smoothly. A few months after we implemented the EHR, I was officially offered a physician informaticist role.

The onboarding role came about in an interesting way. I was participating in the leadership course offered by SHM and was lucky enough to be in the pilot for the Capstone course. That leadership course is focused around mentoring and sponsorship, and one of the faculty members was Nancy Spector, MD, the associate dean of faculty development at Drexel University, Philadelphia. She talked a lot about mentoring, and I was inspired to set up a mentoring program for our hospitalists. Dr. Spector graciously agreed to mentor me as I worked on my Capstone project, which was to create a mentoring program in a community-based hospitalist group. As I continued to work on the project, coincidentally our medical group decided to redesign our new physician onboarding process. Because I was already involved in the onboarding and training related to our EHR, I became very involved with our medical group's onboarding redesign.

My group's CEO decided to create a new directorship role for onboarding and mentoring, which I recently interviewed for and was offered about two months ago.

I think setting up systems to support our doctors is the common threat between the informatics and the onboarding roles. I want to implement systems that support our doctors, help them succeed, and hopefully make their jobs a little easier.
 

What are the most challenging aspects of practicing hospital medicine? What are the most rewarding?

We practice in a very urban environment, with many low-income patients who have limited resources and access to health care. That can be very challenging. You always wonder if these patients have all the support they need after leaving the hospital. Sometimes I feel that I am just putting a band-aid on the medical problem, so to speak, but not solving the underlying issue. But it can be very rewarding during those times when the hospital and the broader community can bring our resources together to create interventions to help at-risk patients. It doesn’t happen as frequently as we would like, but when it does happen it feels good.

Another challenging aspect is related to perception. There are a lot of consultants in the hospital who view hospitalists as "house staff." That can be very frustrating, and it’s important to steer the conversations away from that perspective, and really try to establish ourselves as colleagues and peers.
 

How will hospital medicine change in the next decade or 2?

It’s a relatively young field, and we’re still figuring it out. I really don’t know how hospital medicine is going to change, but I do know that the field will continue to evolve, given the way U.S. health care is rapidly changing.

Do you have any advice for students and residents interested in hospital medicine?

It’s a fun way to practice medicine and I would encourage students to go into hospital medicine. It’s great for work/life balance. The advice I would give is that it is very important to get involved early in your career. Get involved in medical group or hospital committees. Stay away from the “shift mentality” – that I’m going to work my shifts and leave. That can lead to early burnout, which is a real concern in our field now. Early engagement is essential, so you can help lead these conversations at your hospital.

Charu Puri, MD, FHM, is a hospitalist and medical informaticist at Sutter East Bay Medical Group in Oakland, Calif. She also serves as medical director for onboarding, mentoring, and physician development.

Dr. Puri has been a member of the Society of Hospital Medicine since 2009, and attended the Society’s Leadership Academy, where she was inspired to create a mentorship program at her own institution. She is a member of the San Francisco Bay chapter of SHM and serves on the Performance Measurement and Reporting Committee.
 

At what point in your education/training did you decide to practice hospital medicine? What about hospital medicine appealed to you?

It was early on in my residency that it became clear to me that I wanted to pursue the hospitalist track. It was a natural fit, and I gravitated toward the hospitalist side of medicine. What appealed to me most was that we had the opportunity and privilege to provide care to patients in their most vulnerable state and experience the effects of that care in real time. I found that very gratifying.

There is also a sense of community and camaraderie that comes with working in a hospital setting. Everyone is working together, trying to help patients. The collegiality and the relationships that develop are very rewarding. I have been fortunate enough to have built strong friendships with the hospitalists in my group as well as colleagues from other disciplines in medicine that work in the hospital.
 

What is your current role at Sutter Health?

Alta Bates Summit Medical Center is part of the larger Sutter Health system. I have an administrative role with my medical group in addition to the clinical work I do at the medical center, although first and foremost I identify myself as a hospitalist. About 5 years ago I took on a role in clinical informatics, when our hospital implemented an EHR. Since then I have been working as an inpatient physician informaticist. Most recently I took on a new role as medical director for onboarding, mentoring, and physician development in my medical group.

How do you balance the different duties of your various roles?

I am full time in my administration role, between my informatics role and my onboarding role. I technically don’t have to do clinical shifts if I don’t want to, but it’s important to me to continue clinical practice and maintain my skills and connection to the hospital and colleagues. I do about four clinical shifts a month, and plan to continue doing that. In our group you must do 14 shifts a month to be considered full time, so what I do could be considered about one-third of that.

What are your favorite areas of clinical practice and/or research?

I haven’t had a lot of research experience. My residency program was a community-based program, and my current setting is a community hospital. I haven’t been involved much in the academic side of hospital medicine. As far as clinical practices goes, I think it’s the diversity of hospital medicine that appeals to me. You really get to be a jack of all trades, and experience all the different disciplines of medicine. I like the variety.

Both my informatics and onboarding roles came out of a need that I identified, and just began doing the work before there was an official role. When we implemented our EHR, it was essential to get our doctors organized to make sure they were ready to take care of patients that first day of go live. By the time our hospital went live on the EHR, I had a good understanding of how it worked, and so I was able to create a miniature curriculum for our physicians – templates, order sets, workflows, etc. – to help ensure everything went smoothly. A few months after we implemented the EHR, I was officially offered a physician informaticist role.

The onboarding role came about in an interesting way. I was participating in the leadership course offered by SHM and was lucky enough to be in the pilot for the Capstone course. That leadership course is focused around mentoring and sponsorship, and one of the faculty members was Nancy Spector, MD, the associate dean of faculty development at Drexel University, Philadelphia. She talked a lot about mentoring, and I was inspired to set up a mentoring program for our hospitalists. Dr. Spector graciously agreed to mentor me as I worked on my Capstone project, which was to create a mentoring program in a community-based hospitalist group. As I continued to work on the project, coincidentally our medical group decided to redesign our new physician onboarding process. Because I was already involved in the onboarding and training related to our EHR, I became very involved with our medical group's onboarding redesign.

My group's CEO decided to create a new directorship role for onboarding and mentoring, which I recently interviewed for and was offered about two months ago.

I think setting up systems to support our doctors is the common threat between the informatics and the onboarding roles. I want to implement systems that support our doctors, help them succeed, and hopefully make their jobs a little easier.
 

What are the most challenging aspects of practicing hospital medicine? What are the most rewarding?

We practice in a very urban environment, with many low-income patients who have limited resources and access to health care. That can be very challenging. You always wonder if these patients have all the support they need after leaving the hospital. Sometimes I feel that I am just putting a band-aid on the medical problem, so to speak, but not solving the underlying issue. But it can be very rewarding during those times when the hospital and the broader community can bring our resources together to create interventions to help at-risk patients. It doesn’t happen as frequently as we would like, but when it does happen it feels good.

Another challenging aspect is related to perception. There are a lot of consultants in the hospital who view hospitalists as "house staff." That can be very frustrating, and it’s important to steer the conversations away from that perspective, and really try to establish ourselves as colleagues and peers.
 

How will hospital medicine change in the next decade or 2?

It’s a relatively young field, and we’re still figuring it out. I really don’t know how hospital medicine is going to change, but I do know that the field will continue to evolve, given the way U.S. health care is rapidly changing.

Do you have any advice for students and residents interested in hospital medicine?

It’s a fun way to practice medicine and I would encourage students to go into hospital medicine. It’s great for work/life balance. The advice I would give is that it is very important to get involved early in your career. Get involved in medical group or hospital committees. Stay away from the “shift mentality” – that I’m going to work my shifts and leave. That can lead to early burnout, which is a real concern in our field now. Early engagement is essential, so you can help lead these conversations at your hospital.

Charu Puri, MD, FHM, is a hospitalist and medical informaticist at Sutter East Bay Medical Group in Oakland, Calif. She also serves as medical director for onboarding, mentoring, and physician development.

Dr. Puri has been a member of the Society of Hospital Medicine since 2009, and attended the Society’s Leadership Academy, where she was inspired to create a mentorship program at her own institution. She is a member of the San Francisco Bay chapter of SHM and serves on the Performance Measurement and Reporting Committee.
 

At what point in your education/training did you decide to practice hospital medicine? What about hospital medicine appealed to you?

It was early on in my residency that it became clear to me that I wanted to pursue the hospitalist track. It was a natural fit, and I gravitated toward the hospitalist side of medicine. What appealed to me most was that we had the opportunity and privilege to provide care to patients in their most vulnerable state and experience the effects of that care in real time. I found that very gratifying.

There is also a sense of community and camaraderie that comes with working in a hospital setting. Everyone is working together, trying to help patients. The collegiality and the relationships that develop are very rewarding. I have been fortunate enough to have built strong friendships with the hospitalists in my group as well as colleagues from other disciplines in medicine that work in the hospital.
 

What is your current role at Sutter Health?

Alta Bates Summit Medical Center is part of the larger Sutter Health system. I have an administrative role with my medical group in addition to the clinical work I do at the medical center, although first and foremost I identify myself as a hospitalist. About 5 years ago I took on a role in clinical informatics, when our hospital implemented an EHR. Since then I have been working as an inpatient physician informaticist. Most recently I took on a new role as medical director for onboarding, mentoring, and physician development in my medical group.

How do you balance the different duties of your various roles?

I am full time in my administration role, between my informatics role and my onboarding role. I technically don’t have to do clinical shifts if I don’t want to, but it’s important to me to continue clinical practice and maintain my skills and connection to the hospital and colleagues. I do about four clinical shifts a month, and plan to continue doing that. In our group you must do 14 shifts a month to be considered full time, so what I do could be considered about one-third of that.

What are your favorite areas of clinical practice and/or research?

I haven’t had a lot of research experience. My residency program was a community-based program, and my current setting is a community hospital. I haven’t been involved much in the academic side of hospital medicine. As far as clinical practices goes, I think it’s the diversity of hospital medicine that appeals to me. You really get to be a jack of all trades, and experience all the different disciplines of medicine. I like the variety.

Both my informatics and onboarding roles came out of a need that I identified, and just began doing the work before there was an official role. When we implemented our EHR, it was essential to get our doctors organized to make sure they were ready to take care of patients that first day of go live. By the time our hospital went live on the EHR, I had a good understanding of how it worked, and so I was able to create a miniature curriculum for our physicians – templates, order sets, workflows, etc. – to help ensure everything went smoothly. A few months after we implemented the EHR, I was officially offered a physician informaticist role.

The onboarding role came about in an interesting way. I was participating in the leadership course offered by SHM and was lucky enough to be in the pilot for the Capstone course. That leadership course is focused around mentoring and sponsorship, and one of the faculty members was Nancy Spector, MD, the associate dean of faculty development at Drexel University, Philadelphia. She talked a lot about mentoring, and I was inspired to set up a mentoring program for our hospitalists. Dr. Spector graciously agreed to mentor me as I worked on my Capstone project, which was to create a mentoring program in a community-based hospitalist group. As I continued to work on the project, coincidentally our medical group decided to redesign our new physician onboarding process. Because I was already involved in the onboarding and training related to our EHR, I became very involved with our medical group's onboarding redesign.

My group's CEO decided to create a new directorship role for onboarding and mentoring, which I recently interviewed for and was offered about two months ago.

I think setting up systems to support our doctors is the common threat between the informatics and the onboarding roles. I want to implement systems that support our doctors, help them succeed, and hopefully make their jobs a little easier.
 

What are the most challenging aspects of practicing hospital medicine? What are the most rewarding?

We practice in a very urban environment, with many low-income patients who have limited resources and access to health care. That can be very challenging. You always wonder if these patients have all the support they need after leaving the hospital. Sometimes I feel that I am just putting a band-aid on the medical problem, so to speak, but not solving the underlying issue. But it can be very rewarding during those times when the hospital and the broader community can bring our resources together to create interventions to help at-risk patients. It doesn’t happen as frequently as we would like, but when it does happen it feels good.

Another challenging aspect is related to perception. There are a lot of consultants in the hospital who view hospitalists as "house staff." That can be very frustrating, and it’s important to steer the conversations away from that perspective, and really try to establish ourselves as colleagues and peers.
 

How will hospital medicine change in the next decade or 2?

It’s a relatively young field, and we’re still figuring it out. I really don’t know how hospital medicine is going to change, but I do know that the field will continue to evolve, given the way U.S. health care is rapidly changing.

Do you have any advice for students and residents interested in hospital medicine?

It’s a fun way to practice medicine and I would encourage students to go into hospital medicine. It’s great for work/life balance. The advice I would give is that it is very important to get involved early in your career. Get involved in medical group or hospital committees. Stay away from the “shift mentality” – that I’m going to work my shifts and leave. That can lead to early burnout, which is a real concern in our field now. Early engagement is essential, so you can help lead these conversations at your hospital.

Benji K. Mathews, MD, SFHM, CLHM, is chief of hospital medicine at Regions Hospital in St. Paul, Minn., and director of point of care ultrasound (POCUS) for hospital medicine at HealthPartners. He is also the course director for the Society of Hospital Medicine’s 2020 Annual Conference (HM20), to be held April 16-18 in San Diego.

Dr. Mathews, an associate professor of medicine at the University of Minnesota, Minneapolis, is recognized by fellow hospitalists as a pioneer in the use of bedside ultrasound. In fact, his Certificate of Leadership in Hospital Medicine (CLHM) was completed with a focus on ultrasound in hospital medicine, and he is a Fellow in Diagnostic Safety through the Society to Improve Diagnosis in Medicine. “While a resident, I took an interest in the field of improving diagnosis and combined it with the 21st-century innovative tool of bedside ultrasound,” he said. “Now, I continue to teach clinicians, educators, and learners.”

In addition to his interest in POCUS and medical education, Dr. Mathews also has a passion for global health, rooted in a commitment to reducing health care disparities both locally and globally. He has worked with medical missions, nongovernmental organizations, and orphanages in Nepal, India, Bolivia, Honduras, and Costa Rica. This led him to complete the global health course at the University of Minnesota.

Dr. Mathews spent a few minutes with The Hospitalist to discuss his background and his new role of course director of the HM20 Annual Conference.

Can you describe your journey to becoming a hospitalist?

I’ve been a hospitalist for most of the last decade. I was fortunate to be a part of a great residency program at the University of Minnesota Medical School, which started a hospital medicine pathway that had several nationally recognized hospital medicine leaders as mentors. I was lucky to work with several of them through the HealthPartners organization in Saint Paul, and that developed in me a further desire to practice hospital medicine. The group and mentors provided opportunities to develop further niches in my practice, like bedside ultrasound.

How did you first get involved with SHM?

I entered SHM through the influence of mentors at HealthPartners, especially Burke Kealey, MD, SFHM, senior medical director for hospital specialties at HealthPartners Medical Group in Bloomington, Minn. and a past president of the Society, who encouraged me to participate on SHM committees. I eventually applied for the Annual Conference Committee, and somehow was accepted.

At that time, I was a community hospitalist among a lot of academic hospitalists. I thought that my voice could probably diversify the conversation, and bring the perspective of an early-career hospitalist to the discussion around educational offerings at the Annual Conference. I benefited from good mentorship on that committee, and with that experience I started getting involved with our local chapter in Minnesota. That was very important. I became our local chapter president and was able to combine my efforts with SHM nationally with our regional initiatives.

You have a particular interest in point-of-care ultrasound for hospitalists. How did that make its way into your involvement with SHM?

Point-of-care ultrasound and diagnostic error work really took off when I was a resident. My interest in that funneled naturally into the base curriculum of the Annual Conference, where once a year I could come together with 18 of my best hospitalist friends from across the nation to discuss curriculum. We talk about what content is applicable for frontline clinicians, what is right for early learners, and what innovations are coming in the future. Toward that last point, I was always involved as a judge or volunteer for the Research, Innovations and Clinical Vignettes – or RIV – competition at the Annual Conference. That’s the scientific abstract and poster competition at the conference. My interest grew to a point at which I decided to apply for one of the leadership roles in the RIV. I had the opportunity to serve as an Innovations Lead at RIV one year, and then chaired the overall RIV competition. Those opportunities helped me better understand the cutting-edge research that hospitalists should be aware of and which researchers and clinicians we should be in conversation with.

All these roles together have led me to my service as HM20 course director. I see myself as a lucky guy who has benefited from great mentorship, and I want to take advantage of my opportunities to serve.

We’ve been told that your elementary school–age children have learned to use ultrasound!

Well, they’ve learned how to use handheld ultrasound devices on each other. They’re able to find their siblings’ kidneys and hearts. I often show an image of this to encourage hospitalists that, if children can pick it up, highly educated providers can do the same and more.

To register for the Society of Hospital Medicine’s 2020 Annual Conference, please visit the HM20 Registration page.




 

Benji K. Mathews, MD, SFHM, CLHM, is chief of hospital medicine at Regions Hospital in St. Paul, Minn., and director of point of care ultrasound (POCUS) for hospital medicine at HealthPartners. He is also the course director for the Society of Hospital Medicine’s 2020 Annual Conference (HM20), to be held April 16-18 in San Diego.

Dr. Mathews, an associate professor of medicine at the University of Minnesota, Minneapolis, is recognized by fellow hospitalists as a pioneer in the use of bedside ultrasound. In fact, his Certificate of Leadership in Hospital Medicine (CLHM) was completed with a focus on ultrasound in hospital medicine, and he is a Fellow in Diagnostic Safety through the Society to Improve Diagnosis in Medicine. “While a resident, I took an interest in the field of improving diagnosis and combined it with the 21st-century innovative tool of bedside ultrasound,” he said. “Now, I continue to teach clinicians, educators, and learners.”

In addition to his interest in POCUS and medical education, Dr. Mathews also has a passion for global health, rooted in a commitment to reducing health care disparities both locally and globally. He has worked with medical missions, nongovernmental organizations, and orphanages in Nepal, India, Bolivia, Honduras, and Costa Rica. This led him to complete the global health course at the University of Minnesota.

Dr. Mathews spent a few minutes with The Hospitalist to discuss his background and his new role of course director of the HM20 Annual Conference.

Can you describe your journey to becoming a hospitalist?

I’ve been a hospitalist for most of the last decade. I was fortunate to be a part of a great residency program at the University of Minnesota Medical School, which started a hospital medicine pathway that had several nationally recognized hospital medicine leaders as mentors. I was lucky to work with several of them through the HealthPartners organization in Saint Paul, and that developed in me a further desire to practice hospital medicine. The group and mentors provided opportunities to develop further niches in my practice, like bedside ultrasound.

How did you first get involved with SHM?

I entered SHM through the influence of mentors at HealthPartners, especially Burke Kealey, MD, SFHM, senior medical director for hospital specialties at HealthPartners Medical Group in Bloomington, Minn. and a past president of the Society, who encouraged me to participate on SHM committees. I eventually applied for the Annual Conference Committee, and somehow was accepted.

At that time, I was a community hospitalist among a lot of academic hospitalists. I thought that my voice could probably diversify the conversation, and bring the perspective of an early-career hospitalist to the discussion around educational offerings at the Annual Conference. I benefited from good mentorship on that committee, and with that experience I started getting involved with our local chapter in Minnesota. That was very important. I became our local chapter president and was able to combine my efforts with SHM nationally with our regional initiatives.

You have a particular interest in point-of-care ultrasound for hospitalists. How did that make its way into your involvement with SHM?

Point-of-care ultrasound and diagnostic error work really took off when I was a resident. My interest in that funneled naturally into the base curriculum of the Annual Conference, where once a year I could come together with 18 of my best hospitalist friends from across the nation to discuss curriculum. We talk about what content is applicable for frontline clinicians, what is right for early learners, and what innovations are coming in the future. Toward that last point, I was always involved as a judge or volunteer for the Research, Innovations and Clinical Vignettes – or RIV – competition at the Annual Conference. That’s the scientific abstract and poster competition at the conference. My interest grew to a point at which I decided to apply for one of the leadership roles in the RIV. I had the opportunity to serve as an Innovations Lead at RIV one year, and then chaired the overall RIV competition. Those opportunities helped me better understand the cutting-edge research that hospitalists should be aware of and which researchers and clinicians we should be in conversation with.

All these roles together have led me to my service as HM20 course director. I see myself as a lucky guy who has benefited from great mentorship, and I want to take advantage of my opportunities to serve.

We’ve been told that your elementary school–age children have learned to use ultrasound!

Well, they’ve learned how to use handheld ultrasound devices on each other. They’re able to find their siblings’ kidneys and hearts. I often show an image of this to encourage hospitalists that, if children can pick it up, highly educated providers can do the same and more.

To register for the Society of Hospital Medicine’s 2020 Annual Conference, please visit the HM20 Registration page.




 

Benji K. Mathews, MD, SFHM, CLHM, is chief of hospital medicine at Regions Hospital in St. Paul, Minn., and director of point of care ultrasound (POCUS) for hospital medicine at HealthPartners. He is also the course director for the Society of Hospital Medicine’s 2020 Annual Conference (HM20), to be held April 16-18 in San Diego.

Dr. Mathews, an associate professor of medicine at the University of Minnesota, Minneapolis, is recognized by fellow hospitalists as a pioneer in the use of bedside ultrasound. In fact, his Certificate of Leadership in Hospital Medicine (CLHM) was completed with a focus on ultrasound in hospital medicine, and he is a Fellow in Diagnostic Safety through the Society to Improve Diagnosis in Medicine. “While a resident, I took an interest in the field of improving diagnosis and combined it with the 21st-century innovative tool of bedside ultrasound,” he said. “Now, I continue to teach clinicians, educators, and learners.”

In addition to his interest in POCUS and medical education, Dr. Mathews also has a passion for global health, rooted in a commitment to reducing health care disparities both locally and globally. He has worked with medical missions, nongovernmental organizations, and orphanages in Nepal, India, Bolivia, Honduras, and Costa Rica. This led him to complete the global health course at the University of Minnesota.

Dr. Mathews spent a few minutes with The Hospitalist to discuss his background and his new role of course director of the HM20 Annual Conference.

Can you describe your journey to becoming a hospitalist?

I’ve been a hospitalist for most of the last decade. I was fortunate to be a part of a great residency program at the University of Minnesota Medical School, which started a hospital medicine pathway that had several nationally recognized hospital medicine leaders as mentors. I was lucky to work with several of them through the HealthPartners organization in Saint Paul, and that developed in me a further desire to practice hospital medicine. The group and mentors provided opportunities to develop further niches in my practice, like bedside ultrasound.

How did you first get involved with SHM?

I entered SHM through the influence of mentors at HealthPartners, especially Burke Kealey, MD, SFHM, senior medical director for hospital specialties at HealthPartners Medical Group in Bloomington, Minn. and a past president of the Society, who encouraged me to participate on SHM committees. I eventually applied for the Annual Conference Committee, and somehow was accepted.

At that time, I was a community hospitalist among a lot of academic hospitalists. I thought that my voice could probably diversify the conversation, and bring the perspective of an early-career hospitalist to the discussion around educational offerings at the Annual Conference. I benefited from good mentorship on that committee, and with that experience I started getting involved with our local chapter in Minnesota. That was very important. I became our local chapter president and was able to combine my efforts with SHM nationally with our regional initiatives.

You have a particular interest in point-of-care ultrasound for hospitalists. How did that make its way into your involvement with SHM?

Point-of-care ultrasound and diagnostic error work really took off when I was a resident. My interest in that funneled naturally into the base curriculum of the Annual Conference, where once a year I could come together with 18 of my best hospitalist friends from across the nation to discuss curriculum. We talk about what content is applicable for frontline clinicians, what is right for early learners, and what innovations are coming in the future. Toward that last point, I was always involved as a judge or volunteer for the Research, Innovations and Clinical Vignettes – or RIV – competition at the Annual Conference. That’s the scientific abstract and poster competition at the conference. My interest grew to a point at which I decided to apply for one of the leadership roles in the RIV. I had the opportunity to serve as an Innovations Lead at RIV one year, and then chaired the overall RIV competition. Those opportunities helped me better understand the cutting-edge research that hospitalists should be aware of and which researchers and clinicians we should be in conversation with.

All these roles together have led me to my service as HM20 course director. I see myself as a lucky guy who has benefited from great mentorship, and I want to take advantage of my opportunities to serve.

We’ve been told that your elementary school–age children have learned to use ultrasound!

Well, they’ve learned how to use handheld ultrasound devices on each other. They’re able to find their siblings’ kidneys and hearts. I often show an image of this to encourage hospitalists that, if children can pick it up, highly educated providers can do the same and more.

To register for the Society of Hospital Medicine’s 2020 Annual Conference, please visit the HM20 Registration page.




 

Ilaria Gadalla, DMSc, PA-C, is a hospitalist at Treasure Coast Hospitalists in Port St. Lucie, Fla., and serves as the physician assistant department chair/program director at South University, West Palm Beach, Fla., where she supervises more than 40 PAs, medical directors, and administrative staff across the South University campuses.

Ms. Gadalla is the chair of SHM’s NP/PA Special Interest Group, which was integral in drafting the society’s recent white paper on NP/PA integration and optimization.

She says that she continuously drives innovative projects for NPs and PAs to demonstrate excellence in collaboration by working closely with C-suite administration to expand quality improvement and education efforts. A prime example is the optimal communication system that she developed within her first week as a hospitalist in the Port St. Lucie area. Nursing, ED, and pharmacy staff had difficulty contacting hospitalists since the electronic medical record would not reflect the assigned hospitalist. She developed a simple contact sheet that included the hospitalist team each day. This method is still in use today.
 

At what point in your life did you realize you wanted to be a physician assistant?

I worked as a respiratory therapist and had a desire to expand my knowledge to manage critical care patients. I applied to Albany (N.Y.) Medical College, where I received my PA training. I knew before PA school that I was passionate about the medical field and wanted to advance my education and training.

How did you decide to become a PA hospitalist?

From day one at my first job, I knew that I loved inpatient medicine. I had a unique position as a cardiology hospitalist in Baltimore. That was my first experience working in hospital medicine. As a team of PAs, we worked closely with hospitalists in addition to the cardiologists. I really enjoyed the acuity of hospital medicine, and the brilliant hospitalist colleagues I worked with. They fueled my clinical knowledge daily, and that really drew me further into hospital medicine.

What is your current position?

I have a unique position. I work primarily in an academic role, as a program director and department chair of the physician assistant program at South University in West Palm Beach. I provide oversight for four PA program campuses located in Florida. Georgia, and Virginia. I also work clinically as a hospitalist at Treasure Coast Hospitalists in the Port St. Lucie area.

What are some of your favorite parts of your work?

My favorite aspect within the academic environment is what I call the “lightbulb moment” – that instant when you see your students comprehending and applying critical thinking regarding patient care. In clinical practice, I really enjoy educating and navigating a patient through their diagnosis and management. It’s like teaching, in that a patient can also have a lightbulb moment.

What are the most challenging aspects of practicing hospital medicine, from a PA’s perspective?

Medicine is an art, and each patient’s body is different. It’s a challenge to create individualized care in a system where metrics and templates exist. An additional challenge is simply navigating the culture of medicine and its receptiveness to physician assistants.

How does a hospitalist PA work differently than a PA in other health care settings?

PAs in hospital medicine must excel in communication skills. We are frequently the primary liaison between families, patients, specialists, consultants, and various departments daily. PAs in other care settings also communicate with a broad variety of people, but in hospital medicine that communication is required to be much more rapid. Your skills must really rise to the next level.

There is also the opportunity for PAs to integrate within hospital committees and the C-suite. That is very different from other settings.
 

How can PAs and nurse practitioners fit best into hospital medicine groups?

Initially, a hospital medicine group needs to identify their specific needs when deciding to integrate PAs and NPs. There must be a culture of receptiveness, with proper onboarding. That is a vital necessity, because without a proper onboarding process and a welcoming culture, a group is set up to fail.

What kind of resources do hospitalist PAs require to succeed?

There is a big need for education that targets the hospital C-suite and our physician colleagues about the scope of practice and autonomy that a PA can have. There are significant misconceptions about the capabilities of hospitalist PAs, and the additional value we bring to a team. PAs do not want to replace our MD/DO colleagues.

What do you see on the horizon for PAs and NPs in hospital medicine?

As the chair of SHM’s NP/PA Special Interest Group, we see a significant need for onboarding resources, because there is a hospitalist staffing shortage in the United States, and that gap can be filled with NPs and PAs. There is a lack of understanding about how to onboard and integrate advanced practice providers, so we are working intently on providing a toolkit that will assist groups with this process.

Do you have any advice for students who are interested in becoming hospitalist PAs?

I would encourage students to seek mentoring from a hospitalist PA. This can really help prepare you for the inpatient world, as it’s very different from outpatient medicine with a higher acuity of patient care. I would also encourage students to join SHM, as there are many resources to help improve your skills and increase your confidence as you grow within your career.

Ilaria Gadalla, DMSc, PA-C, is a hospitalist at Treasure Coast Hospitalists in Port St. Lucie, Fla., and serves as the physician assistant department chair/program director at South University, West Palm Beach, Fla., where she supervises more than 40 PAs, medical directors, and administrative staff across the South University campuses.

Ms. Gadalla is the chair of SHM’s NP/PA Special Interest Group, which was integral in drafting the society’s recent white paper on NP/PA integration and optimization.

She says that she continuously drives innovative projects for NPs and PAs to demonstrate excellence in collaboration by working closely with C-suite administration to expand quality improvement and education efforts. A prime example is the optimal communication system that she developed within her first week as a hospitalist in the Port St. Lucie area. Nursing, ED, and pharmacy staff had difficulty contacting hospitalists since the electronic medical record would not reflect the assigned hospitalist. She developed a simple contact sheet that included the hospitalist team each day. This method is still in use today.
 

At what point in your life did you realize you wanted to be a physician assistant?

I worked as a respiratory therapist and had a desire to expand my knowledge to manage critical care patients. I applied to Albany (N.Y.) Medical College, where I received my PA training. I knew before PA school that I was passionate about the medical field and wanted to advance my education and training.

How did you decide to become a PA hospitalist?

From day one at my first job, I knew that I loved inpatient medicine. I had a unique position as a cardiology hospitalist in Baltimore. That was my first experience working in hospital medicine. As a team of PAs, we worked closely with hospitalists in addition to the cardiologists. I really enjoyed the acuity of hospital medicine, and the brilliant hospitalist colleagues I worked with. They fueled my clinical knowledge daily, and that really drew me further into hospital medicine.

What is your current position?

I have a unique position. I work primarily in an academic role, as a program director and department chair of the physician assistant program at South University in West Palm Beach. I provide oversight for four PA program campuses located in Florida. Georgia, and Virginia. I also work clinically as a hospitalist at Treasure Coast Hospitalists in the Port St. Lucie area.

What are some of your favorite parts of your work?

My favorite aspect within the academic environment is what I call the “lightbulb moment” – that instant when you see your students comprehending and applying critical thinking regarding patient care. In clinical practice, I really enjoy educating and navigating a patient through their diagnosis and management. It’s like teaching, in that a patient can also have a lightbulb moment.

What are the most challenging aspects of practicing hospital medicine, from a PA’s perspective?

Medicine is an art, and each patient’s body is different. It’s a challenge to create individualized care in a system where metrics and templates exist. An additional challenge is simply navigating the culture of medicine and its receptiveness to physician assistants.

How does a hospitalist PA work differently than a PA in other health care settings?

PAs in hospital medicine must excel in communication skills. We are frequently the primary liaison between families, patients, specialists, consultants, and various departments daily. PAs in other care settings also communicate with a broad variety of people, but in hospital medicine that communication is required to be much more rapid. Your skills must really rise to the next level.

There is also the opportunity for PAs to integrate within hospital committees and the C-suite. That is very different from other settings.
 

How can PAs and nurse practitioners fit best into hospital medicine groups?

Initially, a hospital medicine group needs to identify their specific needs when deciding to integrate PAs and NPs. There must be a culture of receptiveness, with proper onboarding. That is a vital necessity, because without a proper onboarding process and a welcoming culture, a group is set up to fail.

What kind of resources do hospitalist PAs require to succeed?

There is a big need for education that targets the hospital C-suite and our physician colleagues about the scope of practice and autonomy that a PA can have. There are significant misconceptions about the capabilities of hospitalist PAs, and the additional value we bring to a team. PAs do not want to replace our MD/DO colleagues.

What do you see on the horizon for PAs and NPs in hospital medicine?

As the chair of SHM’s NP/PA Special Interest Group, we see a significant need for onboarding resources, because there is a hospitalist staffing shortage in the United States, and that gap can be filled with NPs and PAs. There is a lack of understanding about how to onboard and integrate advanced practice providers, so we are working intently on providing a toolkit that will assist groups with this process.

Do you have any advice for students who are interested in becoming hospitalist PAs?

I would encourage students to seek mentoring from a hospitalist PA. This can really help prepare you for the inpatient world, as it’s very different from outpatient medicine with a higher acuity of patient care. I would also encourage students to join SHM, as there are many resources to help improve your skills and increase your confidence as you grow within your career.

Ilaria Gadalla, DMSc, PA-C, is a hospitalist at Treasure Coast Hospitalists in Port St. Lucie, Fla., and serves as the physician assistant department chair/program director at South University, West Palm Beach, Fla., where she supervises more than 40 PAs, medical directors, and administrative staff across the South University campuses.

Ms. Gadalla is the chair of SHM’s NP/PA Special Interest Group, which was integral in drafting the society’s recent white paper on NP/PA integration and optimization.

She says that she continuously drives innovative projects for NPs and PAs to demonstrate excellence in collaboration by working closely with C-suite administration to expand quality improvement and education efforts. A prime example is the optimal communication system that she developed within her first week as a hospitalist in the Port St. Lucie area. Nursing, ED, and pharmacy staff had difficulty contacting hospitalists since the electronic medical record would not reflect the assigned hospitalist. She developed a simple contact sheet that included the hospitalist team each day. This method is still in use today.
 

At what point in your life did you realize you wanted to be a physician assistant?

I worked as a respiratory therapist and had a desire to expand my knowledge to manage critical care patients. I applied to Albany (N.Y.) Medical College, where I received my PA training. I knew before PA school that I was passionate about the medical field and wanted to advance my education and training.

How did you decide to become a PA hospitalist?

From day one at my first job, I knew that I loved inpatient medicine. I had a unique position as a cardiology hospitalist in Baltimore. That was my first experience working in hospital medicine. As a team of PAs, we worked closely with hospitalists in addition to the cardiologists. I really enjoyed the acuity of hospital medicine, and the brilliant hospitalist colleagues I worked with. They fueled my clinical knowledge daily, and that really drew me further into hospital medicine.

What is your current position?

I have a unique position. I work primarily in an academic role, as a program director and department chair of the physician assistant program at South University in West Palm Beach. I provide oversight for four PA program campuses located in Florida. Georgia, and Virginia. I also work clinically as a hospitalist at Treasure Coast Hospitalists in the Port St. Lucie area.

What are some of your favorite parts of your work?

My favorite aspect within the academic environment is what I call the “lightbulb moment” – that instant when you see your students comprehending and applying critical thinking regarding patient care. In clinical practice, I really enjoy educating and navigating a patient through their diagnosis and management. It’s like teaching, in that a patient can also have a lightbulb moment.

What are the most challenging aspects of practicing hospital medicine, from a PA’s perspective?

Medicine is an art, and each patient’s body is different. It’s a challenge to create individualized care in a system where metrics and templates exist. An additional challenge is simply navigating the culture of medicine and its receptiveness to physician assistants.

How does a hospitalist PA work differently than a PA in other health care settings?

PAs in hospital medicine must excel in communication skills. We are frequently the primary liaison between families, patients, specialists, consultants, and various departments daily. PAs in other care settings also communicate with a broad variety of people, but in hospital medicine that communication is required to be much more rapid. Your skills must really rise to the next level.

There is also the opportunity for PAs to integrate within hospital committees and the C-suite. That is very different from other settings.
 

How can PAs and nurse practitioners fit best into hospital medicine groups?

Initially, a hospital medicine group needs to identify their specific needs when deciding to integrate PAs and NPs. There must be a culture of receptiveness, with proper onboarding. That is a vital necessity, because without a proper onboarding process and a welcoming culture, a group is set up to fail.

What kind of resources do hospitalist PAs require to succeed?

There is a big need for education that targets the hospital C-suite and our physician colleagues about the scope of practice and autonomy that a PA can have. There are significant misconceptions about the capabilities of hospitalist PAs, and the additional value we bring to a team. PAs do not want to replace our MD/DO colleagues.

What do you see on the horizon for PAs and NPs in hospital medicine?

As the chair of SHM’s NP/PA Special Interest Group, we see a significant need for onboarding resources, because there is a hospitalist staffing shortage in the United States, and that gap can be filled with NPs and PAs. There is a lack of understanding about how to onboard and integrate advanced practice providers, so we are working intently on providing a toolkit that will assist groups with this process.

Do you have any advice for students who are interested in becoming hospitalist PAs?

I would encourage students to seek mentoring from a hospitalist PA. This can really help prepare you for the inpatient world, as it’s very different from outpatient medicine with a higher acuity of patient care. I would also encourage students to join SHM, as there are many resources to help improve your skills and increase your confidence as you grow within your career.

Amit Vashist, MD, SFHM, is the senior vice president and chief clinical officer at Ballad Health, an integrated 21-hospital health system serving 29 counties of northeast Tennessee, southwest Virginia, northwest North Carolina, and southeast Kentucky.

Dr. Vashist, who is a member of the Hospitalist’s editorial advisory board, focuses on clinical quality and safety, value-based initiatives to improve quality while reducing cost of care, performance improvement, and oversight of the enterprise-wide clinical delivery of care. He also provides administrative oversight of the Ballad Health Clinical Council – a model of physician partnership for clinical transformation and outcomes improvement.

Dr. Vashist is a dual board-certified internist and psychiatrist and an avid proponent of initiatives aimed at promoting quality, improving safety, reducing cost, and minimizing variation in the delivery of patient care across diverse settings. His work has been instrumental in improving outcomes and reducing mortality in patients with sepsis, earning him several local, regional, and national awards, and his work in promoting a zero-harm culture at Ballad Health has been instrumental in significantly reducing hospital-acquired infections system wide.

Prior to transitioning into the role of the chief clinical officer, Dr. Vashist served as the chair of the Ballad Health Clinical Council and the system chair for Ballad Health’s hospitalist division running a group of over 130 hospitalists.

Why did you choose a career in medicine?

The ability to have a positive impact and help others. In addition, I love learning new information and skills, and medicine affords one the opportunity to be a lifelong learner.

What do you like most about working as a hospitalist?

The relatively fast-paced nature of the work and the ability to tie seemingly fragmented episodes of patient care together. I believe that no other specialty offers that 30,000-foot vantage view of things in clinical medicine.

What do you like the least?

The shift worker mindset emanating from the traditional and rigid 7-on, 7-off model. A sense of team can be lost in this model and, contrary to conventional thinking, this model can accelerate hospitalist burnout.

What’s the best advice you ever received?

“You’ve gotta learn to listen!”

What’s the worst advice you ever received?

“Don’t rock the boat.” I strongly believe that frequent disruption is required to change the established status quo.

What aspect of patient care is most challenging?

A perceived disruption in the continuity of care by virtue of a new hospitalist seeing those patients, and the challenge to build the same level of trust and comfort as the outgoing hospitalist. Superior models of care have developed over the years promoting a better continuity of care but this domain continues to pose a challenge to proponents of hospital medicine.

What’s the biggest change you’ve seen in hospital medicine in your career?

Hospitalists being increasingly perceived as the “quarterbacks” and gatekeepers of quality, costs of care, and clinical outcomes in our hospitals and health care systems.

What’s the biggest change you would like to see in hospital medicine?

Inpatient volumes across the country continue to shrink, and this trend will not change for the foreseeable future. Hospitalists have got to embrace newer models of care faster, like hospitals at home, postacute care, transitional care clinics, hospital at home, etc. Remember what they say: “If you are not at the table, you are on the menu.” Now is our time to be at the table, and be the champions of change and move to true value (quality plus experience/cost), or else, we could end up and vanish like Blockbuster.

Outside of patient care, tell us about your career interests.

Implementing value-driven initiatives, pursuing endeavors aimed at cutting out waste and redundancy in health care, and developing a new generation of physician leaders with these skill sets.

Where do you see yourself in 10 years?

Leveraging my experience, training and expertise in hospital medicine to design better systems of health care that transcend above and beyond the four walls of the hospital, and facilitate true consumerism and “patient centeredness.”

What has been your most meaningful experience with SHM?

Attending the annual SHM meetings for the past several years, which have helped me to not only reap rewards from the numerous educational sessions but has also helped me develop a rich network of friends, colleagues, and mentors whose advice I solicit from time to time.

Amit Vashist, MD, SFHM, is the senior vice president and chief clinical officer at Ballad Health, an integrated 21-hospital health system serving 29 counties of northeast Tennessee, southwest Virginia, northwest North Carolina, and southeast Kentucky.

Dr. Vashist, who is a member of the Hospitalist’s editorial advisory board, focuses on clinical quality and safety, value-based initiatives to improve quality while reducing cost of care, performance improvement, and oversight of the enterprise-wide clinical delivery of care. He also provides administrative oversight of the Ballad Health Clinical Council – a model of physician partnership for clinical transformation and outcomes improvement.

Dr. Vashist is a dual board-certified internist and psychiatrist and an avid proponent of initiatives aimed at promoting quality, improving safety, reducing cost, and minimizing variation in the delivery of patient care across diverse settings. His work has been instrumental in improving outcomes and reducing mortality in patients with sepsis, earning him several local, regional, and national awards, and his work in promoting a zero-harm culture at Ballad Health has been instrumental in significantly reducing hospital-acquired infections system wide.

Prior to transitioning into the role of the chief clinical officer, Dr. Vashist served as the chair of the Ballad Health Clinical Council and the system chair for Ballad Health’s hospitalist division running a group of over 130 hospitalists.

Why did you choose a career in medicine?

The ability to have a positive impact and help others. In addition, I love learning new information and skills, and medicine affords one the opportunity to be a lifelong learner.

What do you like most about working as a hospitalist?

The relatively fast-paced nature of the work and the ability to tie seemingly fragmented episodes of patient care together. I believe that no other specialty offers that 30,000-foot vantage view of things in clinical medicine.

What do you like the least?

The shift worker mindset emanating from the traditional and rigid 7-on, 7-off model. A sense of team can be lost in this model and, contrary to conventional thinking, this model can accelerate hospitalist burnout.

What’s the best advice you ever received?

“You’ve gotta learn to listen!”

What’s the worst advice you ever received?

“Don’t rock the boat.” I strongly believe that frequent disruption is required to change the established status quo.

What aspect of patient care is most challenging?

A perceived disruption in the continuity of care by virtue of a new hospitalist seeing those patients, and the challenge to build the same level of trust and comfort as the outgoing hospitalist. Superior models of care have developed over the years promoting a better continuity of care but this domain continues to pose a challenge to proponents of hospital medicine.

What’s the biggest change you’ve seen in hospital medicine in your career?

Hospitalists being increasingly perceived as the “quarterbacks” and gatekeepers of quality, costs of care, and clinical outcomes in our hospitals and health care systems.

What’s the biggest change you would like to see in hospital medicine?

Inpatient volumes across the country continue to shrink, and this trend will not change for the foreseeable future. Hospitalists have got to embrace newer models of care faster, like hospitals at home, postacute care, transitional care clinics, hospital at home, etc. Remember what they say: “If you are not at the table, you are on the menu.” Now is our time to be at the table, and be the champions of change and move to true value (quality plus experience/cost), or else, we could end up and vanish like Blockbuster.

Outside of patient care, tell us about your career interests.

Implementing value-driven initiatives, pursuing endeavors aimed at cutting out waste and redundancy in health care, and developing a new generation of physician leaders with these skill sets.

Where do you see yourself in 10 years?

Leveraging my experience, training and expertise in hospital medicine to design better systems of health care that transcend above and beyond the four walls of the hospital, and facilitate true consumerism and “patient centeredness.”

What has been your most meaningful experience with SHM?

Attending the annual SHM meetings for the past several years, which have helped me to not only reap rewards from the numerous educational sessions but has also helped me develop a rich network of friends, colleagues, and mentors whose advice I solicit from time to time.

Amit Vashist, MD, SFHM, is the senior vice president and chief clinical officer at Ballad Health, an integrated 21-hospital health system serving 29 counties of northeast Tennessee, southwest Virginia, northwest North Carolina, and southeast Kentucky.

Dr. Vashist, who is a member of the Hospitalist’s editorial advisory board, focuses on clinical quality and safety, value-based initiatives to improve quality while reducing cost of care, performance improvement, and oversight of the enterprise-wide clinical delivery of care. He also provides administrative oversight of the Ballad Health Clinical Council – a model of physician partnership for clinical transformation and outcomes improvement.

Dr. Vashist is a dual board-certified internist and psychiatrist and an avid proponent of initiatives aimed at promoting quality, improving safety, reducing cost, and minimizing variation in the delivery of patient care across diverse settings. His work has been instrumental in improving outcomes and reducing mortality in patients with sepsis, earning him several local, regional, and national awards, and his work in promoting a zero-harm culture at Ballad Health has been instrumental in significantly reducing hospital-acquired infections system wide.

Prior to transitioning into the role of the chief clinical officer, Dr. Vashist served as the chair of the Ballad Health Clinical Council and the system chair for Ballad Health’s hospitalist division running a group of over 130 hospitalists.

Why did you choose a career in medicine?

The ability to have a positive impact and help others. In addition, I love learning new information and skills, and medicine affords one the opportunity to be a lifelong learner.

What do you like most about working as a hospitalist?

The relatively fast-paced nature of the work and the ability to tie seemingly fragmented episodes of patient care together. I believe that no other specialty offers that 30,000-foot vantage view of things in clinical medicine.

What do you like the least?

The shift worker mindset emanating from the traditional and rigid 7-on, 7-off model. A sense of team can be lost in this model and, contrary to conventional thinking, this model can accelerate hospitalist burnout.

What’s the best advice you ever received?

“You’ve gotta learn to listen!”

What’s the worst advice you ever received?

“Don’t rock the boat.” I strongly believe that frequent disruption is required to change the established status quo.

What aspect of patient care is most challenging?

A perceived disruption in the continuity of care by virtue of a new hospitalist seeing those patients, and the challenge to build the same level of trust and comfort as the outgoing hospitalist. Superior models of care have developed over the years promoting a better continuity of care but this domain continues to pose a challenge to proponents of hospital medicine.

What’s the biggest change you’ve seen in hospital medicine in your career?

Hospitalists being increasingly perceived as the “quarterbacks” and gatekeepers of quality, costs of care, and clinical outcomes in our hospitals and health care systems.

What’s the biggest change you would like to see in hospital medicine?

Inpatient volumes across the country continue to shrink, and this trend will not change for the foreseeable future. Hospitalists have got to embrace newer models of care faster, like hospitals at home, postacute care, transitional care clinics, hospital at home, etc. Remember what they say: “If you are not at the table, you are on the menu.” Now is our time to be at the table, and be the champions of change and move to true value (quality plus experience/cost), or else, we could end up and vanish like Blockbuster.

Outside of patient care, tell us about your career interests.

Implementing value-driven initiatives, pursuing endeavors aimed at cutting out waste and redundancy in health care, and developing a new generation of physician leaders with these skill sets.

Where do you see yourself in 10 years?

Leveraging my experience, training and expertise in hospital medicine to design better systems of health care that transcend above and beyond the four walls of the hospital, and facilitate true consumerism and “patient centeredness.”

What has been your most meaningful experience with SHM?

Attending the annual SHM meetings for the past several years, which have helped me to not only reap rewards from the numerous educational sessions but has also helped me develop a rich network of friends, colleagues, and mentors whose advice I solicit from time to time.

Vineet Chopra, MD, MSc, FHM, is associate professor of medicine and chief of the Division of Hospital Medicine at Michigan Medicine and the VA Ann Arbor (Michigan) Health System. A career hospitalist, Dr. Chopra’s research is dedicated to improving the safety of hospitalized patients through prevention of hospital-acquired complications. His work focuses on identifying and preventing complications associated with central venous catheters with a particular emphasis on peripherally inserted central catheters (PICCs).

Dr. Chopra is the recipient of numerous teaching and research awards including the 2016 Kaiser Permanente Award for Clinical Teaching, the Jerome W. Conn Award for Outstanding Research in the Department of Medicine, the 2016 Society of Hospital Medicine Award for Excellence in Research, and the 2014 McDevitt Award for Research Excellence. He has published over 100 peer-reviewed articles and has served as associate editor for the American Journal of Medicine and Journal of Hospital Medicine.
 

At what point in your education/training did you decide to practice hospital medicine? What about hospital medicine appealed to you?

I think I knew very early – toward the middle of my intern year – that I wanted to be a hospitalist. There was much that drew me to the field. First, I loved being in the inpatient setting. The tempo of work, the unexpected nature of what may come next, and the opportunity to truly have an impact on a patients life at their time of greatest need appealed to me. I wasn’t as inclined towards the procedural fields and also loved the cognitive aspects of general medicine – doing the work up on a difficult diagnosis or medically managing a patient with acute coronary syndrome came naturally. I found myself loving the work so much so that it didn’t feel like work. And the rest was history!

What is your current role at Michigan Medicine?

I started at Michigan Medicine in 2008 as a full-time clinician taking care of patients on direct care and resident services. After 3 years of clinical work, I decided it was time to hone in on a specific skill set and went back to a research fellowship.

I become Michigan’s first fellow in hospital medicine – the guinea pig – for what would turn out to be one of the best decisions in my life. After finishing fellowship, I switched my focus from clinical work to research and rose up the ranks to receive tenure as an associate professor of medicine. After attaining tenure, I was among a handful of people in the nation who had success in both the research and the clinical arenas and leadership opportunities began to come my way.

I was fortunate to be recruited as the inaugural division chief of hospital medicine at Michigan Medicine in 2017. The Division of hospital medicine is the 13th in the department of medicine and the first one to be created in over 60 years. As division chief, I oversee all of our clinical, academic, research, and educational endeavors. Currently, we have approximately 130 hospitalists in our group and about 30 advanced practice providers (APPs) with a support and research staff of about 15 individuals. So I like to say we have a big family!
 

What are your favorite areas of clinical practice and/or research?

I am fortunate to have the ability to enjoy all that hospital medicine has to offer. I still appreciate the challenges that direct care brings, and I continue to do as much as I can in this area. I also enjoy working with residents and medical students at the university and at our VA site – where much of my focus is devoted to making sure all learners on the team are growing while they provide excellent patient care. To meet a new patient and work to develop a therapeutic relationship with them such that we can make positive changes in their disease trajectory remains my favorite part of clinical work.

My research work remains closely linked to my clinical interests around preventing patient harm and improving patient safety – so studying hospital-acquired infections, coming up with new ideas and strategies, and then implementing them when on clinical service represents the perfect blend of the two. My research is largely focused on intravenous devices and catheters, and I focus my work on preventing harms such as bloodstream infection, venous thrombosis, and related adverse events. I have been fortunate to receive national and international attention for my research, including adoption of my work into guidelines and changes to national policies. I am honored to serve on the most important federal advisory committee that advises the government on health care infections (the committee is called HICPAC – Healthcare Infection Control Practice Advisory Committee).
 

What are the most challenging aspects of practicing hospital medicine? What are the most rewarding?

For me, the most challenging aspects are also the most rewarding. First and foremost, making a connection with a patient and their family to understand their concerns and define a therapeutic alliance is both challenging and rewarding. Second, ensuring that we have the ability to work efficiently and effectively to manage patient care is sometimes challenging but also the most rewarding aspect of the job. I am fortunate to work in a health system where I am surrounded by smart colleagues, important resources, advanced technology, and the support of nurses and advanced practice providers who share this zeal of patient care with me.

Finally, one the greatest challenges and rewards remains time. Our work is hard and grueling, and it is often very challenging to get things done at different times of the day. But the ability to make a diagnosis or see a patient improve makes it all worth it!
 

How will hospital medicine change in the next decade or two?

I predict our work will shift from a model that is reactive – taking care of patients that are sick and need hospitalization – to a proactive approach where the focus will remain on keeping people out of the hospital. This doesn’t necessarily mean that we will be out of a job – but I see the model of our work shifting to ensure that patients who are discharged remain healthy and well. This means we will need to embrace extensivist models, hospital at home care, and aspects such as bridge clinics.

I also think our work will evolve to harness some of the incredible technology that surrounds us outside health care, but has not yet permeated our work flow. To that end, aspects such as virtual consultations and patient assessments, and remote monitoring that includes biometrics, will all fall into our workflow. And of course, lets not forget about the mighty electronic medical record and how that will affect our experience and work. I see much more of our work shifting toward becoming digital experts, harnessing the power of big data and predictive analytics to provide better care for patients. These are skills that are emerging in our field, but we have not yet mastered the art of managing data.
 

Do you have any advice for students and residents interested in hospital medicine?

I would highly recommend taking on a rotation with a hospitalist, carrying the pager and working side-by-side with someone who truly loves what they do. Many students and residents just see the on/off nature of the work, but that is truly skin deep in terms of attraction.

The beauty of hospital medicine is that you can be everything for a patient – their doctor, their health care navigator, their friend, and their partner during their hospital stay. Find that joy – you will not regret it!

Vineet Chopra, MD, MSc, FHM, is associate professor of medicine and chief of the Division of Hospital Medicine at Michigan Medicine and the VA Ann Arbor (Michigan) Health System. A career hospitalist, Dr. Chopra’s research is dedicated to improving the safety of hospitalized patients through prevention of hospital-acquired complications. His work focuses on identifying and preventing complications associated with central venous catheters with a particular emphasis on peripherally inserted central catheters (PICCs).

Dr. Chopra is the recipient of numerous teaching and research awards including the 2016 Kaiser Permanente Award for Clinical Teaching, the Jerome W. Conn Award for Outstanding Research in the Department of Medicine, the 2016 Society of Hospital Medicine Award for Excellence in Research, and the 2014 McDevitt Award for Research Excellence. He has published over 100 peer-reviewed articles and has served as associate editor for the American Journal of Medicine and Journal of Hospital Medicine.
 

At what point in your education/training did you decide to practice hospital medicine? What about hospital medicine appealed to you?

I think I knew very early – toward the middle of my intern year – that I wanted to be a hospitalist. There was much that drew me to the field. First, I loved being in the inpatient setting. The tempo of work, the unexpected nature of what may come next, and the opportunity to truly have an impact on a patients life at their time of greatest need appealed to me. I wasn’t as inclined towards the procedural fields and also loved the cognitive aspects of general medicine – doing the work up on a difficult diagnosis or medically managing a patient with acute coronary syndrome came naturally. I found myself loving the work so much so that it didn’t feel like work. And the rest was history!

What is your current role at Michigan Medicine?

I started at Michigan Medicine in 2008 as a full-time clinician taking care of patients on direct care and resident services. After 3 years of clinical work, I decided it was time to hone in on a specific skill set and went back to a research fellowship.

I become Michigan’s first fellow in hospital medicine – the guinea pig – for what would turn out to be one of the best decisions in my life. After finishing fellowship, I switched my focus from clinical work to research and rose up the ranks to receive tenure as an associate professor of medicine. After attaining tenure, I was among a handful of people in the nation who had success in both the research and the clinical arenas and leadership opportunities began to come my way.

I was fortunate to be recruited as the inaugural division chief of hospital medicine at Michigan Medicine in 2017. The Division of hospital medicine is the 13th in the department of medicine and the first one to be created in over 60 years. As division chief, I oversee all of our clinical, academic, research, and educational endeavors. Currently, we have approximately 130 hospitalists in our group and about 30 advanced practice providers (APPs) with a support and research staff of about 15 individuals. So I like to say we have a big family!
 

What are your favorite areas of clinical practice and/or research?

I am fortunate to have the ability to enjoy all that hospital medicine has to offer. I still appreciate the challenges that direct care brings, and I continue to do as much as I can in this area. I also enjoy working with residents and medical students at the university and at our VA site – where much of my focus is devoted to making sure all learners on the team are growing while they provide excellent patient care. To meet a new patient and work to develop a therapeutic relationship with them such that we can make positive changes in their disease trajectory remains my favorite part of clinical work.

My research work remains closely linked to my clinical interests around preventing patient harm and improving patient safety – so studying hospital-acquired infections, coming up with new ideas and strategies, and then implementing them when on clinical service represents the perfect blend of the two. My research is largely focused on intravenous devices and catheters, and I focus my work on preventing harms such as bloodstream infection, venous thrombosis, and related adverse events. I have been fortunate to receive national and international attention for my research, including adoption of my work into guidelines and changes to national policies. I am honored to serve on the most important federal advisory committee that advises the government on health care infections (the committee is called HICPAC – Healthcare Infection Control Practice Advisory Committee).
 

What are the most challenging aspects of practicing hospital medicine? What are the most rewarding?

For me, the most challenging aspects are also the most rewarding. First and foremost, making a connection with a patient and their family to understand their concerns and define a therapeutic alliance is both challenging and rewarding. Second, ensuring that we have the ability to work efficiently and effectively to manage patient care is sometimes challenging but also the most rewarding aspect of the job. I am fortunate to work in a health system where I am surrounded by smart colleagues, important resources, advanced technology, and the support of nurses and advanced practice providers who share this zeal of patient care with me.

Finally, one the greatest challenges and rewards remains time. Our work is hard and grueling, and it is often very challenging to get things done at different times of the day. But the ability to make a diagnosis or see a patient improve makes it all worth it!
 

How will hospital medicine change in the next decade or two?

I predict our work will shift from a model that is reactive – taking care of patients that are sick and need hospitalization – to a proactive approach where the focus will remain on keeping people out of the hospital. This doesn’t necessarily mean that we will be out of a job – but I see the model of our work shifting to ensure that patients who are discharged remain healthy and well. This means we will need to embrace extensivist models, hospital at home care, and aspects such as bridge clinics.

I also think our work will evolve to harness some of the incredible technology that surrounds us outside health care, but has not yet permeated our work flow. To that end, aspects such as virtual consultations and patient assessments, and remote monitoring that includes biometrics, will all fall into our workflow. And of course, lets not forget about the mighty electronic medical record and how that will affect our experience and work. I see much more of our work shifting toward becoming digital experts, harnessing the power of big data and predictive analytics to provide better care for patients. These are skills that are emerging in our field, but we have not yet mastered the art of managing data.
 

Do you have any advice for students and residents interested in hospital medicine?

I would highly recommend taking on a rotation with a hospitalist, carrying the pager and working side-by-side with someone who truly loves what they do. Many students and residents just see the on/off nature of the work, but that is truly skin deep in terms of attraction.

The beauty of hospital medicine is that you can be everything for a patient – their doctor, their health care navigator, their friend, and their partner during their hospital stay. Find that joy – you will not regret it!

Vineet Chopra, MD, MSc, FHM, is associate professor of medicine and chief of the Division of Hospital Medicine at Michigan Medicine and the VA Ann Arbor (Michigan) Health System. A career hospitalist, Dr. Chopra’s research is dedicated to improving the safety of hospitalized patients through prevention of hospital-acquired complications. His work focuses on identifying and preventing complications associated with central venous catheters with a particular emphasis on peripherally inserted central catheters (PICCs).

Dr. Chopra is the recipient of numerous teaching and research awards including the 2016 Kaiser Permanente Award for Clinical Teaching, the Jerome W. Conn Award for Outstanding Research in the Department of Medicine, the 2016 Society of Hospital Medicine Award for Excellence in Research, and the 2014 McDevitt Award for Research Excellence. He has published over 100 peer-reviewed articles and has served as associate editor for the American Journal of Medicine and Journal of Hospital Medicine.
 

At what point in your education/training did you decide to practice hospital medicine? What about hospital medicine appealed to you?

I think I knew very early – toward the middle of my intern year – that I wanted to be a hospitalist. There was much that drew me to the field. First, I loved being in the inpatient setting. The tempo of work, the unexpected nature of what may come next, and the opportunity to truly have an impact on a patients life at their time of greatest need appealed to me. I wasn’t as inclined towards the procedural fields and also loved the cognitive aspects of general medicine – doing the work up on a difficult diagnosis or medically managing a patient with acute coronary syndrome came naturally. I found myself loving the work so much so that it didn’t feel like work. And the rest was history!

What is your current role at Michigan Medicine?

I started at Michigan Medicine in 2008 as a full-time clinician taking care of patients on direct care and resident services. After 3 years of clinical work, I decided it was time to hone in on a specific skill set and went back to a research fellowship.

I become Michigan’s first fellow in hospital medicine – the guinea pig – for what would turn out to be one of the best decisions in my life. After finishing fellowship, I switched my focus from clinical work to research and rose up the ranks to receive tenure as an associate professor of medicine. After attaining tenure, I was among a handful of people in the nation who had success in both the research and the clinical arenas and leadership opportunities began to come my way.

I was fortunate to be recruited as the inaugural division chief of hospital medicine at Michigan Medicine in 2017. The Division of hospital medicine is the 13th in the department of medicine and the first one to be created in over 60 years. As division chief, I oversee all of our clinical, academic, research, and educational endeavors. Currently, we have approximately 130 hospitalists in our group and about 30 advanced practice providers (APPs) with a support and research staff of about 15 individuals. So I like to say we have a big family!
 

What are your favorite areas of clinical practice and/or research?

I am fortunate to have the ability to enjoy all that hospital medicine has to offer. I still appreciate the challenges that direct care brings, and I continue to do as much as I can in this area. I also enjoy working with residents and medical students at the university and at our VA site – where much of my focus is devoted to making sure all learners on the team are growing while they provide excellent patient care. To meet a new patient and work to develop a therapeutic relationship with them such that we can make positive changes in their disease trajectory remains my favorite part of clinical work.

My research work remains closely linked to my clinical interests around preventing patient harm and improving patient safety – so studying hospital-acquired infections, coming up with new ideas and strategies, and then implementing them when on clinical service represents the perfect blend of the two. My research is largely focused on intravenous devices and catheters, and I focus my work on preventing harms such as bloodstream infection, venous thrombosis, and related adverse events. I have been fortunate to receive national and international attention for my research, including adoption of my work into guidelines and changes to national policies. I am honored to serve on the most important federal advisory committee that advises the government on health care infections (the committee is called HICPAC – Healthcare Infection Control Practice Advisory Committee).
 

What are the most challenging aspects of practicing hospital medicine? What are the most rewarding?

For me, the most challenging aspects are also the most rewarding. First and foremost, making a connection with a patient and their family to understand their concerns and define a therapeutic alliance is both challenging and rewarding. Second, ensuring that we have the ability to work efficiently and effectively to manage patient care is sometimes challenging but also the most rewarding aspect of the job. I am fortunate to work in a health system where I am surrounded by smart colleagues, important resources, advanced technology, and the support of nurses and advanced practice providers who share this zeal of patient care with me.

Finally, one the greatest challenges and rewards remains time. Our work is hard and grueling, and it is often very challenging to get things done at different times of the day. But the ability to make a diagnosis or see a patient improve makes it all worth it!
 

How will hospital medicine change in the next decade or two?

I predict our work will shift from a model that is reactive – taking care of patients that are sick and need hospitalization – to a proactive approach where the focus will remain on keeping people out of the hospital. This doesn’t necessarily mean that we will be out of a job – but I see the model of our work shifting to ensure that patients who are discharged remain healthy and well. This means we will need to embrace extensivist models, hospital at home care, and aspects such as bridge clinics.

I also think our work will evolve to harness some of the incredible technology that surrounds us outside health care, but has not yet permeated our work flow. To that end, aspects such as virtual consultations and patient assessments, and remote monitoring that includes biometrics, will all fall into our workflow. And of course, lets not forget about the mighty electronic medical record and how that will affect our experience and work. I see much more of our work shifting toward becoming digital experts, harnessing the power of big data and predictive analytics to provide better care for patients. These are skills that are emerging in our field, but we have not yet mastered the art of managing data.
 

Do you have any advice for students and residents interested in hospital medicine?

I would highly recommend taking on a rotation with a hospitalist, carrying the pager and working side-by-side with someone who truly loves what they do. Many students and residents just see the on/off nature of the work, but that is truly skin deep in terms of attraction.

The beauty of hospital medicine is that you can be everything for a patient – their doctor, their health care navigator, their friend, and their partner during their hospital stay. Find that joy – you will not regret it!