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What Kind of Car Will A Specialist Be Driving in 2030?

(Something I sent along to my PGYs.  Thought you might enjoy.  And think about where hospitalists fit into all of this) A Porsche or a Prius? Have a look at the two figures below and see if you can spot the dilemma: See it? I knew that you could. Here's the thing.  We have lived with an arrangement that reimburses specialists more than generalists for greater than fifty years.  You would think because that is so, the progenitors of the system knew what they were doing and assigned the right amount of compensation to each type of physician.  Specialists and proceduralitsts do stuff so pay them more. On one level, that makes sense.  After all, you can see the results specialists achieve quickly given all those high tech thingies they use that come with instruction manuals.  They produce big levels of patient satisfaction and often, get that instant cure.  Folks…

Next Step in Sustainability: Re-Thinking How Hospitalists Organize Their Work

Do we really need another commentary on the shortcomings of the 7-on/7-off work schedule?  My colleague John Nelson has written and spoken about this extensively, most recently in his January 2016 column in The Hospitalist.  And while I’ve been planning to write this post for a while, Bob Wachter got the jump on me by famously declaring at his HM16 closing presentation in March that “I think one thing we got wrong was a 7-days-on/7-days-off schedule.”  Nevertheless, I can’t resist weighing in. When I first started working with hospitalist groups more than a dozen years ago, hospitalists routinely told me that the 7-on/7-off schedule was one of the main reasons they chose to go into this specialty.  But too often when I visit groups today there are at least a few more experienced doctors who say they are thinking of leaving the field if they can’t find an alternative to…

Revamped MOC, Opioid Addiction Epidemic in Hospital Medicine News

by Brett Radler
This issue of SHM & Hospital Medicine in the News features: Details of the revamped maintenance of certification assessment program from the ABIM The opioid addiction epidemic, including the possibility of mandatory training for doctors who prescribe opioids and the epidemic’s effect on hospitalizations and hospital costs The rise of medical errors to the third leading cause of death in the United States Potential penalties for physicians associated with tight MACRA deadlines surrounding the updated quality and IT measures that go into effect on January 1, 2017 A look at North America’s first all-digital hospital, which has automated over 75 percent of its functions, including pharmacy, laundry and food delivery A recent blog post from Dr. Brad Flansbaum on The Hospital Leader blog that was republished by Medscape   ABIM Announces Plans to Offer Physicians MOC Assessment Options in January 2018 The American Board of Internal Medicine (ABIM) today announced…
Brett Radler is the Communications Specialist at the Society of Hospital Medicine (SHM). He is responsible for managing the day-to-day social media engagement across SHM’s social media platforms, including Facebook, Twitter, LinkedIn and YouTube, and assists in the management of SHM’s blog, The Hospital Leader. In addition to his social media roles, Brett develops content for SHM’s monthly newsmagazine, The Hospitalist, and monitors media coverage relevant to the hospital medicine movement. Brett holds a bachelor’s degree in Communication from Rutgers University in New Brunswick, NJ and also serves as on-air talent at a New Jersey radio station in his spare time.

No Words Needed. A Pictorial On Why I Punt On Hospital Report Cards.

  If I was in flyover country without a contact and needed emergency services how would I research the best hospital in a pinch?  If you read Consumer Reports or a major newspaper, of course, you would run to the nearest handy dandy hospital report card and pick out the facility with the A grade. Me?  Yeah, I would look, but unless the hospital were a bottom dweller, say a D or F (less than 10% of facilities I muster), I would not think much of barreling through the ER doors to get whatever creaky tissue like substance that needs fixing taken out. It's not that I don't believe there are excellent performers.  Of course, I do.  It's just that we don't have good enough measurements to stack them out all proper in the here and now.  And I know that because I live on the front lines--just like most of you. I see…

Peak Performance: Messler’s Hospitalist Hierarchy of Needs

Your alarm goes off at 6am. You show up for work, with your list of about 13 patients. Your bedside nursing team greets you and everyone else by their first name. You have time to see everyone twice today, and sit in on two family meetings, while your colleague holds your pager. After rounds you report a medication error to leadership, and are rewarded for your attention to a culture of safety, which the hospital treats as a learning opportunity. During the day, a committee meeting on an improvement project that interests you starts on time and ends early. Your input is valued, as is everyone else’s at the meeting. At the session’s end, you are rewarded with a new title. Leadership reminds everyone the essential role for hospitalists and thanks them for another great quarter. Additionally, you are told your title comes with a new perk, no night call…
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