Physicians routinely are deluged with offers for certifications in hospital medicine, geriatric medicine and other specialties. Unaccredited boards have been set up to solicit phony certifications requiring no training, testing or medical background review, according to Christine Cassel, MD, president and CEO of the American Board of Internal Medicine (ABIM).

ABIM is concerned about the welfare of patients who may choose doctors representing themselves as "board certified" based on a certificate from one of these unaccredited boards.

"Physicians should trust their instincts," Dr. Cassel says. "If a deal seems too good to be true, it probably is. Hospitalists should be especially wary of solicitations from the American Board of Hospital Physicians (ABOHP). The organization is not a member of the American Board of Medical Specialties (ABMS), and is not recognized by key healthcare credentialing accreditation entities."

Robert Wachter, MD, chief of the division of hospital medicine at the University of California San Francisco Medical Center and chair of ABIM's Committee on Hospital Medicine Focused Recognition, adds, "The ABIM has been working hard to create a pathway that recognizes the professional focus of internist-hospitalists, and I hope it will be available in the not-so-distant future. Personally, I encourage all hospitalists to pursue board certification and keep their certification up-to-date. This scam points out the importance of ensuring that the certification is legitimate."

If an unrecognizable organization sends you a board certificate offer, alert ABIM at security@abim.org.

Physicians routinely are deluged with offers for certifications in hospital medicine, geriatric medicine and other specialties. Unaccredited boards have been set up to solicit phony certifications requiring no training, testing or medical background review, according to Christine Cassel, MD, president and CEO of the American Board of Internal Medicine (ABIM).

ABIM is concerned about the welfare of patients who may choose doctors representing themselves as "board certified" based on a certificate from one of these unaccredited boards.

"Physicians should trust their instincts," Dr. Cassel says. "If a deal seems too good to be true, it probably is. Hospitalists should be especially wary of solicitations from the American Board of Hospital Physicians (ABOHP). The organization is not a member of the American Board of Medical Specialties (ABMS), and is not recognized by key healthcare credentialing accreditation entities."

Robert Wachter, MD, chief of the division of hospital medicine at the University of California San Francisco Medical Center and chair of ABIM's Committee on Hospital Medicine Focused Recognition, adds, "The ABIM has been working hard to create a pathway that recognizes the professional focus of internist-hospitalists, and I hope it will be available in the not-so-distant future. Personally, I encourage all hospitalists to pursue board certification and keep their certification up-to-date. This scam points out the importance of ensuring that the certification is legitimate."

If an unrecognizable organization sends you a board certificate offer, alert ABIM at security@abim.org.

Physicians routinely are deluged with offers for certifications in hospital medicine, geriatric medicine and other specialties. Unaccredited boards have been set up to solicit phony certifications requiring no training, testing or medical background review, according to Christine Cassel, MD, president and CEO of the American Board of Internal Medicine (ABIM).

ABIM is concerned about the welfare of patients who may choose doctors representing themselves as "board certified" based on a certificate from one of these unaccredited boards.

"Physicians should trust their instincts," Dr. Cassel says. "If a deal seems too good to be true, it probably is. Hospitalists should be especially wary of solicitations from the American Board of Hospital Physicians (ABOHP). The organization is not a member of the American Board of Medical Specialties (ABMS), and is not recognized by key healthcare credentialing accreditation entities."

Robert Wachter, MD, chief of the division of hospital medicine at the University of California San Francisco Medical Center and chair of ABIM's Committee on Hospital Medicine Focused Recognition, adds, "The ABIM has been working hard to create a pathway that recognizes the professional focus of internist-hospitalists, and I hope it will be available in the not-so-distant future. Personally, I encourage all hospitalists to pursue board certification and keep their certification up-to-date. This scam points out the importance of ensuring that the certification is legitimate."

If an unrecognizable organization sends you a board certificate offer, alert ABIM at security@abim.org.

What is the main reason women make less money than men in identical positions? A lack of negotiation skills, says Rachel George, MD, MBA, FHM, regional medical director and vice president of operations for Brentwood, Tenn.-based Cogent Healthcare.

“Women aren’t as comfortable negotiating as men are,” Dr. George says. “The fact is, individuals who ask for more generally get more.”

Dr. George offers women the following negotiation tips:

1. Investigate. Research average salaries for the position you are applying for, the region you live in, and the company you’d be working for. One place to start: the 2007-2008 SHM Bi-annual Survey on the State of the Hospital Medicine Movement.

2. Set goals. Define how much you want to make and ask for that amount. “You try harder when you set a goal,” Dr. George says.

3. Create BATNA. This concept, from the book “Getting to Yes: Negotiating Agreements Without Giving In”, is about the Best Alternative To a Negotiated Agreement (BATNA). Ask yourself: Do you have other positions lined up in case the one you’re applying for doesn’t work out?

4. Be realistic. Ridiculous offers will get you nowhere. Don’t ask for higher than the 95th percentile of the average salary for the position you’re applying for.

5. Look beyond salary. If your potential employer won’t budge on salary, consider other forms of compensation: CME money, PTO time, fewer work hours. “All these things can be negotiated to achieve the right package for you,” Dr. George says.

6. Practice, practice, practice. Negotiation is a learned trait; try role-playing with someone you trust.

7. Be persistent. Women tend to give up sooner than men. “Bargaining doesn’t end at the first conversation or transaction,” she says.

What is the main reason women make less money than men in identical positions? A lack of negotiation skills, says Rachel George, MD, MBA, FHM, regional medical director and vice president of operations for Brentwood, Tenn.-based Cogent Healthcare.

“Women aren’t as comfortable negotiating as men are,” Dr. George says. “The fact is, individuals who ask for more generally get more.”

Dr. George offers women the following negotiation tips:

1. Investigate. Research average salaries for the position you are applying for, the region you live in, and the company you’d be working for. One place to start: the 2007-2008 SHM Bi-annual Survey on the State of the Hospital Medicine Movement.

2. Set goals. Define how much you want to make and ask for that amount. “You try harder when you set a goal,” Dr. George says.

3. Create BATNA. This concept, from the book “Getting to Yes: Negotiating Agreements Without Giving In”, is about the Best Alternative To a Negotiated Agreement (BATNA). Ask yourself: Do you have other positions lined up in case the one you’re applying for doesn’t work out?

4. Be realistic. Ridiculous offers will get you nowhere. Don’t ask for higher than the 95th percentile of the average salary for the position you’re applying for.

5. Look beyond salary. If your potential employer won’t budge on salary, consider other forms of compensation: CME money, PTO time, fewer work hours. “All these things can be negotiated to achieve the right package for you,” Dr. George says.

6. Practice, practice, practice. Negotiation is a learned trait; try role-playing with someone you trust.

7. Be persistent. Women tend to give up sooner than men. “Bargaining doesn’t end at the first conversation or transaction,” she says.

What is the main reason women make less money than men in identical positions? A lack of negotiation skills, says Rachel George, MD, MBA, FHM, regional medical director and vice president of operations for Brentwood, Tenn.-based Cogent Healthcare.

“Women aren’t as comfortable negotiating as men are,” Dr. George says. “The fact is, individuals who ask for more generally get more.”

Dr. George offers women the following negotiation tips:

1. Investigate. Research average salaries for the position you are applying for, the region you live in, and the company you’d be working for. One place to start: the 2007-2008 SHM Bi-annual Survey on the State of the Hospital Medicine Movement.

2. Set goals. Define how much you want to make and ask for that amount. “You try harder when you set a goal,” Dr. George says.

3. Create BATNA. This concept, from the book “Getting to Yes: Negotiating Agreements Without Giving In”, is about the Best Alternative To a Negotiated Agreement (BATNA). Ask yourself: Do you have other positions lined up in case the one you’re applying for doesn’t work out?

4. Be realistic. Ridiculous offers will get you nowhere. Don’t ask for higher than the 95th percentile of the average salary for the position you’re applying for.

5. Look beyond salary. If your potential employer won’t budge on salary, consider other forms of compensation: CME money, PTO time, fewer work hours. “All these things can be negotiated to achieve the right package for you,” Dr. George says.

6. Practice, practice, practice. Negotiation is a learned trait; try role-playing with someone you trust.

7. Be persistent. Women tend to give up sooner than men. “Bargaining doesn’t end at the first conversation or transaction,” she says.

Dan Dressler, MD, MSc, FHM, was introduced to the hospitalist concept a decade ago during a breakout session at a Society of General Internal Medicine meeting. A resident at the time, Dressler immediately latched on to the HM concept.

“I was like, ‘Wow, this is interesting. There are a lot of fun, exciting people,’ ” he says. “I thought they had a great vision for medicine. It was the direction I wanted to go.”

Dr. Dressler joined SHM in 2000. Now he supervises the nation’s largest academic hospitalist program and is one of SHM’s newest board members. He officially joined the 12-member board at HM09 in Chicago and will serve a three-year term.

Now the director of education for the section of hospital medicine, associate professor and associate residency director in the department of medicine at Emory University School of Medicine in Atlanta, Dressler has a passion for teaching, evidence-based medicine, and quality initiatives. He’s worked in academic and community hospital settings; he’s served on SHM’s Education Committee; and he’s chaired SHM’s Core Competencies task force. “I have a huge interest in education,” Dr. Dressler says, adding he will serve as the course director for HM11 in Dallas.

His mission is to make sure all hospitalists across the country have the same baseline skills. “I consider this a new opportunity, a new challenge,” he says. “I believe SHM is a high-level, high-quality organization. It’s a group that is going to lead medicine.”

Dan Dressler, MD, MSc, FHM, was introduced to the hospitalist concept a decade ago during a breakout session at a Society of General Internal Medicine meeting. A resident at the time, Dressler immediately latched on to the HM concept.

“I was like, ‘Wow, this is interesting. There are a lot of fun, exciting people,’ ” he says. “I thought they had a great vision for medicine. It was the direction I wanted to go.”

Dr. Dressler joined SHM in 2000. Now he supervises the nation’s largest academic hospitalist program and is one of SHM’s newest board members. He officially joined the 12-member board at HM09 in Chicago and will serve a three-year term.

Now the director of education for the section of hospital medicine, associate professor and associate residency director in the department of medicine at Emory University School of Medicine in Atlanta, Dressler has a passion for teaching, evidence-based medicine, and quality initiatives. He’s worked in academic and community hospital settings; he’s served on SHM’s Education Committee; and he’s chaired SHM’s Core Competencies task force. “I have a huge interest in education,” Dr. Dressler says, adding he will serve as the course director for HM11 in Dallas.

His mission is to make sure all hospitalists across the country have the same baseline skills. “I consider this a new opportunity, a new challenge,” he says. “I believe SHM is a high-level, high-quality organization. It’s a group that is going to lead medicine.”

Dan Dressler, MD, MSc, FHM, was introduced to the hospitalist concept a decade ago during a breakout session at a Society of General Internal Medicine meeting. A resident at the time, Dressler immediately latched on to the HM concept.

“I was like, ‘Wow, this is interesting. There are a lot of fun, exciting people,’ ” he says. “I thought they had a great vision for medicine. It was the direction I wanted to go.”

Dr. Dressler joined SHM in 2000. Now he supervises the nation’s largest academic hospitalist program and is one of SHM’s newest board members. He officially joined the 12-member board at HM09 in Chicago and will serve a three-year term.

Now the director of education for the section of hospital medicine, associate professor and associate residency director in the department of medicine at Emory University School of Medicine in Atlanta, Dressler has a passion for teaching, evidence-based medicine, and quality initiatives. He’s worked in academic and community hospital settings; he’s served on SHM’s Education Committee; and he’s chaired SHM’s Core Competencies task force. “I have a huge interest in education,” Dr. Dressler says, adding he will serve as the course director for HM11 in Dallas.

His mission is to make sure all hospitalists across the country have the same baseline skills. “I consider this a new opportunity, a new challenge,” he says. “I believe SHM is a high-level, high-quality organization. It’s a group that is going to lead medicine.”

Researchers say they have found a strategy to overcome the limitations of haploidentical hematopoietic stem cell transplantation (HSCT).

To prevent the early, severe graft-versus-host disease (GVHD) associated with haploidentical HSCT, donor T cells reacting with recipient antigens are eliminated from the graft prior to transplant.

However, the depletion of T cells can lead to delayed immune reconstitution in the transplant recipient, which increases the risk of infection and death.

Results of a new study may help clinicians decrease those risks. The study showed that the infusion of specially engineered haploidentical donor T cells induced early reconstitution of post-HSCT immunity. These cells were also able to control GVHD and preserve a graft-versus-leukemia effect.

This study appeared in the May issue of The Lancet Oncology and was funded by the biotech company MolMed SpA.

Claudio Bordignon, MD, from the Raffaele Scientific Institute, Milan, Italy, and colleagues conducted this phase 1/2, multicenter, nonrandomized trial of haploidentical T-cell depleted HSCT in 50 high-risk leukemia patients in remission.

Of the 50 patients, 28 patients received T cells engineered to carry the herpes simplex thymidine kinase suicide gene (TK cells).

To prepare the TK cells, the researchers used the haploidentical donor T lymphocytes that were collected prior to mobilization with G-CSF or marrow harvesting of stem cells. The T lymphocytes were expanded in vitro and then transduced with the herpes simplex thymidine kinase suicide gene. This rendered the cells sensitive to the antiviral agent ganciclovir, which enabled the researchers to selectively eliminate the cells upon the development of GVHD.

Twenty-eight patients received a first dose of TK cells. If patients did not achieve immune reconstitution 30 days later, they received up to 3 additional monthly infusions of TK cells. Transplant recipients did not receive GVHD prophylaxis following TK cell infusion.

Twenty-two patients achieved immune reconstitution at a median time of 75 days after HSCT and 23 days following TK cell infusion. Immune reconstitution was dependent on the dose of TK cells.

A progressive decline in the number and severity of infectious complications occurred in patients with immune reconstitution. Patients without immune reconstitution continued to have more frequent and more severe infectious complications.

Nonrelapse mortality at 100 days posttransplant was lower in patients who achieved immune reconstitution than in those who did not, at 14% and 60%, respectively. The researchers said this was possibly due to protection from late infectious mortality.

Effective immune reconstitution did not increase the incidence of GVHD, the researchers said. Rates of GVHD were similar to rates reported in other studies. Ten patients developed grades 1 to 4 acute GVHD, and 1 patient developed chronic GVHD.

Dr Bordignon and colleagues said acute GVHD was directly associated with infiltration of the TK cells at affected lesions. The team was able to control acute GVHD by administering ganciclovir, thereby activating the suicide gene and eliminating the TK cells.

Researchers say they have found a strategy to overcome the limitations of haploidentical hematopoietic stem cell transplantation (HSCT).

To prevent the early, severe graft-versus-host disease (GVHD) associated with haploidentical HSCT, donor T cells reacting with recipient antigens are eliminated from the graft prior to transplant.

However, the depletion of T cells can lead to delayed immune reconstitution in the transplant recipient, which increases the risk of infection and death.

Results of a new study may help clinicians decrease those risks. The study showed that the infusion of specially engineered haploidentical donor T cells induced early reconstitution of post-HSCT immunity. These cells were also able to control GVHD and preserve a graft-versus-leukemia effect.

This study appeared in the May issue of The Lancet Oncology and was funded by the biotech company MolMed SpA.

Claudio Bordignon, MD, from the Raffaele Scientific Institute, Milan, Italy, and colleagues conducted this phase 1/2, multicenter, nonrandomized trial of haploidentical T-cell depleted HSCT in 50 high-risk leukemia patients in remission.

Of the 50 patients, 28 patients received T cells engineered to carry the herpes simplex thymidine kinase suicide gene (TK cells).

To prepare the TK cells, the researchers used the haploidentical donor T lymphocytes that were collected prior to mobilization with G-CSF or marrow harvesting of stem cells. The T lymphocytes were expanded in vitro and then transduced with the herpes simplex thymidine kinase suicide gene. This rendered the cells sensitive to the antiviral agent ganciclovir, which enabled the researchers to selectively eliminate the cells upon the development of GVHD.

Twenty-eight patients received a first dose of TK cells. If patients did not achieve immune reconstitution 30 days later, they received up to 3 additional monthly infusions of TK cells. Transplant recipients did not receive GVHD prophylaxis following TK cell infusion.

Twenty-two patients achieved immune reconstitution at a median time of 75 days after HSCT and 23 days following TK cell infusion. Immune reconstitution was dependent on the dose of TK cells.

A progressive decline in the number and severity of infectious complications occurred in patients with immune reconstitution. Patients without immune reconstitution continued to have more frequent and more severe infectious complications.

Nonrelapse mortality at 100 days posttransplant was lower in patients who achieved immune reconstitution than in those who did not, at 14% and 60%, respectively. The researchers said this was possibly due to protection from late infectious mortality.

Effective immune reconstitution did not increase the incidence of GVHD, the researchers said. Rates of GVHD were similar to rates reported in other studies. Ten patients developed grades 1 to 4 acute GVHD, and 1 patient developed chronic GVHD.

Dr Bordignon and colleagues said acute GVHD was directly associated with infiltration of the TK cells at affected lesions. The team was able to control acute GVHD by administering ganciclovir, thereby activating the suicide gene and eliminating the TK cells.

Researchers say they have found a strategy to overcome the limitations of haploidentical hematopoietic stem cell transplantation (HSCT).

To prevent the early, severe graft-versus-host disease (GVHD) associated with haploidentical HSCT, donor T cells reacting with recipient antigens are eliminated from the graft prior to transplant.

However, the depletion of T cells can lead to delayed immune reconstitution in the transplant recipient, which increases the risk of infection and death.

Results of a new study may help clinicians decrease those risks. The study showed that the infusion of specially engineered haploidentical donor T cells induced early reconstitution of post-HSCT immunity. These cells were also able to control GVHD and preserve a graft-versus-leukemia effect.

This study appeared in the May issue of The Lancet Oncology and was funded by the biotech company MolMed SpA.

Claudio Bordignon, MD, from the Raffaele Scientific Institute, Milan, Italy, and colleagues conducted this phase 1/2, multicenter, nonrandomized trial of haploidentical T-cell depleted HSCT in 50 high-risk leukemia patients in remission.

Of the 50 patients, 28 patients received T cells engineered to carry the herpes simplex thymidine kinase suicide gene (TK cells).

To prepare the TK cells, the researchers used the haploidentical donor T lymphocytes that were collected prior to mobilization with G-CSF or marrow harvesting of stem cells. The T lymphocytes were expanded in vitro and then transduced with the herpes simplex thymidine kinase suicide gene. This rendered the cells sensitive to the antiviral agent ganciclovir, which enabled the researchers to selectively eliminate the cells upon the development of GVHD.

Twenty-eight patients received a first dose of TK cells. If patients did not achieve immune reconstitution 30 days later, they received up to 3 additional monthly infusions of TK cells. Transplant recipients did not receive GVHD prophylaxis following TK cell infusion.

Twenty-two patients achieved immune reconstitution at a median time of 75 days after HSCT and 23 days following TK cell infusion. Immune reconstitution was dependent on the dose of TK cells.

A progressive decline in the number and severity of infectious complications occurred in patients with immune reconstitution. Patients without immune reconstitution continued to have more frequent and more severe infectious complications.

Nonrelapse mortality at 100 days posttransplant was lower in patients who achieved immune reconstitution than in those who did not, at 14% and 60%, respectively. The researchers said this was possibly due to protection from late infectious mortality.

Effective immune reconstitution did not increase the incidence of GVHD, the researchers said. Rates of GVHD were similar to rates reported in other studies. Ten patients developed grades 1 to 4 acute GVHD, and 1 patient developed chronic GVHD.

Dr Bordignon and colleagues said acute GVHD was directly associated with infiltration of the TK cells at affected lesions. The team was able to control acute GVHD by administering ganciclovir, thereby activating the suicide gene and eliminating the TK cells.

The hospitalist movement has turned the corner from an emerging field to an established specialty some 30,000 strong that will be a change agent for healthcare reform, SHM officials declared today at HM09 in Chicago.

"Hospital medicine is the elephant that stood up," says Larry Wellikson, MD, FHM, CEO of SHM. "We are no longer the new people, the little engine that could. We are a huge force moving through medicine and healthcare—we like to think to good purpose."

Dr. Wellikson's comments punctuated the annual State of HM address, which drew a record crowd of 2,000 at this year's sold-out conference. His comments were bookended by former SHM president Patrick Cawley, MD, FHM, and SHM President Scott Flanders, MD, FHM. All three touted the society's collaborations with other healthcare groups, quality initiatives, and the seemingly endless growth spurt in the field.

The addresses followed the induction of the inaugural class of Fellows in Hospital Medicine. More than 400 of the 514 fellows were in attendance. HM leaders point to the fellowship program as another milestone in cementing HM's place in healthcare. Other plaudits were bestowed upon the society's training programs for patient discharge, the attention paid to the needs of academic hospitalists, and the Public Policy Committee’s work in connecting with congressional leaders who are likely to help President Obama shepherd through major healthcare reforms this summer.

"For a specialty that is so new, we have an absolutely special seat at the table," Dr. Wellikson says. "We are now ready for prime time, ready to lead, and ready to go."

The hospitalist movement has turned the corner from an emerging field to an established specialty some 30,000 strong that will be a change agent for healthcare reform, SHM officials declared today at HM09 in Chicago.

"Hospital medicine is the elephant that stood up," says Larry Wellikson, MD, FHM, CEO of SHM. "We are no longer the new people, the little engine that could. We are a huge force moving through medicine and healthcare—we like to think to good purpose."

Dr. Wellikson's comments punctuated the annual State of HM address, which drew a record crowd of 2,000 at this year's sold-out conference. His comments were bookended by former SHM president Patrick Cawley, MD, FHM, and SHM President Scott Flanders, MD, FHM. All three touted the society's collaborations with other healthcare groups, quality initiatives, and the seemingly endless growth spurt in the field.

The addresses followed the induction of the inaugural class of Fellows in Hospital Medicine. More than 400 of the 514 fellows were in attendance. HM leaders point to the fellowship program as another milestone in cementing HM's place in healthcare. Other plaudits were bestowed upon the society's training programs for patient discharge, the attention paid to the needs of academic hospitalists, and the Public Policy Committee’s work in connecting with congressional leaders who are likely to help President Obama shepherd through major healthcare reforms this summer.

"For a specialty that is so new, we have an absolutely special seat at the table," Dr. Wellikson says. "We are now ready for prime time, ready to lead, and ready to go."

The hospitalist movement has turned the corner from an emerging field to an established specialty some 30,000 strong that will be a change agent for healthcare reform, SHM officials declared today at HM09 in Chicago.

"Hospital medicine is the elephant that stood up," says Larry Wellikson, MD, FHM, CEO of SHM. "We are no longer the new people, the little engine that could. We are a huge force moving through medicine and healthcare—we like to think to good purpose."

Dr. Wellikson's comments punctuated the annual State of HM address, which drew a record crowd of 2,000 at this year's sold-out conference. His comments were bookended by former SHM president Patrick Cawley, MD, FHM, and SHM President Scott Flanders, MD, FHM. All three touted the society's collaborations with other healthcare groups, quality initiatives, and the seemingly endless growth spurt in the field.

The addresses followed the induction of the inaugural class of Fellows in Hospital Medicine. More than 400 of the 514 fellows were in attendance. HM leaders point to the fellowship program as another milestone in cementing HM's place in healthcare. Other plaudits were bestowed upon the society's training programs for patient discharge, the attention paid to the needs of academic hospitalists, and the Public Policy Committee’s work in connecting with congressional leaders who are likely to help President Obama shepherd through major healthcare reforms this summer.

"For a specialty that is so new, we have an absolutely special seat at the table," Dr. Wellikson says. "We are now ready for prime time, ready to lead, and ready to go."

Who is better at decreasing mortality and length of stay: intensivists or hospitalists? Neither, researchers at Emory University in Atlanta report.

The group, led by Kristin Wise, MD, assistant professor of medicine at Emory, sought to answer this question at a time when an increasing number of hospitals are turning to hospitalists to fill manpower gaps in ICUs. For its timely research, the group is being honored: The Emory team's abstract was one of three chosen as HM09's Best of Research, Innovations, and Clinical Vignettes (RIV). The presenting abstracts received the highest scores; 409 abstracts were submitted for this year's RIV competition.

Emory's prospective, cohort study of 1,084 patients showed no statistically significant difference in mortality rate between patients treated by the intensivist team and the hospitalist ICU team. "It definitely shows hospitalists can provide high-quality ICU staffing … and can help address future critical-care needs as we’re facing an intensivist shortage," Dr. Wise says.

New Communication Tool

University of Michigan (UM) hospitalists Vineet I. Chopra, MBBS, MD, FACP, and Prasanth Gogineni, MD, together with a team of engineering students at UM, won the best of innovations award for their work on a Web site and iPhone application meant to replace the pager system healthcare teams currently use to communicate.

Using the application, known as MComm, hospitalists and other members of healthcare teams can delegate tasks to other physicians, as well as acknowledge when their own tasks are completed." Medical communication is fundamental to inpatient safety, quality, and cost of care," says Dr. Chopra, clinical assistant professor of medicine at UM. "We believe MComm represents a technological breakthrough in medical communication and the process of improving workflow. The use of electronic technology that organizes patients according to team and priority is unprecedented."

Inspirational Case

Twylla Tassava, MS, MD, administrator of academic consult service at Saint Joseph Mercy Hospital in Ann Arbor, Mich., described a novel way to treat intracranial pressure in patients with diabetes insipidus.

A 17-year-old female whose car was hit by a truck traveling 50 mph presented with a Glasgow coma score of 4 and multiple traumatic injuries. The hospitalist team was consulted on day two, when the patient released 1,790 cc of urine in one hour, an indication of diabetes insipudis (DI). When DI occurs within the first three days of brain injury, research shows the mortality rate to be 86%. Dr. Tassava’s team proposed using permissive hypernatremia to control the patient’s intracranial pressure.

The result: The patient recovered and is now a healthy 18-year-old college student with superior intellectual skills, normal motor function, and only mild memory impairment.

Who is better at decreasing mortality and length of stay: intensivists or hospitalists? Neither, researchers at Emory University in Atlanta report.

The group, led by Kristin Wise, MD, assistant professor of medicine at Emory, sought to answer this question at a time when an increasing number of hospitals are turning to hospitalists to fill manpower gaps in ICUs. For its timely research, the group is being honored: The Emory team's abstract was one of three chosen as HM09's Best of Research, Innovations, and Clinical Vignettes (RIV). The presenting abstracts received the highest scores; 409 abstracts were submitted for this year's RIV competition.

Emory's prospective, cohort study of 1,084 patients showed no statistically significant difference in mortality rate between patients treated by the intensivist team and the hospitalist ICU team. "It definitely shows hospitalists can provide high-quality ICU staffing … and can help address future critical-care needs as we’re facing an intensivist shortage," Dr. Wise says.

New Communication Tool

University of Michigan (UM) hospitalists Vineet I. Chopra, MBBS, MD, FACP, and Prasanth Gogineni, MD, together with a team of engineering students at UM, won the best of innovations award for their work on a Web site and iPhone application meant to replace the pager system healthcare teams currently use to communicate.

Using the application, known as MComm, hospitalists and other members of healthcare teams can delegate tasks to other physicians, as well as acknowledge when their own tasks are completed." Medical communication is fundamental to inpatient safety, quality, and cost of care," says Dr. Chopra, clinical assistant professor of medicine at UM. "We believe MComm represents a technological breakthrough in medical communication and the process of improving workflow. The use of electronic technology that organizes patients according to team and priority is unprecedented."

Inspirational Case

Twylla Tassava, MS, MD, administrator of academic consult service at Saint Joseph Mercy Hospital in Ann Arbor, Mich., described a novel way to treat intracranial pressure in patients with diabetes insipidus.

A 17-year-old female whose car was hit by a truck traveling 50 mph presented with a Glasgow coma score of 4 and multiple traumatic injuries. The hospitalist team was consulted on day two, when the patient released 1,790 cc of urine in one hour, an indication of diabetes insipudis (DI). When DI occurs within the first three days of brain injury, research shows the mortality rate to be 86%. Dr. Tassava’s team proposed using permissive hypernatremia to control the patient’s intracranial pressure.

The result: The patient recovered and is now a healthy 18-year-old college student with superior intellectual skills, normal motor function, and only mild memory impairment.

Who is better at decreasing mortality and length of stay: intensivists or hospitalists? Neither, researchers at Emory University in Atlanta report.

The group, led by Kristin Wise, MD, assistant professor of medicine at Emory, sought to answer this question at a time when an increasing number of hospitals are turning to hospitalists to fill manpower gaps in ICUs. For its timely research, the group is being honored: The Emory team's abstract was one of three chosen as HM09's Best of Research, Innovations, and Clinical Vignettes (RIV). The presenting abstracts received the highest scores; 409 abstracts were submitted for this year's RIV competition.

Emory's prospective, cohort study of 1,084 patients showed no statistically significant difference in mortality rate between patients treated by the intensivist team and the hospitalist ICU team. "It definitely shows hospitalists can provide high-quality ICU staffing … and can help address future critical-care needs as we’re facing an intensivist shortage," Dr. Wise says.

New Communication Tool

University of Michigan (UM) hospitalists Vineet I. Chopra, MBBS, MD, FACP, and Prasanth Gogineni, MD, together with a team of engineering students at UM, won the best of innovations award for their work on a Web site and iPhone application meant to replace the pager system healthcare teams currently use to communicate.

Using the application, known as MComm, hospitalists and other members of healthcare teams can delegate tasks to other physicians, as well as acknowledge when their own tasks are completed." Medical communication is fundamental to inpatient safety, quality, and cost of care," says Dr. Chopra, clinical assistant professor of medicine at UM. "We believe MComm represents a technological breakthrough in medical communication and the process of improving workflow. The use of electronic technology that organizes patients according to team and priority is unprecedented."

Inspirational Case

Twylla Tassava, MS, MD, administrator of academic consult service at Saint Joseph Mercy Hospital in Ann Arbor, Mich., described a novel way to treat intracranial pressure in patients with diabetes insipidus.

A 17-year-old female whose car was hit by a truck traveling 50 mph presented with a Glasgow coma score of 4 and multiple traumatic injuries. The hospitalist team was consulted on day two, when the patient released 1,790 cc of urine in one hour, an indication of diabetes insipudis (DI). When DI occurs within the first three days of brain injury, research shows the mortality rate to be 86%. Dr. Tassava’s team proposed using permissive hypernatremia to control the patient’s intracranial pressure.

The result: The patient recovered and is now a healthy 18-year-old college student with superior intellectual skills, normal motor function, and only mild memory impairment.

The hospital of the future will be smaller and more focused in its clinical care, and it will compete with cutting-edge technology available to patients in their homes, their shopping haunts, and their pharmacies, Narendra Kini, MD, MHA, said today during the pediatric keynote address at HM09 in Chicago.

Dr. Kini, president and CEO of Miami Children's Hospital, says changes affecting hospitalists—such as the automation of routine chores performed by hospitalists and the growth of retail clinics—might be just "whispers" now, but they likely will force fundamental changes in how pediatricians deliver care. And while the individual technologies might not seem like a paradigm shift, new products and procedures like Google Health will create better-educated patients who demand to be partners in their clinical decisions, Dr. Kini adds.

"The technology is irrelevant. What it is is the trends," Dr. Kini says. "When the market demands it, it is here to stay."

But electronic medical records (EMR) and other IT upgrades cost money that many children's hospitals simply don't have in today's economy, says Jeff Bennett, MD, FAAP, FHM, of Kentucky Children's Hospital in Lexington, Ky. "There's a huge cost attached," Dr. Bennett says. "We're talking about massive outlays of money."

Dr. Kini says he understands limitations and doesn't expect pediatric hospitalists or their institutions to adapt immediately. But he wants pediatric HM leaders to start looking at the next 10 years of industry growth to ensure they chart a growth curve.

"You're letting others dictate the parameters of your profession," Dr. Kini says. "You can't let government and payors do that. What does hospital medicine want to be in 2015? You should be answering that now."

The hospital of the future will be smaller and more focused in its clinical care, and it will compete with cutting-edge technology available to patients in their homes, their shopping haunts, and their pharmacies, Narendra Kini, MD, MHA, said today during the pediatric keynote address at HM09 in Chicago.

Dr. Kini, president and CEO of Miami Children's Hospital, says changes affecting hospitalists—such as the automation of routine chores performed by hospitalists and the growth of retail clinics—might be just "whispers" now, but they likely will force fundamental changes in how pediatricians deliver care. And while the individual technologies might not seem like a paradigm shift, new products and procedures like Google Health will create better-educated patients who demand to be partners in their clinical decisions, Dr. Kini adds.

"The technology is irrelevant. What it is is the trends," Dr. Kini says. "When the market demands it, it is here to stay."

But electronic medical records (EMR) and other IT upgrades cost money that many children's hospitals simply don't have in today's economy, says Jeff Bennett, MD, FAAP, FHM, of Kentucky Children's Hospital in Lexington, Ky. "There's a huge cost attached," Dr. Bennett says. "We're talking about massive outlays of money."

Dr. Kini says he understands limitations and doesn't expect pediatric hospitalists or their institutions to adapt immediately. But he wants pediatric HM leaders to start looking at the next 10 years of industry growth to ensure they chart a growth curve.

"You're letting others dictate the parameters of your profession," Dr. Kini says. "You can't let government and payors do that. What does hospital medicine want to be in 2015? You should be answering that now."

The hospital of the future will be smaller and more focused in its clinical care, and it will compete with cutting-edge technology available to patients in their homes, their shopping haunts, and their pharmacies, Narendra Kini, MD, MHA, said today during the pediatric keynote address at HM09 in Chicago.

Dr. Kini, president and CEO of Miami Children's Hospital, says changes affecting hospitalists—such as the automation of routine chores performed by hospitalists and the growth of retail clinics—might be just "whispers" now, but they likely will force fundamental changes in how pediatricians deliver care. And while the individual technologies might not seem like a paradigm shift, new products and procedures like Google Health will create better-educated patients who demand to be partners in their clinical decisions, Dr. Kini adds.

"The technology is irrelevant. What it is is the trends," Dr. Kini says. "When the market demands it, it is here to stay."

But electronic medical records (EMR) and other IT upgrades cost money that many children's hospitals simply don't have in today's economy, says Jeff Bennett, MD, FAAP, FHM, of Kentucky Children's Hospital in Lexington, Ky. "There's a huge cost attached," Dr. Bennett says. "We're talking about massive outlays of money."

Dr. Kini says he understands limitations and doesn't expect pediatric hospitalists or their institutions to adapt immediately. But he wants pediatric HM leaders to start looking at the next 10 years of industry growth to ensure they chart a growth curve.

"You're letting others dictate the parameters of your profession," Dr. Kini says. "You can't let government and payors do that. What does hospital medicine want to be in 2015? You should be answering that now."

HM09's exhibit hall was abuzz today as representatives from about 200 companies stood poised and ready to greet a steady stream of hospitalists making their way into the hall following this morning's plenary sessions.

The American College of Chest Physicians' (ACCP) booth, for example, was quickly enveloped by hospitalists trying out the society’s robotic patient stimulator. "We use [it] to train physicians at the variety of courses that the college offers," explains Chad Jackson, MS, RRT, CHT, senior manager of clinical skill and simulation education for the ACCP. "This robotic stimulator is very realistic: He breathes, he bleeds, he pees. We can shock him just like you do real patients."

This is Mark Jamieson's fourth SHM annual meeting. The regional vice president of PatientKeeper, an IT company based in Newton, Mass., says the feedback his company receives at annual meetings influences product development. "A lot of times you go to these shows and you talk to administrators and IT people," he says. "This is one of the very few shows where you talk to docs who are doing the work every day."

Jamieson, who expects to talk to more than 200 hospitalists today, says he's witnessed HM's growth firsthand. "Four years ago when we were in Chicago you'd talk to people and they'd say, 'Yea, we're starting a hospital group, there are four of us now and we're looking to get more.' Then you see those same people the next year and they say, 'There are five of us and we want one more.' The next year they'd say, 'There are 12 of us and we want to get to 20.' It's interesting to see this movement, this segment grow."

HM09's exhibit hall was abuzz today as representatives from about 200 companies stood poised and ready to greet a steady stream of hospitalists making their way into the hall following this morning's plenary sessions.

The American College of Chest Physicians' (ACCP) booth, for example, was quickly enveloped by hospitalists trying out the society’s robotic patient stimulator. "We use [it] to train physicians at the variety of courses that the college offers," explains Chad Jackson, MS, RRT, CHT, senior manager of clinical skill and simulation education for the ACCP. "This robotic stimulator is very realistic: He breathes, he bleeds, he pees. We can shock him just like you do real patients."

This is Mark Jamieson's fourth SHM annual meeting. The regional vice president of PatientKeeper, an IT company based in Newton, Mass., says the feedback his company receives at annual meetings influences product development. "A lot of times you go to these shows and you talk to administrators and IT people," he says. "This is one of the very few shows where you talk to docs who are doing the work every day."

Jamieson, who expects to talk to more than 200 hospitalists today, says he's witnessed HM's growth firsthand. "Four years ago when we were in Chicago you'd talk to people and they'd say, 'Yea, we're starting a hospital group, there are four of us now and we're looking to get more.' Then you see those same people the next year and they say, 'There are five of us and we want one more.' The next year they'd say, 'There are 12 of us and we want to get to 20.' It's interesting to see this movement, this segment grow."

HM09's exhibit hall was abuzz today as representatives from about 200 companies stood poised and ready to greet a steady stream of hospitalists making their way into the hall following this morning's plenary sessions.

The American College of Chest Physicians' (ACCP) booth, for example, was quickly enveloped by hospitalists trying out the society’s robotic patient stimulator. "We use [it] to train physicians at the variety of courses that the college offers," explains Chad Jackson, MS, RRT, CHT, senior manager of clinical skill and simulation education for the ACCP. "This robotic stimulator is very realistic: He breathes, he bleeds, he pees. We can shock him just like you do real patients."

This is Mark Jamieson's fourth SHM annual meeting. The regional vice president of PatientKeeper, an IT company based in Newton, Mass., says the feedback his company receives at annual meetings influences product development. "A lot of times you go to these shows and you talk to administrators and IT people," he says. "This is one of the very few shows where you talk to docs who are doing the work every day."

Jamieson, who expects to talk to more than 200 hospitalists today, says he's witnessed HM's growth firsthand. "Four years ago when we were in Chicago you'd talk to people and they'd say, 'Yea, we're starting a hospital group, there are four of us now and we're looking to get more.' Then you see those same people the next year and they say, 'There are five of us and we want one more.' The next year they'd say, 'There are 12 of us and we want to get to 20.' It's interesting to see this movement, this segment grow."

Vascular access to a chicken, coding guidelines for NPs and PAs, and a new course to earn points toward the American Board of Internal Medicine’s Maintenance of Certification (MOC) program were among the highlights as SHM kicked off its annual meeting today in Chicago.

The first of four days at HM09 started with a slate of seven pre-courses to help hospitalists earn CME credit and provide participants a chance to learn about the latest HM trends. CME sessions included best practices for HM group management, critical-care medicine, approaches to clinical teaching, and the ever-popular didactic forum with hands-on procedures training.

"It's intimidating when you feel like you've gotten behind the curve," says Mark Ault, MD, director of the division of general internal medicine and assistant chairman for clinical affairs of the Department of Medicine at Cedars-Sinai Medical Center in Los Angeles. "It’s energizing to be brought back up" to speed.

An instructor, Dr. Ault was showcasing ultrasound technology in the crowded procedures session where physicians at his station practiced central-line placement on chickens. Attendance at each of the seven pre-courses was high. In fact, the room hosting the critical care program had half a dozen physicians sitting on the floor.

One of the more popular sessions was the certification pre-course, which featured automated keypads and a daylong sampling of board-like questions. Physicians’ answers to the questions—right and wrong—were displayed and discussed between participants and instructors.

Vascular access to a chicken, coding guidelines for NPs and PAs, and a new course to earn points toward the American Board of Internal Medicine’s Maintenance of Certification (MOC) program were among the highlights as SHM kicked off its annual meeting today in Chicago.

The first of four days at HM09 started with a slate of seven pre-courses to help hospitalists earn CME credit and provide participants a chance to learn about the latest HM trends. CME sessions included best practices for HM group management, critical-care medicine, approaches to clinical teaching, and the ever-popular didactic forum with hands-on procedures training.

"It's intimidating when you feel like you've gotten behind the curve," says Mark Ault, MD, director of the division of general internal medicine and assistant chairman for clinical affairs of the Department of Medicine at Cedars-Sinai Medical Center in Los Angeles. "It’s energizing to be brought back up" to speed.

An instructor, Dr. Ault was showcasing ultrasound technology in the crowded procedures session where physicians at his station practiced central-line placement on chickens. Attendance at each of the seven pre-courses was high. In fact, the room hosting the critical care program had half a dozen physicians sitting on the floor.

One of the more popular sessions was the certification pre-course, which featured automated keypads and a daylong sampling of board-like questions. Physicians’ answers to the questions—right and wrong—were displayed and discussed between participants and instructors.

Vascular access to a chicken, coding guidelines for NPs and PAs, and a new course to earn points toward the American Board of Internal Medicine’s Maintenance of Certification (MOC) program were among the highlights as SHM kicked off its annual meeting today in Chicago.

The first of four days at HM09 started with a slate of seven pre-courses to help hospitalists earn CME credit and provide participants a chance to learn about the latest HM trends. CME sessions included best practices for HM group management, critical-care medicine, approaches to clinical teaching, and the ever-popular didactic forum with hands-on procedures training.

"It's intimidating when you feel like you've gotten behind the curve," says Mark Ault, MD, director of the division of general internal medicine and assistant chairman for clinical affairs of the Department of Medicine at Cedars-Sinai Medical Center in Los Angeles. "It’s energizing to be brought back up" to speed.

An instructor, Dr. Ault was showcasing ultrasound technology in the crowded procedures session where physicians at his station practiced central-line placement on chickens. Attendance at each of the seven pre-courses was high. In fact, the room hosting the critical care program had half a dozen physicians sitting on the floor.

One of the more popular sessions was the certification pre-course, which featured automated keypads and a daylong sampling of board-like questions. Physicians’ answers to the questions—right and wrong—were displayed and discussed between participants and instructors.

Katherine Dallow, MD, is attending HM09 to interact with colleagues, take a variety of CME courses, and to prepare for American Board of Internal Medicine (ABIM) board certification.

"I already feel smarter," says Dr. Dallow, a hospitalist at Beth Israel Deaconess Medical Center in Boston.

Dr. Dallow, one of more than 2,000 hospitalists attending the annual meeting, says she enjoys how SHM condenses all of its events into four days. "There is not a single period of time when there isn't a lecture you want to go to," she says.

In fact, HM09's course offerings are what motivated Gonzalo Eymin, MD, to travel to Chicago from his hometown of Santiago, Chile. Dr. Eymin, one of six internists at Clinical Hospital of the Catholic University of Chile who work primarily with inpatients, says he wants to learn how the HM model works in the U.S. The term "hospitalist" doesn't exist in Chile, he says.

"It's changing in the medical environment, but the economic people, the people who handle the money, [are who] we have to convince," he says.

Even though he's been a practicing hospitalist since 1993, J. Kevin Shustari, MD, FHM, is as confused as ever about reimbursement issues. That's why he's focusing on HM09's coding and billing sessions.

"There are things that are still nebulous," says Dr. Shustari, director of Hospital Internists of New London, an HM group based in Farmington, Conn. "One of the things that’s really gratifying to see is that everybody is struggling with the same issues across the country on a national level: billing, how to conduct a practice effectively, scheduling. We’re still an evolving specialty, so we’re all still learning."

Katherine Dallow, MD, is attending HM09 to interact with colleagues, take a variety of CME courses, and to prepare for American Board of Internal Medicine (ABIM) board certification.

"I already feel smarter," says Dr. Dallow, a hospitalist at Beth Israel Deaconess Medical Center in Boston.

Dr. Dallow, one of more than 2,000 hospitalists attending the annual meeting, says she enjoys how SHM condenses all of its events into four days. "There is not a single period of time when there isn't a lecture you want to go to," she says.

In fact, HM09's course offerings are what motivated Gonzalo Eymin, MD, to travel to Chicago from his hometown of Santiago, Chile. Dr. Eymin, one of six internists at Clinical Hospital of the Catholic University of Chile who work primarily with inpatients, says he wants to learn how the HM model works in the U.S. The term "hospitalist" doesn't exist in Chile, he says.

"It's changing in the medical environment, but the economic people, the people who handle the money, [are who] we have to convince," he says.

Even though he's been a practicing hospitalist since 1993, J. Kevin Shustari, MD, FHM, is as confused as ever about reimbursement issues. That's why he's focusing on HM09's coding and billing sessions.

"There are things that are still nebulous," says Dr. Shustari, director of Hospital Internists of New London, an HM group based in Farmington, Conn. "One of the things that’s really gratifying to see is that everybody is struggling with the same issues across the country on a national level: billing, how to conduct a practice effectively, scheduling. We’re still an evolving specialty, so we’re all still learning."

Katherine Dallow, MD, is attending HM09 to interact with colleagues, take a variety of CME courses, and to prepare for American Board of Internal Medicine (ABIM) board certification.

"I already feel smarter," says Dr. Dallow, a hospitalist at Beth Israel Deaconess Medical Center in Boston.

Dr. Dallow, one of more than 2,000 hospitalists attending the annual meeting, says she enjoys how SHM condenses all of its events into four days. "There is not a single period of time when there isn't a lecture you want to go to," she says.

In fact, HM09's course offerings are what motivated Gonzalo Eymin, MD, to travel to Chicago from his hometown of Santiago, Chile. Dr. Eymin, one of six internists at Clinical Hospital of the Catholic University of Chile who work primarily with inpatients, says he wants to learn how the HM model works in the U.S. The term "hospitalist" doesn't exist in Chile, he says.

"It's changing in the medical environment, but the economic people, the people who handle the money, [are who] we have to convince," he says.

Even though he's been a practicing hospitalist since 1993, J. Kevin Shustari, MD, FHM, is as confused as ever about reimbursement issues. That's why he's focusing on HM09's coding and billing sessions.

"There are things that are still nebulous," says Dr. Shustari, director of Hospital Internists of New London, an HM group based in Farmington, Conn. "One of the things that’s really gratifying to see is that everybody is struggling with the same issues across the country on a national level: billing, how to conduct a practice effectively, scheduling. We’re still an evolving specialty, so we’re all still learning."