The Journal of Hospital Medicine turns 20

We are honored to lead the Journal of Hospital Medicine into its 20th year, continuing our commitment to publishing high-quality research and commentary that advance the field, influence policy, and improve patient care. Enhancing clinical knowledge also remains integral to our mission, hence the many forums to which our readers can avail themselves, including Clinical Progress Notes, Clinical Guideline Highlights for the Hospitalist, Things We Do for No Reason™, Clinical Care Conundrums, and, most recently, Visual Vignettes, a column focused on physical diagnosis.

We have also adapted to and shaped new ways of consuming medical information as we build a community around the journal. Our redesigned website and active engagement by our expanded digital media team on a variety of platforms, including LinkedIn, X (formerly Twitter), Instagram, and Threads, allow readers to engage with us in ways that best meet their needs. Moreover, our pioneering editorial and digital media fellowship programs play a key role in developing academic leaders. Notably, our commitment extends beyond research and education to embracing the dynamic ways healthcare intersects with society. Thus, we have published research and perspectives on vulnerable populations, such as Veterans, LGBTQ+ individuals, the elderly, children, and incarcerated individuals, and perspectives on voting rights, climate change, reproductive rights, and gun violence, issues that inevitably affect our patients and colleagues.

Healthcare, by its nature, intersects with policy and legislation. Decisions made by lawmakers—whether at the federal or state level—have a tangible effect on patient health. For example, changes to child labor laws in some states place some of our most vulnerable populations at risk of exploitation.¹ Permissive gun laws in one state are associated not only with higher within state gun-related suicides and homicides but also with other states' firearm-related deaths.² Decisions surrounding women's healthcare, including abortion access, contraception, and reproductive rights, are being made in statehouses across the country.³ The consequences of these decisions are not abstract: we see them in the lives of real people—in children and adolescents, like the more than 1200 killed in gun-related violence in 2024, and in women who experienced life-threatening septic abortions due to delayed care in restrictive states.^{4, 5}

As healthcare providers, we are caregivers and advocates for our patients first and foremost. As a journal, our responsibility is to acknowledge and inform our readers about broader societal issues, including those shaped by political discourse, that directly influence our patients' health. The decisions those of us in healthcare make—from how to console grieving parents, counsel a pregnant woman whose fetus has chromosomal abnormalities, or navigate end-of-life care to how we incorporate decarbonization activities into our organizational processes—are intertwined with the sociopolitical context in which we practice.

Consider the recent federal policy change to cap the monthly insulin prices for Medicare recipients at $35.⁶ For millions of Americans with diabetes, this is not simply a policy or political issue—it's a change that reverses lethal medication rationing due to high cost, giving them access to life-saving medication without fear of financial ruin. Similarly, policies that allow Medicare to negotiate drug prices, which would ease the financial burden on patients, illustrate how government decisions can directly affect health outcomes.⁷ Medicaid, in contrast to Medicare, is administered at the state level. This difference adds a layer of complexity as access to care, the quality of that care, and the protection of fundamental rights can vary significantly depending on local policy choices.

Some may question whether a medical journal should address issues like these, but healthcare does not exist in a vacuum—it is shaped by laws, policies, and social dynamics. To ignore how these factors influence patient care, health, and well-being would be to overlook an essential aspect of our work as clinicians. We must acknowledge the realities that affect our patients' lives and advocate for improvements to their care. We see this approach as being true to the core mission of medicine, which societal factors have always influenced. Public health initiatives like clean water and vaccination programs arose from a need to address the broader determinants of health. The opioid epidemic cannot be understood without acknowledging its social, economic, and political underpinnings. Likewise, the effects of climate change on public health, racial disparities in healthcare, or access to reproductive care are issues that demand the attention of both policymakers and healthcare professionals.

By providing a forum for scholarly dissemination and discussion of these broader determinants of health, we remain true to our mission. As we move into the next decade, we remain committed to advocating for our patients' health and well-being.

Katherine A. Auger (Cincinnati Children's Hospital Medical Center, [email protected]); Jennifer Baird (Children's Hospital of Los Angeles, [email protected]); Anthony C. Breu (Harvard Medical School, [email protected]); Michelle N. Brooks (South Texas Veterans Health Care System, [email protected]); Daniel J. Brotman (Johns Hopkins University, [email protected]); Susan L. Calcaterra (University of Colorado, [email protected]); Paula Chatterjee (University of Pennsylvania, [email protected]); Alex J. Chinn (Lt. Col. Luke Weathers, Jr. VA Medical Center, [email protected]); Donna Coetzee (University of Minnesota, [email protected]); Stephanie K. Doupnik (Vanderbilt University, [email protected]); Lenny Feldman (Johns Hopkins University, [email protected]); Catherine Glatz (University of Rochester, [email protected]); Rachita Gupta (University of Colorado, [email protected]); Matthew Hall (Children's Hospital Association, [email protected]); Heather N. Hofmann (Loma Linda University, [email protected]); Keri Holmes-Maybank (Medical University of South Carolina, [email protected]); Molly Horstman (Baylor College of Medicine, [email protected]); Nathan Houchens (University of Michigan, [email protected]); Anand D. Jagannath (Oregon Health & Science University, [email protected]); Karen E. Jerardi (Cincinnati Children's Hospital Medical Center, [email protected]); Leah N. Jones (Children's Mercy Kansas City, [email protected]); Farah Acher Kaiksow (University of Wisconsin, [email protected]); Zahir Kanjee (Beth Israel Deaconess Medical Center, [email protected]); Michelle M. Kelly (University of Wisconsin, [email protected]); Benjamin Kinnear (University of Cincinnati, [email protected]); Elise P. Lu (University of Western Ontario, [email protected]); Sanjay Mahant (University of Toronto, [email protected]); Manpreet Malik (Emory University, [email protected]); Kimberly D. Manning (Emory University, [email protected]); Jessica L. Markham (Children's Mercy Kansas City, [email protected]); Stephanie K. Mueller (Brigham and Women's Hospital), Oanh Kieu Nguyen (University of California, San Francisco, [email protected]); Andrew P. J. Olson (University of Minnesota); Michael Osnard (Johns Hopkins University, [email protected]); Rachel J. Peterson (Cincinnati Children's Hospital Medical Center, [email protected]); Priya Prasad (University of California, San Francisco, [email protected]); Rehan Qayyum (Eastern Virginia Medical School, [email protected]); Jennifer Readlynn (University of Rochester, [email protected]); Gregory Ruhnke (University of Chicago, [email protected]); Maria Santos (Providence Cedars Sinai Tarzana Medical Center, [email protected]); Shamini Selvakumar (McMaster University, [email protected]); Suchita Shah Sata (Duke University, [email protected]); Jeffrey L. Schnipper (Brigham and Women's Hospital, [email protected]); Erin E. Shaughnessy (University of Alabama, Birmingham, [email protected]); Heidi J. Sucharew (University of Cincinnati, [email protected]); Maha Sulieman (Emory University, [email protected]); Stephanie Parks Taylor (University of Michigan, [email protected]); Michael Tchou (University of Colorado, [email protected]); Joseph S. Thomas (Buffalo Medical Group, [email protected]); Patricia Tran (University of Illinois, Peoria, [email protected]); Amanda J. Ullman (University of Queensland, [email protected]); Marie E. Wang (Lucile Packard Children's Hospital, [email protected]); Andrew White (University of Washington, [email protected]); Charlie M. Wray (University of California, San Francisco, [email protected]); Ali R. Yazdanyar (University of Pennsylvania, [email protected]).

The authors declare no conflict of interest.