GRAPEVINE, TEX. – Officials at the Society of Hospital Medicine are organizing a meeting with physicians from several specialties, as well as hospital executives and others, to discuss what it will mean when more subspecialists move into the hospital medicine fold.
The Nov. 4 meeting in Las Vegas is still in the planning stages, said Dr. John R. Nelson, an SHM founder and a hospitalist in Bellevue, Wash. The society expects the meeting will be attended by hospitalists in internal medicine, pediatrics, and family medicine, but also by those in neurology, ob.gyn., gastroenterology, general surgery, and psychiatry.
Nearly 90% of hospitalists specialize in general internal medicine, according to 2010 figures from SHM, with many of the remaining hospitalists trained in pediatrics and family medicine. But Dr. Nelson said the hospital medicine model is beginning to emerge across specialties, with ob.gyn. and neurology leading the way.
The upcoming meeting won’t be a clinical conference or a meeting to discuss payments to physicians, Dr. Nelson said. Instead, it will focus on likely implications of expanding the hospital medicine model. Dr. Nelson, who is helping to organize the meeting, said that organizers plan to tackle such questions as the potential impact on hospital credentialing, compensation, and the pace of changes including bundled payments.
Creating a cadre of subspecialty hospitalists is also likely to affect malpractice, Dr. Nelson said, though it’s unclear how. On the one hand, patients would have ready access to physicians at all times in the hospital, potentially lowering the malpractice risk. However, patients would also be seeing physicians who they didn’t know, potentially raising legal risks, he said. And there’s the question of how this could affect patient handoffs and other quality issues around the hospital. "We ought to start thinking about these things," Dr. Nelson said.
The Las Vegas meeting will include several formal presentations on lessons learned from the medicine and pediatric hospitalist movement, and a look at the current quality data, Dr. Nelson said. It will also be a chance for physicians from across specialties to get in a room together and share their experiences, he said.
Dr. Nelson was among a small group of hospitalists from various specialties who got together in San Francisco a few months ago to discuss these issues. He said the physicians had lots of questions for each other about how they handled follow-up, patient reactions, and interactions with community physicians. "We could have talked forever," he said.
The potential audience for the upcoming meeting will also include hospital executives, physician recruiters, and others in health care who have a stake in how hospital medicine evolves.