Meeting The Future Of Hospital Medicine: Highlights From SHM’s 2019 Annual Conference
First… What happened at the SHM Annual Conference?
We kicked off HM19 by hosting a social during pre-course day at the National Pastime Sports Bar & Grill (picture). We were so surprised to meet amazing individuals from across the nation: Tennessee, Missouri, California, Illinois, and Florida! Those in attendance ranged from first-year medical students all the way through chief residents, and many shared that this was their first time attending an SHM conference. Everyone expressed how excited they were to present their research during the RIV poster competition and for the future of hospital medicine.
On the first day of the conference, the morning started out with a keynote from Intermountain Healthcare president and CEO Dr. Marc Harrison on the current state of healthcare and how we need to place a larger emphasis on cost transparency and addressing the social determinants of health. At the conference, there was an Early-Career Hospitalists Track, which was geared towards trainees and young hospitalists. The morning began with a session on how to maximize conference capital quick talk (i.e. how to create an elevator speech) by Dr. Pallabi Sanyal-Dey and Dr. Brian Kwan. Going along with that theme, there was then a session on “Call Night: Common Scenarios Encountered and Strategies to Make it Through the Night” by Dr. Patrick Rendon, Dr. Brian Kwan, and Dr. Pallabi Sanyal-Dey. Through this interactive session, trainees were able to learn how to manage conditions such as sleep management, hypoxia, and navigating the difficult encounters of patients who want to leave against medical advice (AMA). “Hospitalist Billing 101” by Dr. Alan Hall and Dr. Joseph Sweigart emphasized the connection between clinical documentation strategies and how that gets translated to E&M billing elements. They addressed common misconceptions and presented helpful tips!
Afterwards was the resident and student luncheon with more than 100 trainees, making this our largest turnout ever! Our trainees were able to meet various leaders in the field of hospital medicine from institutions throughout the nation. We also had two special guests, leaders from SHM, come say a few words about the importance of strengthening the trainee pipeline to hospital medicine: Dr. Eric Howell and Dr. Nasim Afsar.
Next was “A Whirlwind Tour of Famous Landmark (Articles): Must-Know Literature to Impress Your Peers and Attendings” by Dr. Dennis Chang and Dr. Daniel Ricotta. High-yield points included: the use of high flow oxygen in patients with acute hypoxic respiratory failure, that 5 days of antibiotics for community acquired pneumonia is adequate treatment if clinically stable with no fevers for 48 hours, and you can treat proximal DVT at home with a decreased length of stay, no statistically significant difference in recurrent VTE, major bleeding, or death while improving physical activity and social functioning! With this newfound knowledge, our trainees felt prepared to help teach some of my future medical students on the wards during my intern year.
There was an excellent workshop, “Tweet Your Way to The Top,” which was very interesting from a trainee perspective as we tend to see Twitter as more “old-school.” Drs. Charlie Wray, Vineet Chopra, and Vineet Arora revealed shocking things; people actually use Twitter to help with academic promotion, to network, disseminate medical knowledge, and to keep up with literature. Twitter is a great way to share your work because apparently nowadays, 55% of articles will never be read by anyone with the exception of the co-authors, peer reviewers and editors.
The programming for trainees concluded during day 1 with the Resident/Student Special Interest Group meeting moderated by Aram Namavar, Rachna Rawal, Pamela Vila, and Ara Vartanyan. We had 20 trainees in attendance and had a fruitful discussion centered on how SHM can better engage trainees in the domains of mentorship, content, and outreach. After this meeting was the exciting Research and Innovations Poster Competition, where presenters shared their amazing work in discharge planning, sleep quality improvement projects, and much more! At the end of Day 1, our trainees were already picking sessions for Day 2!
On Day 2, the lunch hour showcased a plethora of clinical vignette posters primarily by trainees. Throughout the day, there were sessions on updates in heart failure, infectious disease, pulmonary/critical care, diabetes and much more! A highlight of Day 2 was the “Updates in Hospital Medicine” plenary presented by Drs. Chris Moriates and Carrie Herzke. This session started with the BEST news ever for all trainees: COFFEE IS GOOD FOR YOU. Using analogies of Iron Man and other clever metaphors, they amazingly reviewed at least 20 landmark studies from JAMA, NEJM, BMJ, and Lancet within one hour! Other highlights to keep in your pocket to impress others on rounds: buprenorphine has a NNT of 50 for opioid use disorder (so ask your attending why are we not using it more?), oral antibiotics were NONINFERIOR compared to 6-week courses of IV antibiotics for left-sided endocarditis (assuming good outpatient follow-up), holding ACE-I for surgery, ESRD patients with atrial fibrillation may be able to be placed on apixaban, extra oxygen may “hurt” patients especially after MI/stroke (beware the oxygen fairies giving oxygen to all patients at night), and aromatherapy may be better than Zofran.
Later during Day 2, there were workshops on VTE prophylaxis (do all patients really need it?) and additional sessions regarding top clinical updates, such as why we should NOT give diabetic patients only sliding-scale insulin. Throughout the day, there were motivating oral presentation on the top research and innovations abstracts! Seeing all the amazing work happening in hospital medicine is exciting. The day concluded with sessions on high-value care, which many of our trainees explained was one of their favorites. The morning of Day 3 featured the engaging “Stump the Professor” and “Medical Jeopardy” sessions, which provided an opportunity to trainees to see how smart all those hospitalist attending physicians truly are. Our trainees enjoyed ending the conference with these sessions! For the trainees who presented, they were grateful and expressed excitement to attend again next year at HM20 in San Diego. We look forward to the advancements and innovations that will occur of this coming year and meeting the future of hospital medicine again!