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Choosing a career in health care administration
Dr. Shah is chief medical officer, Mount Sinai Queens, director of quality and patient safety education, Mount Sinai Health System, associate professor of medicine/GI and geriatrics/palliative medicine, Icahn School of Medicine at Mount Sinai, New York, N.Y.
How did your career pathway lead you into hospital administration?
My career pathway into hospital administration was not by design. Since college, I have always enjoyed building and managing programs. As chief resident, I was exposed to operational and managerial aspects of running an internal medicine residency program as well as an outpatient clinic. This program first exposed me to quality improvement and patient-safety functions within a hospital. I continued to build on this during my GI fellowship and in my first few years as faculty in our division. Patient safety and quality improvement involve the critical thinking and quantitative aspects of research applied to problems in the workplace. This interest and skill, along with my growing experience in management, led me to explore opportunities in hospital administration.
What are your responsibilities in a typical week?
As a chief medical officer at a smaller hospital, my scope of responsibilities includes overseeing health care quality and patient safety, building our outpatient practice and new clinical service lines, building a cohesive medical staff, handling disciplinary and professionalism issues, and overseeing six support departments. I work closely with our chief operating officer, chief nursing officer, executive director, and site chiefs.
What do you enjoy most about working in hospital administration?
I enjoy the work I do related to making care safer for our patients and for those who work in our hospital. I take each patient-safety event personally. The teamwork necessary to understand these events and develop creative solutions is extremely rewarding. I enjoy mentoring our faculty and hospital managers to achieve their own goals. Lastly, I have enjoyed working with professionals with backgrounds that differ from my own. I have learned an incredible amount about hospital operations, leadership, financing, as well as legal and labor-relations issues from our staff in other departments.
What do you find most challenging about working in hospital administration?
The scope of work in my role at my current hospital is very broad. It can be a challenge to focus on long-term goals given the number of “fires” that creep up during the week. I always try to keep patients and staff at the center of my decision making. However, a hospital is a complex organism and decisions also have a financial and operational impact. One challenge is to know and understand this impact and then work with other leaders to develop a solution that works for all.
The other challenge is managing conflict in a way that leads to creative solutions satisfying the needs of multiple stakeholders. We are constantly challenged by limited resources (including time). These challenges are inherent to any leadership position. I am fortunate to work within a leadership team that is collaborative; they are an invaluable resource when these issues arise.
What are the different hospital administration positions that are available to GIs?
More than ever, the options for administrative work in health care have expanded. There are hospital-based roles within a department (e.g., director of endoscopy, clinical chief, director of quality improvement/patient safety for GI) and larger roles in the hospital-at-large (e.g., chief operating officer, chief medical officer, chief quality officer). These roles require certain technical skills and knowledge as well as experience within patient care. Other opportunities include the medical board, credentials committee, or serving as a member of a hospital committee (e.g., pharmacy, perioperative, infection control, process improvement). Since hospitals and health systems have expanded into the outpatient setting, additional positions include medical director for a practice, director of population health, or a leadership role in clinical operations.
Physicians from many different specialties have entered these roles based on their local hospital needs. In addition to clinical experience, leadership and interpersonal skills are critical for success.
How would a fellow or early-career GI who is interested in hospital medicine pursue this career pathway?
My first suggestion is to get involved in local efforts based on your interest. For example, if you are interested in quality improvement, seek to be a member of your department or hospital quality improvement committee. In GI and hepatology, natural places to get involved are around the development of care pathways, readmission committees, and initiatives to increase screening and treatment of hepatitis C or colon cancer. If you are interested in operations, look to see if there is an endoscopy or clinic operations committee you can get involved in. Get to know your medical board and medical staff structure. I gained exposure to this world by observing some of these meetings and then being asked to join them. These are valuable groups that help to create policy, raise important issues, and work with administration in the management of the hospital.
I am also a big fan of informational interviewing. If there are leaders who do the type of work you are interested in, consider reaching out with a call or email and asking to meet with them to talk about their role and career path.
As a fellow, there is an Accreditation Council for Graduate Medical Education requirement to incorporate residents and fellows onto hospital committees. This requirement has been a great way to have fellows incorporated into hospital work. You will find that those in hospital administration are eager to have interested and collegial partners in the work that is being done.
Are there any advanced training options available for those interested in hospital administration?
Depending on the position, there are numerous certificate and master’s programs that can provide formal education. CEOs and COOs may seek an MBA or master’s in Health Care Administration. There are programs that focus on Health Care Leadership or Quality and Patient Safety that are applicable to many leadership positions. These are offered in in-person and online formats. However, many physicians in these positions have a combination of informal and experiential learning programs that developed their skill set.
Some hospital systems offer an internal physician leadership training program to develop early and midcareer physician executives. There are professional organizations that offer courses for leadership development (e.g., American College of Physician Executives). Some business schools offer shorter-format programs that are geared toward health care leaders and focus on finance, operations, or quality.
I received some of my training through the Clinical Quality Fellowship Program, which is a 14-month experiential learning program in quality and patient safety that is run locally in New York City. In addition, I had some leadership training through the Association of American Medical Colleges and through the AGA Future Leaders Program (http://www.gastro.org/about/initiatives/aga-future-leaders-program).
Hospitals, outpatient practices, and health systems offer career paths including patient safety, quality improvement, or hospital management. I have enjoyed stretching my existing skill set in these roles while learning about how health facilities work, gaining knowledge of health care financing, and making care safer while ensuring high quality. These roles require teamwork across professions and specialties. As a gastroenterologist or hepatologist, we bring our own clinical and professional experience, which can be invaluable to the overall health care management team.
Dr. Shah is chief medical officer, Mount Sinai Queens, director of quality and patient safety education, Mount Sinai Health System, associate professor of medicine/GI and geriatrics/palliative medicine, Icahn School of Medicine at Mount Sinai, New York, N.Y.
How did your career pathway lead you into hospital administration?
My career pathway into hospital administration was not by design. Since college, I have always enjoyed building and managing programs. As chief resident, I was exposed to operational and managerial aspects of running an internal medicine residency program as well as an outpatient clinic. This program first exposed me to quality improvement and patient-safety functions within a hospital. I continued to build on this during my GI fellowship and in my first few years as faculty in our division. Patient safety and quality improvement involve the critical thinking and quantitative aspects of research applied to problems in the workplace. This interest and skill, along with my growing experience in management, led me to explore opportunities in hospital administration.
What are your responsibilities in a typical week?
As a chief medical officer at a smaller hospital, my scope of responsibilities includes overseeing health care quality and patient safety, building our outpatient practice and new clinical service lines, building a cohesive medical staff, handling disciplinary and professionalism issues, and overseeing six support departments. I work closely with our chief operating officer, chief nursing officer, executive director, and site chiefs.
What do you enjoy most about working in hospital administration?
I enjoy the work I do related to making care safer for our patients and for those who work in our hospital. I take each patient-safety event personally. The teamwork necessary to understand these events and develop creative solutions is extremely rewarding. I enjoy mentoring our faculty and hospital managers to achieve their own goals. Lastly, I have enjoyed working with professionals with backgrounds that differ from my own. I have learned an incredible amount about hospital operations, leadership, financing, as well as legal and labor-relations issues from our staff in other departments.
What do you find most challenging about working in hospital administration?
The scope of work in my role at my current hospital is very broad. It can be a challenge to focus on long-term goals given the number of “fires” that creep up during the week. I always try to keep patients and staff at the center of my decision making. However, a hospital is a complex organism and decisions also have a financial and operational impact. One challenge is to know and understand this impact and then work with other leaders to develop a solution that works for all.
The other challenge is managing conflict in a way that leads to creative solutions satisfying the needs of multiple stakeholders. We are constantly challenged by limited resources (including time). These challenges are inherent to any leadership position. I am fortunate to work within a leadership team that is collaborative; they are an invaluable resource when these issues arise.
What are the different hospital administration positions that are available to GIs?
More than ever, the options for administrative work in health care have expanded. There are hospital-based roles within a department (e.g., director of endoscopy, clinical chief, director of quality improvement/patient safety for GI) and larger roles in the hospital-at-large (e.g., chief operating officer, chief medical officer, chief quality officer). These roles require certain technical skills and knowledge as well as experience within patient care. Other opportunities include the medical board, credentials committee, or serving as a member of a hospital committee (e.g., pharmacy, perioperative, infection control, process improvement). Since hospitals and health systems have expanded into the outpatient setting, additional positions include medical director for a practice, director of population health, or a leadership role in clinical operations.
Physicians from many different specialties have entered these roles based on their local hospital needs. In addition to clinical experience, leadership and interpersonal skills are critical for success.
How would a fellow or early-career GI who is interested in hospital medicine pursue this career pathway?
My first suggestion is to get involved in local efforts based on your interest. For example, if you are interested in quality improvement, seek to be a member of your department or hospital quality improvement committee. In GI and hepatology, natural places to get involved are around the development of care pathways, readmission committees, and initiatives to increase screening and treatment of hepatitis C or colon cancer. If you are interested in operations, look to see if there is an endoscopy or clinic operations committee you can get involved in. Get to know your medical board and medical staff structure. I gained exposure to this world by observing some of these meetings and then being asked to join them. These are valuable groups that help to create policy, raise important issues, and work with administration in the management of the hospital.
I am also a big fan of informational interviewing. If there are leaders who do the type of work you are interested in, consider reaching out with a call or email and asking to meet with them to talk about their role and career path.
As a fellow, there is an Accreditation Council for Graduate Medical Education requirement to incorporate residents and fellows onto hospital committees. This requirement has been a great way to have fellows incorporated into hospital work. You will find that those in hospital administration are eager to have interested and collegial partners in the work that is being done.
Are there any advanced training options available for those interested in hospital administration?
Depending on the position, there are numerous certificate and master’s programs that can provide formal education. CEOs and COOs may seek an MBA or master’s in Health Care Administration. There are programs that focus on Health Care Leadership or Quality and Patient Safety that are applicable to many leadership positions. These are offered in in-person and online formats. However, many physicians in these positions have a combination of informal and experiential learning programs that developed their skill set.
Some hospital systems offer an internal physician leadership training program to develop early and midcareer physician executives. There are professional organizations that offer courses for leadership development (e.g., American College of Physician Executives). Some business schools offer shorter-format programs that are geared toward health care leaders and focus on finance, operations, or quality.
I received some of my training through the Clinical Quality Fellowship Program, which is a 14-month experiential learning program in quality and patient safety that is run locally in New York City. In addition, I had some leadership training through the Association of American Medical Colleges and through the AGA Future Leaders Program (http://www.gastro.org/about/initiatives/aga-future-leaders-program).
Hospitals, outpatient practices, and health systems offer career paths including patient safety, quality improvement, or hospital management. I have enjoyed stretching my existing skill set in these roles while learning about how health facilities work, gaining knowledge of health care financing, and making care safer while ensuring high quality. These roles require teamwork across professions and specialties. As a gastroenterologist or hepatologist, we bring our own clinical and professional experience, which can be invaluable to the overall health care management team.
Dr. Shah is chief medical officer, Mount Sinai Queens, director of quality and patient safety education, Mount Sinai Health System, associate professor of medicine/GI and geriatrics/palliative medicine, Icahn School of Medicine at Mount Sinai, New York, N.Y.
How did your career pathway lead you into hospital administration?
My career pathway into hospital administration was not by design. Since college, I have always enjoyed building and managing programs. As chief resident, I was exposed to operational and managerial aspects of running an internal medicine residency program as well as an outpatient clinic. This program first exposed me to quality improvement and patient-safety functions within a hospital. I continued to build on this during my GI fellowship and in my first few years as faculty in our division. Patient safety and quality improvement involve the critical thinking and quantitative aspects of research applied to problems in the workplace. This interest and skill, along with my growing experience in management, led me to explore opportunities in hospital administration.
What are your responsibilities in a typical week?
As a chief medical officer at a smaller hospital, my scope of responsibilities includes overseeing health care quality and patient safety, building our outpatient practice and new clinical service lines, building a cohesive medical staff, handling disciplinary and professionalism issues, and overseeing six support departments. I work closely with our chief operating officer, chief nursing officer, executive director, and site chiefs.
What do you enjoy most about working in hospital administration?
I enjoy the work I do related to making care safer for our patients and for those who work in our hospital. I take each patient-safety event personally. The teamwork necessary to understand these events and develop creative solutions is extremely rewarding. I enjoy mentoring our faculty and hospital managers to achieve their own goals. Lastly, I have enjoyed working with professionals with backgrounds that differ from my own. I have learned an incredible amount about hospital operations, leadership, financing, as well as legal and labor-relations issues from our staff in other departments.
What do you find most challenging about working in hospital administration?
The scope of work in my role at my current hospital is very broad. It can be a challenge to focus on long-term goals given the number of “fires” that creep up during the week. I always try to keep patients and staff at the center of my decision making. However, a hospital is a complex organism and decisions also have a financial and operational impact. One challenge is to know and understand this impact and then work with other leaders to develop a solution that works for all.
The other challenge is managing conflict in a way that leads to creative solutions satisfying the needs of multiple stakeholders. We are constantly challenged by limited resources (including time). These challenges are inherent to any leadership position. I am fortunate to work within a leadership team that is collaborative; they are an invaluable resource when these issues arise.
What are the different hospital administration positions that are available to GIs?
More than ever, the options for administrative work in health care have expanded. There are hospital-based roles within a department (e.g., director of endoscopy, clinical chief, director of quality improvement/patient safety for GI) and larger roles in the hospital-at-large (e.g., chief operating officer, chief medical officer, chief quality officer). These roles require certain technical skills and knowledge as well as experience within patient care. Other opportunities include the medical board, credentials committee, or serving as a member of a hospital committee (e.g., pharmacy, perioperative, infection control, process improvement). Since hospitals and health systems have expanded into the outpatient setting, additional positions include medical director for a practice, director of population health, or a leadership role in clinical operations.
Physicians from many different specialties have entered these roles based on their local hospital needs. In addition to clinical experience, leadership and interpersonal skills are critical for success.
How would a fellow or early-career GI who is interested in hospital medicine pursue this career pathway?
My first suggestion is to get involved in local efforts based on your interest. For example, if you are interested in quality improvement, seek to be a member of your department or hospital quality improvement committee. In GI and hepatology, natural places to get involved are around the development of care pathways, readmission committees, and initiatives to increase screening and treatment of hepatitis C or colon cancer. If you are interested in operations, look to see if there is an endoscopy or clinic operations committee you can get involved in. Get to know your medical board and medical staff structure. I gained exposure to this world by observing some of these meetings and then being asked to join them. These are valuable groups that help to create policy, raise important issues, and work with administration in the management of the hospital.
I am also a big fan of informational interviewing. If there are leaders who do the type of work you are interested in, consider reaching out with a call or email and asking to meet with them to talk about their role and career path.
As a fellow, there is an Accreditation Council for Graduate Medical Education requirement to incorporate residents and fellows onto hospital committees. This requirement has been a great way to have fellows incorporated into hospital work. You will find that those in hospital administration are eager to have interested and collegial partners in the work that is being done.
Are there any advanced training options available for those interested in hospital administration?
Depending on the position, there are numerous certificate and master’s programs that can provide formal education. CEOs and COOs may seek an MBA or master’s in Health Care Administration. There are programs that focus on Health Care Leadership or Quality and Patient Safety that are applicable to many leadership positions. These are offered in in-person and online formats. However, many physicians in these positions have a combination of informal and experiential learning programs that developed their skill set.
Some hospital systems offer an internal physician leadership training program to develop early and midcareer physician executives. There are professional organizations that offer courses for leadership development (e.g., American College of Physician Executives). Some business schools offer shorter-format programs that are geared toward health care leaders and focus on finance, operations, or quality.
I received some of my training through the Clinical Quality Fellowship Program, which is a 14-month experiential learning program in quality and patient safety that is run locally in New York City. In addition, I had some leadership training through the Association of American Medical Colleges and through the AGA Future Leaders Program (http://www.gastro.org/about/initiatives/aga-future-leaders-program).
Hospitals, outpatient practices, and health systems offer career paths including patient safety, quality improvement, or hospital management. I have enjoyed stretching my existing skill set in these roles while learning about how health facilities work, gaining knowledge of health care financing, and making care safer while ensuring high quality. These roles require teamwork across professions and specialties. As a gastroenterologist or hepatologist, we bring our own clinical and professional experience, which can be invaluable to the overall health care management team.