The SGIM policy analysis: supporting the generalist voice for participation in policymaking.

This issue ofJGIM contains an article entitled “High Quality Care and Ethical Pay-for-Performance: A Society of General Internal Medicine Policy Analysis” by Wharam and colleagues 1 . The importance of this topic is addressed in an accompanying thought-provoking editorial by Dr. Matt Wynia. This second editorial has a different purpose. We highlight the Wharam article as SGIM’s first full example of an officially sanctioned SGIM policy analysis. While SGIM has always developed position papers on key issues of relevance to our members, the Society has not previously used a systematic process to publish in-depth analyses of its positions in JGIM. Because the product is new for SGIM, this editorial outlines how it developed from an idea to a finished product, focusing on how the preparation and review of the document differs from the typical journal article. By doing so, we hope to inspire SGIM members, committees, interest groups, and task forces to create other policy analyses addressing the critical issues facing general internal medicine practice, education, and research. SGIM’s Council and Health Policy Committee have long wrestled with the challenge of how best to articulate the views of SGIM members on problems and issues facing general internal medicine. This is a critical role for our Society, and one that has become more pressing recently as the prospects for major health-care reform escalate. The central role of primary care appears to be poised for recognition at the same time that the declining workforce threatens the future of our field. At this critical juncture, how can SGIM make its voice heard? We believe that as an organization, SGIM is well positioned to exert influence. SGIM represents a broad-based generalist point of view. We have strong connections to academic medicine and to the trainees who represent the future of our field. Among medical societies, SGIM has gained credibility by establishing its independence from for-profit pharmaceutical and other industries involved in health-care delivery. These are among the qualities that lead other societies and political entities to request SGIM’s participation or support. Yet our member-supported financing, our support for research, education, and quality improvement activities, and our reliance primarily on volunteer labor limit the number of policy issues in which our governing bodies can effectively engage. A solution to this dilemma is to engage SGIM committees and interest groups in creating a broad set of policy analyses that our members can use to participate more effectively in local, regional, and national policy venues. In this way, SGIM can support but also extend the reach of individual members. A policy analysis will differ from the product of SGIM individual members by having a defined process of review and input from the SGIM Council and Health Policy Committee. We envision published SGIM policy analyses as a subset of those posted on the SGIM web pages. Published policies would be salient, high quality, peer-reviewed products of general interest to our members. These published analyses would represent collaborative effort among the authors working with the SGIM Council, Health Policy Committee, and the JGIM editorial team. The Wharam article represents a collaboration of this sort. It is an example of the kind of thoughtful policy analysis we hope to support. We would therefore like to highlight some of the article’s key features from the point of view of SGIM