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The State of Hospital Medicine in 2018

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The State of Hospital Medicine in 2018 January 2019 THE OPIOID EPIDEMIC KEY CLINICAL QUESTION IN THE LITERATURE Volume 23 No. 1 U.S. Surgeon General When can anticoagulation Physician burnout may p3 weighs in. p12 resume in stroke patients? p16 jeopardize care. Dr. Andrew White, University of Washington Medical The state Center, Seattle of hospital medicine in 2018 Productivity, pay, and roles remain center stage By Larry Beresford n a national health care environ- ment undergoing unprecedented transformation, the specialty of hospital medicine appears to Ibe an island of relative stability, a conclusion that is supported by the principal findings from SHM’s 2018 State of Hospital Medicine (SoHM) report. The report of hospitalist group practice characteristics, as well as other key data defining the field’s current status, that the Society of Hospital Medicine puts out every 2 years reveals that overall salaries for hospitalist physicians are up by 3.8% since 2016. Although produc- tivity, as measured by work relative value units (RVUs), remained largely flat over the same period, financial support per full-time equivalent (FTE) physician position to hospital- ist groups from their hospitals and health systems is up significantly. The median financial support Continued on page 8 COURTESTY CLARE MCLEAN/ the-hospitalist.org UW MEDICINE PEDIATRIC HM PRESIDENT’S DESK Alissa Darden, Nasim Afsar, MD MD, MBA, SFHM Public insurance SHM will develop content Lebanon Jct. KY Jct. Lebanon Denville, NJ 07834-3000 NJ Denville, Permit No. 384 No. Permit p20 eligibility limits will put p31 and resources specific PAID P.O. Box 3000, 3000, Box P.O. U.S. Postage U.S. vulnerable children at to population health Presorted Standard Standard Presorted THE HOSPITALIST THE CHANGE SERVICE REQUESTED SERVICE CHANGE greater risk. management. CAREER NEWS January 2019 Volume 23 No. 1 Hospitalist PHYSICIAN EDITOR THE SOCIETY OF HOSPITAL MEDICINE Danielle B. Scheurer, MD, SFHM, MSCR; Phone: 800-843-3360 [email protected] Fax: 267-702-2690 Website: www.HospitalMedicine.org PEDIATRIC EDITOR movers and shakers Laurence Wellikson, MD, MHM, CEO Weijen Chang, MD, FACP, SFHM [email protected] Vice President of Marketing & Communications By Matt Pesyna Dr. Fitterman has served as presi- COORDINATING EDITORS Lisa Zoks dent of SHM’s Long Island chapter. Dennis Chang, MD [email protected] THE FUTURE HOSPITALIST he Michigan chapter of the Previously, Dr. Fitterman was Marketing Communications Manager Society of Hospital Medicine chief resident at the State Universi- Jonathan Pell, MD Brett Radler KEY CLINICAL GUIDELINES [email protected] has named Peter Watson, ty of New York at Stony Brook, and Marketing Communications Specialist CONTRIBUTING WRITERS MD, SFHM, as state Hospi- he remains an associate professor at Felicia Steele Nasim Afsar, MD, MBA, SFHM [email protected] Ttalist of the Year. Dr. Watson is the Hofstra University, Hempstead, N.Y. Imuetinyan Asuen, MD vice president of care management Larry Beresford SHM BOARD OF DIRECTORS Ted Bosworth President and outcomes for Health Alliance Allen Kachalia, Nasim Afsar, MD, SFHM Andrew D. Bowser Plan (HAP) in Detroit. The Michigan MD, was named President-Elect Alissa Darden, MD chapter cited Dr. Watson’s leadership director of the Christopher Frost, MD, SFHM Erin Gabriel, MD Treasurer in hospital medicine and “generosity Armstrong Insti- Demetra Gibson, MD, MPH Danielle Scheurer, MD, MSRC, SFHM of spirit” as reasons for his selection. tute for Patient Horatio (Teddy) Holzer, MD Secretary Tracy Cardin, ACNP-BC, SFHM Aveena Kochar, MD Dr. Watson oversees nurses, social Safety and Qual- Immediate Past President Anne Linker, MD Ron Greeno, MD, FCCP, MHM workers, and support staff while ity and senior Farrin A. Manian, MD, MPH Steven B. Deitelzweig, MD, MMM, FACC, also serving as HAP Midwest Health vice president of Matt Pesyna FACP, SFHM Plan’s medical director. He’s a found- Dr. Kachalia patient safety and Daniel Restrepo, MD Howard R. Epstein, MD, SFHM Saranya Sasidharan, MD Kris Rehm, MD, SFHM ing member of the Michigan SHM quality for Johns Mitchel L. Zoler Bradley Sharpe, MD, FACP, SFHM chapter, which he formerly repre- Hopkins Medicine in Baltimore. Dr. FRONTLINE MEDICAL Jerome C. Siy, MD, SFHM Rachel Thompson, MD, MPH, SFHM sented as president. Kachalia is a general internist who COMMUNICATIONS EDITORIAL STAFF Patrick Torcson, MD, MMM, SFHM Dr. Watson spent 11 years oversee- has been an active academic hospi- Editor in Chief Mary Jo M. Dales FRONTLINE MEDICAL ing the Henry Ford Medical Group’s talist at Brigham and Women’s Hos- Executive Editors Denise Fulton, Kathy Scarbeck COMMUNICATIONS ADVERTISING STAFF hospitalist program prior to joining pital in Boston. Editor Richard Pizzi VP/Group Publisher; Director, FMC Society Partners HAP, and still works as an attending Dr. Kachalia will oversee patient Creative Director Louise A. Koenig Mark Branca hospitalist for Henry Ford. safety and quality across all of Hop- Director, Production/Manufacturing Rebecca Slebodnik Directors, Business Development kins Medicine. He also will guide Valerie Bednarz, 973-206-8954 Hyung (Harry) academic efforts for the Armstrong EDITORIAL ADVISORY BOARD cell 973-907-0230 [email protected] Geeta Arora, MD; Michael J. Beck, MD; Cho, MD, was Institute, formed recently thanks to Artie Krivopal, 973-206-8218 Harry Cho, MD; Marina S. Farah, MD, cell 973-202-5402 [email protected] named the in- a $10 million gift. MHA; Stella Fitzgibbons, MD, FACP, Classied Sales Representative augural chief In addition to his hospitalist work, FHM; Benjamin Frizner, MD, FHM; Heather Gonroski, 973-290-8259 value officer for Dr. Kachalia comes to Hopkins after Nicolas Houghton, DNP, RN, ACNP-BC; [email protected] James Kim, MD; Melody Msiska, MD; Linda Wilson, 973-290-8243 NYC Health + serving as chief quality officer and Venkataraman Palabindala, MD, SFHM; [email protected] Hospitals, which vice president of quality and safety Raj Sehgal, MD, FHM; Rehaan Shafe, Senior Director of Classied Sales includes 11 hospi- at Brigham Health. MD; Kranthi Sitammagari, MD; Tim LaPella, 484-921-5001 tals in New York Amith Skandhan, MD, FHM; cell 610-506-3474 [email protected] Dr. Cho Lonika Sood, MD, FACP, FHM; and is the largest Riane Dodge, PA, has been elevated Advertising Ofces 7 Century Drive, Amanda T. Trask, FACHE, MBA, MHA, Suite 302, Parsippany, NJ 07054-4609 public health system in the United to director of clinical education in SFHM; Amit Vashist, MD, FACP; 973-206-3434, fax 973-206-9378 States. He will oversee systemwide physician assistant studies at Clark- Jill Waldman, MD, SFHM initiatives in value improvement son University, Potsdam, N.Y. The THE HOSPITALIST is the official newspaper of the Society THE HOSPITALIST (ISSN 1553-085X) is published monthly and the reduction of unnecessary veteran physician assistant previ- of Hospital Medicine, reporting on issues and trends in for the Society of Hospital Medicine by Frontline Medical testing and treatment. ously worked as a hospitalist in the hospital medicine. THE HOSPITALIST reaches more than Communications Inc., 7 Century Drive, Suite 302, Par- 35,000 hospitalists, physician assistants, nurse practitioners, sippany, NJ 07054-4609. Print subscriptions are free for Prior to this appointment, Dr. Cho Claxton Hepburn Medical Center in medical residents, and health care administrators interested Society of Hospital Medicine members. Annual paid sub- served as an academic hospitalist at Ogdensburg, N.Y. There, she cared in the practice and business of hospital medicine. Content scriptions are available to all others for the following rates: Mount Sinai Hospital for 7 years, lead- for patients in acute rehab, mental for THE HOSPITALIST is provided by Frontline Medical Communications. Content for the Society Pages is provided Individual: Domestic – $184 (One Year), $343 (Two Years), ing high-value care initiatives. Cur- health, and on regular medical floors. by the Society of Hospital Medicine. $495 (Three Years) Canada/Mexico – $271 (One Year), rently, he is a senior fellow with the Ms. Dodge also has a background $489 (Two Years), $753 (Three Years) Other Nations- Copyright 2019 Society of Hospital Medicine. All rights Surface – $335 (One Year), $646 (Two Years), $946 Lown Institute in Brookline, Mass., in urgent care and family medicine, reserved. No part of this publication may be reproduced, (Three Years) Other Nations - Air – $431 (One Year), and director of quality improvement and has experience as an emergency stored, or transmitted in any form or by any means $835 (Two Years), $1,264 (Three Years) implementation for the High Value department technician. and without the prior permission in writing from the Institution: United States – $382; copyright holder. The ideas and opinions expressed in Canada/Mexico – $463 All Other Nations – $537 Practice Academic Alliance. THE HOSPITALIST do not necessarily reflect those of the Student/Resident: $51 Society or the Publisher. The Society of Hospital Medicine The Journal of Hospital Medicine, Current – $35 (US), $47 (Canada/Mexico), and Frontline Medical Communications will not assume Single Issue: Nick Fitterman, the official peer-reviewed journal of $59 (All Other Nations) Back Issue – $47 (US), $59 responsibility for damages, loss, or claims of any kind (Canada/Mexico), $71 (All Other Nations) MD, SFHM, has SHM, has announced the appoint- arising from or related to the information contained in this been promoted to ment of Samir S. Shah, MD, MSCE, publication, including any claims related to the products, POSTMASTER: Send changes of address (with old mailing executive director SFHM to editor-in-chief, effective drugs, or services mentioned herein. label) to THE HOSPITALIST, Subscription Services, P.O. Box 3000, Denville, NJ 07834-3000. at Huntington January 1, 2019. Dr. Shah is a profes- Letters to the Editor: [email protected] To subscribe, change your address, purchase The Society of Hospital Medicine’s headquarters is located RECIPIENT: (N.Y.) Hospital. sor of pediatrics at the University of a single issue, file a missing issue claim, or have any at 1500 Spring Garden, Suite 501, Philadelphia, PA 19130.
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