Equal rights for general internists?
Equal rights for general internists?
Matthew Grayson Tuck
0 Medical University of South Carolina , Charleston, SC , USA
1 George Washington University School of Medicine and Health Sciences , Washington, DC , USA
2 Veterans Affairs Medical Center , Washington, DC , USA
KEY WORDS: hospitalists; internal medicine; academic performance.
We are responding to the recent commentary from The Editors
Desk by Carol Bates on BEqual Rights for General Internists?^1.
In the editorial, Dr. Bates advocates for equity in dedicated time
for academic pursuits between outpatient and inpatient academic
generalists. We agree that dedicated non-clinical time devoted to
academic pursuits is vital for successful promotion for generalists
regardless of where they are practicing; previous studies of
successfully promoted academic internists have identified this
as a key element .2 Academic hospitalists work an average of 15
clinical shifts per month compared to between 15 to 19 shifts per
month for non-academic hospitalists and 16 to 19 clinical days
per month estimated by Bates for outpatient generalists. An
implicit assumption made by Bates was that hospitalists do not
have responsibilities outside of clinical work. During
nonclinical time, academic hospitalists have been called upon to
educate learners, perform institutional quality improvement and
patient safety initiatives, and serve on hospital committees. These
responsibilities do not cease during inpatient clinical time. As
with our outpatient academic colleagues, this allows for little to
no dedicated time for research.3
Increasing time pressures and clinical loads are an issue
across the board for all specialties, making the need for
adequate time for scholarship critical for everyone. Adding to
these struggles, hospital medicine is a relatively new area
within general internal medicine. Due to the relative infancy
of the field, there are few senior members to provide
mentorship, potentially inhibiting academic promotion and
scholarship.4 The qualitative study in last month’s issue of
JGIM by Cumbler and colleagues offers potential solutions
and much-needed resources for academic hospitalists early in
their careers.5 We are all generalists on a continuum of
outpatient and inpatient care and we should be working together to
help solve mutual issues like dedicated time for non-clinical
academic pursuits. I am hopeful that the editorial board of
JGIM shares these values and will continue to be a forum for
articles, like the one by Cumbler and colleagues, wherein we
can accomplish this shared strategic priority inclusively.
Matthew Tuck, MD, MEd and Keri Holmes-Maybank,
Chair and Co-Chair of the Society of General Internal
Medicine’s Academic Hospitalist Commission
Acknowledgements: We would like to thank Drs. Luci Leykum and
Maria BGaby^ Frank for review of this Letter to the Editor.
1. Bates CK . Equal Rights for General Internists? JGIM 2018 . https://doi. org/10.1007/s11606-018-4355-4.
2. Reid , MB , Misky GJ , Harrison RA , Sharpe B , Auerbach A , Glasheen JJ . Mentorship, productivity, and promotion among academic hospitalists . JGIM 2012 ; 27 ; 23 - 7 .
3. Hinami K , Whelan CT , Miller JA , Wolosin RJ , Wetterneck TB . Job characteristics, satisfaction, and burnout across hospitalist practice models . J Hosp Med 2012 ; 5 ; 402 - 410 .
4. Flanders SA , Centor B , Weber V , McGinn T , DeSalvo K , Auerbach A . Challenges and opportunities in Academic Hospital Medicine: Report from the Academic Hospital Medicine Submit. J Hosp Med 2009 ; 4 ; 240 - 246 .
5. Cumber E , Rendon P , Yirdaw E , et al. Keys to career success: Resources and barriers identified by early-career academic hospitalists . JGIM 2018 . https://doi.org/10.1007/s11606-018-4336-7.