Karen Goldstein, MD, MSPH
Post submitted by Karen Goldstein, MD, MSPH
This year’s Society for General Internal Medicine (SGIM) conference provided a great opportunity for Duke trainees and faculty to share their work and steep in the activities of the larger general internal medicine community. Conference offerings focused on the major theme of “Generalists engaged in Population Health: Improving Outcomes and Equity through Research, Education and Patient Care”. Duke GIM was well-represented by medical students, residents and fellow trainees, and faculty. In total, Duke attendees presented three oral abstracts (including an excellent plenary presentation by Jerry Lee, MSII!) and 16 posters, moderated one oral abstract session, and led three symposia/workshops. Additionally, Duke faculty participated in multiple SGIM task forces and many other collaborative activities. Dr. Ebony Boulware was also honored by SGIM with the Mid-Career Research Mentorship Award.
At the SGIM conference, I saw three major themes underlying the general topic of population health:
“We go into primary care… because it is the absolute best thing you can do with your life”
– Dr. Karen DeSalvo, U.S. Department of Health and Human Services
Healthcare Payment Reform
First, there was significant focus on healthcare payment reform, alternative care delivery models, and the challenges and opportunities therein. Dr. Tim Ferris (Senior Vice President for population health at Massachusetts General Hospital) presented the 2016 Malcom L. Peterson Honor lecture on the topic of Progress in Improving Healthcare Delivery. After reviewing the current challenges facing the US healthcare system regarding access, quality, cost and workforce, he proposed that we stop the practice of “one size fits all” care delivery in favor of a more nuanced approach to patient-centered care through adding new layers in the ecology of healthcare. Specifically, he was ready to make the shift from studying the efficacy of various interventions for population health and moving to implementation. The conference was also attended by Dr. Karen DeSalvo (acting Assistant Secretary for Health in the US Department of Health and Human Services) who was honored as the Distinguished Professor of Women and Medicine. Dr. DeSalvo highlighted the importance of sharing innovative practices and actively partnering with local public health officials to shape the future direction of population health. She encouraged the GIM community to consider the underlying determinants of health that make a patient’s zip code a stronger predictor of health and mortality than their genetic code.
Health Disparities
Second, there were multiple discussions centered on the challenges of caring for patients who have high utilization of healthcare services, and those who are adversely impacted by health disparities. As examples of innovative models of care, two workshops highlighted VA-based initiatives on population-based intensive management programs and healthcare for homeless veterans. Oral abstracts highlighted the use of community health workers and peer support to address disparities in diabetes and hypertension self-management among high-risk populations. In a plenary oral presentation, our own Duke medical students described their experiential educational initiative that connects first year medical students with multi-morbid patients thereby simultaneously building student knowledge about community-based care coordination and fostering a sense of the importance of patient-centered care.
Proud to be GIM
Finally, the conference sought opportunities to recognize and promote the value of general internal medicine through numerous mentorship opportunities, a new SGIM campaign (“Proud to be GIM”), and ubiquitous tweets (#SGIM16 and #ProudtobeGIM). This effort was bolstered by record attendance at this year’s conference of 2,160 participants. Dr. DeSalvo summarized this sentiment by noting, “we go into primary care… because it is the absolute best thing you can do with your life”.
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For more about Dr. Goldstein, read her faculty spotlight here.
