Financial Management

Serious Upgrade for SHM’s 2016 State of Hospital Medicine Report

Great news! The long-anticipated 2016 State of Hospital Medicine (SoHM) Report was released last week to rave reviews. Pre-orders of the report blew away previous records, and that’s on top of the almost 600 hospital medicine groups (HMGs) that received free versions of the report as a result of participating in the survey. Again this year, the SoHM Report breaks down the latest statistics for a number of salary and workload benchmarks and a wide variety of HMG structural and operational characteristics that inform those two areas. I was privileged to be on a web conference last week in which SHM staffer extraordinaire Patrick Vulgamore, the primary writer/editor of the report, walked us through the enhanced online version. And I have to say it’s a massive upgrade to previous digital versions. Two extra-cool things about the new digital version: It is searchable. It can be accessed via a mobile app.…

You May Have The Killer Med App. But My Hand Still Beats Yours.

Think about how many times per week you pull out your medical calculator to plug and play a Wells or CHADS-VASc score.  Twice?  Three times?  Now think about how many times you get pestered about readmissions--be it through case managers, hospital leaders, or through your paycheck.  Probably daily. You can use an app every day and think it's useful.  But it's the regs and invisible stuff that trumps what you got.  That's my "hand." I have written in the past about high impact readmission publications.  They may seem far removed from what you do in your everyday lives.  Maybe so.  But sometimes the audience for these articles are not frontline clinicians--even though their ability to transform your practice life may be more potent than what you would absorb and use from a familiar journal. Many of us have been carping for years about the post-discharge responsibility period for hospitals as…

Your Career Path. Did You Get Pushed or Pulled?

I recently read the following written by Daniel Ofri, MD in the NYT: The stereotype of specialists handling the more complex and intellectually challenging cases makes many generalists fume. Generalists observe that specialists get the “simplicity” of handling very narrow slivers of medicine. It’s much easier to be an expert when you only have a handful of diseases to worry about. And any issue that a specialist doesn’t want to deal with can be permissibly kicked back to the generalist. The generalist, however, gets no dispensation. Every issue that the patient raises must be addressed. Every symptom from any organ has to be acknowledged. Plus, every medication prescribed by every specialist must be accounted for. Every competing interest between the many medical cooks in today’s fragmented health care environment must be integrated. It brought to mind something else I saw of late--Modern Healthcare's physician compensation survey.  The publication obtained data from…

The Next Hospital Decade: Broken Hips Versus Band-Aid Strips

  I had planned on writing on MACRA and the inability of those who criticize the law to offer up alternatives to fix the flaws.  I got tired of the conclusions from the skeptics: let providers be and they will do the right thing.  That is a recipe for the pendulum to swing too far in one direction.  The "right thing" will wind up costing the Treasury a ton of dough.  History has already born that out. I am one of the skeptics as well, though.  I had no idea how CMS was planning to stitch this whole thing together--and I was waiting for hints from Andy Slavitt, top dog at CMS, based on his testimony last week on the Hill. Well, if you shorted Kleenex stock, pat yourself on the back. You can put your hankies away because it looks like CMS may postpone the start date.  My screed…

What I Did on My Summer Vacation

One of the best parts of my “job” as a more-or-less emeritus member of SHM’s Practice Analysis Committee is the chance to be involved up close and personal in the development, analysis, and reporting of the biannual State of Hospital Medicine (SoHM) survey. In fact, I’ve either led or been integrally involved in every SoHM survey since 2006, and that has enabled me to gain an extremely valuable perspective on how the specialty of hospital medicine has evolved over the last 10 years. During the last few weeks, I’ve been up to my eyeballs reviewing sections of the new 2016 survey report that were drafted – as was the case in 2014 – by Patrick Vulgamore, MPH, SHM staffer extraordinaire. While some of the data is still being analyzed, my excitement is growing about the new survey results. The State of Hospital Medicine Report will be available to the public…
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