Vegas Awaits: Hospital Medicine 2017

I’m packing up for Vegas. I always look forward to the yearly conference. And back in Vegas, expectations are high. However, we all know there will be one or two distractions from the conference schedule.

Here are few takeaways I hope to obtain from both the conference and Vegas.

  1. Building Community
  2. The Power of Networking
  3. Placing the Right Bets
  4. The Importance of Arts
  5. AYCE Benefits

Building Community

While I’m in Vegas, I may wander north of the strip and head for Container Park and the Downtown Project. The Zappos CEO poured $350 million of his wealth into this downtown Las Vegas project, with the goal of rapidly building a community from scratch as start-up city. Health can be impacted by the design of a city, and many cities are taking that cue. The Downtown Project wanted to create a walkable city and a new tech industry while experimenting with city building at the private level. The community measures collisions, where random chance encounters occur. Folks from different disciplines cross paths regularly and eventually begin to collaborate. In the hospital setting, when we linger at nursing stations, chat up colleagues in the lounge, we do ourselves a service rather than hide away in our hospitalist office. How can we foster that in the hospital? In the community?

Health can be designed into planning. In suburbia, cul de sacs are the dead ends of city planning. Someone living in midtown Atlanta, with walkable spaces, is likely to weigh 10 pounds less than a similar person living in the suburbs north of the city.

Vivek Murthy, our, unfortunately, former surgeon general, spoke to this idea last year at HM16. Hospitalists focus on improving the hospital; those walls keep us confined in our geography and our thinking about health. Dr. Murthy inspired us last year to think beyond the hospital, where our impact can be exponentially powerful. I recently joined two local committees that play a role improving the lives of the underserved in my county.

The Power of Networking

Two of the most important aspects of SHM conferences for me are leaving geared up to tackle challenges at home and meeting inspiring new contacts to bounce ideas off of. Every year, I leave impressed with the innovative work occurring at hospitals across the country. At the conference, reconnections and new connections abound. I always enjoy finding former colleagues. But I will make that extra effort to meet someone new, swap ideas and come up with new ones together. I brought back Project BOOST to my hospital years ago after chatting it up with Mark Williams, at that time a new initiative. I was inspired to do bedside rounding after conversations with Jason Stein and others who had implemented his work. New ideas spring out of the quality improvement special interest forum each year, sometimes in the fellows lounge over an afternoon snack, and I always enjoy meeting new committee members.

 Placing the Right Bets

Some of the tables have better house odds than others. Playing blackjack, with a good strategy, favors the house by only 1% or less. Craps and roulette can also have decent odds if you have a consistent strategy. However, if you hit the slots, the odds lean to 5% or more to the casino. If you do enjoy the slots, your odds get better with higher denomination slots than the penny slots.

Finding the right bets at work takes some strategy as well. For instance, go for the quality improvement projects that favor the house. That means knowing the goals of the administration, your hospitalist director or the ER before you tackle a new project. For large projects, knowing the administration’s goals – and lining up to meet those goals – will garner you more support and more likely long-term success. Leverage that success for future projects.

The Importance of Arts

There is always a show to catch in Vegas, something for everyone up and down the strip. You might not define each of these as “art”, but for every Tape Face and Carrot Top there is a Cirque du Soleil or Elton John.

I’m a firm believer in the power of the arts. Stories and theater can inspire and heal. They also add perspective, foster empathy and add new insights. Seeing problems from the patient’s perspective and the new challenges from your director’s perspective can help you become more engaged and more compassionate in your approach.

Enjoy the Buffets

The buffets are a bit of a win/lose strategy. I am always amazed at the endless choices, hungry with the variety, and then leave bloated with regret and the aftertaste of infinite flavors as I crawl out. Seinfeld describes buffets as a “food-human interaction environment that’s basically like driving your dog up to Petco, giving him money and saying to him, ‘Why don’t you go in and get whatever you think you should have?’”

 “No one would go into a restaurant and say to the waiter, ‘I want a yogurt parfait, spare ribs waffle, four cookies and an egg white omelet.’” –Jerry Seinfeld

Choice has its challenges but offering up variety introduces us to new experiences.

Next week will provide no shortage of choices. Sometimes the list feels a bit overwhelming. A buffet of educational opportunities to explore: quality, practice management, clinical updates in short or big bites, academic and research sessions, and high-value care, among others. I will want one of everything but know any bet on these will be good ones. This will be the one place in Vegas where everyone will be a winner.

There’s a lot to see in the glitz and glam. I hope to see you there, perhaps at the buffet, at the blackjack table, walking the strip or sharing new ideas about the future of hospital medicine.

What happens in Vegas will definitely not stay there. Bring some lessons home, and share the wealth.

Jordan Messler

Jordan is a hospitalist at Morton Plant Hospitalists in Clearwater, Florida. He currently chairs SHM’s Quality and Patient Safety Committee. In addition, he’s been active in several SHM mentoring programs, most recently with Project BOOST and Glycemic Control. He went to medical school at University of South Florida, in Tampa, and completed his residency at Emory University.

He recognizes the challenges of working in a hospital that lines the intracostal waterways of a spring break mecca. Requests that if you want to be selected as a mentored site, you will have a similar location with palm trees and coastline nearby. He tries to find time to sit on the beach with his family to escape the hospital’s miasma. While there, he looks forward to reading about the history of hospitals/medicine, and how it relates to quality (Anti-UpToDate reading material). But inevitably will get a five year old dumping sand on him, and then has to explain why she is buried up to her neck.

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