Physicians are lifelong learners by definition. But Elizabeth Cook, MD, is still an actual student.
Dr. Cook, medical director of the hospitalist division of Medical Associates of Central Virginia in Lynchburg, Va., is working toward her master’s degree in public health (MPH) leadership at the University of North Carolina in Chapel Hill, N.C. She is on target to graduate in 2016.
“I am interested in health policy and how the big decisions made at high levels are translated into day-to-day operations,” she says. “Oftentimes the unintended consequences are substantial for some of these decisions. I think it is important for those who do the daily provider work to be a part of the process to help inform the decisions.”
That day-to-day work for Dr. Cook now includes serving as one of seven new members of Team Hospitalist, the volunteer editorial advisory board of The Hospitalist.
Question: Why did you choose a career in medicine?
Answer: A long series of events. My undergrad degree was in television/film/radio production. I was working in the field but was exposed to the field of medicine for the first time after I tore an ACL [anterior cruciate ligament] and had knee surgery. Some friends worked in medicine and, between their encouragement and my fascination with medicine and the way the body works, I decided to change directions and pursued a medical degree.
Q: How/when did you decide to become a hospitalist?
A: I hated inpatient medicine when I was in medical school and as a family practice resident. I intended to open a private practice (family practice) office, but a mentor convinced me to take a job as hospitalist as an interim step while working on putting together the office. I did open the office with intention to transition to just that long term. After doing both for a while, I started to really enjoy the collegiality and pace of hospitalist work and decided to close the office and do hospitalist work full time. That was 14 years ago, and I’ve never second-guessed my decision.
Q: Was there a specific person who steered you to hospital medicine?
A: A part-time faculty member at the residency where I trained really encouraged me to try hospitalist work. He felt like I would enjoy the pace and the ability to interact with specialists and colleagues, and he was absolutely right. I still thank him and sometimes rib him about it when things are really crazy.
Q: What do you like most about working as a hospitalist?
A: I love the pace and the constant interaction with specialists, nursing staff, and other providers. I also have a great group of fellow hospitalists. We have been a very stable group, and some of us have been together for a long time doing this. Almost feels like family. I also like the constant learning that takes place in the interactions with specialists. They keep us on the cutting edge of medicine, and the patients always provide a new and interesting challenge to learn from.
Q: What do you dislike most?
A: We have a very flexible schedule, but it does require lots of weekends and evenings. It makes it hard to have a social life and do things with people outside of medicine who maintain the usual (Monday to Friday) life.
Q: What’s the best advice you ever received?
A: Have fun with whatever you are doing.
Q: What’s the biggest change you’ve seen in HM in your career?
A: The patients are much sicker and more complicated than when I first started. We have become really good at managing a lot of things as outpatients, so what is left is a lot of really challenging, time-consuming patients. It’s intellectually rewarding but can be exhausting when you are seeing 16 to 20 patients a day like that.
Q: What’s the biggest change you would like to see in HM?
A: I think we need better coordination with care and more connection to the outpatient setting. I often feel like I am sending my patients out into a black hole, and I just hope they end up with all the things I have ordered and recommended.
Q: For group leaders, why is it important for you to continue seeing patients?
A: Seeing patients is critical. It keeps me in touch with the issues and challenges that my providers deal with. It also creates a sense of teamwork and puts us on equal footing rather than my being perceived as a distant administrator.
Q: As a hospitalist, seeing most of your patients for the very first time, what aspect of patient care is most challenging?
A: Being in the hospital, by its very nature, places patients and families in circumstances that are often scary and out of their control. It creates a lot of emotions that can charge interactions. After so many years, the management and diagnosis can lose their sense of impact for providers, as it is daily routine. It is important to remember the patients’ perspective and learn ways to reassure and inform to defuse some of the high emotions.
Q: What aspect of patient care is most rewarding?
A: When a patient comes in very sick and I am able to identify and treat the problem and watch them make a good recovery. It feels like I am doing something meaningful and important in life.
Q: What is your biggest professional challenge?
A: Interacting with hospital administration, as there are often competing demands and desires that require politics, collaboration, and people skills to get everyone pulling in the same direction.
Q: What’s next professionally?
A: I am not sure. I am eager to see what doors the MPH opens for me. I would be interested in consulting work, helping smaller programs look at opportunities for growth and ways to collaborate and align interests with their hospital administrators. Also, working in health policy interests me.
Q: If you weren’t a doctor, what would you be doing right now?
A: I have written a book and a screenplay and really enjoy that. In my dream world, I would be able to work full time as an author.
Richard Quinn is a freelance journalist in New Jersey.