South Florida Hospital News
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January 2007 - Volume 3 - Issue 7


A Journey of 1,000 Miles … The Society of Hospital Medicine Celebrates a Decade of Hospitalist Achievements

It has been said that a journey of a thousand miles must begin with a single step. That single step for the hospital medicine movement was first taken about a decade ago when two University of California physicians coined the phrase "hospitalist" in a 1996 New England Journal of Medicine article.

The article profiled a new breed of physician — one that eschewed traditional office practice to focus solely on treatment of patients in the hospital. Authors Robert M. Wachter, M.D., FACP, and Lee Goldstein, M.D., boldly asserted that the then-unknown "hospitalist movement" would become the dominant model for inpatient care in the U.S.

Their prediction caused a firestorm of criticism from corners of the medical world that feared straying from tradition and fretted about the challenges of patient "handoffs," communication gaps and loss of control. That firestorm faded quickly, however, as hospitalists rallied — through organization — to meet the challenges of the budding specialty and respond to expressed concerns.

The vehicle through which hospitalists organized and collaborated was a new society called the National Association of Inpatient Physicians. The NAIP (later changed to the Society of Hospital Medicine) was established by hospitalists John R. Nelson, M.D., and Winthrop F. Whitcomb, M.D., who in January 1997 mailed letters to 300 physicians to assess interest in establishing a society dedicated to hospitalist collaboration and to meeting the political, economic, and organizational challenges of hospital medicine. That letter led to the formation of NAIP — the first organization to officially recognize and represent the nation’s hospitalists.

Although NAIP’s initial membership was small — about 12 members — they were armed with "two powerful ideas," according to former president Dr. Wachter. One, that physicians who focused all of their energies in the hospital could improve both the quality and efficiency of care for patients and the hospital system, and two, that a society representing such providers could be dynamic, inclusive, rigorous, ethical and fun.

Small and nimble, NAIP burst out of the starting gate by co-sponsoring the nation’s first hospital medicine demographics survey in the fall of 1997 and then organized its first annual meeting in April 1998, attracting more than 250 hospitalists.

Today, the Society of Hospital Medicine is the leading national voice and resource for more than 15,000 hospitalists in the U.S. and enjoys a membership that is 6,000 strong. And while we may no longer be small as a society, we have remained nimble, playing a critical role that has shaped the growth of this specialty.

Early on, for example, when critics voiced concerns over potential discontinuity of patient care, SHM responded by establishing protocols for patient handoffs. And when managed care organizations attempted to mandate the use of hospitalists, SHM joined with other medical societies to vigorously oppose them, urging support instead for a voluntary model.

Among the many activities led by SHM, none were more important than facilitating national acceptance of hospital medicine and its goal of redefining inpatient care. To this end, the Society developed early strategic relationships with the American Board of Internal Medicine, the American College of Physicians, the Agency for Healthcare Research and Quality, and others. We joined with to take the lead on medical error reporting. We launched communications tools that connected hospitalists to news, information, education and networking opportunities. We published national studies about the benefits of hospital medicine, and placed articles about hospitalists in national journals, newspapers and magazines.

The result of our energetic outreach was rapid acceptance and inclusion in leadership roles regarding every aspect of inpatient care. By 2001, hospital medicine had been dubbed "Healthcare’s Rising Supermodel" by Modern Healthcare, SHM had enrolled more than 3,000 members, and hospitalists had emerged as the "new breed" of physicians.

Through the years, SHM was the fortunate beneficiary of a membership that was unafraid — in fact eager — to break new boundaries and go where no hospitalist had gone before. Their unflagging dedication helped to catapult SHM to new heights year after year, culminating in 2006 — the eve of our ten-year anniversary — with the launch of a peer-reviewed journal, the Journal of Hospital Medicine, which was recently accepted by the National Library of Medicine for inclusion in PubMED; the establishment of comprehensive Core Competencies in Hospital Medicine to guide hospitalist education and to further define hospital medicine; and a decision by the ABIM to develop a Focused Recognition for formally credentialing hospitalists.

It is extremely fitting and rewarding that ABIM is taking this pivotal step now, as SHM and hospitalists celebrate our first decade. SHM could not have asked for a better "birthday gift" to hospitalists.

It is also fitting to emphasize that our specialty would not be standing at this amazing crossroad without the vision, planning and dedication of our original founders and the leaders who followed in their footsteps. Their commitment to taking that all-important first step in our 1,000 mile journey made hospital medicine the fastest-growing specialty in the history of American medicine and kick-started a revolution to change the way inpatient care is delivered.

Today our goal is nothing short of transforming our national hospital system. Working together with hospital leaders, nurses, specialists and other medical societies, we will take many new steps in our 1,000 mile journey toward a better healthcare future. We look forward to taking that journey with you.

Laurence Wellikson, M.D., FACP, is a board certified specialist in internal medicine and is chief executive officer of the Society of Hospital Medicine. Dr. Wellikson also is an assistant professor of medicine at the University of California at Irvine Medical School. He can be reached at 1-800-843-3360 or
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