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Hospitalist movers and shakers – Jan. 2018
Michael Rader, MD, has been named the chief medical officer of the Department of Veterans Affairs New York/New Jersey Health Care Network. The network serves upward of a half-million veterans in 76 counties in New York, New Jersey, and Pennsylvania. Dr. Rader’s appointment began on Oct. 15, 2017.
Previously, Dr. Rader was chief medical officer at Prospect East Orange (N.J.) General. In his new position, the 35-year veteran will be charged with overseeing care at VA facilities in Albany Stratton, Bath, Canandaigua, and Syracuse in New York, as well as the VA Western New York Health System, the New York Harbor Health System, the New Jersey Health Care System, Hudson Valley Healthcare System, the James J. Peters and Northport VA Medical Centers, as well as 66 community-based outpatient clinics.
The Rhode Island Medical Society has elected Bradley Collins, MD, as its new president. An internist and hospitalist, Dr. Collins practices at Miriam Hospital in Providence, R.I., where he started in 2006 as a staff hospitalist. He’s now the medical director of appeals for Lifespan at Miriam.
Dr. Collins is an assistant professor of clinical medicine at Brown University’s Alpert Medical School, while also serving as a fellow for the Society of Hospital Medicine.
Tracy Cardin, ACNP, SFHM, has been named associate director of clinical integration at Adfinitas Health, a private hospitalist company based in Maryland that serves more than 50 hospitals and post-acute care centers across the Mid-Atlantic region. Cardin is responsible for advancing the company’s training and onboarding infrastructure to support the full integration of physicians, nurse practitioners, and physician assistants into the Adfinitas care delivery model.
Jeffrey Millard, MD, has been named Patient Experience Provider of the Year by the employees and staff at Hardin Memorial Health (Elizabethtown, Ky.). Dr. Millard has been a hospitalist at Hardin Memorial Hospital since 2012.
The Patient Experience Provider of the Year award recognizes a provider who exceeds the company’s mission and vision with patients and their families, as well as with the hospital’s staff. Dr. Millard was chosen from a list of more than 800 nominations.
Benjamin Keidan, MD, has been appointed as chief medical officer for Boulder (Colo.) Community Health. Dr. Keidan advances from his previous role as medical director of quality and population health for outpatient primary care and specialty clinics.
Dr. Keidan is a former internist and hospitalist for BCH and has worked in Boulder County for the past 12 years. He is only the second CMO in BCH’s history.
Dinesh Bande, MD, has been selected as the new chair of the department of internal medicine at the University of North Dakota, Grand Forks. Dr. Bande is a clinical associate professor at the school and a hospitalist with Sanford Health.
Dr. Bande has been the clerkship director for third-year medical students at UND for the past 2 years. As chair of internal medicine, he will oversee education, research, clinical care, training, and service programs within the department.
Vicki Iannotti, MD, has been named chief medical officer at the Elizabeth Ann Seton Pediatric Center in Yonkers, N.Y. Dr. Iannotti joins Seton after spending 12 years as associate chief of pediatrics and pediatric hospital medicine at Maria Fareri Children’s Hospital in Valhalla, N.Y.
At Seton, Dr. Iannotti will oversee 100 medical professionals at the 201,000-square-foot facility, which is the largest provider of children’s acute care in the United States.
Business moves
Management Service Organization Continuum Health (Marlton, N.J.) has signed an agreement with the Mid-Atlantic region’s largest private hospitalist group, Adfinitas Health (Hanover, Md.), to be its revenue management cycle partner. Founded in 1999, Continuum Health now serves more than 1,500 providers in more than 400 locations.
Colquitt Regional Medical Center in Moultrie, Ga., has expanded its hospitalist program, adding 5 physicians to increase its total to 10 on-staff hospitalists. Colquitt Regional’s program began in 2012 with four hospitalists.
In the past, Colquitt Regional has shared hospitalists with surrounding hospitals to meet the demand for care. With the addition of the five new physicians, the hospital can provide full-time hospital medicine care with physicians employed by Colquitt Regional.
Michael Rader, MD, has been named the chief medical officer of the Department of Veterans Affairs New York/New Jersey Health Care Network. The network serves upward of a half-million veterans in 76 counties in New York, New Jersey, and Pennsylvania. Dr. Rader’s appointment began on Oct. 15, 2017.
Previously, Dr. Rader was chief medical officer at Prospect East Orange (N.J.) General. In his new position, the 35-year veteran will be charged with overseeing care at VA facilities in Albany Stratton, Bath, Canandaigua, and Syracuse in New York, as well as the VA Western New York Health System, the New York Harbor Health System, the New Jersey Health Care System, Hudson Valley Healthcare System, the James J. Peters and Northport VA Medical Centers, as well as 66 community-based outpatient clinics.
The Rhode Island Medical Society has elected Bradley Collins, MD, as its new president. An internist and hospitalist, Dr. Collins practices at Miriam Hospital in Providence, R.I., where he started in 2006 as a staff hospitalist. He’s now the medical director of appeals for Lifespan at Miriam.
Dr. Collins is an assistant professor of clinical medicine at Brown University’s Alpert Medical School, while also serving as a fellow for the Society of Hospital Medicine.
Tracy Cardin, ACNP, SFHM, has been named associate director of clinical integration at Adfinitas Health, a private hospitalist company based in Maryland that serves more than 50 hospitals and post-acute care centers across the Mid-Atlantic region. Cardin is responsible for advancing the company’s training and onboarding infrastructure to support the full integration of physicians, nurse practitioners, and physician assistants into the Adfinitas care delivery model.
Jeffrey Millard, MD, has been named Patient Experience Provider of the Year by the employees and staff at Hardin Memorial Health (Elizabethtown, Ky.). Dr. Millard has been a hospitalist at Hardin Memorial Hospital since 2012.
The Patient Experience Provider of the Year award recognizes a provider who exceeds the company’s mission and vision with patients and their families, as well as with the hospital’s staff. Dr. Millard was chosen from a list of more than 800 nominations.
Benjamin Keidan, MD, has been appointed as chief medical officer for Boulder (Colo.) Community Health. Dr. Keidan advances from his previous role as medical director of quality and population health for outpatient primary care and specialty clinics.
Dr. Keidan is a former internist and hospitalist for BCH and has worked in Boulder County for the past 12 years. He is only the second CMO in BCH’s history.
Dinesh Bande, MD, has been selected as the new chair of the department of internal medicine at the University of North Dakota, Grand Forks. Dr. Bande is a clinical associate professor at the school and a hospitalist with Sanford Health.
Dr. Bande has been the clerkship director for third-year medical students at UND for the past 2 years. As chair of internal medicine, he will oversee education, research, clinical care, training, and service programs within the department.
Vicki Iannotti, MD, has been named chief medical officer at the Elizabeth Ann Seton Pediatric Center in Yonkers, N.Y. Dr. Iannotti joins Seton after spending 12 years as associate chief of pediatrics and pediatric hospital medicine at Maria Fareri Children’s Hospital in Valhalla, N.Y.
At Seton, Dr. Iannotti will oversee 100 medical professionals at the 201,000-square-foot facility, which is the largest provider of children’s acute care in the United States.
Business moves
Management Service Organization Continuum Health (Marlton, N.J.) has signed an agreement with the Mid-Atlantic region’s largest private hospitalist group, Adfinitas Health (Hanover, Md.), to be its revenue management cycle partner. Founded in 1999, Continuum Health now serves more than 1,500 providers in more than 400 locations.
Colquitt Regional Medical Center in Moultrie, Ga., has expanded its hospitalist program, adding 5 physicians to increase its total to 10 on-staff hospitalists. Colquitt Regional’s program began in 2012 with four hospitalists.
In the past, Colquitt Regional has shared hospitalists with surrounding hospitals to meet the demand for care. With the addition of the five new physicians, the hospital can provide full-time hospital medicine care with physicians employed by Colquitt Regional.
Michael Rader, MD, has been named the chief medical officer of the Department of Veterans Affairs New York/New Jersey Health Care Network. The network serves upward of a half-million veterans in 76 counties in New York, New Jersey, and Pennsylvania. Dr. Rader’s appointment began on Oct. 15, 2017.
Previously, Dr. Rader was chief medical officer at Prospect East Orange (N.J.) General. In his new position, the 35-year veteran will be charged with overseeing care at VA facilities in Albany Stratton, Bath, Canandaigua, and Syracuse in New York, as well as the VA Western New York Health System, the New York Harbor Health System, the New Jersey Health Care System, Hudson Valley Healthcare System, the James J. Peters and Northport VA Medical Centers, as well as 66 community-based outpatient clinics.
The Rhode Island Medical Society has elected Bradley Collins, MD, as its new president. An internist and hospitalist, Dr. Collins practices at Miriam Hospital in Providence, R.I., where he started in 2006 as a staff hospitalist. He’s now the medical director of appeals for Lifespan at Miriam.
Dr. Collins is an assistant professor of clinical medicine at Brown University’s Alpert Medical School, while also serving as a fellow for the Society of Hospital Medicine.
Tracy Cardin, ACNP, SFHM, has been named associate director of clinical integration at Adfinitas Health, a private hospitalist company based in Maryland that serves more than 50 hospitals and post-acute care centers across the Mid-Atlantic region. Cardin is responsible for advancing the company’s training and onboarding infrastructure to support the full integration of physicians, nurse practitioners, and physician assistants into the Adfinitas care delivery model.
Jeffrey Millard, MD, has been named Patient Experience Provider of the Year by the employees and staff at Hardin Memorial Health (Elizabethtown, Ky.). Dr. Millard has been a hospitalist at Hardin Memorial Hospital since 2012.
The Patient Experience Provider of the Year award recognizes a provider who exceeds the company’s mission and vision with patients and their families, as well as with the hospital’s staff. Dr. Millard was chosen from a list of more than 800 nominations.
Benjamin Keidan, MD, has been appointed as chief medical officer for Boulder (Colo.) Community Health. Dr. Keidan advances from his previous role as medical director of quality and population health for outpatient primary care and specialty clinics.
Dr. Keidan is a former internist and hospitalist for BCH and has worked in Boulder County for the past 12 years. He is only the second CMO in BCH’s history.
Dinesh Bande, MD, has been selected as the new chair of the department of internal medicine at the University of North Dakota, Grand Forks. Dr. Bande is a clinical associate professor at the school and a hospitalist with Sanford Health.
Dr. Bande has been the clerkship director for third-year medical students at UND for the past 2 years. As chair of internal medicine, he will oversee education, research, clinical care, training, and service programs within the department.
Vicki Iannotti, MD, has been named chief medical officer at the Elizabeth Ann Seton Pediatric Center in Yonkers, N.Y. Dr. Iannotti joins Seton after spending 12 years as associate chief of pediatrics and pediatric hospital medicine at Maria Fareri Children’s Hospital in Valhalla, N.Y.
At Seton, Dr. Iannotti will oversee 100 medical professionals at the 201,000-square-foot facility, which is the largest provider of children’s acute care in the United States.
Business moves
Management Service Organization Continuum Health (Marlton, N.J.) has signed an agreement with the Mid-Atlantic region’s largest private hospitalist group, Adfinitas Health (Hanover, Md.), to be its revenue management cycle partner. Founded in 1999, Continuum Health now serves more than 1,500 providers in more than 400 locations.
Colquitt Regional Medical Center in Moultrie, Ga., has expanded its hospitalist program, adding 5 physicians to increase its total to 10 on-staff hospitalists. Colquitt Regional’s program began in 2012 with four hospitalists.
In the past, Colquitt Regional has shared hospitalists with surrounding hospitals to meet the demand for care. With the addition of the five new physicians, the hospital can provide full-time hospital medicine care with physicians employed by Colquitt Regional.
A love of teaching: James Kim, MD
While James Kim, MD, did not originally begin medical school with a plan to become a hospitalist, he has embraced his current role wholeheartedly.
Since becoming board certified in both internal medicine and infectious diseases, Dr. Kim has welcomed the opportunity to be part of hospital medicine, which gives him the opportunity to pursue his other passion: teaching and mentoring.
“It’s not just what you know but how you convey what you know to other people,” said Dr. Kim. “While you might get useful information from a didactic teaching style, it’s important to ask questions to encourage the learner to think about not only what the right answer is but also what’s the thought process required to get the answer.”
As one of the newest additions to the editorial advisory board of The Hospitalist, Dr. Kim took time to tell us more about himself in a recent interview.
QUESTION: How did you find your career path in medicine?
ANSWER: I originally went into medical school thinking I was going to do pediatrics, but then I realized that I really enjoy talking to people and that I like the process of thinking through diagnoses, managing patients, and learning about what makes their circumstances unique.
Q: How did you get into hospital medicine?
A: When I finished my internal medicine residency, I thought I was going to do medical missions. However, I realized along the way that the care you need to provide in order to really make a difference in other countries requires a constant presence there – not just a week or two. So after my fellowship, I was searching for jobs and found a hospitalist position at the University of California, Los Angeles. When I saw it, I thought ‘Wow, I really miss doing inpatient medicine.’
Q: Since you started, what have been some of your favorite parts of hospital medicine?
A: When people come to you in the hospital setting, they are usually pretty sick. It is very satisfying when, through the course of a person’s hospital stay, we are able to come up with a plan that can get them acutely better.
Q: What do you think is the hardest part of hospital medicine?
A: I think one of the things that is most frustrating is when we are placed into a situation in which we are not necessarily doing medical work for a patient but are doing something more like social work. For instance, there are cases in which patients can not be on their own in the community, and there’s no family to take them in, so the hospital, on behalf of the state, has to take them in.
Q: What else do you do outside of hospitalist work?
A: Since I’ve finished medical school, I’ve always been in some kind of academia, which is not something I would have expected. But as time has gone by, I have really come to appreciate being in academia. I really enjoy teaching, and I also think that an academic institution kind of keeps me on my toes. I’m involved with interprofessional education at Emory, with teaching medical students, interns, and residents when I’m on teaching service, and obviously now I’m on The Hospitalist editorial board. I’m looking forward to keeping abreast of what’s hot in the world of hospital medicine.
Q: What are you excited about bringing to The Hospitalist editorial board?
A: I want to try to contribute ideas. I feel that even in my short time at Emory, I’ve gotten to know a few people who might be good resources for reporters to interview or even who might write articles themselves. I also think that seeing what is trending in the world of hospital medicine is a nice way of understanding the future direction of hospital medicine.
Q: What have you seen as being the biggest change in hospital medicine since you started?
A: I feel as though I’ve kept my head down and plowed forward through the first part of my career, but I think that, more than anything else, what I’ve noticed is bigger shifts within health care itself. I know that there’s a lot of consolidation going on. I think that there are many questions that are going to come up about how do we manage a health care system as complicated as America’s and how do we deliver optimal care to people especially when sometimes we end up in situations in which we don’t have all the resources that we would want to have because of circumstances.
Q: Do you see anything in particular on the horizon for hospital medicine?
A: I’ve noticed that there’s been more “hospitalist-ization” – if that’s even a term – of other medical services. At our institution, we already have an acute care service that is basically hospital medicine for general surgery. I think another thing that’s been kind of a hot topic recently is a point-of-care testing, including ultrasounds for line placements.
Q: Where do you see yourself in 10 years?
A: I really enjoy my work at Emory. I want to find more opportunities to teach. For example, I’ve already gotten involved in teaching physician assistant students about how to perform interviews and deliver presentations for attendings. A lot of serendipitous things have happened to me over time, so I think I will continue to teach, but I’m open to those opportunities that present themselves in the future.
Q: What’s the best book you’ve read recently and why?
A: “The Hero with a Thousand Faces,” by Joseph Campbell. This is a very well-known book – I think George Lucas made reference to it when he was writing Star Wars – but I think it was a great literary way to examine the hero’s journey. Once you read the book, and you then watch any kind of movie or read any other kind of adventure narrative, you can’t miss the pattern.
While James Kim, MD, did not originally begin medical school with a plan to become a hospitalist, he has embraced his current role wholeheartedly.
Since becoming board certified in both internal medicine and infectious diseases, Dr. Kim has welcomed the opportunity to be part of hospital medicine, which gives him the opportunity to pursue his other passion: teaching and mentoring.
“It’s not just what you know but how you convey what you know to other people,” said Dr. Kim. “While you might get useful information from a didactic teaching style, it’s important to ask questions to encourage the learner to think about not only what the right answer is but also what’s the thought process required to get the answer.”
As one of the newest additions to the editorial advisory board of The Hospitalist, Dr. Kim took time to tell us more about himself in a recent interview.
QUESTION: How did you find your career path in medicine?
ANSWER: I originally went into medical school thinking I was going to do pediatrics, but then I realized that I really enjoy talking to people and that I like the process of thinking through diagnoses, managing patients, and learning about what makes their circumstances unique.
Q: How did you get into hospital medicine?
A: When I finished my internal medicine residency, I thought I was going to do medical missions. However, I realized along the way that the care you need to provide in order to really make a difference in other countries requires a constant presence there – not just a week or two. So after my fellowship, I was searching for jobs and found a hospitalist position at the University of California, Los Angeles. When I saw it, I thought ‘Wow, I really miss doing inpatient medicine.’
Q: Since you started, what have been some of your favorite parts of hospital medicine?
A: When people come to you in the hospital setting, they are usually pretty sick. It is very satisfying when, through the course of a person’s hospital stay, we are able to come up with a plan that can get them acutely better.
Q: What do you think is the hardest part of hospital medicine?
A: I think one of the things that is most frustrating is when we are placed into a situation in which we are not necessarily doing medical work for a patient but are doing something more like social work. For instance, there are cases in which patients can not be on their own in the community, and there’s no family to take them in, so the hospital, on behalf of the state, has to take them in.
Q: What else do you do outside of hospitalist work?
A: Since I’ve finished medical school, I’ve always been in some kind of academia, which is not something I would have expected. But as time has gone by, I have really come to appreciate being in academia. I really enjoy teaching, and I also think that an academic institution kind of keeps me on my toes. I’m involved with interprofessional education at Emory, with teaching medical students, interns, and residents when I’m on teaching service, and obviously now I’m on The Hospitalist editorial board. I’m looking forward to keeping abreast of what’s hot in the world of hospital medicine.
Q: What are you excited about bringing to The Hospitalist editorial board?
A: I want to try to contribute ideas. I feel that even in my short time at Emory, I’ve gotten to know a few people who might be good resources for reporters to interview or even who might write articles themselves. I also think that seeing what is trending in the world of hospital medicine is a nice way of understanding the future direction of hospital medicine.
Q: What have you seen as being the biggest change in hospital medicine since you started?
A: I feel as though I’ve kept my head down and plowed forward through the first part of my career, but I think that, more than anything else, what I’ve noticed is bigger shifts within health care itself. I know that there’s a lot of consolidation going on. I think that there are many questions that are going to come up about how do we manage a health care system as complicated as America’s and how do we deliver optimal care to people especially when sometimes we end up in situations in which we don’t have all the resources that we would want to have because of circumstances.
Q: Do you see anything in particular on the horizon for hospital medicine?
A: I’ve noticed that there’s been more “hospitalist-ization” – if that’s even a term – of other medical services. At our institution, we already have an acute care service that is basically hospital medicine for general surgery. I think another thing that’s been kind of a hot topic recently is a point-of-care testing, including ultrasounds for line placements.
Q: Where do you see yourself in 10 years?
A: I really enjoy my work at Emory. I want to find more opportunities to teach. For example, I’ve already gotten involved in teaching physician assistant students about how to perform interviews and deliver presentations for attendings. A lot of serendipitous things have happened to me over time, so I think I will continue to teach, but I’m open to those opportunities that present themselves in the future.
Q: What’s the best book you’ve read recently and why?
A: “The Hero with a Thousand Faces,” by Joseph Campbell. This is a very well-known book – I think George Lucas made reference to it when he was writing Star Wars – but I think it was a great literary way to examine the hero’s journey. Once you read the book, and you then watch any kind of movie or read any other kind of adventure narrative, you can’t miss the pattern.
While James Kim, MD, did not originally begin medical school with a plan to become a hospitalist, he has embraced his current role wholeheartedly.
Since becoming board certified in both internal medicine and infectious diseases, Dr. Kim has welcomed the opportunity to be part of hospital medicine, which gives him the opportunity to pursue his other passion: teaching and mentoring.
“It’s not just what you know but how you convey what you know to other people,” said Dr. Kim. “While you might get useful information from a didactic teaching style, it’s important to ask questions to encourage the learner to think about not only what the right answer is but also what’s the thought process required to get the answer.”
As one of the newest additions to the editorial advisory board of The Hospitalist, Dr. Kim took time to tell us more about himself in a recent interview.
QUESTION: How did you find your career path in medicine?
ANSWER: I originally went into medical school thinking I was going to do pediatrics, but then I realized that I really enjoy talking to people and that I like the process of thinking through diagnoses, managing patients, and learning about what makes their circumstances unique.
Q: How did you get into hospital medicine?
A: When I finished my internal medicine residency, I thought I was going to do medical missions. However, I realized along the way that the care you need to provide in order to really make a difference in other countries requires a constant presence there – not just a week or two. So after my fellowship, I was searching for jobs and found a hospitalist position at the University of California, Los Angeles. When I saw it, I thought ‘Wow, I really miss doing inpatient medicine.’
Q: Since you started, what have been some of your favorite parts of hospital medicine?
A: When people come to you in the hospital setting, they are usually pretty sick. It is very satisfying when, through the course of a person’s hospital stay, we are able to come up with a plan that can get them acutely better.
Q: What do you think is the hardest part of hospital medicine?
A: I think one of the things that is most frustrating is when we are placed into a situation in which we are not necessarily doing medical work for a patient but are doing something more like social work. For instance, there are cases in which patients can not be on their own in the community, and there’s no family to take them in, so the hospital, on behalf of the state, has to take them in.
Q: What else do you do outside of hospitalist work?
A: Since I’ve finished medical school, I’ve always been in some kind of academia, which is not something I would have expected. But as time has gone by, I have really come to appreciate being in academia. I really enjoy teaching, and I also think that an academic institution kind of keeps me on my toes. I’m involved with interprofessional education at Emory, with teaching medical students, interns, and residents when I’m on teaching service, and obviously now I’m on The Hospitalist editorial board. I’m looking forward to keeping abreast of what’s hot in the world of hospital medicine.
Q: What are you excited about bringing to The Hospitalist editorial board?
A: I want to try to contribute ideas. I feel that even in my short time at Emory, I’ve gotten to know a few people who might be good resources for reporters to interview or even who might write articles themselves. I also think that seeing what is trending in the world of hospital medicine is a nice way of understanding the future direction of hospital medicine.
Q: What have you seen as being the biggest change in hospital medicine since you started?
A: I feel as though I’ve kept my head down and plowed forward through the first part of my career, but I think that, more than anything else, what I’ve noticed is bigger shifts within health care itself. I know that there’s a lot of consolidation going on. I think that there are many questions that are going to come up about how do we manage a health care system as complicated as America’s and how do we deliver optimal care to people especially when sometimes we end up in situations in which we don’t have all the resources that we would want to have because of circumstances.
Q: Do you see anything in particular on the horizon for hospital medicine?
A: I’ve noticed that there’s been more “hospitalist-ization” – if that’s even a term – of other medical services. At our institution, we already have an acute care service that is basically hospital medicine for general surgery. I think another thing that’s been kind of a hot topic recently is a point-of-care testing, including ultrasounds for line placements.
Q: Where do you see yourself in 10 years?
A: I really enjoy my work at Emory. I want to find more opportunities to teach. For example, I’ve already gotten involved in teaching physician assistant students about how to perform interviews and deliver presentations for attendings. A lot of serendipitous things have happened to me over time, so I think I will continue to teach, but I’m open to those opportunities that present themselves in the future.
Q: What’s the best book you’ve read recently and why?
A: “The Hero with a Thousand Faces,” by Joseph Campbell. This is a very well-known book – I think George Lucas made reference to it when he was writing Star Wars – but I think it was a great literary way to examine the hero’s journey. Once you read the book, and you then watch any kind of movie or read any other kind of adventure narrative, you can’t miss the pattern.
More thoughts about hospitalist burnout
I wrote about physician burnout and well-being in the July 2017 version of this column, and am still thinking a great deal about those issues. In the past 6 months, I can’t identify anything that strikes me as a real breakthrough in addressing these issues. However, the ever-increasing attention and resources directed at physician burnout and wellness, on both a local and national level, strike me as reason for cautious optimism.
A chief wellness officer
In summer 2017, Stanford University created a new physician executive role called chief wellness officer (CWO). As far as I am aware, this is the first such position connected with a hospital or medical school. It will be interesting to see if other organizations create similar positions, although I suspect that in places where it is explicitly recognized as a priority, responsibility for this work will be one of the many duties of a chief medical officer or other such executive, and not a position devoted solely to wellness. Interestingly, an Internet search revealed that some non–health care businesses have executive positions with that title, though the role seems focused more on physical health – as in exercise and smoking cessation – than emotional well-being and burnout.
According to a statement on the Stanford Medicine website, the new CWO will work with colleagues to continue “building on its innovative WellMD Center , which was established in 2016. The center has engaged more than 200 physicians through programs focusing on peer support, stress reduction, and ways to cultivate compassion and resilience, as well as a literature and a dinner series in which physicians explore the challenges and rewards of being a doctor. The center also aims to relieve some of the burden on physicians by improving efficiency and simplifying workplace systems, such as electronic medical records.”
A national conference
Over the last 2 or 3 years many, if not most, physician conferences, including the SHM annual conference, have added some content around physician burnout and well-being. But for the first time I’m aware of, an entire conference, the American Conference on Physician Health, addressed these topics in San Francisco in October 2017, and attracted 425 attendees along with an all-star faculty. I couldn’t attend myself, but found a reporter’s summary informative and I recommend it.
While the summary didn’t suggest the conference provided a cure or simple path to improvement, I’m encouraged that the topic has attracted the attention of some pretty smart people. If there is a second edition of this conference, I’ll try hard to attend.
Worthwhile web resources
The home page of Stanford’s WellMD Center provides a continuously updated list of recent research publications on physician health and links to many other resources, and is worth bookmarking.
Another great educational resource for physician wellness is the AMA’s STEPS Forward, a site devoted to practice improvement that provides guidance on patient care, work flow and process, leading change, technology and finance, as well as professional well-being. Of the five separate education modules in the latter category, I found the one on “Preventing Physician Burnout” especially informative. The site is free, doesn’t require an AMA membership, and can provide CME credit.
Making a difference locally: Individuals
Surveys, research, and the experience of experts available via the above resources and others are very valuable, but may be hard to translate into action for you and your fellow local caregivers. My sense is that many hospitalists address their own work-related distress by simply working less in total – reducing their full-time equivalents. That may be the most tangible and accessible intervention, and undeniably the right thing to do in some cases. But it isn’t an ideal approach for our field, which faces chronic staffing shortages. And it doesn’t do anything to change the average level of distress of a day of work. I worry that many people will find disappointment if working fewer shifts is their only burnout mitigation strategy.
Ensuring that you have some work-related interest outside of direct patient care, such as being the local electronic health record expert, or even the person leading formation of a support committee, can be really valuable. I first addressed this topic in the June 2011 issue of The Hospitalist, and there is a long list of things to consider: mindfulness, practicing “ self-compassion ,” cultivating deeper social connections in and out of the workplace, etc. Ultimately, each of us will have to choose our own path, and for some that should include professional help, e.g., from a mental health care provider.
But as a colleague once put it, a focus on changing ourselves is akin to just learning to take a punch better. A worthwhile endeavor, but it’s also necessary to try to decrease the number of punches thrown our way.
Making a difference locally: Medical staff
I’m part of the Provider Support Committee at my hospital, and I have concluded that nearly every hospital should have a group like this. Our own committee was modeled after the support committee at a hospital five miles away, and both groups see value in collaborating in our efforts. In fact, a person from each hospital’s committee serves on the committee at the other hospital.
These committees have popped up in other institutions, and many have been at it longer than at my hospital. But they all seem to share a mission of developing and implementing programs to position caregivers to thrive in their work, increase resilience, and reduce their risk of burnout. Some interventions are focused on making changes to an EHR, work schedules, work flows, or even staffing levels (i.e., reducing the “number of punches”). Other efforts are directed toward establishing groups that support personal reflection and/or social connections among providers.
A review of activities undertaken by seven different organizations is available at the AMA STEPS forward Preventing Physician Burnout website (click on “STEPS in practice.”)
Dr. Nelson has had a career in clinical practice as a hospitalist starting in 1988. He is cofounder and past president of SHM, and principal in Nelson Flores Hospital Medicine Consultants. He is codirector for SHM’s practice management courses. Contact him at [email protected]
I wrote about physician burnout and well-being in the July 2017 version of this column, and am still thinking a great deal about those issues. In the past 6 months, I can’t identify anything that strikes me as a real breakthrough in addressing these issues. However, the ever-increasing attention and resources directed at physician burnout and wellness, on both a local and national level, strike me as reason for cautious optimism.
A chief wellness officer
In summer 2017, Stanford University created a new physician executive role called chief wellness officer (CWO). As far as I am aware, this is the first such position connected with a hospital or medical school. It will be interesting to see if other organizations create similar positions, although I suspect that in places where it is explicitly recognized as a priority, responsibility for this work will be one of the many duties of a chief medical officer or other such executive, and not a position devoted solely to wellness. Interestingly, an Internet search revealed that some non–health care businesses have executive positions with that title, though the role seems focused more on physical health – as in exercise and smoking cessation – than emotional well-being and burnout.
According to a statement on the Stanford Medicine website, the new CWO will work with colleagues to continue “building on its innovative WellMD Center , which was established in 2016. The center has engaged more than 200 physicians through programs focusing on peer support, stress reduction, and ways to cultivate compassion and resilience, as well as a literature and a dinner series in which physicians explore the challenges and rewards of being a doctor. The center also aims to relieve some of the burden on physicians by improving efficiency and simplifying workplace systems, such as electronic medical records.”
A national conference
Over the last 2 or 3 years many, if not most, physician conferences, including the SHM annual conference, have added some content around physician burnout and well-being. But for the first time I’m aware of, an entire conference, the American Conference on Physician Health, addressed these topics in San Francisco in October 2017, and attracted 425 attendees along with an all-star faculty. I couldn’t attend myself, but found a reporter’s summary informative and I recommend it.
While the summary didn’t suggest the conference provided a cure or simple path to improvement, I’m encouraged that the topic has attracted the attention of some pretty smart people. If there is a second edition of this conference, I’ll try hard to attend.
Worthwhile web resources
The home page of Stanford’s WellMD Center provides a continuously updated list of recent research publications on physician health and links to many other resources, and is worth bookmarking.
Another great educational resource for physician wellness is the AMA’s STEPS Forward, a site devoted to practice improvement that provides guidance on patient care, work flow and process, leading change, technology and finance, as well as professional well-being. Of the five separate education modules in the latter category, I found the one on “Preventing Physician Burnout” especially informative. The site is free, doesn’t require an AMA membership, and can provide CME credit.
Making a difference locally: Individuals
Surveys, research, and the experience of experts available via the above resources and others are very valuable, but may be hard to translate into action for you and your fellow local caregivers. My sense is that many hospitalists address their own work-related distress by simply working less in total – reducing their full-time equivalents. That may be the most tangible and accessible intervention, and undeniably the right thing to do in some cases. But it isn’t an ideal approach for our field, which faces chronic staffing shortages. And it doesn’t do anything to change the average level of distress of a day of work. I worry that many people will find disappointment if working fewer shifts is their only burnout mitigation strategy.
Ensuring that you have some work-related interest outside of direct patient care, such as being the local electronic health record expert, or even the person leading formation of a support committee, can be really valuable. I first addressed this topic in the June 2011 issue of The Hospitalist, and there is a long list of things to consider: mindfulness, practicing “ self-compassion ,” cultivating deeper social connections in and out of the workplace, etc. Ultimately, each of us will have to choose our own path, and for some that should include professional help, e.g., from a mental health care provider.
But as a colleague once put it, a focus on changing ourselves is akin to just learning to take a punch better. A worthwhile endeavor, but it’s also necessary to try to decrease the number of punches thrown our way.
Making a difference locally: Medical staff
I’m part of the Provider Support Committee at my hospital, and I have concluded that nearly every hospital should have a group like this. Our own committee was modeled after the support committee at a hospital five miles away, and both groups see value in collaborating in our efforts. In fact, a person from each hospital’s committee serves on the committee at the other hospital.
These committees have popped up in other institutions, and many have been at it longer than at my hospital. But they all seem to share a mission of developing and implementing programs to position caregivers to thrive in their work, increase resilience, and reduce their risk of burnout. Some interventions are focused on making changes to an EHR, work schedules, work flows, or even staffing levels (i.e., reducing the “number of punches”). Other efforts are directed toward establishing groups that support personal reflection and/or social connections among providers.
A review of activities undertaken by seven different organizations is available at the AMA STEPS forward Preventing Physician Burnout website (click on “STEPS in practice.”)
Dr. Nelson has had a career in clinical practice as a hospitalist starting in 1988. He is cofounder and past president of SHM, and principal in Nelson Flores Hospital Medicine Consultants. He is codirector for SHM’s practice management courses. Contact him at [email protected]
I wrote about physician burnout and well-being in the July 2017 version of this column, and am still thinking a great deal about those issues. In the past 6 months, I can’t identify anything that strikes me as a real breakthrough in addressing these issues. However, the ever-increasing attention and resources directed at physician burnout and wellness, on both a local and national level, strike me as reason for cautious optimism.
A chief wellness officer
In summer 2017, Stanford University created a new physician executive role called chief wellness officer (CWO). As far as I am aware, this is the first such position connected with a hospital or medical school. It will be interesting to see if other organizations create similar positions, although I suspect that in places where it is explicitly recognized as a priority, responsibility for this work will be one of the many duties of a chief medical officer or other such executive, and not a position devoted solely to wellness. Interestingly, an Internet search revealed that some non–health care businesses have executive positions with that title, though the role seems focused more on physical health – as in exercise and smoking cessation – than emotional well-being and burnout.
According to a statement on the Stanford Medicine website, the new CWO will work with colleagues to continue “building on its innovative WellMD Center , which was established in 2016. The center has engaged more than 200 physicians through programs focusing on peer support, stress reduction, and ways to cultivate compassion and resilience, as well as a literature and a dinner series in which physicians explore the challenges and rewards of being a doctor. The center also aims to relieve some of the burden on physicians by improving efficiency and simplifying workplace systems, such as electronic medical records.”
A national conference
Over the last 2 or 3 years many, if not most, physician conferences, including the SHM annual conference, have added some content around physician burnout and well-being. But for the first time I’m aware of, an entire conference, the American Conference on Physician Health, addressed these topics in San Francisco in October 2017, and attracted 425 attendees along with an all-star faculty. I couldn’t attend myself, but found a reporter’s summary informative and I recommend it.
While the summary didn’t suggest the conference provided a cure or simple path to improvement, I’m encouraged that the topic has attracted the attention of some pretty smart people. If there is a second edition of this conference, I’ll try hard to attend.
Worthwhile web resources
The home page of Stanford’s WellMD Center provides a continuously updated list of recent research publications on physician health and links to many other resources, and is worth bookmarking.
Another great educational resource for physician wellness is the AMA’s STEPS Forward, a site devoted to practice improvement that provides guidance on patient care, work flow and process, leading change, technology and finance, as well as professional well-being. Of the five separate education modules in the latter category, I found the one on “Preventing Physician Burnout” especially informative. The site is free, doesn’t require an AMA membership, and can provide CME credit.
Making a difference locally: Individuals
Surveys, research, and the experience of experts available via the above resources and others are very valuable, but may be hard to translate into action for you and your fellow local caregivers. My sense is that many hospitalists address their own work-related distress by simply working less in total – reducing their full-time equivalents. That may be the most tangible and accessible intervention, and undeniably the right thing to do in some cases. But it isn’t an ideal approach for our field, which faces chronic staffing shortages. And it doesn’t do anything to change the average level of distress of a day of work. I worry that many people will find disappointment if working fewer shifts is their only burnout mitigation strategy.
Ensuring that you have some work-related interest outside of direct patient care, such as being the local electronic health record expert, or even the person leading formation of a support committee, can be really valuable. I first addressed this topic in the June 2011 issue of The Hospitalist, and there is a long list of things to consider: mindfulness, practicing “ self-compassion ,” cultivating deeper social connections in and out of the workplace, etc. Ultimately, each of us will have to choose our own path, and for some that should include professional help, e.g., from a mental health care provider.
But as a colleague once put it, a focus on changing ourselves is akin to just learning to take a punch better. A worthwhile endeavor, but it’s also necessary to try to decrease the number of punches thrown our way.
Making a difference locally: Medical staff
I’m part of the Provider Support Committee at my hospital, and I have concluded that nearly every hospital should have a group like this. Our own committee was modeled after the support committee at a hospital five miles away, and both groups see value in collaborating in our efforts. In fact, a person from each hospital’s committee serves on the committee at the other hospital.
These committees have popped up in other institutions, and many have been at it longer than at my hospital. But they all seem to share a mission of developing and implementing programs to position caregivers to thrive in their work, increase resilience, and reduce their risk of burnout. Some interventions are focused on making changes to an EHR, work schedules, work flows, or even staffing levels (i.e., reducing the “number of punches”). Other efforts are directed toward establishing groups that support personal reflection and/or social connections among providers.
A review of activities undertaken by seven different organizations is available at the AMA STEPS forward Preventing Physician Burnout website (click on “STEPS in practice.”)
Dr. Nelson has had a career in clinical practice as a hospitalist starting in 1988. He is cofounder and past president of SHM, and principal in Nelson Flores Hospital Medicine Consultants. He is codirector for SHM’s practice management courses. Contact him at [email protected]
Sneak Peek: The Hospital Leader blog – Dec. 2017
Cultivating women leaders in health care #WIMmonth #ThisIsWhatADoctorLooksLike
On my flight home from Scotland, I had a moment to watch a movie while my daughter was caught up in the encore adventures of Moana. I stumbled upon “Hidden Figures,” the story of the African American women at NASA who helped launch John Glenn into space, reviving the nation’s space program.
Turns out I wasn’t the only one who stumbled upon this. Harvard researcher Julie Silver, MD, raised the question about invisible women leaders when reviewing quotes in magazines like Modern Healthcare or Forbes. Moreover, her research demonstrates that, for many professional society awards, 0% are given to women! This is happening in specialties that had nearly even proportions of women and men in practice, such as dermatology and rehab medicine. Last month, I was dumbfounded when I saw a full-page New York Times ad of Top Surgeons by Castle Connolly featuring 16 surgeons, all male.
While Castle Connolly does name female top doctors and market ad opportunities to women and men, I learned that only men sign up for the ads. While this raises more questions, the optics remain problematic – women doctors are hidden. Regardless of the venue, we must do a better job profiling our female leaders. In addition, it is important to recognize that female leaders face well-documented and somewhat controversial challenges that require careful thought:
- Stereotype threat: Some of the original research on stereotype threat done in college students showed that, if women who are about to take a math test are told that the test will expose gender differences, such as men do better at math, women will perform worse AND men will do better. The threat of stereotypes is that women can internalize them and this may hamper their progress. The good news is that education on stereotype threat apparently helps.
- Impostor syndrome: Even highly successful people apparently suffer from impostor syndrome, the fear that they do not deserve their success, but it is much worse in women than in men. You are always trying to conquer the little voice in your head that tells you that you are not good enough.
Read the full post at hospitalleader.org.
Also on The Hospital Leader …
- If I were you, I would not be bullish on long-term care by Brad Flansbaum, DO, MPH, MHM
- Da Vinci wuz here by Jordan Messler, MD, SFHM
- Making the implicit explicit by Leslie Flores, MHA, SFHM
- Should we really focus on “patient-centered care”? by Tracy Cardin, ACNP-BC, SFHM
Cultivating women leaders in health care #WIMmonth #ThisIsWhatADoctorLooksLike
On my flight home from Scotland, I had a moment to watch a movie while my daughter was caught up in the encore adventures of Moana. I stumbled upon “Hidden Figures,” the story of the African American women at NASA who helped launch John Glenn into space, reviving the nation’s space program.
Turns out I wasn’t the only one who stumbled upon this. Harvard researcher Julie Silver, MD, raised the question about invisible women leaders when reviewing quotes in magazines like Modern Healthcare or Forbes. Moreover, her research demonstrates that, for many professional society awards, 0% are given to women! This is happening in specialties that had nearly even proportions of women and men in practice, such as dermatology and rehab medicine. Last month, I was dumbfounded when I saw a full-page New York Times ad of Top Surgeons by Castle Connolly featuring 16 surgeons, all male.
While Castle Connolly does name female top doctors and market ad opportunities to women and men, I learned that only men sign up for the ads. While this raises more questions, the optics remain problematic – women doctors are hidden. Regardless of the venue, we must do a better job profiling our female leaders. In addition, it is important to recognize that female leaders face well-documented and somewhat controversial challenges that require careful thought:
- Stereotype threat: Some of the original research on stereotype threat done in college students showed that, if women who are about to take a math test are told that the test will expose gender differences, such as men do better at math, women will perform worse AND men will do better. The threat of stereotypes is that women can internalize them and this may hamper their progress. The good news is that education on stereotype threat apparently helps.
- Impostor syndrome: Even highly successful people apparently suffer from impostor syndrome, the fear that they do not deserve their success, but it is much worse in women than in men. You are always trying to conquer the little voice in your head that tells you that you are not good enough.
Read the full post at hospitalleader.org.
Also on The Hospital Leader …
- If I were you, I would not be bullish on long-term care by Brad Flansbaum, DO, MPH, MHM
- Da Vinci wuz here by Jordan Messler, MD, SFHM
- Making the implicit explicit by Leslie Flores, MHA, SFHM
- Should we really focus on “patient-centered care”? by Tracy Cardin, ACNP-BC, SFHM
Cultivating women leaders in health care #WIMmonth #ThisIsWhatADoctorLooksLike
On my flight home from Scotland, I had a moment to watch a movie while my daughter was caught up in the encore adventures of Moana. I stumbled upon “Hidden Figures,” the story of the African American women at NASA who helped launch John Glenn into space, reviving the nation’s space program.
Turns out I wasn’t the only one who stumbled upon this. Harvard researcher Julie Silver, MD, raised the question about invisible women leaders when reviewing quotes in magazines like Modern Healthcare or Forbes. Moreover, her research demonstrates that, for many professional society awards, 0% are given to women! This is happening in specialties that had nearly even proportions of women and men in practice, such as dermatology and rehab medicine. Last month, I was dumbfounded when I saw a full-page New York Times ad of Top Surgeons by Castle Connolly featuring 16 surgeons, all male.
While Castle Connolly does name female top doctors and market ad opportunities to women and men, I learned that only men sign up for the ads. While this raises more questions, the optics remain problematic – women doctors are hidden. Regardless of the venue, we must do a better job profiling our female leaders. In addition, it is important to recognize that female leaders face well-documented and somewhat controversial challenges that require careful thought:
- Stereotype threat: Some of the original research on stereotype threat done in college students showed that, if women who are about to take a math test are told that the test will expose gender differences, such as men do better at math, women will perform worse AND men will do better. The threat of stereotypes is that women can internalize them and this may hamper their progress. The good news is that education on stereotype threat apparently helps.
- Impostor syndrome: Even highly successful people apparently suffer from impostor syndrome, the fear that they do not deserve their success, but it is much worse in women than in men. You are always trying to conquer the little voice in your head that tells you that you are not good enough.
Read the full post at hospitalleader.org.
Also on The Hospital Leader …
- If I were you, I would not be bullish on long-term care by Brad Flansbaum, DO, MPH, MHM
- Da Vinci wuz here by Jordan Messler, MD, SFHM
- Making the implicit explicit by Leslie Flores, MHA, SFHM
- Should we really focus on “patient-centered care”? by Tracy Cardin, ACNP-BC, SFHM
Swarm and suspicion leadership
During your career, you serve as staff member and leader to many different professional groups. Some are collaborative, collegial, and supportive. Others are competitive, antagonistic, or even combative. What are the benefits and downsides of each of these cultures and what can you do, as a hospitalist leader, to influence the character of your workplace?
The field of “game theory” provides insights into the distinction. The first questions to ask are “What is the game you are playing?” and then “Who is the competition?” In a “winner-takes-all” scenario, such as a sporting event, each team seeks strategic advantage over the other team. In baseball terms, the winner gets more points when at bat and denies more points when on the field. However, when competing as a team, winning together requires collaboration to build strategy, execute plays, and reach victory. You compete against the other team and collaborate within your own team.
Scientists who study negotiation strategies and conflict resolution find that collaborative groups spend less time countering one another and, instead, investing that same effort into building constructive outcomes, a force multiplier.
In the winner-takes-all model, the baseball team that gets “outs,” makes plays, and advances team members to home plate, wins. If there is contest within the team, players invest that same effort into seeking their own gain at the expense of others. Benefits derived from shared effort are shunned in favor of benefits accrued to one player over the other. It is a distinction between “I won” versus “We won.”
Hospital medicine is not a win/lose sport, yet over the years, hospitalists have shared with me that their institution or group at times feels like a competitive field with winners and losers. If this distinction is placed on a continuum, what factors encourage a more collaborative environment and what factors do the opposite, toward the adversarial side of the continuum? It makes a substantive difference in the interactions and accomplishments that a group achieves.
My colleagues and I at Harvard study leaders in times of crisis. A crisis makes apparent what is often more subtle during routine times. Our study of leaders in the wake of the Boston Marathon bombings was among our most revealing.
During most crises, an operational leader is designated to oversee the whole of the response. This is an individual with organizational authority and subject-matter expertise appropriate to the situation at hand. In Boston, however, there were so many different jurisdictions – federal, state, and local – and so many different agencies, that no one leader stood above the others. They worked in a remarkably collaborative fashion. While the bombings themselves were tragic, the response itself was a success: All who survived the initial blasts lived, a function of remarkable emergency care, distribution to hospitals, and good medical care. The perpetrators were caught in 102 hours, and “Boston Strong” reflected a genuine city resilience.
These leaders worked together in ways that we had rarely seen before. What we discovered was a phenomenon we call “swarm leadership,” inspired by the ways ants, bees, and termites engage in collective work and decision making. These creatures have clear lines of communication and structures for judgment calls, often about food sources, nesting locations, and threats.
There are five principles of swarm leadership:
- Unity of mission – In Boston, that was to “save lives,” and it motivated and activated the whole of the response.
- Generosity of spirit and action – Across the community, people were eager to assist in the response.
- Everyone stayed in their own lanes of responsibility and helped others succeed in theirs – There were law enforcement, medical, and resilience activities and the theme across the leaders was “how can I help make you a success?”
- No ego and no blame – There was a level of emotional intelligence and maturity among the leaders.
- A foundation of trusting relations – These leaders had known one another for years and, though the decisions were tough, they were confident in the motives and actions of the others.
While the discovery emerged from our crisis research, the findings equally apply to other, more routine work and interactions. Conduct your own assessment. Have you worked in groups in which these principles of swarm leadership characterized the experience? People were focused on a shared mission: They were available to assist one another; accomplished their work in ways that were respectful and supportive of their different responsibilities; did not claim undue credit or swipe at each another; and knew one another well enough to trust the others’ actions and motives.
The flip side of this continuum of collaboration and competition we term “suspicion leadership.” This is characterized by selfish ambitions; narcissistic actions; grabs for authority and resources; credit taking for the good and accusations for the bad; and an environment of mistrust and back stabbing.
Leaders influence the tone and tenor of their own group’s interactions as well as interactions among different working groups. As role models, if they articulate and demonstrate a mission that others can rally around, they forge that critical unity of mission. By contrast, suspicion leaders make it clear that “it is all about me and my priorities.” There is much work to be done, and swarm leaders ensure that people have the resources, autonomy, and support necessary to get the job done. On the other end, the work environment is burdened by the uncertainties about who does what and who is responsible. Swarm leaders are focused on “we” and suspicion leaders are caught up on “me.” There is no trust when people are suspicious of one another. Much can be accomplished when people believe in themselves, their colleagues, and the reasons that bring them together.
As a hospitalist leader, you influence where on this continuum your group will lie. It is your choice to be a role model for the principles of swarm, encouraging the same among others. When those principles become the beacons by which you work and relate, you will find an environment that inspires people to be and to do their best.
In the next column, how to build trust within your teams.
Dr. Marcus is director, Program on Health Care Negotiation and Conflict Resolution, at the Harvard T.H. Chan School of Public Health, in Boston.
During your career, you serve as staff member and leader to many different professional groups. Some are collaborative, collegial, and supportive. Others are competitive, antagonistic, or even combative. What are the benefits and downsides of each of these cultures and what can you do, as a hospitalist leader, to influence the character of your workplace?
The field of “game theory” provides insights into the distinction. The first questions to ask are “What is the game you are playing?” and then “Who is the competition?” In a “winner-takes-all” scenario, such as a sporting event, each team seeks strategic advantage over the other team. In baseball terms, the winner gets more points when at bat and denies more points when on the field. However, when competing as a team, winning together requires collaboration to build strategy, execute plays, and reach victory. You compete against the other team and collaborate within your own team.
Scientists who study negotiation strategies and conflict resolution find that collaborative groups spend less time countering one another and, instead, investing that same effort into building constructive outcomes, a force multiplier.
In the winner-takes-all model, the baseball team that gets “outs,” makes plays, and advances team members to home plate, wins. If there is contest within the team, players invest that same effort into seeking their own gain at the expense of others. Benefits derived from shared effort are shunned in favor of benefits accrued to one player over the other. It is a distinction between “I won” versus “We won.”
Hospital medicine is not a win/lose sport, yet over the years, hospitalists have shared with me that their institution or group at times feels like a competitive field with winners and losers. If this distinction is placed on a continuum, what factors encourage a more collaborative environment and what factors do the opposite, toward the adversarial side of the continuum? It makes a substantive difference in the interactions and accomplishments that a group achieves.
My colleagues and I at Harvard study leaders in times of crisis. A crisis makes apparent what is often more subtle during routine times. Our study of leaders in the wake of the Boston Marathon bombings was among our most revealing.
During most crises, an operational leader is designated to oversee the whole of the response. This is an individual with organizational authority and subject-matter expertise appropriate to the situation at hand. In Boston, however, there were so many different jurisdictions – federal, state, and local – and so many different agencies, that no one leader stood above the others. They worked in a remarkably collaborative fashion. While the bombings themselves were tragic, the response itself was a success: All who survived the initial blasts lived, a function of remarkable emergency care, distribution to hospitals, and good medical care. The perpetrators were caught in 102 hours, and “Boston Strong” reflected a genuine city resilience.
These leaders worked together in ways that we had rarely seen before. What we discovered was a phenomenon we call “swarm leadership,” inspired by the ways ants, bees, and termites engage in collective work and decision making. These creatures have clear lines of communication and structures for judgment calls, often about food sources, nesting locations, and threats.
There are five principles of swarm leadership:
- Unity of mission – In Boston, that was to “save lives,” and it motivated and activated the whole of the response.
- Generosity of spirit and action – Across the community, people were eager to assist in the response.
- Everyone stayed in their own lanes of responsibility and helped others succeed in theirs – There were law enforcement, medical, and resilience activities and the theme across the leaders was “how can I help make you a success?”
- No ego and no blame – There was a level of emotional intelligence and maturity among the leaders.
- A foundation of trusting relations – These leaders had known one another for years and, though the decisions were tough, they were confident in the motives and actions of the others.
While the discovery emerged from our crisis research, the findings equally apply to other, more routine work and interactions. Conduct your own assessment. Have you worked in groups in which these principles of swarm leadership characterized the experience? People were focused on a shared mission: They were available to assist one another; accomplished their work in ways that were respectful and supportive of their different responsibilities; did not claim undue credit or swipe at each another; and knew one another well enough to trust the others’ actions and motives.
The flip side of this continuum of collaboration and competition we term “suspicion leadership.” This is characterized by selfish ambitions; narcissistic actions; grabs for authority and resources; credit taking for the good and accusations for the bad; and an environment of mistrust and back stabbing.
Leaders influence the tone and tenor of their own group’s interactions as well as interactions among different working groups. As role models, if they articulate and demonstrate a mission that others can rally around, they forge that critical unity of mission. By contrast, suspicion leaders make it clear that “it is all about me and my priorities.” There is much work to be done, and swarm leaders ensure that people have the resources, autonomy, and support necessary to get the job done. On the other end, the work environment is burdened by the uncertainties about who does what and who is responsible. Swarm leaders are focused on “we” and suspicion leaders are caught up on “me.” There is no trust when people are suspicious of one another. Much can be accomplished when people believe in themselves, their colleagues, and the reasons that bring them together.
As a hospitalist leader, you influence where on this continuum your group will lie. It is your choice to be a role model for the principles of swarm, encouraging the same among others. When those principles become the beacons by which you work and relate, you will find an environment that inspires people to be and to do their best.
In the next column, how to build trust within your teams.
Dr. Marcus is director, Program on Health Care Negotiation and Conflict Resolution, at the Harvard T.H. Chan School of Public Health, in Boston.
During your career, you serve as staff member and leader to many different professional groups. Some are collaborative, collegial, and supportive. Others are competitive, antagonistic, or even combative. What are the benefits and downsides of each of these cultures and what can you do, as a hospitalist leader, to influence the character of your workplace?
The field of “game theory” provides insights into the distinction. The first questions to ask are “What is the game you are playing?” and then “Who is the competition?” In a “winner-takes-all” scenario, such as a sporting event, each team seeks strategic advantage over the other team. In baseball terms, the winner gets more points when at bat and denies more points when on the field. However, when competing as a team, winning together requires collaboration to build strategy, execute plays, and reach victory. You compete against the other team and collaborate within your own team.
Scientists who study negotiation strategies and conflict resolution find that collaborative groups spend less time countering one another and, instead, investing that same effort into building constructive outcomes, a force multiplier.
In the winner-takes-all model, the baseball team that gets “outs,” makes plays, and advances team members to home plate, wins. If there is contest within the team, players invest that same effort into seeking their own gain at the expense of others. Benefits derived from shared effort are shunned in favor of benefits accrued to one player over the other. It is a distinction between “I won” versus “We won.”
Hospital medicine is not a win/lose sport, yet over the years, hospitalists have shared with me that their institution or group at times feels like a competitive field with winners and losers. If this distinction is placed on a continuum, what factors encourage a more collaborative environment and what factors do the opposite, toward the adversarial side of the continuum? It makes a substantive difference in the interactions and accomplishments that a group achieves.
My colleagues and I at Harvard study leaders in times of crisis. A crisis makes apparent what is often more subtle during routine times. Our study of leaders in the wake of the Boston Marathon bombings was among our most revealing.
During most crises, an operational leader is designated to oversee the whole of the response. This is an individual with organizational authority and subject-matter expertise appropriate to the situation at hand. In Boston, however, there were so many different jurisdictions – federal, state, and local – and so many different agencies, that no one leader stood above the others. They worked in a remarkably collaborative fashion. While the bombings themselves were tragic, the response itself was a success: All who survived the initial blasts lived, a function of remarkable emergency care, distribution to hospitals, and good medical care. The perpetrators were caught in 102 hours, and “Boston Strong” reflected a genuine city resilience.
These leaders worked together in ways that we had rarely seen before. What we discovered was a phenomenon we call “swarm leadership,” inspired by the ways ants, bees, and termites engage in collective work and decision making. These creatures have clear lines of communication and structures for judgment calls, often about food sources, nesting locations, and threats.
There are five principles of swarm leadership:
- Unity of mission – In Boston, that was to “save lives,” and it motivated and activated the whole of the response.
- Generosity of spirit and action – Across the community, people were eager to assist in the response.
- Everyone stayed in their own lanes of responsibility and helped others succeed in theirs – There were law enforcement, medical, and resilience activities and the theme across the leaders was “how can I help make you a success?”
- No ego and no blame – There was a level of emotional intelligence and maturity among the leaders.
- A foundation of trusting relations – These leaders had known one another for years and, though the decisions were tough, they were confident in the motives and actions of the others.
While the discovery emerged from our crisis research, the findings equally apply to other, more routine work and interactions. Conduct your own assessment. Have you worked in groups in which these principles of swarm leadership characterized the experience? People were focused on a shared mission: They were available to assist one another; accomplished their work in ways that were respectful and supportive of their different responsibilities; did not claim undue credit or swipe at each another; and knew one another well enough to trust the others’ actions and motives.
The flip side of this continuum of collaboration and competition we term “suspicion leadership.” This is characterized by selfish ambitions; narcissistic actions; grabs for authority and resources; credit taking for the good and accusations for the bad; and an environment of mistrust and back stabbing.
Leaders influence the tone and tenor of their own group’s interactions as well as interactions among different working groups. As role models, if they articulate and demonstrate a mission that others can rally around, they forge that critical unity of mission. By contrast, suspicion leaders make it clear that “it is all about me and my priorities.” There is much work to be done, and swarm leaders ensure that people have the resources, autonomy, and support necessary to get the job done. On the other end, the work environment is burdened by the uncertainties about who does what and who is responsible. Swarm leaders are focused on “we” and suspicion leaders are caught up on “me.” There is no trust when people are suspicious of one another. Much can be accomplished when people believe in themselves, their colleagues, and the reasons that bring them together.
As a hospitalist leader, you influence where on this continuum your group will lie. It is your choice to be a role model for the principles of swarm, encouraging the same among others. When those principles become the beacons by which you work and relate, you will find an environment that inspires people to be and to do their best.
In the next column, how to build trust within your teams.
Dr. Marcus is director, Program on Health Care Negotiation and Conflict Resolution, at the Harvard T.H. Chan School of Public Health, in Boston.
Hospitalist movers and shakers – Nov. 2017
Pediatric hospitalist Patrick Conway, MD, has been named president and chief executive officer of Blue Cross and Blue Shield of North Carolina. Dr. Conway will take over for the retiring Brad Wilson on Oct. 1.
Dr. Conway is currently the deputy administrator for Innovation and Quality, and the director of the Center for Medicare and Medicaid Innovation for the Centers for Medicare and Medicaid Services (CMS). Previously, he was CMO at CMS, having served both the Obama and Trump administrations.
Hossam Hafez, MD, recently claimed the role of chief of Hospitalist Service with Health Quest Medical Practice (LaGrangeville, N.Y.). Dr. Hafez will be based out of Health Quest’s Vassar Brothers Medical Center in Poughkeepsie, N.Y., coordinating care in that hospital and throughout the Health Quest system.
Dr. Hafez has served full-time hospitalist stints with MidMichigan Health’s Physician Hospitalist Group, as well as with RiteMed Urgent Care. A native of Egypt, Dr. Hafez is fluent in both English and Arabic.
Caldwell UNC Healthcare (Lenoir, N.C.) has promoted David Lowry, MD, to chief medical officer as of Aug. 1, 2017.
Dr. Lowry, a longtime hospitalist and veteran in hospital medicine in general, will lead the building’s hospitalist program, support the chief of staff, and provide direct patient care, as well. He will serve as physician advisor for Caldwell’s Clinical Documentation, Utilization Review, Respiratory Care, and Rehabilitation departments.
Dr. Lowry boasts more than 25 years experience in hospital medicine and led in the creation of Caldwell’s hospitalist program. Since joining Caldwell, he has held leadership positions including chief of medicine. He received the hospital’s Donald D. McNeill Jr. Award for Outstanding Physician Leadership in 2014, as voted by his peers.
Joahd Toure, MD, recently was hired by Adirondack Health (Saranac Lake, N.Y.) as its new chief medical officer. He started his new position in late June 2017.
A Massachusetts native, Dr. Toure most recently worked as chief of hospitalist medicine with AdvantageCare Physicians in New York City. There, he helped manage care for patients in that system’s 16 hospitals in the New York metro area. Previously, he was regional medical director for Essex Inpatient Physicians (Boxford, Mass.) and a staff hospitalist at South Shore Hospital (South Weymouth, Mass.).
Longtime employee Emily Chapman, MD, has been promoted to chief medical officer and vice president of medical affairs at Children’s Minnesota Hospital (Minneapolis). The former vice CMO took on her new role on July 5, 2017.
Previously, Dr. Chapman served Children’s as its hospitalist program director, and as director of graduate medical education. She is an American Academy of Pediatrics Fellow.
Mark Sockell, MD, is the new chief medical officer at Meritage Medical Network in Novato, Calif. Meritage is a physician-run network that includes more than 700 board-certified physicians in both primary care and specialist fields.
Dr. Sockell has been a member of Meritage’s Board of Directors since 2014, and he specializes in risk adjustment and quality measures. His career has focused on medical education, headed by a stint as director of medical education at St. Mary’s Medical Center (San Francisco). There, he created and ran the inpatient hospitalist program.
Business Moves
Hammond-Henry Hospital (Geneseo, Ill.) recently announced the creation of a hospitalist program, utilizing the facility’s own emergency room physicians. Hammond-Henry will staff one emergency room doctor available for rounds outside of their ER work throughout the day.
The center’s hospitalist program will be led by medical director Kevin Jeffries, MD, who also will serve as one of the hospital’s ER physicians/hospitalists.
Avera Queen of Peace Hospital (Mitchell, S.D.) started its own hospitalist program on Aug. 1, 2017, launching with the goal of improving patient experience within the building. Avera’s hospitalists will be on-site for 12 hours each day, assisting specialists and working with patients who do not have a local primary care physician.
Queen of Peace is the regional referral center for an 11-county area, part of Avera Health System’s 330 facilities across North and South Dakota, Minnesota, Iowa, and Nebraska.
Pediatric hospitalist Patrick Conway, MD, has been named president and chief executive officer of Blue Cross and Blue Shield of North Carolina. Dr. Conway will take over for the retiring Brad Wilson on Oct. 1.
Dr. Conway is currently the deputy administrator for Innovation and Quality, and the director of the Center for Medicare and Medicaid Innovation for the Centers for Medicare and Medicaid Services (CMS). Previously, he was CMO at CMS, having served both the Obama and Trump administrations.
Hossam Hafez, MD, recently claimed the role of chief of Hospitalist Service with Health Quest Medical Practice (LaGrangeville, N.Y.). Dr. Hafez will be based out of Health Quest’s Vassar Brothers Medical Center in Poughkeepsie, N.Y., coordinating care in that hospital and throughout the Health Quest system.
Dr. Hafez has served full-time hospitalist stints with MidMichigan Health’s Physician Hospitalist Group, as well as with RiteMed Urgent Care. A native of Egypt, Dr. Hafez is fluent in both English and Arabic.
Caldwell UNC Healthcare (Lenoir, N.C.) has promoted David Lowry, MD, to chief medical officer as of Aug. 1, 2017.
Dr. Lowry, a longtime hospitalist and veteran in hospital medicine in general, will lead the building’s hospitalist program, support the chief of staff, and provide direct patient care, as well. He will serve as physician advisor for Caldwell’s Clinical Documentation, Utilization Review, Respiratory Care, and Rehabilitation departments.
Dr. Lowry boasts more than 25 years experience in hospital medicine and led in the creation of Caldwell’s hospitalist program. Since joining Caldwell, he has held leadership positions including chief of medicine. He received the hospital’s Donald D. McNeill Jr. Award for Outstanding Physician Leadership in 2014, as voted by his peers.
Joahd Toure, MD, recently was hired by Adirondack Health (Saranac Lake, N.Y.) as its new chief medical officer. He started his new position in late June 2017.
A Massachusetts native, Dr. Toure most recently worked as chief of hospitalist medicine with AdvantageCare Physicians in New York City. There, he helped manage care for patients in that system’s 16 hospitals in the New York metro area. Previously, he was regional medical director for Essex Inpatient Physicians (Boxford, Mass.) and a staff hospitalist at South Shore Hospital (South Weymouth, Mass.).
Longtime employee Emily Chapman, MD, has been promoted to chief medical officer and vice president of medical affairs at Children’s Minnesota Hospital (Minneapolis). The former vice CMO took on her new role on July 5, 2017.
Previously, Dr. Chapman served Children’s as its hospitalist program director, and as director of graduate medical education. She is an American Academy of Pediatrics Fellow.
Mark Sockell, MD, is the new chief medical officer at Meritage Medical Network in Novato, Calif. Meritage is a physician-run network that includes more than 700 board-certified physicians in both primary care and specialist fields.
Dr. Sockell has been a member of Meritage’s Board of Directors since 2014, and he specializes in risk adjustment and quality measures. His career has focused on medical education, headed by a stint as director of medical education at St. Mary’s Medical Center (San Francisco). There, he created and ran the inpatient hospitalist program.
Business Moves
Hammond-Henry Hospital (Geneseo, Ill.) recently announced the creation of a hospitalist program, utilizing the facility’s own emergency room physicians. Hammond-Henry will staff one emergency room doctor available for rounds outside of their ER work throughout the day.
The center’s hospitalist program will be led by medical director Kevin Jeffries, MD, who also will serve as one of the hospital’s ER physicians/hospitalists.
Avera Queen of Peace Hospital (Mitchell, S.D.) started its own hospitalist program on Aug. 1, 2017, launching with the goal of improving patient experience within the building. Avera’s hospitalists will be on-site for 12 hours each day, assisting specialists and working with patients who do not have a local primary care physician.
Queen of Peace is the regional referral center for an 11-county area, part of Avera Health System’s 330 facilities across North and South Dakota, Minnesota, Iowa, and Nebraska.
Pediatric hospitalist Patrick Conway, MD, has been named president and chief executive officer of Blue Cross and Blue Shield of North Carolina. Dr. Conway will take over for the retiring Brad Wilson on Oct. 1.
Dr. Conway is currently the deputy administrator for Innovation and Quality, and the director of the Center for Medicare and Medicaid Innovation for the Centers for Medicare and Medicaid Services (CMS). Previously, he was CMO at CMS, having served both the Obama and Trump administrations.
Hossam Hafez, MD, recently claimed the role of chief of Hospitalist Service with Health Quest Medical Practice (LaGrangeville, N.Y.). Dr. Hafez will be based out of Health Quest’s Vassar Brothers Medical Center in Poughkeepsie, N.Y., coordinating care in that hospital and throughout the Health Quest system.
Dr. Hafez has served full-time hospitalist stints with MidMichigan Health’s Physician Hospitalist Group, as well as with RiteMed Urgent Care. A native of Egypt, Dr. Hafez is fluent in both English and Arabic.
Caldwell UNC Healthcare (Lenoir, N.C.) has promoted David Lowry, MD, to chief medical officer as of Aug. 1, 2017.
Dr. Lowry, a longtime hospitalist and veteran in hospital medicine in general, will lead the building’s hospitalist program, support the chief of staff, and provide direct patient care, as well. He will serve as physician advisor for Caldwell’s Clinical Documentation, Utilization Review, Respiratory Care, and Rehabilitation departments.
Dr. Lowry boasts more than 25 years experience in hospital medicine and led in the creation of Caldwell’s hospitalist program. Since joining Caldwell, he has held leadership positions including chief of medicine. He received the hospital’s Donald D. McNeill Jr. Award for Outstanding Physician Leadership in 2014, as voted by his peers.
Joahd Toure, MD, recently was hired by Adirondack Health (Saranac Lake, N.Y.) as its new chief medical officer. He started his new position in late June 2017.
A Massachusetts native, Dr. Toure most recently worked as chief of hospitalist medicine with AdvantageCare Physicians in New York City. There, he helped manage care for patients in that system’s 16 hospitals in the New York metro area. Previously, he was regional medical director for Essex Inpatient Physicians (Boxford, Mass.) and a staff hospitalist at South Shore Hospital (South Weymouth, Mass.).
Longtime employee Emily Chapman, MD, has been promoted to chief medical officer and vice president of medical affairs at Children’s Minnesota Hospital (Minneapolis). The former vice CMO took on her new role on July 5, 2017.
Previously, Dr. Chapman served Children’s as its hospitalist program director, and as director of graduate medical education. She is an American Academy of Pediatrics Fellow.
Mark Sockell, MD, is the new chief medical officer at Meritage Medical Network in Novato, Calif. Meritage is a physician-run network that includes more than 700 board-certified physicians in both primary care and specialist fields.
Dr. Sockell has been a member of Meritage’s Board of Directors since 2014, and he specializes in risk adjustment and quality measures. His career has focused on medical education, headed by a stint as director of medical education at St. Mary’s Medical Center (San Francisco). There, he created and ran the inpatient hospitalist program.
Business Moves
Hammond-Henry Hospital (Geneseo, Ill.) recently announced the creation of a hospitalist program, utilizing the facility’s own emergency room physicians. Hammond-Henry will staff one emergency room doctor available for rounds outside of their ER work throughout the day.
The center’s hospitalist program will be led by medical director Kevin Jeffries, MD, who also will serve as one of the hospital’s ER physicians/hospitalists.
Avera Queen of Peace Hospital (Mitchell, S.D.) started its own hospitalist program on Aug. 1, 2017, launching with the goal of improving patient experience within the building. Avera’s hospitalists will be on-site for 12 hours each day, assisting specialists and working with patients who do not have a local primary care physician.
Queen of Peace is the regional referral center for an 11-county area, part of Avera Health System’s 330 facilities across North and South Dakota, Minnesota, Iowa, and Nebraska.
Inclusion valued by advanced practice providers
Editor’s note: Each month, the Society of Hospital Medicine puts the spotlight on some of our most active members who are making substantial contributions to hospital medicine. Log on to www.hospitalmedicine.org/getinvolved for more information on how you can lend your expertise to help SHM improve the care of hospitalized patients.
This month, The Hospitalist spotlights Lorraine Britting, ANP, SFHM, clinical director of advanced practice in cardiology medicine at Beth Israel Deaconess Medical Center, Boston. Ms. Britting has been an SHM member for over 10 years, has served on various SHM committees, and was one of the first nurse practitioners to earn the Senior Fellow in Hospital Medicine designation.
How did you become a hospital medicine nurse practitioner, and when did you join SHM?
I was a nurse working in a CCU and MICU for 19 years when I graduated from a master’s program as a nurse practitioner (NP) in adult care. I thought I was going to work in the outpatient side after graduation, but my experience was much more suited to hospital medicine.
My first job in 2004 was as a hospitalist in a very small community hospital affiliated with Beth Israel Deaconess Medical Center. I was the first NP to work as an inpatient provider there, which was challenging, but I had the opportunity to wear many hats and be involved with numerous quality initiatives that helped me grow as a provider and a leader. I was working as the clinical manager of three hospitalist programs under the director by the time I left. I now work in inpatient cardiology and am the director of advanced practice providers (APPs) for cardiology medicine. I joined SHM in 2005 when it was a small but rapidly growing society, and I started work on the NP/PA Committee. I was also involved in the Hospital Quality and Patient Safety Committee for 6 years and worked as a peer reviewer for the Journal of Hospital Medicine.
Describe your role on the Membership Committee. What is the committee currently working on?
I am finishing my 3rd year on the committee. In the last few months, we have been focusing on member engagement. We have collected information on why members choose to join SHM and what deters potential members from joining SHM and we are developing strategies to build and retain our membership. The Membership Committee also reviews Fellows applications and discusses modifications of requirements each year.
As an NP, I have unique insight into motivations for why other APPs would join SHM and which membership benefits are most valuable. I find that many APPs join SHM because they feel that SHM treats them as equals, not junior members, as in some other physician organizations.
What does the Senior Fellow in Hospital Medicine designation mean to you?
I am grateful that SHM allows all members to be a part of the Fellows program, and I was honored to be one of the first NPs to become a Senior Fellow. Many medical societies allow APPs to join but do not offer the opportunity to become Fellows.
The Senior Fellowship application was a rigorous process and required experience in multiple areas, including quality projects, hospital committees, SHM Annual Conference attendance, and other clinical and nonclinical work that advances the profession.
As a nurse practitioner, which SHM resources do you find most valuable?
As a specialist NP, it’s easy for me to be current in cardiology but harder to keep current in general medicine. I find the clinical information very helpful to keep me up to date on hospital medicine. The Journal of Hospital Medicine and The Hospitalist are must reads, and the Annual Conference is, of course, very informative. I also enjoy the conversations on the Hospital Medicine Exchange and feel that the Choosing Wisely campaign is an excellent contribution to the goal of cost containment in everyday practice.
One of the best features of SHM is that I can meet other clinicians from around the country and around the world who have innovations or novel ideas that I can bring back to my institution.
What advice do you have for nurse practitioners as their role in hospital medicine continues to evolve?
I say to my staff that they should always say yes. Yes to continuing education, yes to opportunities for growth and advancement, yes to promotions, yes to research, etc. Careers develop in nonlinear ways, and you have to follow the opportunities as they come.
Ms. Steele is the marketing communications specialist at the Society of Hospital Medicine.
Editor’s note: Each month, the Society of Hospital Medicine puts the spotlight on some of our most active members who are making substantial contributions to hospital medicine. Log on to www.hospitalmedicine.org/getinvolved for more information on how you can lend your expertise to help SHM improve the care of hospitalized patients.
This month, The Hospitalist spotlights Lorraine Britting, ANP, SFHM, clinical director of advanced practice in cardiology medicine at Beth Israel Deaconess Medical Center, Boston. Ms. Britting has been an SHM member for over 10 years, has served on various SHM committees, and was one of the first nurse practitioners to earn the Senior Fellow in Hospital Medicine designation.
How did you become a hospital medicine nurse practitioner, and when did you join SHM?
I was a nurse working in a CCU and MICU for 19 years when I graduated from a master’s program as a nurse practitioner (NP) in adult care. I thought I was going to work in the outpatient side after graduation, but my experience was much more suited to hospital medicine.
My first job in 2004 was as a hospitalist in a very small community hospital affiliated with Beth Israel Deaconess Medical Center. I was the first NP to work as an inpatient provider there, which was challenging, but I had the opportunity to wear many hats and be involved with numerous quality initiatives that helped me grow as a provider and a leader. I was working as the clinical manager of three hospitalist programs under the director by the time I left. I now work in inpatient cardiology and am the director of advanced practice providers (APPs) for cardiology medicine. I joined SHM in 2005 when it was a small but rapidly growing society, and I started work on the NP/PA Committee. I was also involved in the Hospital Quality and Patient Safety Committee for 6 years and worked as a peer reviewer for the Journal of Hospital Medicine.
Describe your role on the Membership Committee. What is the committee currently working on?
I am finishing my 3rd year on the committee. In the last few months, we have been focusing on member engagement. We have collected information on why members choose to join SHM and what deters potential members from joining SHM and we are developing strategies to build and retain our membership. The Membership Committee also reviews Fellows applications and discusses modifications of requirements each year.
As an NP, I have unique insight into motivations for why other APPs would join SHM and which membership benefits are most valuable. I find that many APPs join SHM because they feel that SHM treats them as equals, not junior members, as in some other physician organizations.
What does the Senior Fellow in Hospital Medicine designation mean to you?
I am grateful that SHM allows all members to be a part of the Fellows program, and I was honored to be one of the first NPs to become a Senior Fellow. Many medical societies allow APPs to join but do not offer the opportunity to become Fellows.
The Senior Fellowship application was a rigorous process and required experience in multiple areas, including quality projects, hospital committees, SHM Annual Conference attendance, and other clinical and nonclinical work that advances the profession.
As a nurse practitioner, which SHM resources do you find most valuable?
As a specialist NP, it’s easy for me to be current in cardiology but harder to keep current in general medicine. I find the clinical information very helpful to keep me up to date on hospital medicine. The Journal of Hospital Medicine and The Hospitalist are must reads, and the Annual Conference is, of course, very informative. I also enjoy the conversations on the Hospital Medicine Exchange and feel that the Choosing Wisely campaign is an excellent contribution to the goal of cost containment in everyday practice.
One of the best features of SHM is that I can meet other clinicians from around the country and around the world who have innovations or novel ideas that I can bring back to my institution.
What advice do you have for nurse practitioners as their role in hospital medicine continues to evolve?
I say to my staff that they should always say yes. Yes to continuing education, yes to opportunities for growth and advancement, yes to promotions, yes to research, etc. Careers develop in nonlinear ways, and you have to follow the opportunities as they come.
Ms. Steele is the marketing communications specialist at the Society of Hospital Medicine.
Editor’s note: Each month, the Society of Hospital Medicine puts the spotlight on some of our most active members who are making substantial contributions to hospital medicine. Log on to www.hospitalmedicine.org/getinvolved for more information on how you can lend your expertise to help SHM improve the care of hospitalized patients.
This month, The Hospitalist spotlights Lorraine Britting, ANP, SFHM, clinical director of advanced practice in cardiology medicine at Beth Israel Deaconess Medical Center, Boston. Ms. Britting has been an SHM member for over 10 years, has served on various SHM committees, and was one of the first nurse practitioners to earn the Senior Fellow in Hospital Medicine designation.
How did you become a hospital medicine nurse practitioner, and when did you join SHM?
I was a nurse working in a CCU and MICU for 19 years when I graduated from a master’s program as a nurse practitioner (NP) in adult care. I thought I was going to work in the outpatient side after graduation, but my experience was much more suited to hospital medicine.
My first job in 2004 was as a hospitalist in a very small community hospital affiliated with Beth Israel Deaconess Medical Center. I was the first NP to work as an inpatient provider there, which was challenging, but I had the opportunity to wear many hats and be involved with numerous quality initiatives that helped me grow as a provider and a leader. I was working as the clinical manager of three hospitalist programs under the director by the time I left. I now work in inpatient cardiology and am the director of advanced practice providers (APPs) for cardiology medicine. I joined SHM in 2005 when it was a small but rapidly growing society, and I started work on the NP/PA Committee. I was also involved in the Hospital Quality and Patient Safety Committee for 6 years and worked as a peer reviewer for the Journal of Hospital Medicine.
Describe your role on the Membership Committee. What is the committee currently working on?
I am finishing my 3rd year on the committee. In the last few months, we have been focusing on member engagement. We have collected information on why members choose to join SHM and what deters potential members from joining SHM and we are developing strategies to build and retain our membership. The Membership Committee also reviews Fellows applications and discusses modifications of requirements each year.
As an NP, I have unique insight into motivations for why other APPs would join SHM and which membership benefits are most valuable. I find that many APPs join SHM because they feel that SHM treats them as equals, not junior members, as in some other physician organizations.
What does the Senior Fellow in Hospital Medicine designation mean to you?
I am grateful that SHM allows all members to be a part of the Fellows program, and I was honored to be one of the first NPs to become a Senior Fellow. Many medical societies allow APPs to join but do not offer the opportunity to become Fellows.
The Senior Fellowship application was a rigorous process and required experience in multiple areas, including quality projects, hospital committees, SHM Annual Conference attendance, and other clinical and nonclinical work that advances the profession.
As a nurse practitioner, which SHM resources do you find most valuable?
As a specialist NP, it’s easy for me to be current in cardiology but harder to keep current in general medicine. I find the clinical information very helpful to keep me up to date on hospital medicine. The Journal of Hospital Medicine and The Hospitalist are must reads, and the Annual Conference is, of course, very informative. I also enjoy the conversations on the Hospital Medicine Exchange and feel that the Choosing Wisely campaign is an excellent contribution to the goal of cost containment in everyday practice.
One of the best features of SHM is that I can meet other clinicians from around the country and around the world who have innovations or novel ideas that I can bring back to my institution.
What advice do you have for nurse practitioners as their role in hospital medicine continues to evolve?
I say to my staff that they should always say yes. Yes to continuing education, yes to opportunities for growth and advancement, yes to promotions, yes to research, etc. Careers develop in nonlinear ways, and you have to follow the opportunities as they come.
Ms. Steele is the marketing communications specialist at the Society of Hospital Medicine.
Sneak Peek: The Hospital Leader blog – Nov. 2017
What we expect and what we get from work
Are American workers becoming happier with less? An interesting article in the Wall Street Journal reported on the findings of a recent survey of U.S. workers by the Conference Board, a research organization. Although the survey wasn’t specific to health care, much less to hospitalists, I see some parallels that might cause many of us to stop and think more carefully about what we expect from our work.
American workers today tend to have less job security and fewer employer-paid benefits than they did in previous generations. A companion graphic in the WSJ reported that, while in 1973 only 6% of Americans said they worked too many hours and 7% said they had trouble completing their work in the time allotted, by 2016 26% said they often worked more than 48 hours a week and half said they work during their free time at least periodically. Two-thirds of Americans now say they need to spend at least half of their day working at high speeds or meeting tight deadlines.
Yet, despite these trends, the Conference Board found that overall, U.S. workers are more satisfied with their jobs than they have been in the past. The WSJ article posits that workers are happier at work because they have adjusted to lower expectations of the employer-employee relationship. In addition, workers have more flexibility today to change jobs or companies to find the right fit or pursue advancement, and often have more influence over when, where, and how they do their jobs than ever before. Many are working as temps or independent contractors, or in similar “contingent” arrangements. Finally, more employers are offering a wider array of tools to aid with work-life balance, such as paid medical and family leave.
So what does all this have to do with hospitalists?
Read the full post at hospitalleader.org.
Also on The Hospital Leader…
- 95% of inpatient providers would get an F on this exam by Brad Flansbaum, DO, MPH, MHM
- When it comes to health care violence, silence isn’t an option by Danielle Scheurer, MD, MSCR, SFHM,
- How do we keep our providers safe? by Tracy Cardin, ACNP-BC, SFHM
- We have a voice. It’s time we use it #DoctorsSpeakOut by Vineet Arora, MD, MAPP, MHM
What we expect and what we get from work
Are American workers becoming happier with less? An interesting article in the Wall Street Journal reported on the findings of a recent survey of U.S. workers by the Conference Board, a research organization. Although the survey wasn’t specific to health care, much less to hospitalists, I see some parallels that might cause many of us to stop and think more carefully about what we expect from our work.
American workers today tend to have less job security and fewer employer-paid benefits than they did in previous generations. A companion graphic in the WSJ reported that, while in 1973 only 6% of Americans said they worked too many hours and 7% said they had trouble completing their work in the time allotted, by 2016 26% said they often worked more than 48 hours a week and half said they work during their free time at least periodically. Two-thirds of Americans now say they need to spend at least half of their day working at high speeds or meeting tight deadlines.
Yet, despite these trends, the Conference Board found that overall, U.S. workers are more satisfied with their jobs than they have been in the past. The WSJ article posits that workers are happier at work because they have adjusted to lower expectations of the employer-employee relationship. In addition, workers have more flexibility today to change jobs or companies to find the right fit or pursue advancement, and often have more influence over when, where, and how they do their jobs than ever before. Many are working as temps or independent contractors, or in similar “contingent” arrangements. Finally, more employers are offering a wider array of tools to aid with work-life balance, such as paid medical and family leave.
So what does all this have to do with hospitalists?
Read the full post at hospitalleader.org.
Also on The Hospital Leader…
- 95% of inpatient providers would get an F on this exam by Brad Flansbaum, DO, MPH, MHM
- When it comes to health care violence, silence isn’t an option by Danielle Scheurer, MD, MSCR, SFHM,
- How do we keep our providers safe? by Tracy Cardin, ACNP-BC, SFHM
- We have a voice. It’s time we use it #DoctorsSpeakOut by Vineet Arora, MD, MAPP, MHM
What we expect and what we get from work
Are American workers becoming happier with less? An interesting article in the Wall Street Journal reported on the findings of a recent survey of U.S. workers by the Conference Board, a research organization. Although the survey wasn’t specific to health care, much less to hospitalists, I see some parallels that might cause many of us to stop and think more carefully about what we expect from our work.
American workers today tend to have less job security and fewer employer-paid benefits than they did in previous generations. A companion graphic in the WSJ reported that, while in 1973 only 6% of Americans said they worked too many hours and 7% said they had trouble completing their work in the time allotted, by 2016 26% said they often worked more than 48 hours a week and half said they work during their free time at least periodically. Two-thirds of Americans now say they need to spend at least half of their day working at high speeds or meeting tight deadlines.
Yet, despite these trends, the Conference Board found that overall, U.S. workers are more satisfied with their jobs than they have been in the past. The WSJ article posits that workers are happier at work because they have adjusted to lower expectations of the employer-employee relationship. In addition, workers have more flexibility today to change jobs or companies to find the right fit or pursue advancement, and often have more influence over when, where, and how they do their jobs than ever before. Many are working as temps or independent contractors, or in similar “contingent” arrangements. Finally, more employers are offering a wider array of tools to aid with work-life balance, such as paid medical and family leave.
So what does all this have to do with hospitalists?
Read the full post at hospitalleader.org.
Also on The Hospital Leader…
- 95% of inpatient providers would get an F on this exam by Brad Flansbaum, DO, MPH, MHM
- When it comes to health care violence, silence isn’t an option by Danielle Scheurer, MD, MSCR, SFHM,
- How do we keep our providers safe? by Tracy Cardin, ACNP-BC, SFHM
- We have a voice. It’s time we use it #DoctorsSpeakOut by Vineet Arora, MD, MAPP, MHM
Understanding people is complex, yet essential for effective leadership
Editor’s note: Each month, Society of Hospital Medicine puts the spotlight on some of our most active members who are making substantial contributions to hospital medicine. Log on to www.hospitalmedicine.org/getinvolved for more information on how you can lend your expertise to help SHM improve the care of hospitalized patients.
What are the requirements to become a Master in Hospital Medicine, and how has this designation been beneficial to your career?
I have been an SHM member since the early years (early 2000s, I think), and I became a Master in Hospital Medicine (MHM) in 2013. I see the MHM designation as recognizing accomplishments that have been critical in advancing the field of hospital medicine and SHM as a society.
I would guess that my contributions to the SHM Board, being SHM president, cofounding (with others) the Academic Hospitalist Academy, founding (with others) the Quality Safety Educators Academy, and being the founding chair of the American Board of Internal Medicine’s Focused Practice in Hospital Medicine pathway were probably what led to my induction.
The salient question probably isn’t “How has this designation been beneficial to my career?” but, rather, “How, after receiving the MHM designation, has my career benefited hospital medicine and SHM?” To my mind, there are some awards in life that recognize excellence in the completion of a task. They herald the end of a finite game: a “best research project” award, for example. But then there are a special few recognitions that, while they recognize past contributions, focus more upon the future than the past. They are infinite recognitions, because implicitly, they are recognitions of “promise” as much as achievement. They convey the organization’s trust in, and high expectations for, the recipient. In sum, they are simultaneously an honor and an obligation … an obligation and an expectation that the recipient will continue to do even more. In academic parlance, being “tenured” is a good example; for the Society of Hospital Medicine, the equivalent is the MHM recognition. I have done a lot for SHM, but the MHM designation obligates me to do even more. Honoring that obligation is what I plan to do with my career.
How did you become involved with SHM’s Leadership Academy, and how has the program developed over the years?
I started doing a 1-hour talk when the Mastering Teamwork course started. I did that for a couple of years but, as my career was evolving into higher-level institutional and hospital leadership, there was much more to talk about than I could fit into 1 hour.
The core of my leadership message is based in the “character ethic” (being better than who you are) and not the popular “personality ethic” (looking better than you are). So it’s that … plus all of the leadership mistakes I have made along the way. And that’s a lot of mistakes … enough to fill 9 hours of Mastering Teamwork.
In your opinion, what are some of the main takeaways for those who participate in SHM’s Leadership Academy?
Two of the three core components of great leadership are having a mission and purpose and being sincere. Leadership Academy can’t deliver the first two, so participants do have to come prepared to be trained.
Understanding people is the third core component, and mastering that skill is really complex. It is not something you can do with a clever slogan and a new lapel pin. It comes in many forms: teamwork, communication, networking, dealing with crisis, orchestrating change, etc. But at its core, Leadership Academy is all about training future leaders in how to understand people … and to develop the skills to inspire, motivate, and move their team to greater heights. Because at its core, leadership is about getting people to go places they otherwise didn’t want to go and to do things that they didn’t already want to do. And, to do that, you have to understand people.
As an active SHM member of many years, what advice do you have for members who wish to get more involved?
You have to start somewhere, and you have to see the entry level years as investing in yourself. There will be sacrifice involved, so don’t expect immediate returns on the investment, and the first few years might not be that fun.
Every year, there is a call for committee membership, and you need to get involved in one or more of those committees. Find the most senior hospitalist, who is the most involved in SHM, and tell her that you want to be on an SHM committee, and could she nominate you? If you do not have that luxury, then pay attention at the SHM annual conference. The SHM president-elect is responsible for building out the SHM committee nominees; as president, you are always looking to find enthusiastic people to be on the committees. Receiving emails from enthusiastic members is more welcome than you might think. As soon as that person is announced, find her email and start making the request to be on a committee. Be open to the assignment: Even if it is not your favorite committee, being there is more important than not.
But remember, networking and reputation are “two tailed.” You can improve your reputation by meaningful and consistent participation on a committee (leading to higher and better leadership opportunities), but you can also tarnish it by being assigned to a committee and not doing anything. You do that once, and there is a high probability that you will not be asked back again.
Great strategy, at the end of the day, is always putting yourself in a position with the maximum number of options. The key to personal development strategy is networking. The more people you know, the higher the probability that your email box will light up with the “Hey, do you want to collaborate on this project together?” sort of emails. Attend the annual conferences, attend the SHM Academies (Leadership, Quality and Safety Educators Academy, Academic Hospitalist Academy, etc.). Build genuine relationships with the people you meet there, and the rest will work out just fine.
Ms. Steele is the marketing communications specialist at the Society of Hospital Medicine.
Editor’s note: Each month, Society of Hospital Medicine puts the spotlight on some of our most active members who are making substantial contributions to hospital medicine. Log on to www.hospitalmedicine.org/getinvolved for more information on how you can lend your expertise to help SHM improve the care of hospitalized patients.
What are the requirements to become a Master in Hospital Medicine, and how has this designation been beneficial to your career?
I have been an SHM member since the early years (early 2000s, I think), and I became a Master in Hospital Medicine (MHM) in 2013. I see the MHM designation as recognizing accomplishments that have been critical in advancing the field of hospital medicine and SHM as a society.
I would guess that my contributions to the SHM Board, being SHM president, cofounding (with others) the Academic Hospitalist Academy, founding (with others) the Quality Safety Educators Academy, and being the founding chair of the American Board of Internal Medicine’s Focused Practice in Hospital Medicine pathway were probably what led to my induction.
The salient question probably isn’t “How has this designation been beneficial to my career?” but, rather, “How, after receiving the MHM designation, has my career benefited hospital medicine and SHM?” To my mind, there are some awards in life that recognize excellence in the completion of a task. They herald the end of a finite game: a “best research project” award, for example. But then there are a special few recognitions that, while they recognize past contributions, focus more upon the future than the past. They are infinite recognitions, because implicitly, they are recognitions of “promise” as much as achievement. They convey the organization’s trust in, and high expectations for, the recipient. In sum, they are simultaneously an honor and an obligation … an obligation and an expectation that the recipient will continue to do even more. In academic parlance, being “tenured” is a good example; for the Society of Hospital Medicine, the equivalent is the MHM recognition. I have done a lot for SHM, but the MHM designation obligates me to do even more. Honoring that obligation is what I plan to do with my career.
How did you become involved with SHM’s Leadership Academy, and how has the program developed over the years?
I started doing a 1-hour talk when the Mastering Teamwork course started. I did that for a couple of years but, as my career was evolving into higher-level institutional and hospital leadership, there was much more to talk about than I could fit into 1 hour.
The core of my leadership message is based in the “character ethic” (being better than who you are) and not the popular “personality ethic” (looking better than you are). So it’s that … plus all of the leadership mistakes I have made along the way. And that’s a lot of mistakes … enough to fill 9 hours of Mastering Teamwork.
In your opinion, what are some of the main takeaways for those who participate in SHM’s Leadership Academy?
Two of the three core components of great leadership are having a mission and purpose and being sincere. Leadership Academy can’t deliver the first two, so participants do have to come prepared to be trained.
Understanding people is the third core component, and mastering that skill is really complex. It is not something you can do with a clever slogan and a new lapel pin. It comes in many forms: teamwork, communication, networking, dealing with crisis, orchestrating change, etc. But at its core, Leadership Academy is all about training future leaders in how to understand people … and to develop the skills to inspire, motivate, and move their team to greater heights. Because at its core, leadership is about getting people to go places they otherwise didn’t want to go and to do things that they didn’t already want to do. And, to do that, you have to understand people.
As an active SHM member of many years, what advice do you have for members who wish to get more involved?
You have to start somewhere, and you have to see the entry level years as investing in yourself. There will be sacrifice involved, so don’t expect immediate returns on the investment, and the first few years might not be that fun.
Every year, there is a call for committee membership, and you need to get involved in one or more of those committees. Find the most senior hospitalist, who is the most involved in SHM, and tell her that you want to be on an SHM committee, and could she nominate you? If you do not have that luxury, then pay attention at the SHM annual conference. The SHM president-elect is responsible for building out the SHM committee nominees; as president, you are always looking to find enthusiastic people to be on the committees. Receiving emails from enthusiastic members is more welcome than you might think. As soon as that person is announced, find her email and start making the request to be on a committee. Be open to the assignment: Even if it is not your favorite committee, being there is more important than not.
But remember, networking and reputation are “two tailed.” You can improve your reputation by meaningful and consistent participation on a committee (leading to higher and better leadership opportunities), but you can also tarnish it by being assigned to a committee and not doing anything. You do that once, and there is a high probability that you will not be asked back again.
Great strategy, at the end of the day, is always putting yourself in a position with the maximum number of options. The key to personal development strategy is networking. The more people you know, the higher the probability that your email box will light up with the “Hey, do you want to collaborate on this project together?” sort of emails. Attend the annual conferences, attend the SHM Academies (Leadership, Quality and Safety Educators Academy, Academic Hospitalist Academy, etc.). Build genuine relationships with the people you meet there, and the rest will work out just fine.
Ms. Steele is the marketing communications specialist at the Society of Hospital Medicine.
Editor’s note: Each month, Society of Hospital Medicine puts the spotlight on some of our most active members who are making substantial contributions to hospital medicine. Log on to www.hospitalmedicine.org/getinvolved for more information on how you can lend your expertise to help SHM improve the care of hospitalized patients.
What are the requirements to become a Master in Hospital Medicine, and how has this designation been beneficial to your career?
I have been an SHM member since the early years (early 2000s, I think), and I became a Master in Hospital Medicine (MHM) in 2013. I see the MHM designation as recognizing accomplishments that have been critical in advancing the field of hospital medicine and SHM as a society.
I would guess that my contributions to the SHM Board, being SHM president, cofounding (with others) the Academic Hospitalist Academy, founding (with others) the Quality Safety Educators Academy, and being the founding chair of the American Board of Internal Medicine’s Focused Practice in Hospital Medicine pathway were probably what led to my induction.
The salient question probably isn’t “How has this designation been beneficial to my career?” but, rather, “How, after receiving the MHM designation, has my career benefited hospital medicine and SHM?” To my mind, there are some awards in life that recognize excellence in the completion of a task. They herald the end of a finite game: a “best research project” award, for example. But then there are a special few recognitions that, while they recognize past contributions, focus more upon the future than the past. They are infinite recognitions, because implicitly, they are recognitions of “promise” as much as achievement. They convey the organization’s trust in, and high expectations for, the recipient. In sum, they are simultaneously an honor and an obligation … an obligation and an expectation that the recipient will continue to do even more. In academic parlance, being “tenured” is a good example; for the Society of Hospital Medicine, the equivalent is the MHM recognition. I have done a lot for SHM, but the MHM designation obligates me to do even more. Honoring that obligation is what I plan to do with my career.
How did you become involved with SHM’s Leadership Academy, and how has the program developed over the years?
I started doing a 1-hour talk when the Mastering Teamwork course started. I did that for a couple of years but, as my career was evolving into higher-level institutional and hospital leadership, there was much more to talk about than I could fit into 1 hour.
The core of my leadership message is based in the “character ethic” (being better than who you are) and not the popular “personality ethic” (looking better than you are). So it’s that … plus all of the leadership mistakes I have made along the way. And that’s a lot of mistakes … enough to fill 9 hours of Mastering Teamwork.
In your opinion, what are some of the main takeaways for those who participate in SHM’s Leadership Academy?
Two of the three core components of great leadership are having a mission and purpose and being sincere. Leadership Academy can’t deliver the first two, so participants do have to come prepared to be trained.
Understanding people is the third core component, and mastering that skill is really complex. It is not something you can do with a clever slogan and a new lapel pin. It comes in many forms: teamwork, communication, networking, dealing with crisis, orchestrating change, etc. But at its core, Leadership Academy is all about training future leaders in how to understand people … and to develop the skills to inspire, motivate, and move their team to greater heights. Because at its core, leadership is about getting people to go places they otherwise didn’t want to go and to do things that they didn’t already want to do. And, to do that, you have to understand people.
As an active SHM member of many years, what advice do you have for members who wish to get more involved?
You have to start somewhere, and you have to see the entry level years as investing in yourself. There will be sacrifice involved, so don’t expect immediate returns on the investment, and the first few years might not be that fun.
Every year, there is a call for committee membership, and you need to get involved in one or more of those committees. Find the most senior hospitalist, who is the most involved in SHM, and tell her that you want to be on an SHM committee, and could she nominate you? If you do not have that luxury, then pay attention at the SHM annual conference. The SHM president-elect is responsible for building out the SHM committee nominees; as president, you are always looking to find enthusiastic people to be on the committees. Receiving emails from enthusiastic members is more welcome than you might think. As soon as that person is announced, find her email and start making the request to be on a committee. Be open to the assignment: Even if it is not your favorite committee, being there is more important than not.
But remember, networking and reputation are “two tailed.” You can improve your reputation by meaningful and consistent participation on a committee (leading to higher and better leadership opportunities), but you can also tarnish it by being assigned to a committee and not doing anything. You do that once, and there is a high probability that you will not be asked back again.
Great strategy, at the end of the day, is always putting yourself in a position with the maximum number of options. The key to personal development strategy is networking. The more people you know, the higher the probability that your email box will light up with the “Hey, do you want to collaborate on this project together?” sort of emails. Attend the annual conferences, attend the SHM Academies (Leadership, Quality and Safety Educators Academy, Academic Hospitalist Academy, etc.). Build genuine relationships with the people you meet there, and the rest will work out just fine.
Ms. Steele is the marketing communications specialist at the Society of Hospital Medicine.
Emphasizing an entrepreneurial spirit: Raman Palabindala, MD
Venkatraraman “Raman” Palabindala, MD, FACP, SFHM, was destined to be a doctor since his first breath. Born in India, his father decided Dr. Palabindala would take the mantle as the doctor of the family, while his siblings took to other professions like engineering.
Eager to be in the thick of things, Dr. Palabindala has voraciously pursued leadership positions, leading to his current role as chief of the Division of Hospital Medicine at the University of Mississippi Medical Center, Jackson.
Dr. Palabindala is enthusiastic about his role as one of the eight new members of The Hospitalist editorial advisory board, and took time to tell us more about himself in a recent interview.
Q: How did you get into medicine?
A: It’s all because of my dad’s motivation. My father believed in education, so when I was born, he said, “He’s going to be a doctor,” and as I grew up, I just worked towards being a physician and nothing else. I didn’t even have an option of choosing anything else. My dad said that I would be a doctor, and I am a doctor. I feel like that was the best thing that happened to me, though; it worked out well.
Q: How and when did you decide to go into hospital medicine?
A: After I came to the U.S., I joined residency in internal medicine at GBMC – that’s Greater Baltimore Medical Center – it’s affiliated with Johns Hopkins. I always wanted to be an internist, but my experiences in the clinic world were not so great. But I really enjoyed inpatient medicine, so in my 3rd year, when I was doing my chief residency year, I did get opportunities to join a fellowship, but I decided just to be a hospitalist at that time.
Q: What do you find to be rewarding about hospital medicine?
Q: What is one of the biggest challenges in hospital medicine?
A: I think talking about the business aspect of medicine, because it is like a taboo. We don’t really want to talk about whether the patient is covered or not covered by insurance, how much we are billing, and why we must discuss business issues while we are trying to focus on patient care, but these things are going to indirectly affect patient care, too. If you didn’t note the patient status accurately, they are going to get an inappropriate bill.
Q: What’s the best advice you have received that you try to pass on to your students?
A: Do the rounds at the bedside. We have the tendency of doing everything outside and then going in the room and just telling the patient what we are going to do. Instead, I encourage everyone to be at the bedside. Even without students, I go and sit at the bedside and then review the data in terms the patient can understand, and then explain the care plan, so they actually feel like we are at the bedside for a longer time. We are with the patient for at least 10 to 15 minutes, but at the same time, we are getting things done. I encourage my students and residents to do this.
Q: What is the worst advice you’ve received?
A: I don’t know if this is the “worst” advice, but in my second year, I was trying to take some leadership positions and was told I should wait, that leadership skills come with experience. I do think that’s a bad piece of advice. It’s all about learning how hard you work and then how fast you learn, and then how fast you implement. People who work, learn, and implement quickly can make a difference.
Q: Outside of patient care, what other career interests do you have?
A: I’m interested in smart clinics, and I actually have a patent for smart clinic chains. I’m a big fan of primary care, because, like hospitalists revolutionized inpatient care, I think we can revolutionize the outpatient care experience as well. I don’t think we are being very efficient with outpatient care.
But if I was not practicing medicine, I probably would be a chef. I like to cook, and I would open up my own restaurant if I was not doing this.
Q: Where do you see yourself in 10 years?
A: I want to be a consultant, evaluating hospitalist programs and guiding programs to grow and be more efficient. That, I think, would be the primary job that I would like to be doing, along with giving lectures and teaching about patient safety and quality, and educating younger physicians about the business of medicine.
Q: What experience with SHM has made the most lasting impact on you?
A: I would say the best impression was from the Academic Hospitalist Academy meeting I attended in Denver. I think that was helpful, because it was like a boot camp where you have only a limited number of attendees with a dedicated mentor. That was amazing, and I learned a lot. It helped me in redesigning my approach to where I would like to be both short- and long-term. I implemented at least 50 percent of what I learned at that meeting.
Q: What’s the best book that you’ve read recently and why was it the best?
A: Being Mortal by Atul Gawande. It’s a really beautiful book.
[email protected]
On Twitter @eaztweets
Venkatraraman “Raman” Palabindala, MD, FACP, SFHM, was destined to be a doctor since his first breath. Born in India, his father decided Dr. Palabindala would take the mantle as the doctor of the family, while his siblings took to other professions like engineering.
Eager to be in the thick of things, Dr. Palabindala has voraciously pursued leadership positions, leading to his current role as chief of the Division of Hospital Medicine at the University of Mississippi Medical Center, Jackson.
Dr. Palabindala is enthusiastic about his role as one of the eight new members of The Hospitalist editorial advisory board, and took time to tell us more about himself in a recent interview.
Q: How did you get into medicine?
A: It’s all because of my dad’s motivation. My father believed in education, so when I was born, he said, “He’s going to be a doctor,” and as I grew up, I just worked towards being a physician and nothing else. I didn’t even have an option of choosing anything else. My dad said that I would be a doctor, and I am a doctor. I feel like that was the best thing that happened to me, though; it worked out well.
Q: How and when did you decide to go into hospital medicine?
A: After I came to the U.S., I joined residency in internal medicine at GBMC – that’s Greater Baltimore Medical Center – it’s affiliated with Johns Hopkins. I always wanted to be an internist, but my experiences in the clinic world were not so great. But I really enjoyed inpatient medicine, so in my 3rd year, when I was doing my chief residency year, I did get opportunities to join a fellowship, but I decided just to be a hospitalist at that time.
Q: What do you find to be rewarding about hospital medicine?
Q: What is one of the biggest challenges in hospital medicine?
A: I think talking about the business aspect of medicine, because it is like a taboo. We don’t really want to talk about whether the patient is covered or not covered by insurance, how much we are billing, and why we must discuss business issues while we are trying to focus on patient care, but these things are going to indirectly affect patient care, too. If you didn’t note the patient status accurately, they are going to get an inappropriate bill.
Q: What’s the best advice you have received that you try to pass on to your students?
A: Do the rounds at the bedside. We have the tendency of doing everything outside and then going in the room and just telling the patient what we are going to do. Instead, I encourage everyone to be at the bedside. Even without students, I go and sit at the bedside and then review the data in terms the patient can understand, and then explain the care plan, so they actually feel like we are at the bedside for a longer time. We are with the patient for at least 10 to 15 minutes, but at the same time, we are getting things done. I encourage my students and residents to do this.
Q: What is the worst advice you’ve received?
A: I don’t know if this is the “worst” advice, but in my second year, I was trying to take some leadership positions and was told I should wait, that leadership skills come with experience. I do think that’s a bad piece of advice. It’s all about learning how hard you work and then how fast you learn, and then how fast you implement. People who work, learn, and implement quickly can make a difference.
Q: Outside of patient care, what other career interests do you have?
A: I’m interested in smart clinics, and I actually have a patent for smart clinic chains. I’m a big fan of primary care, because, like hospitalists revolutionized inpatient care, I think we can revolutionize the outpatient care experience as well. I don’t think we are being very efficient with outpatient care.
But if I was not practicing medicine, I probably would be a chef. I like to cook, and I would open up my own restaurant if I was not doing this.
Q: Where do you see yourself in 10 years?
A: I want to be a consultant, evaluating hospitalist programs and guiding programs to grow and be more efficient. That, I think, would be the primary job that I would like to be doing, along with giving lectures and teaching about patient safety and quality, and educating younger physicians about the business of medicine.
Q: What experience with SHM has made the most lasting impact on you?
A: I would say the best impression was from the Academic Hospitalist Academy meeting I attended in Denver. I think that was helpful, because it was like a boot camp where you have only a limited number of attendees with a dedicated mentor. That was amazing, and I learned a lot. It helped me in redesigning my approach to where I would like to be both short- and long-term. I implemented at least 50 percent of what I learned at that meeting.
Q: What’s the best book that you’ve read recently and why was it the best?
A: Being Mortal by Atul Gawande. It’s a really beautiful book.
[email protected]
On Twitter @eaztweets
Venkatraraman “Raman” Palabindala, MD, FACP, SFHM, was destined to be a doctor since his first breath. Born in India, his father decided Dr. Palabindala would take the mantle as the doctor of the family, while his siblings took to other professions like engineering.
Eager to be in the thick of things, Dr. Palabindala has voraciously pursued leadership positions, leading to his current role as chief of the Division of Hospital Medicine at the University of Mississippi Medical Center, Jackson.
Dr. Palabindala is enthusiastic about his role as one of the eight new members of The Hospitalist editorial advisory board, and took time to tell us more about himself in a recent interview.
Q: How did you get into medicine?
A: It’s all because of my dad’s motivation. My father believed in education, so when I was born, he said, “He’s going to be a doctor,” and as I grew up, I just worked towards being a physician and nothing else. I didn’t even have an option of choosing anything else. My dad said that I would be a doctor, and I am a doctor. I feel like that was the best thing that happened to me, though; it worked out well.
Q: How and when did you decide to go into hospital medicine?
A: After I came to the U.S., I joined residency in internal medicine at GBMC – that’s Greater Baltimore Medical Center – it’s affiliated with Johns Hopkins. I always wanted to be an internist, but my experiences in the clinic world were not so great. But I really enjoyed inpatient medicine, so in my 3rd year, when I was doing my chief residency year, I did get opportunities to join a fellowship, but I decided just to be a hospitalist at that time.
Q: What do you find to be rewarding about hospital medicine?
Q: What is one of the biggest challenges in hospital medicine?
A: I think talking about the business aspect of medicine, because it is like a taboo. We don’t really want to talk about whether the patient is covered or not covered by insurance, how much we are billing, and why we must discuss business issues while we are trying to focus on patient care, but these things are going to indirectly affect patient care, too. If you didn’t note the patient status accurately, they are going to get an inappropriate bill.
Q: What’s the best advice you have received that you try to pass on to your students?
A: Do the rounds at the bedside. We have the tendency of doing everything outside and then going in the room and just telling the patient what we are going to do. Instead, I encourage everyone to be at the bedside. Even without students, I go and sit at the bedside and then review the data in terms the patient can understand, and then explain the care plan, so they actually feel like we are at the bedside for a longer time. We are with the patient for at least 10 to 15 minutes, but at the same time, we are getting things done. I encourage my students and residents to do this.
Q: What is the worst advice you’ve received?
A: I don’t know if this is the “worst” advice, but in my second year, I was trying to take some leadership positions and was told I should wait, that leadership skills come with experience. I do think that’s a bad piece of advice. It’s all about learning how hard you work and then how fast you learn, and then how fast you implement. People who work, learn, and implement quickly can make a difference.
Q: Outside of patient care, what other career interests do you have?
A: I’m interested in smart clinics, and I actually have a patent for smart clinic chains. I’m a big fan of primary care, because, like hospitalists revolutionized inpatient care, I think we can revolutionize the outpatient care experience as well. I don’t think we are being very efficient with outpatient care.
But if I was not practicing medicine, I probably would be a chef. I like to cook, and I would open up my own restaurant if I was not doing this.
Q: Where do you see yourself in 10 years?
A: I want to be a consultant, evaluating hospitalist programs and guiding programs to grow and be more efficient. That, I think, would be the primary job that I would like to be doing, along with giving lectures and teaching about patient safety and quality, and educating younger physicians about the business of medicine.
Q: What experience with SHM has made the most lasting impact on you?
A: I would say the best impression was from the Academic Hospitalist Academy meeting I attended in Denver. I think that was helpful, because it was like a boot camp where you have only a limited number of attendees with a dedicated mentor. That was amazing, and I learned a lot. It helped me in redesigning my approach to where I would like to be both short- and long-term. I implemented at least 50 percent of what I learned at that meeting.
Q: What’s the best book that you’ve read recently and why was it the best?
A: Being Mortal by Atul Gawande. It’s a really beautiful book.
[email protected]
On Twitter @eaztweets