This month, Thomas McIlraith, MD, SFHM, will be on stage at HM13 accepting one of the first SHM Certificates in Leadership. As chair of hospital medicine at Sacramento, Calif.-based Mercy Medical Group, Dr. McIlraith already is familiar with the need for leadership in our specialty and shares why SHM’s Leadership Academy and new certification have helped his hospital and his career.
Question: What made you apply for the Certificate in Leadership in the first place?
Answer: I have always felt that a young field like hospital medicine needs to have resources to develop leadership; I don’t think there is another place in the field of medicine that has more shared responsibility requiring coordinated response than hospital medicine.
I have always been impressed and grateful that SHM recognized this and put forth the considerable effort required to create and develop the Leadership Academies into the premiere institution that they have evolved into. That is why I not only got involved in the leadership academies personally, but also had my entire leadership team complete the curriculum.
Certification is the culmination of that experience for me; I am hoping it is not the end, however. I have had other leadership training course work, and while the SHM Leadership Academies and the certification process were the best experience, I have learned that you can never have too much leadership training.
There are always new challenges a leader will be called on to face, and leadership skills need to continually grow.
Q: What’s been the biggest impact on your career so far? How do you plan on using it in the future?
A: It is not enough to be successful; you have to be able to tell the story of your success. Most of us want to be humble and focus on serving our patients, but the tree that falls in the woods is applicable to successful hospital medicine programs: If nobody hears about it, are you really successful? Can you really drive change?
Lenny Marcus put it best in his SHM Leadership Academy session on meta-leadership: Learning how to communicate to your boss is leading up; communicating across the silos of your organization is meta-leadership. The academies teach you about the skills you need for leadership; certification allows you to put those skills into action.
I vividly remember the day that academy instructor Eric Rice called me up to give me feedback on the first draft of my project. I was already stressed out because in four days I knew I had to give a critical presentation to top hospital leadership and health plan medical directors about our group. We had two new hospital presidents and a new service area senior vice president that had already terminated their contract with the ED group that covered three of the four hospitals. I knew they were scrutinizing my group; the pressure was on.
Eric gave the feedback that I had been focusing on the clinical aspects of my project and said I needed to tell the economic story—to measure the economic impact of my intervention. Further, he advised me on how to get the data to tell that story. I knew that he had just given me the material I needed to blow away the upcoming presentation to the hospital presidents, but would I get the data in time? I called up the CFO of the hospital as Eric advised, told him that I needed the data for a presentation I was giving to his boss in four days.
I got the data in time and blew away the presentation. I got to inform one of the new presidents that we had improved the contribution margin in his ICU by half a million dollars and cut length of stay by 0.9 days, while dramatically improving sepsis mortality. I was then able to go on and tell the HM leaders of our entire hospital system about our intervention and encouraged them to take similar steps.
Someday I hope I get the chance to tell Lenny Marcus this story; I hope he will consider me a meta-leader.
After the dust settled from those successes, I went back to my computer to write up the final draft of my project and I was able to tell a much better story than I ever could have without that advice Eric Rice and the committee [gave me].
My new boss was at the presentation that I gave. We went to the American Medical Group Association conference recently, and he did not hesitate to walk around bragging about what we had done, often quoting the numbers I delivered in my presentation. In another coda to the story, the new service area senior vice president asked my wife and I to join him and his wife for dinner; we have struck up a very valuable friendship.
—Thomas McIlraith, MD, SFHM
Q: What would you say to others who are thinking about applying for the certificate?
A: What are you waiting for?
On a more serious note, we are all engaged with important projects to make our hospitals run better, to keep our patients safer, and give our patients better experience. In the certification process, you continue with that work while top leaders from the field of hospital medicine coach and advise you.
Not only do you come out with a better product in the short term, but also you have better skills for taking on projects in the future; you know what questions to ask and what stories to tell and to whom. That stays with you long after the certification project is over.
Q: How are the results of your project benefiting your institution?
A: My hospitalists are seeing increased productivity and my hospitals are seeing stronger contribution margin in tough economic times. Further, the successful completion of the project has elevated the reputation of my department.