Micah Beachy, D.O., associate professor in the UNMC Department of Internal Medicine-Hospital Medicine, has been named among the top hospitalists in the country by the American College of Physicians (ACP). The rankings appear in the 12th annual edition of ACP Hospitalist magazine.
The issue profiles the top 10 physicians in the country, who were nominated by their colleagues and chosen by the magazine’s editorial board, for their accomplishments in areas of hospitalist practice such as patient care, quality improvement and medical education.
In high school, Dr. Beachy was sure he was on the track to becoming a teacher. After going to medical school and residency and then making a career in academic medicine, he turned out to be right.
“I was able to find a way to do things that I thought I had attributes for as early as high school, and it came somewhat full circle,” said Dr. Beachy, who is governor-elect for the Nebraska Chapter of the ACP.
In his teaching role, he focuses on instructing learners about the importance of getting to the right diagnosis but also how to be thoughtful about which tests, procedures, or radiographs are needed to get there. “I spend a lot of time talking about high-value care, which obviously ACP has helped inform, and being mindful of the health care resources that we’re utilizing,” he said.
One example that often comes up is telemetry. “Telemetry is something that can be very helpful . . . but often, the indication for telemetry is something that resolves in a couple days, or the patient’s stay quickly outlasts the utility of telemetry,” he said. Plus, the patient’s experience of telemetry can be uncomfortable, Dr. Beachy said. “It’s also easy to forget that there is a person on the other side of the telemetry monitor sitting in a room watching for arrhythmias on 30 to 40 monitors. That’s a health care cost that isn’t necessarily readily thought of.”
To address unnecessary telemetry use, Dr. Beachy was involved in a quality improvement project that used the electronic health record to remind clinicians to assess the ongoing need for telemetry.
He wanted to make sure the reminders didn’t create alert fatigue and contribute to burnout (he’s also an ACP Wellness Champion), so the reminders are in an electronic daily checklist that includes other important measures, such as deep venous thrombosis prophylaxis and appropriate catheter management.
“If you utilize the checklist, it actually helps document those items in your note as well, so you’re not having to double up on work,” Dr. Beachy said. The reminders have reduced the number of days that patients are on telemetry and have also resulted in some cost savings and improvements in patient experience, he said.
Talking about costs of care is becoming the new normal in medical education, Dr. Beachy said. Compared to his first years of practice, conversations about high-value care are less surprising to today’s learners.
“There’s been groundwork that’s been laid during the last five years. People are more receptive . . . and I do think that there is a little bit more of an openness and a responsibility that we have to ensure resources are utilized appropriately,” Dr. Beachy said.
As the Nebraska Medical Center’s medical director for clinical effectiveness, he also works on high-value care at the organizational level, finding areas where there is variation in care delivery and trying to put best practices into place, as well as reducing the cost of care whenever feasible. Rather than taking away from his teaching responsibilities, Dr. Beachy’s administrative role has actually helped inform his conversations with patients and learners.
“It has further cemented the need to talk about patient cost [and] how we ensure quality of care and safe care while being mindful about the cost of the care for the patient,” he said.
Congratulations Micah!!