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Insider’s Point of View


Dr. Aguirre

Felix Aguirre, MD, entered the field of hospital medicine before the term “hospitalist” had been coined. He didn’t realize how quickly the field would explode, but it didn’t take long to find out. Aguirre helped start an inpatient service in 1994, taking care of patients for about 20 primary-care physicians. Within three years, his service cared for the patients of 360 doctors.

Dr. Aguirre cofounded Hospitalists of San Antonio in 2000, and he served as president of the company until it merged with IPC: The Hospitalist Co. three years later.

A graduate of the U.S. Military Academy at West Point, Dr. Aguirre spent several years as an air-traffic controller before attending medical school. He currently is vice president of medical affairs for California-based IPC, which provides management services to hospitalist practices in more than 400 facilities.

“The biggest reward is being part of a growth industry, helping to mold it and move it forward,” says Dr. Aguirre, who is responsible for medical and leadership oversight, as well as developing IPC’s physicians and providers. “I’m very proud it’s starting to get distinction as a separate specialty, and I really like the idea of getting in on the ground floor. Everybody likes to be one of the pioneers of an industry.”

Question: How did West Point help prepare you for your current career?

Answer: As part of your education at West Point, you need to learn to be a follower before you can learn to be a leader. Coming out of the academy, I was pretty cocky and I thought I could do anything. I’ve learned some pretty humbling lessons, and experience teaches you how to temper that attitude.

Q: How about your time as an air-traffic controller?

A: You have to be able to deal with many things at once and be able to deal with pressure. That experience is great for a career in an emergency room and in hospital medicine, where you’re juggling a lot of information and facing situations that require pretty rapid action.

Q: When you entered HM, did you have a sense of how much—and how quickly—the field would grow?

A: No. It really was in its infancy at that time … but when Dr. (Robert) Wachter (coined the term “hospitalist”), it began to pick up momentum. Before long, we could see there wasn’t going to be any slowing down of this type of medicine. It’s great to be a part of an industry that is still a growing industry, especially in this economic climate. It’s needed now more than ever, so I feel I made the correct decision to enter this field.

Q: Why do you feel it’s needed more now than ever?

A: With healthcare, there needs to be more control, clinically as well as financially. I think hospitalists are well positioned right in the middle of the hospital. They are exposed to every aspect of the hospital’s operation and staff, whether it’s the cleaning service or dietary or physical therapy or talking to specialists or other physicians. Who better to help control what happens than the person who is exposed to it?

Q: What is the biggest challenge you face in your current role?

A: One of the big ones is reduction in variance. Everybody is looking for ways to reduce variance in clinical care, and that’s going to continue to be one of the biggest challenges as we grow. If you’re a small mom-and-pop business, it’s pretty easy to control things. That gets more difficult as you grow. The things that worked when you were smaller don’t work in a medium-sized company, let alone when you become a large company. You have to change the way you manage things, which leads to another challenge—adapting to the change.

Q: Is the fear of a hospitalist shortage on your radar screen?

A: It is. But I can tell you this: We won’t stress about it, because it is going to happen. There will be a shortage—there already is. What we have to try to do is position ourselves as the company, or employer, of choice. We get close to 3,000 applicants a year and hire 200 or so, so we’re fortunate in that we have a tremendous amount of exposure to many of the people who are desiring a hospitalist career.

Q: What do you see as the biggest benefit to the IPC model?

A: There are a couple of things I see, not just as advantages but also as strengths. Number one, IPC has extremely strong leadership. All of the people I work with on the senior leadership level are top-notch people. It’s great to be part of an organization that surrounds itself with talent. The next thing is, it’s a great place to work. IPC was selected as one of the 100 best places to work in healthcare (by Modern Healthcare). We made this list, and a lot of other high-profile names in healthcare did not, so we’re very proud of that.

Q: How does the IPC model translate to increased quality of care?

A: We have resources to educate our physicians. There are hospitals around the country with one-person, two-person, or four-person groups that don’t have the resources to do certain types of training. They acquire it by experience. We’re able to orient them to hospital medicine first … and then bring them along slowly and give them the additional training we think they need to succeed. We also have the resources to do ongoing education and monitor quality measures and efficiency measures as well.

Q: You have been a member of SHM’s Public Policy Committee for about four years. How important is that role?

A: I think it’s incredibly important. The Public Policy Committee gets to be in tune with what the national issues are, and we can help the society foster and create relationships. We had the chance to meet with members of Congress and other national organizations like CMS (Centers for Medicare and Medicaid Services) and AHRQ (Agency for Healthcare Research and Quality), even before healthcare reform became important.

Q: You and other members of the committee went to Washington, D.C., in March. What was the benefit of that trip?

A: We’ve been to Washington several times. We try to do it at least yearly. In previous years, we spent a lot of time just educating people about what hospitalists do. When we first went there, we were surprised by how many members of Congress had never heard of what a hospitalist was. This past year, they were much more aware of what a hospitalist is and how we can help with the goals of healthcare reform.

Q: What’s next for you?

A: I think for now I’m pretty happy with my position and my roles and responsibilities. I help with several different aspects of IPC. I help with some of the risk-management compliance issues. I make presentations to different hospitals and groups we’re thinking of doing business with. I have a varied career, and I enjoy it very much. TH

Mark Leiser is a freelance writer based in New Jersey.

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