Tops in their field

Two of the nation's top 10 hospitalists work at Beth Israel Deaconess Medical Center, according to the American College of Physicians.

Joseph Li, MD, Director of Hospital Medicine, and Melissa Mattison, MD, General Medicine and Division of Gerontology, made the ACP's 2008 list after being nominated by their colleagues for notable contributions to the field.

Li, who was nominated by Russell Phillips, MD, Chief of the Division of General Medicine and Primary Care, decided to become a physician during his junior year of high school after watching his grandfather die of colon cancer. "I knew I wanted to do a job that would help people everyday," Li says.

He became the first full time hospitalist at BIDMC in 1998. Li received the designation of Top Hospitalist by ACP for his role in implementing key initiatives to enhance communication and education. With the help of fellow hospitalist David Feinbloom, MD, General Medicine, and BIDMC's Information Systems Department, an application was created that produces a letter complete with all of a patient's data including notes from each person involved in his or her care. This letter is sent electronically and in hard copy to the patient's primary care physician so that everyone is kept up to date on the patient's condition.

The group now boasts 33 hospitalists. To make it easy for primary care physicians to contact the hospitalist on call, Li designated a single pager number, 9HOSP, and a single e-mail address.

In 2002, the hospitalist group instituted the medical procedure service to ensure medical students and house staff were supervised by a hospitalist while working at patient's bedside. This service allows the students and house staff to hone their skills while guaranteeing a high standard of patient care.

"It's our responsibility to keep outpatient providers informed and to improve the teaching of housestaff. Otherwise, the patient suffers. The most important accomplishment is the systems we've put in place to improve patient care," Li says.

Mattison joins Li on the list of the ACP's Top 10 Hospitalists. Howard Nachamie, MD, Gerontology, nominated her. She is one of only two geriatricians in the hospitalist group at BIDMC and her commitment to educating physicians about providing care to elder patients earned her a spot on the list.

"I was fortunate to grow up with all four of my grandparents nearby. I watched them age and suffer with common problems," Mattison says. "It's hard when anyone is admitted into the hospital, but it's especially hard when you are old and frail."

Mattison created the curriculum for BIDMC's Advancement of Geriatric Education (AGE) Scholarship. A four-year grant from the Donald W. Reynolds Foundation was secured in 2006, allowing eight hospitalists annually to learn about geriatric medicine.

"It's not feasible to train every physician, but unless you are in pediatrics or obstetrics, you are going to have older patients," Mattison says. "It's a privilege to train other doctors."

The curriculum she developed in part focuses on preventing decline of function, recognizing delirium, and understanding how medication is metabolized differently in elderly a patients. "The body's response to medication changes as we age," Mattison says. "It's important to recognize this change and use medications that are less likely to cause side effects in older patients."

She credits her colleagues in the Division of Internal Medicine and the Division of Gerontology for their continued support of her work.

"We have such great doctors here," Mattison says. "It's a great place to be hospitalized no matter what your age."