I sincerely appreciate the responses to my review of an article (“Incidence Rates of Kernicterus Remain Unchanged,” The Hospitalist, October 2011, p. 12) that raised questions regarding a “resurgence” of kernicterus in the 1990s. Kernicterus is a devastating illness, and family members bear an unquestionable burden from this disease. Because phototherapy appears to limit the burden of disease, evidence-based guidelines for appropriate treatment of hyperbilirubinemia are paramount to decreasing the incidence of kernicterus. True rates of kernicterus have been difficult to calculate for a variety of reasons, yet we must get a handle on “who” gets kernicterus if we are to appropriately decide which infants receive phototherapy. Thus, I would strongly agree that using the California database is a limitation of the study reviewed.

The mission of the monthly “Pediatric HM” literature review is to regularly summarize articles that might be of interest in the field of pediatric HM. The letters to the editor we received highlight a critical need to delve deeper into the epidemiology of kernicterus, a journey that must begin with accurate reporting of this disease. We appreciate the opportunity to raise awareness of family-centered concerns surrounding the interpretation and analysis of scientific evidence.

As a final note, Mr. Spencer Brown’s letter states that “nearly half of all babies born (44,000 out of every 100,000) have hyperbilirubinemia” based on an incidence of 0.44 per 100,000 mentioned in my review. I would clarify that 0.44 per 100,000 is a rate of kernicterus and is not a percentage. Thus, 0.44 out of 100,000 children (or 4.4 per million) will develop kernicterus, not 44,000 per 100,000.

Mark Shen, MD, FHM, director of hospital medicine, Dell Children’s Medical Center, Austin, Texas, pediatric physician editor, The Hospitalist

I sincerely appreciate the responses to my review of an article (“Incidence Rates of Kernicterus Remain Unchanged,” The Hospitalist, October 2011, p. 12) that raised questions regarding a “resurgence” of kernicterus in the 1990s. Kernicterus is a devastating illness, and family members bear an unquestionable burden from this disease. Because phototherapy appears to limit the burden of disease, evidence-based guidelines for appropriate treatment of hyperbilirubinemia are paramount to decreasing the incidence of kernicterus. True rates of kernicterus have been difficult to calculate for a variety of reasons, yet we must get a handle on “who” gets kernicterus if we are to appropriately decide which infants receive phototherapy. Thus, I would strongly agree that using the California database is a limitation of the study reviewed.

The mission of the monthly “Pediatric HM” literature review is to regularly summarize articles that might be of interest in the field of pediatric HM. The letters to the editor we received highlight a critical need to delve deeper into the epidemiology of kernicterus, a journey that must begin with accurate reporting of this disease. We appreciate the opportunity to raise awareness of family-centered concerns surrounding the interpretation and analysis of scientific evidence.

As a final note, Mr. Spencer Brown’s letter states that “nearly half of all babies born (44,000 out of every 100,000) have hyperbilirubinemia” based on an incidence of 0.44 per 100,000 mentioned in my review. I would clarify that 0.44 per 100,000 is a rate of kernicterus and is not a percentage. Thus, 0.44 out of 100,000 children (or 4.4 per million) will develop kernicterus, not 44,000 per 100,000.

Mark Shen, MD, FHM, director of hospital medicine, Dell Children’s Medical Center, Austin, Texas, pediatric physician editor, The Hospitalist

I sincerely appreciate the responses to my review of an article (“Incidence Rates of Kernicterus Remain Unchanged,” The Hospitalist, October 2011, p. 12) that raised questions regarding a “resurgence” of kernicterus in the 1990s. Kernicterus is a devastating illness, and family members bear an unquestionable burden from this disease. Because phototherapy appears to limit the burden of disease, evidence-based guidelines for appropriate treatment of hyperbilirubinemia are paramount to decreasing the incidence of kernicterus. True rates of kernicterus have been difficult to calculate for a variety of reasons, yet we must get a handle on “who” gets kernicterus if we are to appropriately decide which infants receive phototherapy. Thus, I would strongly agree that using the California database is a limitation of the study reviewed.

The mission of the monthly “Pediatric HM” literature review is to regularly summarize articles that might be of interest in the field of pediatric HM. The letters to the editor we received highlight a critical need to delve deeper into the epidemiology of kernicterus, a journey that must begin with accurate reporting of this disease. We appreciate the opportunity to raise awareness of family-centered concerns surrounding the interpretation and analysis of scientific evidence.

As a final note, Mr. Spencer Brown’s letter states that “nearly half of all babies born (44,000 out of every 100,000) have hyperbilirubinemia” based on an incidence of 0.44 per 100,000 mentioned in my review. I would clarify that 0.44 per 100,000 is a rate of kernicterus and is not a percentage. Thus, 0.44 out of 100,000 children (or 4.4 per million) will develop kernicterus, not 44,000 per 100,000.

Mark Shen, MD, FHM, director of hospital medicine, Dell Children’s Medical Center, Austin, Texas, pediatric physician editor, The Hospitalist

I recently read your article on the rates of kernicterus and found it quite alarming. I am asking for an immediate apology and a retraction of this article.

This article is interesting since it states that only 25 out of 64,346 hyperbilirubinemia patients actually were truly kernicterus kids. That is a very low stat of 0.0003885 of all children diagnosed with hyperbilirubinemia. It is far less when you take into account all live births. Using DDS as a yardstick may be acceptable, but the surprising conclusion was that treatment made little difference.

To say “The time trend of incidence remained stable during the study years at 0.44 per 100,000 live births” means that nearly half of all babies born (44,000 out of every 100,000) have hyperbilirubinemia. If we use the 0.0003885 multiplier, then we can state that approximately 17 out of every 100,000 live births result in kernicterus. It would be interesting to plot those stats against other states, as well as other countries, to see if 0.0003885 times the total amount of kids with diagnosed hyperbilirubinemia represents a stable sum of actual kernicterus kids.

The clinician’s report seems to imply that kernicterus is an event that is statistically predictable, inevitable, and unavoidable; therefore, in spite of medical intervention, a predictable number of newborns will develop the disease. In a morbid sense, mortality rates are also predictable: “Data from a national database of death certificates revealed a similar stable trend in deaths attributed to kernicterus.”

The bottom line “kernicterus rates remained unchanged in the 1990s” conclusion and the bold citation that “there was not a ‘resurgence’ of kernicterus in the 1990s” are offered up in spite of the zero-tolerance policy of many hospitals that claim to know how to prevent the onset of kernicterus. The monitoring of infants, the early detection of hyperbilirubinemia, the effective and timely use of bili-lights, and possible blood transfusion should be adequate to quash kernicterus forever.

Perhaps newborn patients “with hyperbilirubinemia who are at extremely low risk for kernicterus are being overtreated,” but this does not preclude the need for those at high risk to obtain an early assessment and aggressive treatment. Perhaps the reason why there is no observable change in the incidence of kernicterus over the past 20 years is because the policy does not translate into procedures. Doctors seem to take on a lackadaisical, roll-of-the-dice type of approach to the prevention of kernicterus. Since the numbers are so low, they are not providing the vigilant watch and, therefore, allowing newborns to slip from hyperbilirubinemia to actual kernicterus.

The solution is there; the problem is the implementation. And it is not even a matter of insurance costs, since the therapy for prevention and/or intervention is extremely cheap. The needless suffering of a single kernicterus kid flies in the face of the fact that this is an observable, predictable, and curable disease.

The statistics may be right, but the medical approach is wrong. Whether it is 17 in every 100,000 or 1 in every 5,882, it makes a big difference if the 1 belongs to you. The only acceptable number is zero. The question is not about resurgence; it is more about why we are still seeing any incidences of such an easily preventable disease.

Spencer L. Brown, grandfather of a “kernicterus kid”

I recently read your article on the rates of kernicterus and found it quite alarming. I am asking for an immediate apology and a retraction of this article.

This article is interesting since it states that only 25 out of 64,346 hyperbilirubinemia patients actually were truly kernicterus kids. That is a very low stat of 0.0003885 of all children diagnosed with hyperbilirubinemia. It is far less when you take into account all live births. Using DDS as a yardstick may be acceptable, but the surprising conclusion was that treatment made little difference.

To say “The time trend of incidence remained stable during the study years at 0.44 per 100,000 live births” means that nearly half of all babies born (44,000 out of every 100,000) have hyperbilirubinemia. If we use the 0.0003885 multiplier, then we can state that approximately 17 out of every 100,000 live births result in kernicterus. It would be interesting to plot those stats against other states, as well as other countries, to see if 0.0003885 times the total amount of kids with diagnosed hyperbilirubinemia represents a stable sum of actual kernicterus kids.

The clinician’s report seems to imply that kernicterus is an event that is statistically predictable, inevitable, and unavoidable; therefore, in spite of medical intervention, a predictable number of newborns will develop the disease. In a morbid sense, mortality rates are also predictable: “Data from a national database of death certificates revealed a similar stable trend in deaths attributed to kernicterus.”

The bottom line “kernicterus rates remained unchanged in the 1990s” conclusion and the bold citation that “there was not a ‘resurgence’ of kernicterus in the 1990s” are offered up in spite of the zero-tolerance policy of many hospitals that claim to know how to prevent the onset of kernicterus. The monitoring of infants, the early detection of hyperbilirubinemia, the effective and timely use of bili-lights, and possible blood transfusion should be adequate to quash kernicterus forever.

Perhaps newborn patients “with hyperbilirubinemia who are at extremely low risk for kernicterus are being overtreated,” but this does not preclude the need for those at high risk to obtain an early assessment and aggressive treatment. Perhaps the reason why there is no observable change in the incidence of kernicterus over the past 20 years is because the policy does not translate into procedures. Doctors seem to take on a lackadaisical, roll-of-the-dice type of approach to the prevention of kernicterus. Since the numbers are so low, they are not providing the vigilant watch and, therefore, allowing newborns to slip from hyperbilirubinemia to actual kernicterus.

The solution is there; the problem is the implementation. And it is not even a matter of insurance costs, since the therapy for prevention and/or intervention is extremely cheap. The needless suffering of a single kernicterus kid flies in the face of the fact that this is an observable, predictable, and curable disease.

The statistics may be right, but the medical approach is wrong. Whether it is 17 in every 100,000 or 1 in every 5,882, it makes a big difference if the 1 belongs to you. The only acceptable number is zero. The question is not about resurgence; it is more about why we are still seeing any incidences of such an easily preventable disease.

Spencer L. Brown, grandfather of a “kernicterus kid”

I recently read your article on the rates of kernicterus and found it quite alarming. I am asking for an immediate apology and a retraction of this article.

This article is interesting since it states that only 25 out of 64,346 hyperbilirubinemia patients actually were truly kernicterus kids. That is a very low stat of 0.0003885 of all children diagnosed with hyperbilirubinemia. It is far less when you take into account all live births. Using DDS as a yardstick may be acceptable, but the surprising conclusion was that treatment made little difference.

To say “The time trend of incidence remained stable during the study years at 0.44 per 100,000 live births” means that nearly half of all babies born (44,000 out of every 100,000) have hyperbilirubinemia. If we use the 0.0003885 multiplier, then we can state that approximately 17 out of every 100,000 live births result in kernicterus. It would be interesting to plot those stats against other states, as well as other countries, to see if 0.0003885 times the total amount of kids with diagnosed hyperbilirubinemia represents a stable sum of actual kernicterus kids.

The clinician’s report seems to imply that kernicterus is an event that is statistically predictable, inevitable, and unavoidable; therefore, in spite of medical intervention, a predictable number of newborns will develop the disease. In a morbid sense, mortality rates are also predictable: “Data from a national database of death certificates revealed a similar stable trend in deaths attributed to kernicterus.”

The bottom line “kernicterus rates remained unchanged in the 1990s” conclusion and the bold citation that “there was not a ‘resurgence’ of kernicterus in the 1990s” are offered up in spite of the zero-tolerance policy of many hospitals that claim to know how to prevent the onset of kernicterus. The monitoring of infants, the early detection of hyperbilirubinemia, the effective and timely use of bili-lights, and possible blood transfusion should be adequate to quash kernicterus forever.

Perhaps newborn patients “with hyperbilirubinemia who are at extremely low risk for kernicterus are being overtreated,” but this does not preclude the need for those at high risk to obtain an early assessment and aggressive treatment. Perhaps the reason why there is no observable change in the incidence of kernicterus over the past 20 years is because the policy does not translate into procedures. Doctors seem to take on a lackadaisical, roll-of-the-dice type of approach to the prevention of kernicterus. Since the numbers are so low, they are not providing the vigilant watch and, therefore, allowing newborns to slip from hyperbilirubinemia to actual kernicterus.

The solution is there; the problem is the implementation. And it is not even a matter of insurance costs, since the therapy for prevention and/or intervention is extremely cheap. The needless suffering of a single kernicterus kid flies in the face of the fact that this is an observable, predictable, and curable disease.

The statistics may be right, but the medical approach is wrong. Whether it is 17 in every 100,000 or 1 in every 5,882, it makes a big difference if the 1 belongs to you. The only acceptable number is zero. The question is not about resurgence; it is more about why we are still seeing any incidences of such an easily preventable disease.

Spencer L. Brown, grandfather of a “kernicterus kid”

I’m writing in regard to the article “Incidence Rates of Kernicterus Remain Unchanged” (The Hospitalist, October 2011, p. 12) by Mark Shen, MD, FHM. As a mother of a child with kernicterus (born in 2005), I’m very concerned with the cavalier attitude toward hyperbilirubenia treatment and the reliance upon inaccurate statistics. Reasons for the inaccuracy:

• Your data is for California only;
• DDS reports of kernicterus are likely inaccurate. Nothing our son is enrolled in lists his diagnosis as kernicterus. Most institutions don’t have it in their database. Paperwork for my son shows encephalopathy, cerebral palsy, athetoid cerebral palsy, dystonia, or quadraplegia, but rarely kernicterus. As a result, I and other parents of children with kernicterus can attest to a massive under reporting of kernicterus, wherever you look;
• Our parent group, PICK, is constantly growing, with new members every month across the country and across the world;
• Even death certificates are subject to the fear that comes with kernicterus. Physicians know that putting this information on a death certificate will lead to a lawsuit, and thus are more inclined to list respiratory failure or other secondary causes as the cause of death; and
• Many children with kernicterus are never properly diagnosed or given diagnostic tests like an MRI to confirm the damage. They are instead steered away from the diagnosis, even when it is the obvious cause.

Please understand that the “kinder, gentler” approach to hyperbilirubinemia is why my son has kernicterus. He was repeatedly inspected visually, and our concerns were dismissed. At nine days old, they dismissed our concerns and coded us “low priority.” When finally seen, his bilirubin was 45.6, his pulse ox was 69, and he was posturing. His MRI revealed the classic signal intensity in the globus pallidus. He failed the hearing test that he had passed easily the weak before. His life care plan is 69,000,000. He is fed via G-tube and unable to manipulate his limbs of trunk to perform any daily living tasks. He uses a wheelchair, gait trainer, stander, bath chair, lift, cochlear implant—the list goes on and on.

All of this could have been avoided with a little “overtreatment.” I believe the cost of a proactive approach could hardly compare to the costs that these children with kernicterus incur in their lifetimes.

So many are afraid to admit the potential dangers of newborn jaundice. Many say that they wouldn’t want to scare a parent. As a parent, I’d like to say that I am not afraid of something that is treatable and preventable. Educate us and let us help our children avoid serious peril!

Everyone in the medical community needs to take the proactive approach, as well as find a means of reporting kernicterus that is free of the liability concerns, or be willing to face them.

The CDC has created excellent new materials that seem to be getting very little attention but could have saved my son a lifetime of unspeakable struggle. Please take a look at them and consider distributing them at your treatment facilities.

Miriam Iliff, Fayetteville, N.C., past board member, Parents of Infants and Children with Kernicterus (PICK)

I’m writing in regard to the article “Incidence Rates of Kernicterus Remain Unchanged” (The Hospitalist, October 2011, p. 12) by Mark Shen, MD, FHM. As a mother of a child with kernicterus (born in 2005), I’m very concerned with the cavalier attitude toward hyperbilirubenia treatment and the reliance upon inaccurate statistics. Reasons for the inaccuracy:

• Your data is for California only;
• DDS reports of kernicterus are likely inaccurate. Nothing our son is enrolled in lists his diagnosis as kernicterus. Most institutions don’t have it in their database. Paperwork for my son shows encephalopathy, cerebral palsy, athetoid cerebral palsy, dystonia, or quadraplegia, but rarely kernicterus. As a result, I and other parents of children with kernicterus can attest to a massive under reporting of kernicterus, wherever you look;
• Our parent group, PICK, is constantly growing, with new members every month across the country and across the world;
• Even death certificates are subject to the fear that comes with kernicterus. Physicians know that putting this information on a death certificate will lead to a lawsuit, and thus are more inclined to list respiratory failure or other secondary causes as the cause of death; and
• Many children with kernicterus are never properly diagnosed or given diagnostic tests like an MRI to confirm the damage. They are instead steered away from the diagnosis, even when it is the obvious cause.

Please understand that the “kinder, gentler” approach to hyperbilirubinemia is why my son has kernicterus. He was repeatedly inspected visually, and our concerns were dismissed. At nine days old, they dismissed our concerns and coded us “low priority.” When finally seen, his bilirubin was 45.6, his pulse ox was 69, and he was posturing. His MRI revealed the classic signal intensity in the globus pallidus. He failed the hearing test that he had passed easily the weak before. His life care plan is 69,000,000. He is fed via G-tube and unable to manipulate his limbs of trunk to perform any daily living tasks. He uses a wheelchair, gait trainer, stander, bath chair, lift, cochlear implant—the list goes on and on.

All of this could have been avoided with a little “overtreatment.” I believe the cost of a proactive approach could hardly compare to the costs that these children with kernicterus incur in their lifetimes.

So many are afraid to admit the potential dangers of newborn jaundice. Many say that they wouldn’t want to scare a parent. As a parent, I’d like to say that I am not afraid of something that is treatable and preventable. Educate us and let us help our children avoid serious peril!

Everyone in the medical community needs to take the proactive approach, as well as find a means of reporting kernicterus that is free of the liability concerns, or be willing to face them.

The CDC has created excellent new materials that seem to be getting very little attention but could have saved my son a lifetime of unspeakable struggle. Please take a look at them and consider distributing them at your treatment facilities.

Miriam Iliff, Fayetteville, N.C., past board member, Parents of Infants and Children with Kernicterus (PICK)

I’m writing in regard to the article “Incidence Rates of Kernicterus Remain Unchanged” (The Hospitalist, October 2011, p. 12) by Mark Shen, MD, FHM. As a mother of a child with kernicterus (born in 2005), I’m very concerned with the cavalier attitude toward hyperbilirubenia treatment and the reliance upon inaccurate statistics. Reasons for the inaccuracy:

• Your data is for California only;
• DDS reports of kernicterus are likely inaccurate. Nothing our son is enrolled in lists his diagnosis as kernicterus. Most institutions don’t have it in their database. Paperwork for my son shows encephalopathy, cerebral palsy, athetoid cerebral palsy, dystonia, or quadraplegia, but rarely kernicterus. As a result, I and other parents of children with kernicterus can attest to a massive under reporting of kernicterus, wherever you look;
• Our parent group, PICK, is constantly growing, with new members every month across the country and across the world;
• Even death certificates are subject to the fear that comes with kernicterus. Physicians know that putting this information on a death certificate will lead to a lawsuit, and thus are more inclined to list respiratory failure or other secondary causes as the cause of death; and
• Many children with kernicterus are never properly diagnosed or given diagnostic tests like an MRI to confirm the damage. They are instead steered away from the diagnosis, even when it is the obvious cause.

Please understand that the “kinder, gentler” approach to hyperbilirubinemia is why my son has kernicterus. He was repeatedly inspected visually, and our concerns were dismissed. At nine days old, they dismissed our concerns and coded us “low priority.” When finally seen, his bilirubin was 45.6, his pulse ox was 69, and he was posturing. His MRI revealed the classic signal intensity in the globus pallidus. He failed the hearing test that he had passed easily the weak before. His life care plan is 69,000,000. He is fed via G-tube and unable to manipulate his limbs of trunk to perform any daily living tasks. He uses a wheelchair, gait trainer, stander, bath chair, lift, cochlear implant—the list goes on and on.

All of this could have been avoided with a little “overtreatment.” I believe the cost of a proactive approach could hardly compare to the costs that these children with kernicterus incur in their lifetimes.

So many are afraid to admit the potential dangers of newborn jaundice. Many say that they wouldn’t want to scare a parent. As a parent, I’d like to say that I am not afraid of something that is treatable and preventable. Educate us and let us help our children avoid serious peril!

Everyone in the medical community needs to take the proactive approach, as well as find a means of reporting kernicterus that is free of the liability concerns, or be willing to face them.

The CDC has created excellent new materials that seem to be getting very little attention but could have saved my son a lifetime of unspeakable struggle. Please take a look at them and consider distributing them at your treatment facilities.

Miriam Iliff, Fayetteville, N.C., past board member, Parents of Infants and Children with Kernicterus (PICK)

The growing problem of obesity in America could pose a future liability issue for hospitalists and their employers, according to a bariatric surgeon.

Michael Jay Nusbaum, MD, FACS, FASMBS, FACN, says it's all too common for hospitalists and other physicians to "turf that patient out" to larger medical centers, but he cautions those doctors might be opening themselves to liability issues unless they can explain why they sent a patient elsewhere for care. For example, many hospitals lack wheelchairs, stretchers, tables, and gantries to hold morbidly obese patients.

"Is it really because you feel that the hospital lacks the infrastructure or because you just don't feel like taking on the additional liability that you're transferring the patient?" says Dr. Nusbaum, chief of bariatric surgery at Morristown (N.J.) Medical Center. "That's the question."

Dr. Nusbaum says hospitalists who believe their hospitals lack the proper equipment to treat obese patients should be "going out to the administration and saying, 'Look, we've got a liability issue. We don't have the equipment to take care of these patients if they start coming in.'"

He also believes that some physicians try to avoid obese patients for fear that their quality scores will drop. Dr. Nusbaum says that "disincentive" is built into the system, and it is incumbent on HM leaders and other physicians to push for change.

"The healthcare system in general is unprepared for the obesity epidemic," he adds. "And quite a bit of that is due to decreasing reimbursement and the fact that they need to lay out a lot of capital to take care of morbidly obese patients. ... It comes down to money."

The growing problem of obesity in America could pose a future liability issue for hospitalists and their employers, according to a bariatric surgeon.

Michael Jay Nusbaum, MD, FACS, FASMBS, FACN, says it's all too common for hospitalists and other physicians to "turf that patient out" to larger medical centers, but he cautions those doctors might be opening themselves to liability issues unless they can explain why they sent a patient elsewhere for care. For example, many hospitals lack wheelchairs, stretchers, tables, and gantries to hold morbidly obese patients.

"Is it really because you feel that the hospital lacks the infrastructure or because you just don't feel like taking on the additional liability that you're transferring the patient?" says Dr. Nusbaum, chief of bariatric surgery at Morristown (N.J.) Medical Center. "That's the question."

Dr. Nusbaum says hospitalists who believe their hospitals lack the proper equipment to treat obese patients should be "going out to the administration and saying, 'Look, we've got a liability issue. We don't have the equipment to take care of these patients if they start coming in.'"

He also believes that some physicians try to avoid obese patients for fear that their quality scores will drop. Dr. Nusbaum says that "disincentive" is built into the system, and it is incumbent on HM leaders and other physicians to push for change.

"The healthcare system in general is unprepared for the obesity epidemic," he adds. "And quite a bit of that is due to decreasing reimbursement and the fact that they need to lay out a lot of capital to take care of morbidly obese patients. ... It comes down to money."

The growing problem of obesity in America could pose a future liability issue for hospitalists and their employers, according to a bariatric surgeon.

Michael Jay Nusbaum, MD, FACS, FASMBS, FACN, says it's all too common for hospitalists and other physicians to "turf that patient out" to larger medical centers, but he cautions those doctors might be opening themselves to liability issues unless they can explain why they sent a patient elsewhere for care. For example, many hospitals lack wheelchairs, stretchers, tables, and gantries to hold morbidly obese patients.

"Is it really because you feel that the hospital lacks the infrastructure or because you just don't feel like taking on the additional liability that you're transferring the patient?" says Dr. Nusbaum, chief of bariatric surgery at Morristown (N.J.) Medical Center. "That's the question."

Dr. Nusbaum says hospitalists who believe their hospitals lack the proper equipment to treat obese patients should be "going out to the administration and saying, 'Look, we've got a liability issue. We don't have the equipment to take care of these patients if they start coming in.'"

He also believes that some physicians try to avoid obese patients for fear that their quality scores will drop. Dr. Nusbaum says that "disincentive" is built into the system, and it is incumbent on HM leaders and other physicians to push for change.

"The healthcare system in general is unprepared for the obesity epidemic," he adds. "And quite a bit of that is due to decreasing reimbursement and the fact that they need to lay out a lot of capital to take care of morbidly obese patients. ... It comes down to money."

Pediatric hospitalist Jeff Sperring, MD, didn't set out to be a hospital administrator. But earlier this month he became the president and CEO of Riley Hospital for Children at Indiana University Health in Indianapolis.

Dr. Sperring's path to the C-suite started in 2002, when he helped launch Riley's pediatric HM program following four years in community practice. The program eventually grew to a team of 22 physicians at four hospital sites. He was promoted to Riley's associate chief medical officer (CMO) in 2007, and in 2009 became the hospital's CMO.

"Being a hospitalist was critical to that progression," Dr. Sperring says. "You understand what needs to be changed. More than anything else it's just being available, willing, and able to help."

Dr. Sperring spearheaded a quality project to address the hospital's average length of stay (LOS), which was excessive by national benchmarks. The project helped reduce Riley's LOS by two full days.

He also helped develop a health-system-wide call center for patient referrals from physicians across the state. "Leading a project leads to additional roles, and that leads to this," he says.

Other keys to his advancement: drawing upon mentors and coaches, both within and outside of his health system; relying on his team in the HM department; and building effective partnerships with community physicians, he says. He has not pursued a formal business degree, focusing instead on leadership development training opportunities, including the multi-professional Hoosier Fellows Program at Indiana University. He plans to continue working as hospitalist at Riley, "a week here and there" when he can squeeze it into his expanded administrative responsibilities.

SHM President Joseph Ming Wah Li, MD, MBA, SFHM, says he is not aware of other examples of working hospitalists rising to the top of their hospital's organizational charts. "But I would expect we'd see more and more hospitalists becoming hospital CEOs—both pediatric and adult," he says.

Pediatric hospitalist Jeff Sperring, MD, didn't set out to be a hospital administrator. But earlier this month he became the president and CEO of Riley Hospital for Children at Indiana University Health in Indianapolis.

Dr. Sperring's path to the C-suite started in 2002, when he helped launch Riley's pediatric HM program following four years in community practice. The program eventually grew to a team of 22 physicians at four hospital sites. He was promoted to Riley's associate chief medical officer (CMO) in 2007, and in 2009 became the hospital's CMO.

"Being a hospitalist was critical to that progression," Dr. Sperring says. "You understand what needs to be changed. More than anything else it's just being available, willing, and able to help."

Dr. Sperring spearheaded a quality project to address the hospital's average length of stay (LOS), which was excessive by national benchmarks. The project helped reduce Riley's LOS by two full days.

He also helped develop a health-system-wide call center for patient referrals from physicians across the state. "Leading a project leads to additional roles, and that leads to this," he says.

Other keys to his advancement: drawing upon mentors and coaches, both within and outside of his health system; relying on his team in the HM department; and building effective partnerships with community physicians, he says. He has not pursued a formal business degree, focusing instead on leadership development training opportunities, including the multi-professional Hoosier Fellows Program at Indiana University. He plans to continue working as hospitalist at Riley, "a week here and there" when he can squeeze it into his expanded administrative responsibilities.

SHM President Joseph Ming Wah Li, MD, MBA, SFHM, says he is not aware of other examples of working hospitalists rising to the top of their hospital's organizational charts. "But I would expect we'd see more and more hospitalists becoming hospital CEOs—both pediatric and adult," he says.

Pediatric hospitalist Jeff Sperring, MD, didn't set out to be a hospital administrator. But earlier this month he became the president and CEO of Riley Hospital for Children at Indiana University Health in Indianapolis.

Dr. Sperring's path to the C-suite started in 2002, when he helped launch Riley's pediatric HM program following four years in community practice. The program eventually grew to a team of 22 physicians at four hospital sites. He was promoted to Riley's associate chief medical officer (CMO) in 2007, and in 2009 became the hospital's CMO.

"Being a hospitalist was critical to that progression," Dr. Sperring says. "You understand what needs to be changed. More than anything else it's just being available, willing, and able to help."

Dr. Sperring spearheaded a quality project to address the hospital's average length of stay (LOS), which was excessive by national benchmarks. The project helped reduce Riley's LOS by two full days.

He also helped develop a health-system-wide call center for patient referrals from physicians across the state. "Leading a project leads to additional roles, and that leads to this," he says.

Other keys to his advancement: drawing upon mentors and coaches, both within and outside of his health system; relying on his team in the HM department; and building effective partnerships with community physicians, he says. He has not pursued a formal business degree, focusing instead on leadership development training opportunities, including the multi-professional Hoosier Fellows Program at Indiana University. He plans to continue working as hospitalist at Riley, "a week here and there" when he can squeeze it into his expanded administrative responsibilities.

SHM President Joseph Ming Wah Li, MD, MBA, SFHM, says he is not aware of other examples of working hospitalists rising to the top of their hospital's organizational charts. "But I would expect we'd see more and more hospitalists becoming hospital CEOs—both pediatric and adult," he says.

Kate Goodrich, MD, MHS, was a medical resident at George Washington University (GW) Medical Center in Washington, D.C., in 1997 when a hospitalist service there was launched. A year later, as chief resident, she was able to work as a hospitalist. She enjoyed HM so much that she stayed on at GW in a faculty position and later directed its growing division of hospital medicine.

“I absolutely loved it,” she says.

But other career interests were calling her away from her patients and working the hospital floor. Eventually, she became a key player in the health reform debate and overhaul. “I became more aware of the issues that the country was grappling with because I was seeing them on the front lines—issues such as poor access to primary care,” she says. “I began to wonder: Why does a sector of my patient population keep getting readmitted to the hospital? Why is it so difficult for them to get medications, even when they have insurance? What happens to people who have poor family support or multiple comorbidities?”

Such questions eventually became more important to her than the clinical questions she encountered. And now she is in position to make even more of a difference to patients at GW and across the country. In March 2010, Dr. Goodrich became medical officer for the Office of the Assistant Secretary for Planning and Evaluation (ASPE) in the U.S. Department of Health and Human Services (HHS). And more recently, she became senior technical advisor in the Office of Clinical Standards and Quality at the Centers for Medicare & Medicaid Services (CMS), working closely with another hospitalist leader, Patrick Conway, MD, MSc, SFHM, who recently was appointed CMS’ chief medical officer (see “Hospitalist Takes Charge,” June 2011, p. 20).

“When I started this job, I was gratified to learn that my experience as a hospitalist had unbelievable relevance,” she says. “It surprised me how often I draw upon that experience. My clinical perspective on quality is really valued.”

She retains that connection by working as a hospitalist three or four weeks a year at GW. “I now view the hospitalist world from a different lens,” she says.

Winding Path to Washington

Dr. Goodrich’s path to a health policy career didn’t happen overnight. She originally enrolled in GW’s School of Public Health, taking classes at night, but soon realized that it would take too long to obtain a public health degree that way. In 2008, the Robert Wood Johnson Clinical Scholars Program, based at Yale University, offered her an opportunity to focus more intensively on research questions. “I discovered at Yale that what was more satisfying to me was application of research into action,” she says.

Sian Spurney, MD, director of GW’s hospital medicine division, once shared an office with Dr. Goodrich. She describes Dr. Goodrich as dedicated and committed. “Although I was admittedly very sad when she left GW to pursue her passion for health policy, I was hardly surprised to hear of her successes since completing the RWJ program,” Dr. Spurney says.

During a 2009 summer internship at HHS while she was doing her Yale coursework, Dr. Goodrich worked with Dr. Conway, who was working as the ASPE medical officer at HHS. Dr. Goodrich helped write a report to Congress on the Federal Coordinating Council for Cost-Effectiveness Research (CER), and became immersed in this area of research. She worked on an interagency work group to assemble a spending plan for $400 million in federal CER allocations.

“One of the premises of CER is that it will lead to improved quality of healthcare, which we all know isn’t where it should be—in part because of uncertainty regarding best care,” she says. “We think CER will help us define best treatment in the hospital, as well as outpatient settings.” Examples, she says, would be the treatment of delirium or care for patients with multiple comorbidities. “Hospitalists are well-positioned to disseminate CER within their hospitals and to train others, actively looking for the right evidence, and applying it in practice,” she adds.

Dr. Goodrich refers to Dr. Conway as a mentor and recalls days when they would “talk about the ways the issues we were working on affect hospitalists and how to make them aware of those issues,” she says. “I found myself drawn like a magnet to the policy stuff, especially during the 2008 election. It finally dawned on me that if I love this so much, why not see if I can make it a career?”

Exciting Times for Public Servants

Dr. Goodrich acknowledges the importance of care transitions and hospital readmissions for the national quality agenda. In fact, while at Yale, she researched care transitions for patients with low health literacy.

“I doubt that any hospitalist would disagree that readmissions are bad for patients, but sometimes they feel like everyone’s looking at them when readmissions happen. As a hospitalist, you know it’s a complex problem, by no means within the control of any single hospitalist,” she says. “But we also know that some hospitals have very low readmission rates. So it can be done, and we need to learn from the high performers.”

Given the current focus on healthcare reform, Dr. Goodrich believes now is an exciting time to be working for the government. She suggests ways that other hospitalists can learn about health policy and participate in its development:

• Get involved in local quality initiatives in the hospital and the community;
• Join SHM’s Public Policy Committee;
• Follow health policy blogs, websites, and other resources offered by HHS, SHM, and private groups such as the Commonwealth Fund; and
• Look into health policy fellowships or training opportunities.

Clinical experience is highly valued throughout CMS, Dr. Conway says, noting Dr. Goodrich’s background as a teaching hospitalist with more than a decade of patient care under her belt.

“In all of CMS, there are less than a hundred physicians in total, and not all of them are still in medical practice. So we have to leverage the clinical skills of that small group. As we develop health policies, that experience gives us a greater understanding of what the policies mean—their potential impact on patients,” he says.

Larry Beresford is a freelance writer based in Oakland, Calif.

Kate Goodrich, MD, MHS, was a medical resident at George Washington University (GW) Medical Center in Washington, D.C., in 1997 when a hospitalist service there was launched. A year later, as chief resident, she was able to work as a hospitalist. She enjoyed HM so much that she stayed on at GW in a faculty position and later directed its growing division of hospital medicine.

“I absolutely loved it,” she says.

But other career interests were calling her away from her patients and working the hospital floor. Eventually, she became a key player in the health reform debate and overhaul. “I became more aware of the issues that the country was grappling with because I was seeing them on the front lines—issues such as poor access to primary care,” she says. “I began to wonder: Why does a sector of my patient population keep getting readmitted to the hospital? Why is it so difficult for them to get medications, even when they have insurance? What happens to people who have poor family support or multiple comorbidities?”

Such questions eventually became more important to her than the clinical questions she encountered. And now she is in position to make even more of a difference to patients at GW and across the country. In March 2010, Dr. Goodrich became medical officer for the Office of the Assistant Secretary for Planning and Evaluation (ASPE) in the U.S. Department of Health and Human Services (HHS). And more recently, she became senior technical advisor in the Office of Clinical Standards and Quality at the Centers for Medicare & Medicaid Services (CMS), working closely with another hospitalist leader, Patrick Conway, MD, MSc, SFHM, who recently was appointed CMS’ chief medical officer (see “Hospitalist Takes Charge,” June 2011, p. 20).

“When I started this job, I was gratified to learn that my experience as a hospitalist had unbelievable relevance,” she says. “It surprised me how often I draw upon that experience. My clinical perspective on quality is really valued.”

She retains that connection by working as a hospitalist three or four weeks a year at GW. “I now view the hospitalist world from a different lens,” she says.

Winding Path to Washington

Dr. Goodrich’s path to a health policy career didn’t happen overnight. She originally enrolled in GW’s School of Public Health, taking classes at night, but soon realized that it would take too long to obtain a public health degree that way. In 2008, the Robert Wood Johnson Clinical Scholars Program, based at Yale University, offered her an opportunity to focus more intensively on research questions. “I discovered at Yale that what was more satisfying to me was application of research into action,” she says.

Sian Spurney, MD, director of GW’s hospital medicine division, once shared an office with Dr. Goodrich. She describes Dr. Goodrich as dedicated and committed. “Although I was admittedly very sad when she left GW to pursue her passion for health policy, I was hardly surprised to hear of her successes since completing the RWJ program,” Dr. Spurney says.

During a 2009 summer internship at HHS while she was doing her Yale coursework, Dr. Goodrich worked with Dr. Conway, who was working as the ASPE medical officer at HHS. Dr. Goodrich helped write a report to Congress on the Federal Coordinating Council for Cost-Effectiveness Research (CER), and became immersed in this area of research. She worked on an interagency work group to assemble a spending plan for $400 million in federal CER allocations.

“One of the premises of CER is that it will lead to improved quality of healthcare, which we all know isn’t where it should be—in part because of uncertainty regarding best care,” she says. “We think CER will help us define best treatment in the hospital, as well as outpatient settings.” Examples, she says, would be the treatment of delirium or care for patients with multiple comorbidities. “Hospitalists are well-positioned to disseminate CER within their hospitals and to train others, actively looking for the right evidence, and applying it in practice,” she adds.

Dr. Goodrich refers to Dr. Conway as a mentor and recalls days when they would “talk about the ways the issues we were working on affect hospitalists and how to make them aware of those issues,” she says. “I found myself drawn like a magnet to the policy stuff, especially during the 2008 election. It finally dawned on me that if I love this so much, why not see if I can make it a career?”

Exciting Times for Public Servants

Dr. Goodrich acknowledges the importance of care transitions and hospital readmissions for the national quality agenda. In fact, while at Yale, she researched care transitions for patients with low health literacy.

“I doubt that any hospitalist would disagree that readmissions are bad for patients, but sometimes they feel like everyone’s looking at them when readmissions happen. As a hospitalist, you know it’s a complex problem, by no means within the control of any single hospitalist,” she says. “But we also know that some hospitals have very low readmission rates. So it can be done, and we need to learn from the high performers.”

Given the current focus on healthcare reform, Dr. Goodrich believes now is an exciting time to be working for the government. She suggests ways that other hospitalists can learn about health policy and participate in its development:

• Get involved in local quality initiatives in the hospital and the community;
• Join SHM’s Public Policy Committee;
• Follow health policy blogs, websites, and other resources offered by HHS, SHM, and private groups such as the Commonwealth Fund; and
• Look into health policy fellowships or training opportunities.

Clinical experience is highly valued throughout CMS, Dr. Conway says, noting Dr. Goodrich’s background as a teaching hospitalist with more than a decade of patient care under her belt.

“In all of CMS, there are less than a hundred physicians in total, and not all of them are still in medical practice. So we have to leverage the clinical skills of that small group. As we develop health policies, that experience gives us a greater understanding of what the policies mean—their potential impact on patients,” he says.

Larry Beresford is a freelance writer based in Oakland, Calif.

Kate Goodrich, MD, MHS, was a medical resident at George Washington University (GW) Medical Center in Washington, D.C., in 1997 when a hospitalist service there was launched. A year later, as chief resident, she was able to work as a hospitalist. She enjoyed HM so much that she stayed on at GW in a faculty position and later directed its growing division of hospital medicine.

“I absolutely loved it,” she says.

But other career interests were calling her away from her patients and working the hospital floor. Eventually, she became a key player in the health reform debate and overhaul. “I became more aware of the issues that the country was grappling with because I was seeing them on the front lines—issues such as poor access to primary care,” she says. “I began to wonder: Why does a sector of my patient population keep getting readmitted to the hospital? Why is it so difficult for them to get medications, even when they have insurance? What happens to people who have poor family support or multiple comorbidities?”

Such questions eventually became more important to her than the clinical questions she encountered. And now she is in position to make even more of a difference to patients at GW and across the country. In March 2010, Dr. Goodrich became medical officer for the Office of the Assistant Secretary for Planning and Evaluation (ASPE) in the U.S. Department of Health and Human Services (HHS). And more recently, she became senior technical advisor in the Office of Clinical Standards and Quality at the Centers for Medicare & Medicaid Services (CMS), working closely with another hospitalist leader, Patrick Conway, MD, MSc, SFHM, who recently was appointed CMS’ chief medical officer (see “Hospitalist Takes Charge,” June 2011, p. 20).

“When I started this job, I was gratified to learn that my experience as a hospitalist had unbelievable relevance,” she says. “It surprised me how often I draw upon that experience. My clinical perspective on quality is really valued.”

She retains that connection by working as a hospitalist three or four weeks a year at GW. “I now view the hospitalist world from a different lens,” she says.

Winding Path to Washington

Dr. Goodrich’s path to a health policy career didn’t happen overnight. She originally enrolled in GW’s School of Public Health, taking classes at night, but soon realized that it would take too long to obtain a public health degree that way. In 2008, the Robert Wood Johnson Clinical Scholars Program, based at Yale University, offered her an opportunity to focus more intensively on research questions. “I discovered at Yale that what was more satisfying to me was application of research into action,” she says.

Sian Spurney, MD, director of GW’s hospital medicine division, once shared an office with Dr. Goodrich. She describes Dr. Goodrich as dedicated and committed. “Although I was admittedly very sad when she left GW to pursue her passion for health policy, I was hardly surprised to hear of her successes since completing the RWJ program,” Dr. Spurney says.

During a 2009 summer internship at HHS while she was doing her Yale coursework, Dr. Goodrich worked with Dr. Conway, who was working as the ASPE medical officer at HHS. Dr. Goodrich helped write a report to Congress on the Federal Coordinating Council for Cost-Effectiveness Research (CER), and became immersed in this area of research. She worked on an interagency work group to assemble a spending plan for $400 million in federal CER allocations.

“One of the premises of CER is that it will lead to improved quality of healthcare, which we all know isn’t where it should be—in part because of uncertainty regarding best care,” she says. “We think CER will help us define best treatment in the hospital, as well as outpatient settings.” Examples, she says, would be the treatment of delirium or care for patients with multiple comorbidities. “Hospitalists are well-positioned to disseminate CER within their hospitals and to train others, actively looking for the right evidence, and applying it in practice,” she adds.

Dr. Goodrich refers to Dr. Conway as a mentor and recalls days when they would “talk about the ways the issues we were working on affect hospitalists and how to make them aware of those issues,” she says. “I found myself drawn like a magnet to the policy stuff, especially during the 2008 election. It finally dawned on me that if I love this so much, why not see if I can make it a career?”

Exciting Times for Public Servants

Dr. Goodrich acknowledges the importance of care transitions and hospital readmissions for the national quality agenda. In fact, while at Yale, she researched care transitions for patients with low health literacy.

“I doubt that any hospitalist would disagree that readmissions are bad for patients, but sometimes they feel like everyone’s looking at them when readmissions happen. As a hospitalist, you know it’s a complex problem, by no means within the control of any single hospitalist,” she says. “But we also know that some hospitals have very low readmission rates. So it can be done, and we need to learn from the high performers.”

Given the current focus on healthcare reform, Dr. Goodrich believes now is an exciting time to be working for the government. She suggests ways that other hospitalists can learn about health policy and participate in its development:

• Get involved in local quality initiatives in the hospital and the community;
• Join SHM’s Public Policy Committee;
• Follow health policy blogs, websites, and other resources offered by HHS, SHM, and private groups such as the Commonwealth Fund; and
• Look into health policy fellowships or training opportunities.

Clinical experience is highly valued throughout CMS, Dr. Conway says, noting Dr. Goodrich’s background as a teaching hospitalist with more than a decade of patient care under her belt.

“In all of CMS, there are less than a hundred physicians in total, and not all of them are still in medical practice. So we have to leverage the clinical skills of that small group. As we develop health policies, that experience gives us a greater understanding of what the policies mean—their potential impact on patients,” he says.

Larry Beresford is a freelance writer based in Oakland, Calif.

Dr. Iannini

New Bedford, Mass.-based Southcoast Hospitals Group has announced the appointment of Paul B. Iannini, MD, as physician-in-chief for medicine. Dr. Iannini will directly oversee inpatient medical services, including the hospitalist, intensivist, infectious disease, gastroenterology, endocrinology, and neurology programs. He will work with the medical staff to establish measurements that will facilitate ongoing improvements in the quality of care, efficiency, and cost-effectiveness of care across all three Southcoast Hospitals sites—Charlton Memorial in Fall River, St. Luke’s in New Bedford, and Tobey in Wareham.

Dr. Iannini was formerly vice president for medical services at WellSpan Health in Pennsylvania, with responsibility for 17 hospital-based departments across two hospitals and nine specialty physician practices

Dr. Handin

David Handin, MD, has been named director of the HM program at Emerson Hospital in Concord, Mass.

Dr. Handin has been a full-time hospitalist at Emerson for the past seven years. He began his career in Arizona, where he served for two years in the Indian Health Service on the Navajo reservation and then worked for two more years in a medical practice in Bisbee, Ariz. He returned to Massachusetts in 2000 as an attending physician on the hospitalist service at Brigham and Women’s Hospital in Boston.

Dr. Bowmen

David Bowman, MD, executive director of IPC: The Hospitalist Company Inc.’s Tucson, Ariz., division, has received the Medical Group Management Association (MGMA) and American College of Medical Practice Executives (ACMPE) Physician Executive of the Year award for 2011. The award recognizes a physician executive in a medical group practice who has exhibited outstanding leadership to achieve exceptional performance in the delivery of healthcare in his or her practice and community through personal example and collaborative team management.

Dr. Gorman

Mary Jo Gorman, MD, MBA, MHM, chief executive officer and founder of Advanced ICU Care and former president of SHM, has been named a winner of the 2011 Ernst & Young Entrepreneurial Winning Women competition. The annual competition and leadership program honors female founders or co-founders of businesses whose success demonstrates the creativity, tenacity, and conviction necessary to realize their companies’ full potential and the drive to achieve market leadership.

One of 10 honorees, Dr. Gorman practiced as both an intensivist and a hospitalist physician before founding Advanced ICU Care in 2004. The company combines the technology of telemedicine with the clinical expertise of experienced intensivists and critical-care nurses to provide around-the-clock intensivist coverage.

Dr. Iannini

New Bedford, Mass.-based Southcoast Hospitals Group has announced the appointment of Paul B. Iannini, MD, as physician-in-chief for medicine. Dr. Iannini will directly oversee inpatient medical services, including the hospitalist, intensivist, infectious disease, gastroenterology, endocrinology, and neurology programs. He will work with the medical staff to establish measurements that will facilitate ongoing improvements in the quality of care, efficiency, and cost-effectiveness of care across all three Southcoast Hospitals sites—Charlton Memorial in Fall River, St. Luke’s in New Bedford, and Tobey in Wareham.

Dr. Iannini was formerly vice president for medical services at WellSpan Health in Pennsylvania, with responsibility for 17 hospital-based departments across two hospitals and nine specialty physician practices

Dr. Handin

David Handin, MD, has been named director of the HM program at Emerson Hospital in Concord, Mass.

Dr. Handin has been a full-time hospitalist at Emerson for the past seven years. He began his career in Arizona, where he served for two years in the Indian Health Service on the Navajo reservation and then worked for two more years in a medical practice in Bisbee, Ariz. He returned to Massachusetts in 2000 as an attending physician on the hospitalist service at Brigham and Women’s Hospital in Boston.

Dr. Bowmen

David Bowman, MD, executive director of IPC: The Hospitalist Company Inc.’s Tucson, Ariz., division, has received the Medical Group Management Association (MGMA) and American College of Medical Practice Executives (ACMPE) Physician Executive of the Year award for 2011. The award recognizes a physician executive in a medical group practice who has exhibited outstanding leadership to achieve exceptional performance in the delivery of healthcare in his or her practice and community through personal example and collaborative team management.

Dr. Gorman

Mary Jo Gorman, MD, MBA, MHM, chief executive officer and founder of Advanced ICU Care and former president of SHM, has been named a winner of the 2011 Ernst & Young Entrepreneurial Winning Women competition. The annual competition and leadership program honors female founders or co-founders of businesses whose success demonstrates the creativity, tenacity, and conviction necessary to realize their companies’ full potential and the drive to achieve market leadership.

One of 10 honorees, Dr. Gorman practiced as both an intensivist and a hospitalist physician before founding Advanced ICU Care in 2004. The company combines the technology of telemedicine with the clinical expertise of experienced intensivists and critical-care nurses to provide around-the-clock intensivist coverage.

Dr. Iannini

New Bedford, Mass.-based Southcoast Hospitals Group has announced the appointment of Paul B. Iannini, MD, as physician-in-chief for medicine. Dr. Iannini will directly oversee inpatient medical services, including the hospitalist, intensivist, infectious disease, gastroenterology, endocrinology, and neurology programs. He will work with the medical staff to establish measurements that will facilitate ongoing improvements in the quality of care, efficiency, and cost-effectiveness of care across all three Southcoast Hospitals sites—Charlton Memorial in Fall River, St. Luke’s in New Bedford, and Tobey in Wareham.

Dr. Iannini was formerly vice president for medical services at WellSpan Health in Pennsylvania, with responsibility for 17 hospital-based departments across two hospitals and nine specialty physician practices

Dr. Handin

David Handin, MD, has been named director of the HM program at Emerson Hospital in Concord, Mass.

Dr. Handin has been a full-time hospitalist at Emerson for the past seven years. He began his career in Arizona, where he served for two years in the Indian Health Service on the Navajo reservation and then worked for two more years in a medical practice in Bisbee, Ariz. He returned to Massachusetts in 2000 as an attending physician on the hospitalist service at Brigham and Women’s Hospital in Boston.

Dr. Bowmen

David Bowman, MD, executive director of IPC: The Hospitalist Company Inc.’s Tucson, Ariz., division, has received the Medical Group Management Association (MGMA) and American College of Medical Practice Executives (ACMPE) Physician Executive of the Year award for 2011. The award recognizes a physician executive in a medical group practice who has exhibited outstanding leadership to achieve exceptional performance in the delivery of healthcare in his or her practice and community through personal example and collaborative team management.

Dr. Gorman

Mary Jo Gorman, MD, MBA, MHM, chief executive officer and founder of Advanced ICU Care and former president of SHM, has been named a winner of the 2011 Ernst & Young Entrepreneurial Winning Women competition. The annual competition and leadership program honors female founders or co-founders of businesses whose success demonstrates the creativity, tenacity, and conviction necessary to realize their companies’ full potential and the drive to achieve market leadership.

One of 10 honorees, Dr. Gorman practiced as both an intensivist and a hospitalist physician before founding Advanced ICU Care in 2004. The company combines the technology of telemedicine with the clinical expertise of experienced intensivists and critical-care nurses to provide around-the-clock intensivist coverage.

Knoxville, Tenn.-based TeamHealth Holdings Inc. has announced the acquisition of the operations of Integrity Hospitalists Group LLC (IHG). IHG has been providing hospital medicine services at University Medical Center in Lebanon, Tenn., for the past four years. Physicians affiliated with IHG provide the general medical care of hospitalized patients who do not have an assigned PCP, or whose PCP has chosen to transfer care during their patients’ inpatient stay. TeamHealth Hospital Medicine has begun providing services for this 24/7 HM program, which manages about 10,000 patient encounters a year. Alexander Badru, MD, and Anthony Efobi, MD, have been providing inpatient services for University Medical Center since April 2007, and will continue in their roles with TeamHealth.

IPC: The Hospitalist Company Inc. has acquired five small practices in several of the company’s existing markets. The practices include: Lake Hospitalists Inc. in Leesburg, Fla.; the practice of Babar Sanaullah, MD, PLC, in Grand Rapids, Mich.; Comprehensive Wound Care Inc. in Phoenix, Ariz.; the practice of Ed Soumi, MD, PC, in Las Vegas; and the practice of Elliott I. Greenspan, DO, PC, in Bloomfield Hills, Mich. The five practices have a combined total of about 43,000 encounters a year.

IPC: The Hospitalist Company Inc. also has announced a management transition as part of its chief financial officer succession plan. Richard H. Kline has joined IPC as CFO; the company’s longtime CFO, Devra G. Shapiro, will become its chief administrative officer.

Knoxville, Tenn.-based TeamHealth Holdings Inc. has announced the acquisition of the operations of Integrity Hospitalists Group LLC (IHG). IHG has been providing hospital medicine services at University Medical Center in Lebanon, Tenn., for the past four years. Physicians affiliated with IHG provide the general medical care of hospitalized patients who do not have an assigned PCP, or whose PCP has chosen to transfer care during their patients’ inpatient stay. TeamHealth Hospital Medicine has begun providing services for this 24/7 HM program, which manages about 10,000 patient encounters a year. Alexander Badru, MD, and Anthony Efobi, MD, have been providing inpatient services for University Medical Center since April 2007, and will continue in their roles with TeamHealth.

IPC: The Hospitalist Company Inc. has acquired five small practices in several of the company’s existing markets. The practices include: Lake Hospitalists Inc. in Leesburg, Fla.; the practice of Babar Sanaullah, MD, PLC, in Grand Rapids, Mich.; Comprehensive Wound Care Inc. in Phoenix, Ariz.; the practice of Ed Soumi, MD, PC, in Las Vegas; and the practice of Elliott I. Greenspan, DO, PC, in Bloomfield Hills, Mich. The five practices have a combined total of about 43,000 encounters a year.

IPC: The Hospitalist Company Inc. also has announced a management transition as part of its chief financial officer succession plan. Richard H. Kline has joined IPC as CFO; the company’s longtime CFO, Devra G. Shapiro, will become its chief administrative officer.

Knoxville, Tenn.-based TeamHealth Holdings Inc. has announced the acquisition of the operations of Integrity Hospitalists Group LLC (IHG). IHG has been providing hospital medicine services at University Medical Center in Lebanon, Tenn., for the past four years. Physicians affiliated with IHG provide the general medical care of hospitalized patients who do not have an assigned PCP, or whose PCP has chosen to transfer care during their patients’ inpatient stay. TeamHealth Hospital Medicine has begun providing services for this 24/7 HM program, which manages about 10,000 patient encounters a year. Alexander Badru, MD, and Anthony Efobi, MD, have been providing inpatient services for University Medical Center since April 2007, and will continue in their roles with TeamHealth.

IPC: The Hospitalist Company Inc. has acquired five small practices in several of the company’s existing markets. The practices include: Lake Hospitalists Inc. in Leesburg, Fla.; the practice of Babar Sanaullah, MD, PLC, in Grand Rapids, Mich.; Comprehensive Wound Care Inc. in Phoenix, Ariz.; the practice of Ed Soumi, MD, PC, in Las Vegas; and the practice of Elliott I. Greenspan, DO, PC, in Bloomfield Hills, Mich. The five practices have a combined total of about 43,000 encounters a year.

IPC: The Hospitalist Company Inc. also has announced a management transition as part of its chief financial officer succession plan. Richard H. Kline has joined IPC as CFO; the company’s longtime CFO, Devra G. Shapiro, will become its chief administrative officer.

Dr. Li

SHM’s committees shape the future of HM. And you can be a part of that future by nominating yourself or colleagues for one of SHM’s committees, which cover topics from information technology to early career hospitalists and patient safety.

“The vision and the commitment of SHM’s committees are really what keep SHM and hospitalists ahead of the pack,” says SHM president Joseph Ming-Wah Li, MD, MPH, SFHM. “Getting involved in a committee that is relevant to your practice is a great way to share your passion for your work and connect with some of the most influential leaders in our growing specialty.”

Most committees meet regularly via conference call and meet once a year in person at the SHM annual meeting.

The deadline for nominations is Dec. 5. Interested SHM members can learn more by visiting www.hospitalmedicine.org/committees.

Dr. Li

SHM’s committees shape the future of HM. And you can be a part of that future by nominating yourself or colleagues for one of SHM’s committees, which cover topics from information technology to early career hospitalists and patient safety.

“The vision and the commitment of SHM’s committees are really what keep SHM and hospitalists ahead of the pack,” says SHM president Joseph Ming-Wah Li, MD, MPH, SFHM. “Getting involved in a committee that is relevant to your practice is a great way to share your passion for your work and connect with some of the most influential leaders in our growing specialty.”

Most committees meet regularly via conference call and meet once a year in person at the SHM annual meeting.

The deadline for nominations is Dec. 5. Interested SHM members can learn more by visiting www.hospitalmedicine.org/committees.

Dr. Li

SHM’s committees shape the future of HM. And you can be a part of that future by nominating yourself or colleagues for one of SHM’s committees, which cover topics from information technology to early career hospitalists and patient safety.

“The vision and the commitment of SHM’s committees are really what keep SHM and hospitalists ahead of the pack,” says SHM president Joseph Ming-Wah Li, MD, MPH, SFHM. “Getting involved in a committee that is relevant to your practice is a great way to share your passion for your work and connect with some of the most influential leaders in our growing specialty.”

Most committees meet regularly via conference call and meet once a year in person at the SHM annual meeting.

The deadline for nominations is Dec. 5. Interested SHM members can learn more by visiting www.hospitalmedicine.org/committees.

As with many specialties, female leaders in HM sometimes face different challenges than their male counterparts.

That’s why the next Leadership Academy, Feb. 13-16 in New Orleans, will include special programming specifically designed for women. Program elements include a networking session for female leaders in HM and educational sessions created for them.

“As hospital medicine continues to grow, so will the opportunities for women to become leaders within their hospitals and their hospitalist practices,” says Patience Reich, MD, SFHM. “The Leadership Academy in February will give women the chance to sharpen their leadership skills and share their own experiences with other women in the specialty.”

As part of the special programming for female leaders in healthcare, former healthcare executive and executive coach Kay Cannon will present a special seminar on women in HM. She will share her wisdom about career advancement essentials for the next generation of female leaders.

The academy features two four-day courses: “Foundations for Effective Leadership,” which is presented at every Leadership Academy, and “Advanced Leadership: Strengthening Your Organization,” which is presented once a year.

“Foundations for Effective Leadership” gives participants the primary tools necessary to become a successful HM leader and is the prerequisite for the other two courses in the series. “Advanced Leadership: Strengthening Your Organization” builds on the skills learned in “Foundations” and teaches hospitalists to better grow, manage, and motivate teams.

All SHM Leadership Academy courses are eligible for AMA PRA Category 1 credits.

The New Orleans academy also marks the second Leadership Academy opportunity for hospitalists to learn about SHM’s new Leadership Certification program. By guiding candidates through all three academy courses and a leadership project, Leadership Certification gives hospitalists a new way to tangibly demonstrate their leadership qualifications to their employers—and potential employers.

For more information, visit www.hospitalmedicine.org/leadership.

As with many specialties, female leaders in HM sometimes face different challenges than their male counterparts.

That’s why the next Leadership Academy, Feb. 13-16 in New Orleans, will include special programming specifically designed for women. Program elements include a networking session for female leaders in HM and educational sessions created for them.

“As hospital medicine continues to grow, so will the opportunities for women to become leaders within their hospitals and their hospitalist practices,” says Patience Reich, MD, SFHM. “The Leadership Academy in February will give women the chance to sharpen their leadership skills and share their own experiences with other women in the specialty.”

As part of the special programming for female leaders in healthcare, former healthcare executive and executive coach Kay Cannon will present a special seminar on women in HM. She will share her wisdom about career advancement essentials for the next generation of female leaders.

The academy features two four-day courses: “Foundations for Effective Leadership,” which is presented at every Leadership Academy, and “Advanced Leadership: Strengthening Your Organization,” which is presented once a year.

“Foundations for Effective Leadership” gives participants the primary tools necessary to become a successful HM leader and is the prerequisite for the other two courses in the series. “Advanced Leadership: Strengthening Your Organization” builds on the skills learned in “Foundations” and teaches hospitalists to better grow, manage, and motivate teams.

All SHM Leadership Academy courses are eligible for AMA PRA Category 1 credits.

The New Orleans academy also marks the second Leadership Academy opportunity for hospitalists to learn about SHM’s new Leadership Certification program. By guiding candidates through all three academy courses and a leadership project, Leadership Certification gives hospitalists a new way to tangibly demonstrate their leadership qualifications to their employers—and potential employers.

For more information, visit www.hospitalmedicine.org/leadership.

As with many specialties, female leaders in HM sometimes face different challenges than their male counterparts.

That’s why the next Leadership Academy, Feb. 13-16 in New Orleans, will include special programming specifically designed for women. Program elements include a networking session for female leaders in HM and educational sessions created for them.

“As hospital medicine continues to grow, so will the opportunities for women to become leaders within their hospitals and their hospitalist practices,” says Patience Reich, MD, SFHM. “The Leadership Academy in February will give women the chance to sharpen their leadership skills and share their own experiences with other women in the specialty.”

As part of the special programming for female leaders in healthcare, former healthcare executive and executive coach Kay Cannon will present a special seminar on women in HM. She will share her wisdom about career advancement essentials for the next generation of female leaders.

The academy features two four-day courses: “Foundations for Effective Leadership,” which is presented at every Leadership Academy, and “Advanced Leadership: Strengthening Your Organization,” which is presented once a year.

“Foundations for Effective Leadership” gives participants the primary tools necessary to become a successful HM leader and is the prerequisite for the other two courses in the series. “Advanced Leadership: Strengthening Your Organization” builds on the skills learned in “Foundations” and teaches hospitalists to better grow, manage, and motivate teams.

All SHM Leadership Academy courses are eligible for AMA PRA Category 1 credits.

The New Orleans academy also marks the second Leadership Academy opportunity for hospitalists to learn about SHM’s new Leadership Certification program. By guiding candidates through all three academy courses and a leadership project, Leadership Certification gives hospitalists a new way to tangibly demonstrate their leadership qualifications to their employers—and potential employers.

For more information, visit www.hospitalmedicine.org/leadership.