A Tour of Hospital Medicine in the Blogosphere

With the ranks of hospitalists already over 20,000 strong and growing every day, hospital medicine is the fastest-growing medical specialty in the history of American healthcare. With the height of the election season approaching, and the 2009 aftermath soon to follow, hospital medicine fi nds itself at the center of the debate over the future of the US healthcare system. The intense discussion regarding the future role of hospital medicine provides ample fertilizer for a fl owering blogosphere of commentary on hospitalists. Although a year ago there were not many hospitalist voices to be found online, seemingly from out of nowhere, there are now dozens of bloggers who regularly comment on hospital medicine issues great and small, enriching the debate and ensuring that a diverse range of opinion is heard.

Less than 15 years into its life cycle, hospital medicine’s mission and future is still very much in fl ux. Competing views on the appropriate scope of practice, the merits of various work schedules, diff erent business models, and the emergence of non-physician hospitalists bear witness to the high degree of untamed and latent energy that our specialty struggles to harness. Framing this debate are macro issues such as uncertainty surrounding Medicare reimbursement rates and the physician workforce shortage. Put it all together, and you have what amounts to a warm primordial soup of issues providing an ideal spawning ground for healthcare bloggers to stir to life. The healthcare community is wasting no time seizing the opportunity to make the most of it.

First on the scene Dr. Adam Singer, CEO of IPC The Hospitalist Company (and my employer), has been blogging at www.hospitalistblog.com for nearly two years, making his blog perhaps the fi rst and longest continually active hospitalist blog. As the voice of an organization with more than 800 affi liated hospitalists, Dr. Singer’s blog speaks for the largest hospitalist practice in the US and the only publicly owned practice focused on hospital medicine.

“I think it’s healthy for hospitalists and healthcare executives to speak out directly,” says Singer. “I enjoy the opportunity to communicate in a way that is unfi ltered by interviewers or editors. I try to stay out of the spin zone and say what’s on my mind.”

Unlike some other bloggers in this space, Singer isn’t much of a ranter or complainer in his blogging style. Rather, he tries to keep his messages positive and pointing toward workable solutions. This makes sense for Singer, since he leads an organization with the resources and the credibility to implement meaningful change in the fi eld. Singer lets his years as a practicing hospitalist, as well as his executive experience, be his guide as to which issues are right for his blog. Review Dr. Singer’s postings from the past year or so and what emerges is a message that says, in effect, that hospitalists must develop a multitude of skill sets in order to be successful; these skills include delivering quality patient care, demonstrating excellent communications and interpersonal skills, providing leadership to their facility, and showing a knack for systems and management skills. “I’m happy to share through the blog my 17 years of experience in this field,” he says.

A crowded field

Other hospitalist bloggers take diff erent approaches when it comes to style and content. Th e easiest way for readers to get exposure to the whole menagerie of hospital medicine bloggers is to sign up for Google Alerts under “hospitalist.” But be forewarned: you can expect to get at least 10 to 20 hits each day, so you have to be committed to following the action. A good portion of those alerts are related to job openings, so if you’re only interested in the blog material, you’ll want to dispatch with those quickly.

Hospitalists, as one might expect, are the largest group of active hospital medicine bloggers. Th e following is a brief sampling of a few blogs that I frequently read that regularly comment on hospital medicine:

The Happy Hospitalist

At http://thehappyhospitalist.blogspot.com, you’ll find an energetic hospitalist blogger with a keen wit and good sense of humor, blogging almost daily, mixing observations from his personal practice with views on more “big picture” issues. The Happy Hospitalist brings a very candid and forthright voice to the conversation.

Notes From Dr. RW

Another thoughtful blog from an individual hospitalist, R.W. Donnell’s blog offers measured views on a wide range of topics, approaching each in a very reasoned and articulate way, sometimes worthy of a more extensive treatment than a blog would accommodate. I find Dr. Donnell most engaging when he writes on public policy.

Wachter’s World

Dr. Robert Wachter’s blog, written for Th e Hospitalist magazine, has been active for nearly one year. With every new post, Dr. Wachter demonstrates that he is an important source for thought leadership in the field.

Today’s Hospitalist Another newcomer to the scene, this blog is written by Eric DeLue, MD, and Sandeep Sachdeeva, MD.

DB’s Medical Rants Robert Centor, MD, who blogs at www. medrants.com, maintains a cheerfully agnostic view of hospital medicine, lest we hurt our arms patting ourselves on the back and lose sight of how much remains undone and unanswered about the hospitalist specialty.

Other voices Primary care physician bloggers will sometimes discuss hospital medicine from their own perspective. Among the noteworthy are Jonathan Dee, blogging at www.nzou.com, and Dr. Theresa Chan’s blog on life as a rural family doctor at www.ruraldoctoring.com. I’ve found that primary care physician bloggers are infrequently critical of hospital medicine, which I take as an indication of how far hospitalists have come in their relationship with the primary care community.

Healthcare journalists have also started paying more attention to the hospitalist movement. The Wall Street Journal in particular has done a series of stories about hospital medicine, and its Health Blog by Jacob Goldstein and Sarah Rubenstein is often tuned in to the latest developments in our fi eld. As coverage of hospital medicine continues to proliferate in the mass media, and as the line between the blogosphere and traditional journalism continues to blur, you can expect to fi nd more widespread coverage in popular healthcare news blogs.

Patients also blog from time to time regarding their inpatient experiences under a hospitalist’s care. Negative or hostile blog comments are rare, thanks to the growing acceptance of hospitalists as the primary source for inpatient care and patient’s understanding and appreciation of the value of hospital medicine. Patient complaints in the blogosphere seem no more commonplace than for any other medical specialty. This is further validation of how hospital medicine has truly taken its seat at the table as a major player in the healthcare system.

It is a fortuitous coincidence that the blogosphere has come of age at the same time as hospital medicine; two major societal trends have dovetailed to give both providers and consumers a true voice in the formation of our medical specialty. It seems as if the blogosphere was made for hospitalists. All the readers and writers in the hospitalist blogosphere can be witnesses and participants as hospital medicine continues to defi ne its role as a major asset in the US healthcare system.

Todd J. Kislak is Vice President of Marketing and Development for IPC The Hospitalist Company, Inc, a leading national physician group practice company focused on the delivery of hospital medicine services. For more information, visit the IPC website at www.hospitalist.com.