The division of hospital medicine recently had four speakers at the Society of Hospital Medicine Conference in Nashville, which is regularly attended by thousands of clinicians from across the country. Here, hospitalists are given the opportunity to network with colleagues from different states to learn about research, quality improvement projects, or practice environments at other institutions. Attendees can then take these ideas back to their home institution to improve patient care or to change their practice climate.
“This conference is an annual reminder of the size of hospital medicine as a specialty and the change we can bring for everyone who works with us,” said attendee and presenter Anna Maria South, MD, associate professor of medicine. “It is an opportunity to learn about new practice guidelines and to connect with colleagues outside the stressful work environment where we typically interact with each other.”
Alongside learning from others, Dr. South also presented at the conference. Her presentation Updates in Addiction Medicine for the Busy Hospitalist served to provide hospitalists with the newest research publications relevant for the inpatient management of patients with substance use disorder. “The goal is to use evidence-based methods to provide care that will increase the patient's overall well-being and reduce stressors on the medical system, such as ED visits and readmissions,” said Dr. South.
Rani Chikkanna, MD, associate professor, presented on the strategic role of hospitalists in reducing readmissions. She emphasized applying quality improvement frameworks to design high-impact interventions and operationalize evidence-based bedside practices to facilitate safe discharges and effective transitions of care. She also highlighted how coordinated, team-based approaches to transitions of care can drive meaningful improvements across the board, leading to better patient outcomes, enhanced quality of life, improved patient experience, and greater system efficiency.
“Hospital medicine plays a pivotal role in this transformation,” said Dr. Chikkanna. “Positioned at the center of care, we have a unique ability to influence practice patterns, align teams, and lead the adoption of innovative approaches. True transformation lies not just in what we do, but in how we do it to create a sustainable change that benefits both patients and the system.”
The session also featured a collaboration between Joseph Sweigart, MD, associate professor of medicine and a member of the Society of Hospital Medicine’s Board of Directors; Romil Chadha, MD, MBA, professor of medicine and Chief Medical Information Officer for UK HealthCare; and Leigh Anne Goodman, MD, associate clinical professor of medicine at the University of Arizona College of Medicine–Phoenix and Lead for Clinical Informatics and Data Analytics in the division of hospital medicine. Together, they brought complementary perspectives in hospital medicine leadership, clinical informatics, data analytics, and health system operations to examine how right-sizing hospitalist census can increase value.
Specifically, they presented the case that lower daily census for hospitalists increases overall value by simultaneously improving quality and reducing total cost. Using national SHM data, peer‑reviewed evidence, and workforce experience surveys, they showed that as census rises, decision fatigue, time poverty, burnout, and safety risk increase, all while the meaningful “deep work” that drives quality is crowded out.
“We highlighted that higher volume does not reliably improve outcomes or efficiency, and in many cases is associated with longer length of stay, unnecessary utilization, worse patient experience, and higher downstream costs,” said Dr. Chadha. “Importantly, we connected workload to turnover and vacancy costs, demonstrating that even small increases in attrition rapidly negate marginal RVU gains from higher census. The central message was simple: census is a modifiable design choice, and when aligned with cognitive load and patient complexity, it yields better care at lower total system cost.”
Hospital medicine has matured in an environment where volume has become a proxy for value, often without examining second‑ and third‑order effects. Presentations like Drs. Chadha and Sweigart’s help the field reset the conversation from “how much more can we push?” to “what level of workload produces the best outcomes for patients, clinicians, and organizations?”
This work is important because it:
- Challenges the normalization of deviance around unsafe census levels.
- Reframes hospitalist value beyond wRVUs to include quality, LOS, utilization, patient experience, and workforce sustainability.
- Provides leaders with a data‑driven, financially credible argument for workload redesign grounded in cost avoidance, not just well‑being.
- Reinforces hospital medicine’s identity as a discipline built on systems thinking, cognitive work, and continuous improvement, not throughput alone.
“In short, these conversations help hospital medicine advocate for care models that are safer, more humane, and ultimately more economically sound, which is essential for the long‑term credibility and sustainability of the field,” said Dr. Sweigart.
Alongside these four speakers, 12 other University of Kentucky hospital medicine physicians and APPs attended the conference.
“Having so much speaker and attendee representation means that UK has a national presence within our specialty,” said Joy Engblade, MD, MMM, FACP, assistant professor and chief of the division of hospital medicine.