Drinking the Kool-Aid at SHM 2008

(This is the first in a series of observations on the SHM 2008 national meeting. I enjoy SHM meetings and attend as often as I can. Unfortunately I missed this one. Reading the many blog posts and talking with colleagues who have returned from San Diego may be the next best thing. This, my inaugural post, somewhat critical, does not reflect my overall positive impression of this and other SHM meetings as will be evident from future posts).

Being the fastest growing specialty in medicine must be heady stuff. Notwithstanding the excellent “hard core” clinical content at Society of Hospital Medicine (SHM) meetings the organizational portions of the content, from where I sit, are looking more and more like a Wal-Mart Shareholders Meeting. (If you lived in the back yard of Wal-Mart corporate headquarters as I do you’d know that that gala event is one massive pep rally).

But take a look at some of the self congratulatory and grandiose ideas bandied about in the official blog of the 2008 sessions! One of the speakers, referring to the lofty (and, in the view of some, unrealistic) opinions espoused by IHI leader Donald Berwick, urged attendees to “’drink the Berwick kool-aid’ and insert ourselves in the center of the healthcare system transformation.” Reading some of those posts you’d think the hospitalist movement was what was going to “fix” health care. Enough already. We need to drink a little less Kool-Aid and engage in some critical thinking about what’s being proposed.

There was a refreshing voice of moderation. Bob Wachter, wise and all knowing sage of the hospitalist movement, said in his podcast that hospitalists should be thoughtful about future growth. In the past the agenda of the movement was to make hospitalists indispensable. Now, noted Wachter, we need to be careful that we don’t become too indispensable. We can’t do everything. The hospitalist movement is not going to single handedly “fix” anything. If we as hospitalist colleagues can just help each other ascend the learning curve of cost effective, science based hospital medicine in the care of individual patients we will do well!