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Making a difference

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Hospitalists engaging in advocacy efforts

Hospitalists around the country are devoting large portions of their spare time to a wide range of advocacy efforts. From health policy to caring for the unhoused population to diversity and equity to advocating for fellow hospitalists, these physicians are passionate about their causes and determined to make a difference.

Championing the unhoused

Sarah Stella, MD, FHM, a hospitalist at Denver Health, was initially drawn there because of the population the hospital serves, which includes a high concentration of people experiencing homelessness. As she cared for her patients, Dr. Stella, who is also associate professor of hospital medicine at the University of Colorado, increasingly felt the desire to help prevent the negative downstream outcomes the hospital sees.

To understand the experiences of the unhoused outside the hospital, Dr. Stella started talking to her patients and people in community-based organizations that serve this population. “I learned a ton,” she said. “Homelessness feels like such an intractable, hopeless thing, but the more I talked to people, the more opportunities I saw to work toward something better.”

This led to a pilot grant to work with the Colorado Coalition for the Homeless to set up a community advisory panel. “My goal was to better understand their experiences and to develop a shared vision for how we collectively can do better,” said Dr. Stella. Eventually, she also received a grant from the University of Colorado, and multiple opportunities have sprung up ever since.

For the past several years, Dr. Stella has worked with Denver Health leadership to improve care for the homeless. “Right now, I’m working with a community team on developing an idea to provide peer support from people with a shared lived experience for people who are experiencing homelessness when they’re hospitalized. That’s really where my passion has been in working on the partnership,” she said.

Her advocacy role has been beneficial in her work as a hospitalist, particularly when COVID began. Dr. Stella again partnered with the Colorado Coalition for the Homeless to start a joint task force. “Everyone on our task force is motivated by this powerful desire to improve the health and lives of this community and that’s one of the silver linings in this pandemic for me,” said Dr. Stella.

Advocacy work has also increased Dr. Stella’s knowledge of what community support options are available for the unhoused. This allows her to educate her patients about their options and how to access them.

While she has colleagues who are able to compartmentalize their work, “I absolutely could not be a hospitalist without being an advocate,” Dr. Stella said. “For me, it has been a protective strategy in terms of burnout because I have to feel like I’m working to advocate for better policies and more appropriate resources to address the gaps that I’m seeing.”

Dr. Stella believes that physicians have a special credibility to advocate, tell stories, and use data to back their stories up. “We have to realize that we have this power, and we have it so we can empower others,” she said. “The people I’ve seen in my community who are working so hard to help people who are experiencing homelessness are the heroes. Understanding that and giving power to those people through our voice and our well-respected place in society drives me.”
 

 

 

Strengthening diversity, equity, and inclusion

In September 2020, Michael Bryant, MD, became the inaugural vice chair of Diversity, Equity, and Inclusion for the department of pediatrics at Children’s Hospital Los Angeles, where he is also the division head of pediatric hospital medicine. “I was motivated to apply for this position because I wanted to be an agent for change to eliminate the institutional racism, social injustice, and marginalization that continues to threaten the lives and well-beings of so many Americans,” Dr. Bryant said.

Dr. Michael Bryant

Between the pandemic, the economic decline it has created, and the divisive political landscape, people of color have been especially affected. “These are poignant examples of the ever-widening divide and disenfranchisement many Americans feel,” said Dr. Bryant. “Gandhi said, ‘Be the change that you want to see,’ and that is what I want to model.”

At work, advocacy for diversity, equality, and inclusion is an innate part of everything he does. From the new physicians he recruits to the candidates he considers for leadership positions, Dr. Bryant strives “to have a workforce that mirrors the diversity of the patients we humbly care for and serve.”

Advocacy is intrinsic to Dr. Bryant’s worldview, in his quest to understand and accept each individual’s uniqueness, his desire “to embrace cultural humility,” his recognition that “our differences enhance us instead of diminishing us,” and his willingness to engage in difficult conversations.

“Advocacy means that I acknowledge that intent does not equal impact and that I must accept that what I do and what I say may have unintended consequences,” he said. “When that happens, I must resist becoming defensive and instead be willing to listen and learn.”

Dr. Bryant is proud of his accomplishments and enjoys his advocacy work. In his workplace, there are few African Americans in leadership roles. This means that he is in high demand when it comes to making sure there’s representation during various processes such as hiring and vetting, a disparity known as the “minority tax.”

“I am thankful for the opportunities, but it does take a toll at times,” Dr. Bryant said, which is yet another reason why he is a proponent of increasing diversity and inclusion. “This allows us to build the resource pool as these needs arise and minimizes the toll of the ‘minority tax’ on any single person or small group of individuals.”

This summer, physicians from Dr. Bryant’s hospital participated in the national “White Coats for Black Lives” effort. He found it to be “an incredibly moving event” that hundreds of his colleagues participated in.

Dr. Bryant’s advice for hospitalists who want to get involved in advocacy efforts is to check out the movie “John Lewis: Good Trouble.” “He was a champion of human rights and fought for these rights until his death,” Dr. Bryant said. “He is a true American hero and a wonderful example.”
 

Bolstering health care change

Since his residency, Joshua Lenchus, DO, FACP, SFHM, has developed an ever-increasing interest in legislative advocacy, particularly health policy. Getting involved in this arena requires an understanding of civics and government that goes beyond just the basics. “My desire to affect change in my own profession really served as the catalyst to get involved,” said Dr. Lenchus, the regional chief medical officer at Broward Health Medical Center in Fort Lauderdale, Fla. “What better way to do that than by combining what we do on a daily basis in the practice of medicine with this new understanding of how laws are passed and promulgated?”

Dr. Lenchus has been involved with both state and national medical organizations and has served on public policy committees as a member and as a chair. “The charge of these committees is to monitor and navigate position statements and policies that will drive the entire organization,” he said. This means becoming knowledgeable enough about a topic to be able to talk about it eloquently and adding supporting personal or professional illustrations that reinforce the position to lawmakers.

He finds his advocacy efforts “incredibly rewarding” because they contribute to his endeavors “to help my colleagues practice medicine in a safe, efficient, and productive manner.” For instance, some of the organizations Dr. Lenchus was involved with helped make changes to the Affordable Care Act that ended up in its final version, as well as changes after it passed. “There are tangible things that advocacy enables us to do in our daily practice,” he said.

When something his organizations have advocated for does not pass, they know they need to try a different outlet. “You can’t win every fight,” he said. “Every time you go and comment on an issue, you have to understand that you’re there to do your best, and to the extent that the people you’re talking to are willing to listen to what you have to say, that’s where I think you can make the most impact.” When changes he has helped fight for do pass, “it really is amazing that you can tell your colleagues about your role in achieving meaningful change in the profession.”

Dr. Lenchus acknowledges that advocacy “can be all-consuming at times. We have to understand our limits.” That said, he thinks not engaging in advocacy could increase stress and potential burnout. “I think being involved in advocacy efforts really helps people conduct meaningful work and educates them about what it means not just to them, but to the rest of the medical profession and the patients that we serve,” he said.

For hospitalists who are interested in health policy advocacy, there are many ways to get involved, Dr. Lenchus said. You could join an organization (many organized medical societies have public policy committees), participate in advocacy activities, work on a political campaign, or even run for office yourself. “Ultimately, education and some level of involvement really will make the difference in who navigates our future as hospitalists,” he said.
 

Questioning co-management practices

Though he says he’s in the minority, Hardik Vora, MD, SFHM, medical director for hospital medicine at Riverside Regional Medical Center in Newport News, Va., believes that co-management is going to “make or break hospital medicine. It’s going to have a huge impact on our specialty.”

In the roughly 25-year history of hospital medicine, it has evolved from admitting and caring for patients of primary care physicians to patients of specialists and, more recently, surgical patients. “Now there are (hospital medicine) programs across the country that are pretty much admitting everything,” said Dr. Vora.

As a recruiter for the Riverside Health System for the past eight years, “I have not met a single resident who is trained to do what we’re doing in hospital medicine, because you’re admitting surgical patients all the time and you have primary attending responsibility,” Dr. Vora said. “I see that as a cause of a significant amount of stress because now you’re responsible for something that you don’t have adequate training for.”

In the co-management discussion, Dr. Vora notes that people often bring up the research that shows that the practice has improved surgeon satisfaction. “What bothers me is that…you need to add one more question – how does it affect your hospitalists? And I bet the answer to that question is ‘it has a terrible effect.’”

The expectations surrounding hospitalists these days is a big concern in terms of burnout, Dr. Vora said. “We talk a lot about the drivers of burnout, whether it’s schedule or COVID,” he said. The biggest issue when it comes to burnout, as he sees it, is not COVID; it’s when hospitalists are performing tasks that make them feel they aren’t adding value. “I think that’s a huge topic in hospital medicine right now.”

Dr. Vora believes there should be more discussion and awareness of the potential pitfalls. “Hospitalists should get involved in co-management where they are adding value and certainly not take up the attending responsibility where they’re not adding value and it’s out of the scope of their training and expertise,” he said. “Preventing scope creep and burnout from co-management are some of the key issues I’m really passionate about.”

Dr. Vora said it is important to set realistic goals and remember that it takes time to make change when it comes to advocacy. “You still have to operate within whatever environment is given to you and then you can make change from within,” he said.

His enthusiasm for co-management awareness has led to creating a co-management forum through SHM in his local Hampton Roads chapter. He was also a panelist for an SHM webinar in February 2021 in which the panelists debated co-management.

“I think we really need to look at this as a specialty. Are we going in the right direction?” Dr. Vora asked. “We need to come together as a specialty and make a decision, which is going to be hard because there are competing financial interests and various practice models.”
 

 

 

Improving patient care

Working as a hospitalist at University Medical Center, a safety net hospital in New Orleans, Celeste Newby, MD, PhD, sees plenty of patients who are underinsured or not insured at all. “A lot of my interest in health policy stems from that,” she said.

During her residency, which she finished in 2015, Louisiana became a Medicaid expansion state. This impressed upon Dr. Newby how much Medicaid improved the lives of patients who had previously been uninsured. “We saw procedures getting done that had been put on hold because of financial concerns or medicines that were now affordable that weren’t before,” she said. “It really did make a difference.”

When repeated attempts to repeal the Affordable Care Act began, “it was a call to do health policy work for me personally that just hadn’t come up in the past,” said Dr. Newby, who is also assistant professor of medicine at Tulane University in New Orleans. “I personally found that the best way to do (advocacy work) was to go through medical societies because there is a much stronger voice when you have more people saying the same thing,” she said.

Dr. Newby sits on the Council of Legislation for the Louisiana State Medical Society and participates in the Leadership and Health Policy (LEAHP) Program through the Society of General Internal Medicine.

The LEAHP Program has been instrumental in expanding Dr. Newby’s knowledge of how health policy is made and the mechanisms behind it. It has also taught her “how we can either advise, guide, leverage, or advocate for things that we think would be important for change and moving the country in the right direction in terms of health care.”

Another reason involvement in medical societies is helpful is because, as a busy clinician, it is impossible to keep up with everything. “Working with medical societies, you have people who are more directly involved in the legislature and can give you quicker notice about things that are coming up that are going to be important to you or your co-workers or your patients,” Dr. Newby said.

Dr. Newby feels her advocacy work is an outlet for stress and “a way to work at more of a macro level on problems that I see with my individual patients. It’s a nice compliment.” At the hospital, she can only help one person at a time, but with her advocacy efforts, there’s potential to make changes for many.

“Advocacy now is such a large umbrella that encompasses so many different projects at all kinds of levels,” Dr. Newby said. She suggests looking around your community to see where the needs lie. If you’re passionate about a certain topic or population, see what you can do to help advocate for change there.




 

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Hospitalists engaging in advocacy efforts

Hospitalists engaging in advocacy efforts

Hospitalists around the country are devoting large portions of their spare time to a wide range of advocacy efforts. From health policy to caring for the unhoused population to diversity and equity to advocating for fellow hospitalists, these physicians are passionate about their causes and determined to make a difference.

Championing the unhoused

Sarah Stella, MD, FHM, a hospitalist at Denver Health, was initially drawn there because of the population the hospital serves, which includes a high concentration of people experiencing homelessness. As she cared for her patients, Dr. Stella, who is also associate professor of hospital medicine at the University of Colorado, increasingly felt the desire to help prevent the negative downstream outcomes the hospital sees.

To understand the experiences of the unhoused outside the hospital, Dr. Stella started talking to her patients and people in community-based organizations that serve this population. “I learned a ton,” she said. “Homelessness feels like such an intractable, hopeless thing, but the more I talked to people, the more opportunities I saw to work toward something better.”

This led to a pilot grant to work with the Colorado Coalition for the Homeless to set up a community advisory panel. “My goal was to better understand their experiences and to develop a shared vision for how we collectively can do better,” said Dr. Stella. Eventually, she also received a grant from the University of Colorado, and multiple opportunities have sprung up ever since.

For the past several years, Dr. Stella has worked with Denver Health leadership to improve care for the homeless. “Right now, I’m working with a community team on developing an idea to provide peer support from people with a shared lived experience for people who are experiencing homelessness when they’re hospitalized. That’s really where my passion has been in working on the partnership,” she said.

Her advocacy role has been beneficial in her work as a hospitalist, particularly when COVID began. Dr. Stella again partnered with the Colorado Coalition for the Homeless to start a joint task force. “Everyone on our task force is motivated by this powerful desire to improve the health and lives of this community and that’s one of the silver linings in this pandemic for me,” said Dr. Stella.

Advocacy work has also increased Dr. Stella’s knowledge of what community support options are available for the unhoused. This allows her to educate her patients about their options and how to access them.

While she has colleagues who are able to compartmentalize their work, “I absolutely could not be a hospitalist without being an advocate,” Dr. Stella said. “For me, it has been a protective strategy in terms of burnout because I have to feel like I’m working to advocate for better policies and more appropriate resources to address the gaps that I’m seeing.”

Dr. Stella believes that physicians have a special credibility to advocate, tell stories, and use data to back their stories up. “We have to realize that we have this power, and we have it so we can empower others,” she said. “The people I’ve seen in my community who are working so hard to help people who are experiencing homelessness are the heroes. Understanding that and giving power to those people through our voice and our well-respected place in society drives me.”
 

 

 

Strengthening diversity, equity, and inclusion

In September 2020, Michael Bryant, MD, became the inaugural vice chair of Diversity, Equity, and Inclusion for the department of pediatrics at Children’s Hospital Los Angeles, where he is also the division head of pediatric hospital medicine. “I was motivated to apply for this position because I wanted to be an agent for change to eliminate the institutional racism, social injustice, and marginalization that continues to threaten the lives and well-beings of so many Americans,” Dr. Bryant said.

Dr. Michael Bryant

Between the pandemic, the economic decline it has created, and the divisive political landscape, people of color have been especially affected. “These are poignant examples of the ever-widening divide and disenfranchisement many Americans feel,” said Dr. Bryant. “Gandhi said, ‘Be the change that you want to see,’ and that is what I want to model.”

At work, advocacy for diversity, equality, and inclusion is an innate part of everything he does. From the new physicians he recruits to the candidates he considers for leadership positions, Dr. Bryant strives “to have a workforce that mirrors the diversity of the patients we humbly care for and serve.”

Advocacy is intrinsic to Dr. Bryant’s worldview, in his quest to understand and accept each individual’s uniqueness, his desire “to embrace cultural humility,” his recognition that “our differences enhance us instead of diminishing us,” and his willingness to engage in difficult conversations.

“Advocacy means that I acknowledge that intent does not equal impact and that I must accept that what I do and what I say may have unintended consequences,” he said. “When that happens, I must resist becoming defensive and instead be willing to listen and learn.”

Dr. Bryant is proud of his accomplishments and enjoys his advocacy work. In his workplace, there are few African Americans in leadership roles. This means that he is in high demand when it comes to making sure there’s representation during various processes such as hiring and vetting, a disparity known as the “minority tax.”

“I am thankful for the opportunities, but it does take a toll at times,” Dr. Bryant said, which is yet another reason why he is a proponent of increasing diversity and inclusion. “This allows us to build the resource pool as these needs arise and minimizes the toll of the ‘minority tax’ on any single person or small group of individuals.”

This summer, physicians from Dr. Bryant’s hospital participated in the national “White Coats for Black Lives” effort. He found it to be “an incredibly moving event” that hundreds of his colleagues participated in.

Dr. Bryant’s advice for hospitalists who want to get involved in advocacy efforts is to check out the movie “John Lewis: Good Trouble.” “He was a champion of human rights and fought for these rights until his death,” Dr. Bryant said. “He is a true American hero and a wonderful example.”
 

Bolstering health care change

Since his residency, Joshua Lenchus, DO, FACP, SFHM, has developed an ever-increasing interest in legislative advocacy, particularly health policy. Getting involved in this arena requires an understanding of civics and government that goes beyond just the basics. “My desire to affect change in my own profession really served as the catalyst to get involved,” said Dr. Lenchus, the regional chief medical officer at Broward Health Medical Center in Fort Lauderdale, Fla. “What better way to do that than by combining what we do on a daily basis in the practice of medicine with this new understanding of how laws are passed and promulgated?”

Dr. Lenchus has been involved with both state and national medical organizations and has served on public policy committees as a member and as a chair. “The charge of these committees is to monitor and navigate position statements and policies that will drive the entire organization,” he said. This means becoming knowledgeable enough about a topic to be able to talk about it eloquently and adding supporting personal or professional illustrations that reinforce the position to lawmakers.

He finds his advocacy efforts “incredibly rewarding” because they contribute to his endeavors “to help my colleagues practice medicine in a safe, efficient, and productive manner.” For instance, some of the organizations Dr. Lenchus was involved with helped make changes to the Affordable Care Act that ended up in its final version, as well as changes after it passed. “There are tangible things that advocacy enables us to do in our daily practice,” he said.

When something his organizations have advocated for does not pass, they know they need to try a different outlet. “You can’t win every fight,” he said. “Every time you go and comment on an issue, you have to understand that you’re there to do your best, and to the extent that the people you’re talking to are willing to listen to what you have to say, that’s where I think you can make the most impact.” When changes he has helped fight for do pass, “it really is amazing that you can tell your colleagues about your role in achieving meaningful change in the profession.”

Dr. Lenchus acknowledges that advocacy “can be all-consuming at times. We have to understand our limits.” That said, he thinks not engaging in advocacy could increase stress and potential burnout. “I think being involved in advocacy efforts really helps people conduct meaningful work and educates them about what it means not just to them, but to the rest of the medical profession and the patients that we serve,” he said.

For hospitalists who are interested in health policy advocacy, there are many ways to get involved, Dr. Lenchus said. You could join an organization (many organized medical societies have public policy committees), participate in advocacy activities, work on a political campaign, or even run for office yourself. “Ultimately, education and some level of involvement really will make the difference in who navigates our future as hospitalists,” he said.
 

Questioning co-management practices

Though he says he’s in the minority, Hardik Vora, MD, SFHM, medical director for hospital medicine at Riverside Regional Medical Center in Newport News, Va., believes that co-management is going to “make or break hospital medicine. It’s going to have a huge impact on our specialty.”

In the roughly 25-year history of hospital medicine, it has evolved from admitting and caring for patients of primary care physicians to patients of specialists and, more recently, surgical patients. “Now there are (hospital medicine) programs across the country that are pretty much admitting everything,” said Dr. Vora.

As a recruiter for the Riverside Health System for the past eight years, “I have not met a single resident who is trained to do what we’re doing in hospital medicine, because you’re admitting surgical patients all the time and you have primary attending responsibility,” Dr. Vora said. “I see that as a cause of a significant amount of stress because now you’re responsible for something that you don’t have adequate training for.”

In the co-management discussion, Dr. Vora notes that people often bring up the research that shows that the practice has improved surgeon satisfaction. “What bothers me is that…you need to add one more question – how does it affect your hospitalists? And I bet the answer to that question is ‘it has a terrible effect.’”

The expectations surrounding hospitalists these days is a big concern in terms of burnout, Dr. Vora said. “We talk a lot about the drivers of burnout, whether it’s schedule or COVID,” he said. The biggest issue when it comes to burnout, as he sees it, is not COVID; it’s when hospitalists are performing tasks that make them feel they aren’t adding value. “I think that’s a huge topic in hospital medicine right now.”

Dr. Vora believes there should be more discussion and awareness of the potential pitfalls. “Hospitalists should get involved in co-management where they are adding value and certainly not take up the attending responsibility where they’re not adding value and it’s out of the scope of their training and expertise,” he said. “Preventing scope creep and burnout from co-management are some of the key issues I’m really passionate about.”

Dr. Vora said it is important to set realistic goals and remember that it takes time to make change when it comes to advocacy. “You still have to operate within whatever environment is given to you and then you can make change from within,” he said.

His enthusiasm for co-management awareness has led to creating a co-management forum through SHM in his local Hampton Roads chapter. He was also a panelist for an SHM webinar in February 2021 in which the panelists debated co-management.

“I think we really need to look at this as a specialty. Are we going in the right direction?” Dr. Vora asked. “We need to come together as a specialty and make a decision, which is going to be hard because there are competing financial interests and various practice models.”
 

 

 

Improving patient care

Working as a hospitalist at University Medical Center, a safety net hospital in New Orleans, Celeste Newby, MD, PhD, sees plenty of patients who are underinsured or not insured at all. “A lot of my interest in health policy stems from that,” she said.

During her residency, which she finished in 2015, Louisiana became a Medicaid expansion state. This impressed upon Dr. Newby how much Medicaid improved the lives of patients who had previously been uninsured. “We saw procedures getting done that had been put on hold because of financial concerns or medicines that were now affordable that weren’t before,” she said. “It really did make a difference.”

When repeated attempts to repeal the Affordable Care Act began, “it was a call to do health policy work for me personally that just hadn’t come up in the past,” said Dr. Newby, who is also assistant professor of medicine at Tulane University in New Orleans. “I personally found that the best way to do (advocacy work) was to go through medical societies because there is a much stronger voice when you have more people saying the same thing,” she said.

Dr. Newby sits on the Council of Legislation for the Louisiana State Medical Society and participates in the Leadership and Health Policy (LEAHP) Program through the Society of General Internal Medicine.

The LEAHP Program has been instrumental in expanding Dr. Newby’s knowledge of how health policy is made and the mechanisms behind it. It has also taught her “how we can either advise, guide, leverage, or advocate for things that we think would be important for change and moving the country in the right direction in terms of health care.”

Another reason involvement in medical societies is helpful is because, as a busy clinician, it is impossible to keep up with everything. “Working with medical societies, you have people who are more directly involved in the legislature and can give you quicker notice about things that are coming up that are going to be important to you or your co-workers or your patients,” Dr. Newby said.

Dr. Newby feels her advocacy work is an outlet for stress and “a way to work at more of a macro level on problems that I see with my individual patients. It’s a nice compliment.” At the hospital, she can only help one person at a time, but with her advocacy efforts, there’s potential to make changes for many.

“Advocacy now is such a large umbrella that encompasses so many different projects at all kinds of levels,” Dr. Newby said. She suggests looking around your community to see where the needs lie. If you’re passionate about a certain topic or population, see what you can do to help advocate for change there.




 

Hospitalists around the country are devoting large portions of their spare time to a wide range of advocacy efforts. From health policy to caring for the unhoused population to diversity and equity to advocating for fellow hospitalists, these physicians are passionate about their causes and determined to make a difference.

Championing the unhoused

Sarah Stella, MD, FHM, a hospitalist at Denver Health, was initially drawn there because of the population the hospital serves, which includes a high concentration of people experiencing homelessness. As she cared for her patients, Dr. Stella, who is also associate professor of hospital medicine at the University of Colorado, increasingly felt the desire to help prevent the negative downstream outcomes the hospital sees.

To understand the experiences of the unhoused outside the hospital, Dr. Stella started talking to her patients and people in community-based organizations that serve this population. “I learned a ton,” she said. “Homelessness feels like such an intractable, hopeless thing, but the more I talked to people, the more opportunities I saw to work toward something better.”

This led to a pilot grant to work with the Colorado Coalition for the Homeless to set up a community advisory panel. “My goal was to better understand their experiences and to develop a shared vision for how we collectively can do better,” said Dr. Stella. Eventually, she also received a grant from the University of Colorado, and multiple opportunities have sprung up ever since.

For the past several years, Dr. Stella has worked with Denver Health leadership to improve care for the homeless. “Right now, I’m working with a community team on developing an idea to provide peer support from people with a shared lived experience for people who are experiencing homelessness when they’re hospitalized. That’s really where my passion has been in working on the partnership,” she said.

Her advocacy role has been beneficial in her work as a hospitalist, particularly when COVID began. Dr. Stella again partnered with the Colorado Coalition for the Homeless to start a joint task force. “Everyone on our task force is motivated by this powerful desire to improve the health and lives of this community and that’s one of the silver linings in this pandemic for me,” said Dr. Stella.

Advocacy work has also increased Dr. Stella’s knowledge of what community support options are available for the unhoused. This allows her to educate her patients about their options and how to access them.

While she has colleagues who are able to compartmentalize their work, “I absolutely could not be a hospitalist without being an advocate,” Dr. Stella said. “For me, it has been a protective strategy in terms of burnout because I have to feel like I’m working to advocate for better policies and more appropriate resources to address the gaps that I’m seeing.”

Dr. Stella believes that physicians have a special credibility to advocate, tell stories, and use data to back their stories up. “We have to realize that we have this power, and we have it so we can empower others,” she said. “The people I’ve seen in my community who are working so hard to help people who are experiencing homelessness are the heroes. Understanding that and giving power to those people through our voice and our well-respected place in society drives me.”
 

 

 

Strengthening diversity, equity, and inclusion

In September 2020, Michael Bryant, MD, became the inaugural vice chair of Diversity, Equity, and Inclusion for the department of pediatrics at Children’s Hospital Los Angeles, where he is also the division head of pediatric hospital medicine. “I was motivated to apply for this position because I wanted to be an agent for change to eliminate the institutional racism, social injustice, and marginalization that continues to threaten the lives and well-beings of so many Americans,” Dr. Bryant said.

Dr. Michael Bryant

Between the pandemic, the economic decline it has created, and the divisive political landscape, people of color have been especially affected. “These are poignant examples of the ever-widening divide and disenfranchisement many Americans feel,” said Dr. Bryant. “Gandhi said, ‘Be the change that you want to see,’ and that is what I want to model.”

At work, advocacy for diversity, equality, and inclusion is an innate part of everything he does. From the new physicians he recruits to the candidates he considers for leadership positions, Dr. Bryant strives “to have a workforce that mirrors the diversity of the patients we humbly care for and serve.”

Advocacy is intrinsic to Dr. Bryant’s worldview, in his quest to understand and accept each individual’s uniqueness, his desire “to embrace cultural humility,” his recognition that “our differences enhance us instead of diminishing us,” and his willingness to engage in difficult conversations.

“Advocacy means that I acknowledge that intent does not equal impact and that I must accept that what I do and what I say may have unintended consequences,” he said. “When that happens, I must resist becoming defensive and instead be willing to listen and learn.”

Dr. Bryant is proud of his accomplishments and enjoys his advocacy work. In his workplace, there are few African Americans in leadership roles. This means that he is in high demand when it comes to making sure there’s representation during various processes such as hiring and vetting, a disparity known as the “minority tax.”

“I am thankful for the opportunities, but it does take a toll at times,” Dr. Bryant said, which is yet another reason why he is a proponent of increasing diversity and inclusion. “This allows us to build the resource pool as these needs arise and minimizes the toll of the ‘minority tax’ on any single person or small group of individuals.”

This summer, physicians from Dr. Bryant’s hospital participated in the national “White Coats for Black Lives” effort. He found it to be “an incredibly moving event” that hundreds of his colleagues participated in.

Dr. Bryant’s advice for hospitalists who want to get involved in advocacy efforts is to check out the movie “John Lewis: Good Trouble.” “He was a champion of human rights and fought for these rights until his death,” Dr. Bryant said. “He is a true American hero and a wonderful example.”
 

Bolstering health care change

Since his residency, Joshua Lenchus, DO, FACP, SFHM, has developed an ever-increasing interest in legislative advocacy, particularly health policy. Getting involved in this arena requires an understanding of civics and government that goes beyond just the basics. “My desire to affect change in my own profession really served as the catalyst to get involved,” said Dr. Lenchus, the regional chief medical officer at Broward Health Medical Center in Fort Lauderdale, Fla. “What better way to do that than by combining what we do on a daily basis in the practice of medicine with this new understanding of how laws are passed and promulgated?”

Dr. Lenchus has been involved with both state and national medical organizations and has served on public policy committees as a member and as a chair. “The charge of these committees is to monitor and navigate position statements and policies that will drive the entire organization,” he said. This means becoming knowledgeable enough about a topic to be able to talk about it eloquently and adding supporting personal or professional illustrations that reinforce the position to lawmakers.

He finds his advocacy efforts “incredibly rewarding” because they contribute to his endeavors “to help my colleagues practice medicine in a safe, efficient, and productive manner.” For instance, some of the organizations Dr. Lenchus was involved with helped make changes to the Affordable Care Act that ended up in its final version, as well as changes after it passed. “There are tangible things that advocacy enables us to do in our daily practice,” he said.

When something his organizations have advocated for does not pass, they know they need to try a different outlet. “You can’t win every fight,” he said. “Every time you go and comment on an issue, you have to understand that you’re there to do your best, and to the extent that the people you’re talking to are willing to listen to what you have to say, that’s where I think you can make the most impact.” When changes he has helped fight for do pass, “it really is amazing that you can tell your colleagues about your role in achieving meaningful change in the profession.”

Dr. Lenchus acknowledges that advocacy “can be all-consuming at times. We have to understand our limits.” That said, he thinks not engaging in advocacy could increase stress and potential burnout. “I think being involved in advocacy efforts really helps people conduct meaningful work and educates them about what it means not just to them, but to the rest of the medical profession and the patients that we serve,” he said.

For hospitalists who are interested in health policy advocacy, there are many ways to get involved, Dr. Lenchus said. You could join an organization (many organized medical societies have public policy committees), participate in advocacy activities, work on a political campaign, or even run for office yourself. “Ultimately, education and some level of involvement really will make the difference in who navigates our future as hospitalists,” he said.
 

Questioning co-management practices

Though he says he’s in the minority, Hardik Vora, MD, SFHM, medical director for hospital medicine at Riverside Regional Medical Center in Newport News, Va., believes that co-management is going to “make or break hospital medicine. It’s going to have a huge impact on our specialty.”

In the roughly 25-year history of hospital medicine, it has evolved from admitting and caring for patients of primary care physicians to patients of specialists and, more recently, surgical patients. “Now there are (hospital medicine) programs across the country that are pretty much admitting everything,” said Dr. Vora.

As a recruiter for the Riverside Health System for the past eight years, “I have not met a single resident who is trained to do what we’re doing in hospital medicine, because you’re admitting surgical patients all the time and you have primary attending responsibility,” Dr. Vora said. “I see that as a cause of a significant amount of stress because now you’re responsible for something that you don’t have adequate training for.”

In the co-management discussion, Dr. Vora notes that people often bring up the research that shows that the practice has improved surgeon satisfaction. “What bothers me is that…you need to add one more question – how does it affect your hospitalists? And I bet the answer to that question is ‘it has a terrible effect.’”

The expectations surrounding hospitalists these days is a big concern in terms of burnout, Dr. Vora said. “We talk a lot about the drivers of burnout, whether it’s schedule or COVID,” he said. The biggest issue when it comes to burnout, as he sees it, is not COVID; it’s when hospitalists are performing tasks that make them feel they aren’t adding value. “I think that’s a huge topic in hospital medicine right now.”

Dr. Vora believes there should be more discussion and awareness of the potential pitfalls. “Hospitalists should get involved in co-management where they are adding value and certainly not take up the attending responsibility where they’re not adding value and it’s out of the scope of their training and expertise,” he said. “Preventing scope creep and burnout from co-management are some of the key issues I’m really passionate about.”

Dr. Vora said it is important to set realistic goals and remember that it takes time to make change when it comes to advocacy. “You still have to operate within whatever environment is given to you and then you can make change from within,” he said.

His enthusiasm for co-management awareness has led to creating a co-management forum through SHM in his local Hampton Roads chapter. He was also a panelist for an SHM webinar in February 2021 in which the panelists debated co-management.

“I think we really need to look at this as a specialty. Are we going in the right direction?” Dr. Vora asked. “We need to come together as a specialty and make a decision, which is going to be hard because there are competing financial interests and various practice models.”
 

 

 

Improving patient care

Working as a hospitalist at University Medical Center, a safety net hospital in New Orleans, Celeste Newby, MD, PhD, sees plenty of patients who are underinsured or not insured at all. “A lot of my interest in health policy stems from that,” she said.

During her residency, which she finished in 2015, Louisiana became a Medicaid expansion state. This impressed upon Dr. Newby how much Medicaid improved the lives of patients who had previously been uninsured. “We saw procedures getting done that had been put on hold because of financial concerns or medicines that were now affordable that weren’t before,” she said. “It really did make a difference.”

When repeated attempts to repeal the Affordable Care Act began, “it was a call to do health policy work for me personally that just hadn’t come up in the past,” said Dr. Newby, who is also assistant professor of medicine at Tulane University in New Orleans. “I personally found that the best way to do (advocacy work) was to go through medical societies because there is a much stronger voice when you have more people saying the same thing,” she said.

Dr. Newby sits on the Council of Legislation for the Louisiana State Medical Society and participates in the Leadership and Health Policy (LEAHP) Program through the Society of General Internal Medicine.

The LEAHP Program has been instrumental in expanding Dr. Newby’s knowledge of how health policy is made and the mechanisms behind it. It has also taught her “how we can either advise, guide, leverage, or advocate for things that we think would be important for change and moving the country in the right direction in terms of health care.”

Another reason involvement in medical societies is helpful is because, as a busy clinician, it is impossible to keep up with everything. “Working with medical societies, you have people who are more directly involved in the legislature and can give you quicker notice about things that are coming up that are going to be important to you or your co-workers or your patients,” Dr. Newby said.

Dr. Newby feels her advocacy work is an outlet for stress and “a way to work at more of a macro level on problems that I see with my individual patients. It’s a nice compliment.” At the hospital, she can only help one person at a time, but with her advocacy efforts, there’s potential to make changes for many.

“Advocacy now is such a large umbrella that encompasses so many different projects at all kinds of levels,” Dr. Newby said. She suggests looking around your community to see where the needs lie. If you’re passionate about a certain topic or population, see what you can do to help advocate for change there.




 

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Do you want to become a hospitalist leader?

Article Type
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Thu, 03/18/2021 - 10:18

Learn how or even whether you should

Have you ever thought you could be a leader, in your hospitalist group, in hospital administration, or at another institution? The reasons to seek a leadership role as a hospitalist are many, but there are also many drawbacks. According to hospitalists who have reached high rungs on the leadership ladder, you will need a blend of desire, enthusiasm, education, and experience if you want to succeed in leadership.

The right reasons

“People who make good leaders have a sense of purpose and want to make a difference,” said Eric Howell, MD, MHM, CEO of the Society of Hospital Medicine, and former chief of medical units at Johns Hopkins Bayview in Baltimore. “I think most hospitalists have that sense of wanting to help patients and society, so that’s a strong mission in itself. Just by training and the very design of our health care system, hospitalists are often natural leaders, and in leadership roles, because they run teams of clinicians and train medical students.”

Danielle Scheurer, MD, SFHM, chief quality officer and professor of medicine at the Medical University of South Carolina, and current president of SHM, said some hospitalists end up in leadership roles almost by accident – because there is a leadership “void” in the health system where they work, and no one else wants to step up. Others disconnect from the leadership track and are happy to simply be part of a team.

“If you are yearning to make a difference and that’s your motivation then you will find leadership is more fulfilling than difficult,” she said. “But if you take a leadership role to fill a void or think you just want to take some nonclinical time, it’s probably not a good idea. Some people think administrative leadership is easier than being a hospitalist, but it is not. Leadership should not be about getting away from something else. It should be a thoughtful career move, and if it is, being a leader can be meaningful and fulfilling.”

Nancy Spector, MD, the vice dean for faculty and executive director of the Executive Leadership in Academic Medicine program at Drexel University College of Medicine in Philadelphia, said a willingness to fail is vital for a leader. “You have to be open to successes, yes, but also to making mistakes,” she said. “It’s about honing the skills that leadership requires and be open to development and change.”

Kierstin Cates Kennedy, MD, SFHM, chief of hospital medicine at the University of Alabama at Birmingham, said that a hospitalist fresh out of residency will gain insight into whether leadership is the right path by acquiring a deeper understanding of how health care institutions work.

Dr. Kierstin Cates Kennedy


“When you are new to the hospital, you see how things work, how people interact with each other, and learn the politics,” she said. “One of the easiest ways to do it is get involved in a committee and be a part of meetings. You can have some input and get exposure to other leaders and they can learn more about you. Once you get an organizational understanding under your belt, then you can start taking on projects to gain even more understanding.”
 

 

 

Still up for it?

If you think you have the commitment and desire for leadership as an early career hospitalist, how would you continue down the leadership path?

“A great way is to find a person you want to be like, who could be a mentor. Find a successful leader that you admire, and one who is willing to guide you,” Dr. Howell said. “Books are helpful as well, and I still find I’m learning today – I have a list that includes Drive by Daniel Pink and Good to Great by Jim Collins. There are Malcolm Gladwell books that also have terrific knowledge to impart.”

Mark W. Shen, MD, SFHM, associate professor at Dell Medical School at the University of Texas at Austin and former president of St. Louis Children’s Hospital, said potential hospitalist leaders must be aware of their fellow clinicians.

“Pay attention to the needs of the hospitalist group as they are articulated by the lead hospitalist, the administration, and the patients,” he said. “There are so many activities that come up on a day-in, day-out basis. You should jump in and volunteer to take the lead on some of those activities. Leading your peers is often one of the most challenging parts of leadership. I think taking on even just a small activity like, say, working on a clinical pathway for the group, will result in a lot of preparation for future leadership roles.”

An example of an early career activity that Dr. Shen felt was valuable to future leaders was helping in the development of a hospitalist core curriculum. “We would use the core curriculum to educate students and residents coming through our rotation and have some degree of commonality or standardization,” he said. “So even though I wasn’t an explicit leader of the hospitalist group at the time, I’d say that helping develop the core curriculum aided me in understanding what leadership was all about.”

Getting started in a leadership role, Dr. Spector said, can be helped by embracing a knowledge of the business of medicine. “Business and finance are a reality you shouldn’t avoid,” she said. “Another way to learn is to partner with your local administrators or whoever is running your division or your department. There are business managers and business partners in every institution, and you can learn a great deal from them. It’s important to network and get to know people because we’re a people business, and opportunity comes when people know who you are.”

Dr. Howell noted that advocating for yourself is sometimes hard, and it can be a red flag in some circumstances, but you should tell your bosses where you want to go professionally.

“You can say that you want to grow professionally, and let’s face it, there are naturally-inclined leaders. We all need to be transparent in goal paths,” he said. “But if you want a leadership role for power, money, and prestige then you’re not applying the right thinking. If you want to help others and you have a mission you believe in, then communicate that to your bosses.”

Dr. Scheurer believes choosing between clinical and administrative leadership is not so clear cut, because in the health care setting they tend to morph into each other. “Many times clinicians will end up taking on a leadership role that has a significant administrative component to it,” she said. “I do think if clinicians make a career move and get the right training then they can be exemplary leaders in health care, but I do worry a little about clinicians going into leadership roles without any formal training. They are usually well-intentioned but that’s not enough. It’s not any different than medical training. If you want to be a good leader you need training to develop your skills, and a lot of those skills do not come naturally or easily. We thrust good clinicians into leadership roles because they are good clinicians, but if they don’t have the right skills, being a leader can be a problem.”
 

 

 

How do leaders improve?

If you have made it to a leadership position, and have been in that role for a while, you might start to feel you are stuck in your growth trajectory. If so, how do you continue to improve?

According to Dr. Kennedy, whether you are looking to get into leadership or want to improve, focusing on emotional intelligence is important. “A book like Emotional Intelligence 2.0 by Travis Bradbury is a great introduction,” she said. “With my leadership team, we did a book club where we read Primal Leadership, which is focused on emotional intelligence and on aspects like setting a culture.”

Dr. Howell said that to grow as a leader, be careful what you say no to. “I used to talk about having a tag line that was ‘just say yes,’” he said. “At least try to say yes most of the time because it opens up opportunities and shows you are looking to do more, not less.”

Also, Dr. Howell recommends that leaders look for tools that minimize blind spots and get information from staff through survey assessments. “Get the input of others on your strengths and weaknesses,” he said. “Nurses, doctors, and sometimes patients can give you good information that will help you grow as a leader. Don’t be afraid of feedback.”
 

Never stop learning

Dr. Scheurer said it is important to recognize that you are never finished learning when you are a leader.

“See leadership as a continuous learning journey. You can never be too good of a leader in medicine,” she said. “Never stop learning, because the field keeps changing and you have to constantly learn and find pleasure in that learning. You should look at leadership the same way. A lot of leadership theories change with the times and you should always try to get good advice. You don’t take every piece of advice – just like in medicine when you read an article and you try to apply it to patients in your practice. Take some advice, leave some advice, and develop a leadership style that is genuine and authentic.”

Dr. Kennedy believes that a hospitalist’s leadership potential may be limited if you see continued learning as a chore, rather than an opportunity.

“If you resent it learning about leadership, then is it really for you?” she asked. “I find myself reading on the topic or talking about it, and it’s fun. How do you make an environment work better, how do you inspire people, how do you help them grow? These are some of the most important questions leaders face. Isn’t it fun if you can find some answers?”
 

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Learn how or even whether you should

Learn how or even whether you should

Have you ever thought you could be a leader, in your hospitalist group, in hospital administration, or at another institution? The reasons to seek a leadership role as a hospitalist are many, but there are also many drawbacks. According to hospitalists who have reached high rungs on the leadership ladder, you will need a blend of desire, enthusiasm, education, and experience if you want to succeed in leadership.

The right reasons

“People who make good leaders have a sense of purpose and want to make a difference,” said Eric Howell, MD, MHM, CEO of the Society of Hospital Medicine, and former chief of medical units at Johns Hopkins Bayview in Baltimore. “I think most hospitalists have that sense of wanting to help patients and society, so that’s a strong mission in itself. Just by training and the very design of our health care system, hospitalists are often natural leaders, and in leadership roles, because they run teams of clinicians and train medical students.”

Danielle Scheurer, MD, SFHM, chief quality officer and professor of medicine at the Medical University of South Carolina, and current president of SHM, said some hospitalists end up in leadership roles almost by accident – because there is a leadership “void” in the health system where they work, and no one else wants to step up. Others disconnect from the leadership track and are happy to simply be part of a team.

“If you are yearning to make a difference and that’s your motivation then you will find leadership is more fulfilling than difficult,” she said. “But if you take a leadership role to fill a void or think you just want to take some nonclinical time, it’s probably not a good idea. Some people think administrative leadership is easier than being a hospitalist, but it is not. Leadership should not be about getting away from something else. It should be a thoughtful career move, and if it is, being a leader can be meaningful and fulfilling.”

Nancy Spector, MD, the vice dean for faculty and executive director of the Executive Leadership in Academic Medicine program at Drexel University College of Medicine in Philadelphia, said a willingness to fail is vital for a leader. “You have to be open to successes, yes, but also to making mistakes,” she said. “It’s about honing the skills that leadership requires and be open to development and change.”

Kierstin Cates Kennedy, MD, SFHM, chief of hospital medicine at the University of Alabama at Birmingham, said that a hospitalist fresh out of residency will gain insight into whether leadership is the right path by acquiring a deeper understanding of how health care institutions work.

Dr. Kierstin Cates Kennedy


“When you are new to the hospital, you see how things work, how people interact with each other, and learn the politics,” she said. “One of the easiest ways to do it is get involved in a committee and be a part of meetings. You can have some input and get exposure to other leaders and they can learn more about you. Once you get an organizational understanding under your belt, then you can start taking on projects to gain even more understanding.”
 

 

 

Still up for it?

If you think you have the commitment and desire for leadership as an early career hospitalist, how would you continue down the leadership path?

“A great way is to find a person you want to be like, who could be a mentor. Find a successful leader that you admire, and one who is willing to guide you,” Dr. Howell said. “Books are helpful as well, and I still find I’m learning today – I have a list that includes Drive by Daniel Pink and Good to Great by Jim Collins. There are Malcolm Gladwell books that also have terrific knowledge to impart.”

Mark W. Shen, MD, SFHM, associate professor at Dell Medical School at the University of Texas at Austin and former president of St. Louis Children’s Hospital, said potential hospitalist leaders must be aware of their fellow clinicians.

“Pay attention to the needs of the hospitalist group as they are articulated by the lead hospitalist, the administration, and the patients,” he said. “There are so many activities that come up on a day-in, day-out basis. You should jump in and volunteer to take the lead on some of those activities. Leading your peers is often one of the most challenging parts of leadership. I think taking on even just a small activity like, say, working on a clinical pathway for the group, will result in a lot of preparation for future leadership roles.”

An example of an early career activity that Dr. Shen felt was valuable to future leaders was helping in the development of a hospitalist core curriculum. “We would use the core curriculum to educate students and residents coming through our rotation and have some degree of commonality or standardization,” he said. “So even though I wasn’t an explicit leader of the hospitalist group at the time, I’d say that helping develop the core curriculum aided me in understanding what leadership was all about.”

Getting started in a leadership role, Dr. Spector said, can be helped by embracing a knowledge of the business of medicine. “Business and finance are a reality you shouldn’t avoid,” she said. “Another way to learn is to partner with your local administrators or whoever is running your division or your department. There are business managers and business partners in every institution, and you can learn a great deal from them. It’s important to network and get to know people because we’re a people business, and opportunity comes when people know who you are.”

Dr. Howell noted that advocating for yourself is sometimes hard, and it can be a red flag in some circumstances, but you should tell your bosses where you want to go professionally.

“You can say that you want to grow professionally, and let’s face it, there are naturally-inclined leaders. We all need to be transparent in goal paths,” he said. “But if you want a leadership role for power, money, and prestige then you’re not applying the right thinking. If you want to help others and you have a mission you believe in, then communicate that to your bosses.”

Dr. Scheurer believes choosing between clinical and administrative leadership is not so clear cut, because in the health care setting they tend to morph into each other. “Many times clinicians will end up taking on a leadership role that has a significant administrative component to it,” she said. “I do think if clinicians make a career move and get the right training then they can be exemplary leaders in health care, but I do worry a little about clinicians going into leadership roles without any formal training. They are usually well-intentioned but that’s not enough. It’s not any different than medical training. If you want to be a good leader you need training to develop your skills, and a lot of those skills do not come naturally or easily. We thrust good clinicians into leadership roles because they are good clinicians, but if they don’t have the right skills, being a leader can be a problem.”
 

 

 

How do leaders improve?

If you have made it to a leadership position, and have been in that role for a while, you might start to feel you are stuck in your growth trajectory. If so, how do you continue to improve?

According to Dr. Kennedy, whether you are looking to get into leadership or want to improve, focusing on emotional intelligence is important. “A book like Emotional Intelligence 2.0 by Travis Bradbury is a great introduction,” she said. “With my leadership team, we did a book club where we read Primal Leadership, which is focused on emotional intelligence and on aspects like setting a culture.”

Dr. Howell said that to grow as a leader, be careful what you say no to. “I used to talk about having a tag line that was ‘just say yes,’” he said. “At least try to say yes most of the time because it opens up opportunities and shows you are looking to do more, not less.”

Also, Dr. Howell recommends that leaders look for tools that minimize blind spots and get information from staff through survey assessments. “Get the input of others on your strengths and weaknesses,” he said. “Nurses, doctors, and sometimes patients can give you good information that will help you grow as a leader. Don’t be afraid of feedback.”
 

Never stop learning

Dr. Scheurer said it is important to recognize that you are never finished learning when you are a leader.

“See leadership as a continuous learning journey. You can never be too good of a leader in medicine,” she said. “Never stop learning, because the field keeps changing and you have to constantly learn and find pleasure in that learning. You should look at leadership the same way. A lot of leadership theories change with the times and you should always try to get good advice. You don’t take every piece of advice – just like in medicine when you read an article and you try to apply it to patients in your practice. Take some advice, leave some advice, and develop a leadership style that is genuine and authentic.”

Dr. Kennedy believes that a hospitalist’s leadership potential may be limited if you see continued learning as a chore, rather than an opportunity.

“If you resent it learning about leadership, then is it really for you?” she asked. “I find myself reading on the topic or talking about it, and it’s fun. How do you make an environment work better, how do you inspire people, how do you help them grow? These are some of the most important questions leaders face. Isn’t it fun if you can find some answers?”
 

Have you ever thought you could be a leader, in your hospitalist group, in hospital administration, or at another institution? The reasons to seek a leadership role as a hospitalist are many, but there are also many drawbacks. According to hospitalists who have reached high rungs on the leadership ladder, you will need a blend of desire, enthusiasm, education, and experience if you want to succeed in leadership.

The right reasons

“People who make good leaders have a sense of purpose and want to make a difference,” said Eric Howell, MD, MHM, CEO of the Society of Hospital Medicine, and former chief of medical units at Johns Hopkins Bayview in Baltimore. “I think most hospitalists have that sense of wanting to help patients and society, so that’s a strong mission in itself. Just by training and the very design of our health care system, hospitalists are often natural leaders, and in leadership roles, because they run teams of clinicians and train medical students.”

Danielle Scheurer, MD, SFHM, chief quality officer and professor of medicine at the Medical University of South Carolina, and current president of SHM, said some hospitalists end up in leadership roles almost by accident – because there is a leadership “void” in the health system where they work, and no one else wants to step up. Others disconnect from the leadership track and are happy to simply be part of a team.

“If you are yearning to make a difference and that’s your motivation then you will find leadership is more fulfilling than difficult,” she said. “But if you take a leadership role to fill a void or think you just want to take some nonclinical time, it’s probably not a good idea. Some people think administrative leadership is easier than being a hospitalist, but it is not. Leadership should not be about getting away from something else. It should be a thoughtful career move, and if it is, being a leader can be meaningful and fulfilling.”

Nancy Spector, MD, the vice dean for faculty and executive director of the Executive Leadership in Academic Medicine program at Drexel University College of Medicine in Philadelphia, said a willingness to fail is vital for a leader. “You have to be open to successes, yes, but also to making mistakes,” she said. “It’s about honing the skills that leadership requires and be open to development and change.”

Kierstin Cates Kennedy, MD, SFHM, chief of hospital medicine at the University of Alabama at Birmingham, said that a hospitalist fresh out of residency will gain insight into whether leadership is the right path by acquiring a deeper understanding of how health care institutions work.

Dr. Kierstin Cates Kennedy


“When you are new to the hospital, you see how things work, how people interact with each other, and learn the politics,” she said. “One of the easiest ways to do it is get involved in a committee and be a part of meetings. You can have some input and get exposure to other leaders and they can learn more about you. Once you get an organizational understanding under your belt, then you can start taking on projects to gain even more understanding.”
 

 

 

Still up for it?

If you think you have the commitment and desire for leadership as an early career hospitalist, how would you continue down the leadership path?

“A great way is to find a person you want to be like, who could be a mentor. Find a successful leader that you admire, and one who is willing to guide you,” Dr. Howell said. “Books are helpful as well, and I still find I’m learning today – I have a list that includes Drive by Daniel Pink and Good to Great by Jim Collins. There are Malcolm Gladwell books that also have terrific knowledge to impart.”

Mark W. Shen, MD, SFHM, associate professor at Dell Medical School at the University of Texas at Austin and former president of St. Louis Children’s Hospital, said potential hospitalist leaders must be aware of their fellow clinicians.

“Pay attention to the needs of the hospitalist group as they are articulated by the lead hospitalist, the administration, and the patients,” he said. “There are so many activities that come up on a day-in, day-out basis. You should jump in and volunteer to take the lead on some of those activities. Leading your peers is often one of the most challenging parts of leadership. I think taking on even just a small activity like, say, working on a clinical pathway for the group, will result in a lot of preparation for future leadership roles.”

An example of an early career activity that Dr. Shen felt was valuable to future leaders was helping in the development of a hospitalist core curriculum. “We would use the core curriculum to educate students and residents coming through our rotation and have some degree of commonality or standardization,” he said. “So even though I wasn’t an explicit leader of the hospitalist group at the time, I’d say that helping develop the core curriculum aided me in understanding what leadership was all about.”

Getting started in a leadership role, Dr. Spector said, can be helped by embracing a knowledge of the business of medicine. “Business and finance are a reality you shouldn’t avoid,” she said. “Another way to learn is to partner with your local administrators or whoever is running your division or your department. There are business managers and business partners in every institution, and you can learn a great deal from them. It’s important to network and get to know people because we’re a people business, and opportunity comes when people know who you are.”

Dr. Howell noted that advocating for yourself is sometimes hard, and it can be a red flag in some circumstances, but you should tell your bosses where you want to go professionally.

“You can say that you want to grow professionally, and let’s face it, there are naturally-inclined leaders. We all need to be transparent in goal paths,” he said. “But if you want a leadership role for power, money, and prestige then you’re not applying the right thinking. If you want to help others and you have a mission you believe in, then communicate that to your bosses.”

Dr. Scheurer believes choosing between clinical and administrative leadership is not so clear cut, because in the health care setting they tend to morph into each other. “Many times clinicians will end up taking on a leadership role that has a significant administrative component to it,” she said. “I do think if clinicians make a career move and get the right training then they can be exemplary leaders in health care, but I do worry a little about clinicians going into leadership roles without any formal training. They are usually well-intentioned but that’s not enough. It’s not any different than medical training. If you want to be a good leader you need training to develop your skills, and a lot of those skills do not come naturally or easily. We thrust good clinicians into leadership roles because they are good clinicians, but if they don’t have the right skills, being a leader can be a problem.”
 

 

 

How do leaders improve?

If you have made it to a leadership position, and have been in that role for a while, you might start to feel you are stuck in your growth trajectory. If so, how do you continue to improve?

According to Dr. Kennedy, whether you are looking to get into leadership or want to improve, focusing on emotional intelligence is important. “A book like Emotional Intelligence 2.0 by Travis Bradbury is a great introduction,” she said. “With my leadership team, we did a book club where we read Primal Leadership, which is focused on emotional intelligence and on aspects like setting a culture.”

Dr. Howell said that to grow as a leader, be careful what you say no to. “I used to talk about having a tag line that was ‘just say yes,’” he said. “At least try to say yes most of the time because it opens up opportunities and shows you are looking to do more, not less.”

Also, Dr. Howell recommends that leaders look for tools that minimize blind spots and get information from staff through survey assessments. “Get the input of others on your strengths and weaknesses,” he said. “Nurses, doctors, and sometimes patients can give you good information that will help you grow as a leader. Don’t be afraid of feedback.”
 

Never stop learning

Dr. Scheurer said it is important to recognize that you are never finished learning when you are a leader.

“See leadership as a continuous learning journey. You can never be too good of a leader in medicine,” she said. “Never stop learning, because the field keeps changing and you have to constantly learn and find pleasure in that learning. You should look at leadership the same way. A lot of leadership theories change with the times and you should always try to get good advice. You don’t take every piece of advice – just like in medicine when you read an article and you try to apply it to patients in your practice. Take some advice, leave some advice, and develop a leadership style that is genuine and authentic.”

Dr. Kennedy believes that a hospitalist’s leadership potential may be limited if you see continued learning as a chore, rather than an opportunity.

“If you resent it learning about leadership, then is it really for you?” she asked. “I find myself reading on the topic or talking about it, and it’s fun. How do you make an environment work better, how do you inspire people, how do you help them grow? These are some of the most important questions leaders face. Isn’t it fun if you can find some answers?”
 

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The skill set of the ‘pluripotent’ hospitalist

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Wed, 03/17/2021 - 10:37

Editor’s note: National Hospitalist Day occurs the first Thursday in March annually, and serves to celebrate the fastest growing specialty in modern medicine and hospitalists’ enduring contributions to the evolving health care landscape. On National Hospitalist Day in 2021, SHM convened a virtual roundtable with a diverse group of hospitalists to discuss skill set, wellness, and other key issues for hospitalists. To listen to the entire roundtable discussion, visit this Explore The Space podcast episode.

A hospitalist isn’t just a physician who happens to work in a hospital. They are medical professionals with a robust skill set that they use both inside and outside the hospital setting. But what skill sets do hospitalists need to become successful in their careers? And what skill sets does a “pluripotent” hospitalist need in their armamentarium?

Dr. Maylyn S. Martinez

These were the issues discussed by participants of a virtual roundtable discussion on National Hospitalist Day – March 4, 2021 – as part of a joint effort of the Society of Hospital Medicine and the Explore the Space podcast.

Maylyn S. Martinez, MD, clinician-researcher and clinical associate at the University of Chicago, sees her hospitalist and research skill sets as two “buckets” of skills she can sort through, with diagnostic, knowledge-based care coordination, and interpersonal skills as lanes where she can focus and improve. “I’m always trying to work in, and sharpen, and find ways to get better at something in each of those every day,” she said.

For Anika Kumar, MD, FHM, pediatric editor of the Hospitalist and clinical assistant professor of pediatrics at the Cleveland Clinic Lerner College of Medicine, much of her work is focused on problem solving. “I approach that as: ‘How do I come up with my differential diagnosis, and how do I diagnose the patient?’ I think that the lanes are a little bit different, but there is some overlap.”

Dr. Ndidi Unaka

Adaptability is another important part of the skill set for the hospitalist, Ndidi Unaka, MD, MEd, associate professor in the division of hospital medicine at Cincinnati Children’s Hospital Medical Center, said during the discussion. “I think we all really value teamwork, and we take on the role of being the coordinator and making sure things are getting done in a seamless and thoughtful manner. Communicating with families, communicating with our research team, communicating with primary care physicians. I think that is something we’re very used to doing, and I think we do it well. I think we don’t shy away from difficult conversations with consultants. And I think that’s what makes being a hospitalist so amazing.”
 

Achieving wellness as a hospitalist

Another topic discussed during the roundtable was “comprehensive care for the hospitalist” and how they can achieve a sense of wellness for themselves. Gurpreet Dhaliwal, MD, clinician-educator and professor of medicine at the University of California, San Francisco, said long-term satisfaction in one’s career is less about compensation and more about autonomy, mastery, and purpose.

Dr. Gurpreet Dhaliwal

“Autonomy is shrinking a little bit in health care. But if we connect to our purpose – ‘what are we doing here and how do we connect?’ – it’s either learning about patients and their stories, being with a team of people that you work with, that really builds that purpose,” he said.

Regarding mastery, there’s “tremendous joy if you’re in an environment where people value your mastery, whether it is working in a team or communicating or diagnosing or doing a procedure. If you think of setting up the work environment and those things are in place, I think a lot of wellness can actually happen at work, even though another component, of course, is balancing your life outside of work,” Dr. Dhaliwal said.

This may seem out of reach during COVID-19, but wellness is still achievable during the pandemic, Dr. Martinez said. Her time is spent 75% as a researcher and 25% as a clinician, which is her ideal balance. “I enjoy doing my research, doing my own statistics and writing grants and just learning about this problem that I’ve developed an interest in,” she said. “I just think that’s an important piece for people to focus on as far as health care for the hospitalist, is that there’s no no-one-size-fits-all, that’s for sure.”

Dr. Anika Kumar

Dr. Kumar noted that her clinical time gives her energy for nonclinical work. “I love my clinical time. It’s one of my favorite things that I do,” she said. Although she is tired at the end of the week, “I feel like I am not only giving back to my patients and my team, but I’m also giving back to myself and reminding myself why it is I do what I do every day,” she said.

Wellness for Dr. Unaka meant remembering what drew her to medicine. “It was definitely the opportunity to build strong relationships with patients and families,” she said. While these encounters can sometimes be heavy and stay with a hospitalist, “the fact that we’re in it with them is something that gives a lot of us purpose. I think that when I reflect on all of those things, I’m so happy that I’m in the role that I am.”
 

Unique skills during COVID-19

Mark Shapiro, MD, hospitalist and host of the roundtable and the Explore the Space podcast, also asked the panelists what skills they unexpectedly leveraged during the pandemic. Communication – with colleagues and with the community they serve – was a universal answer among the panelists.

“I learned – really from seeing some of our senior leaders here do it so well – the importance of being visible, particularly at a time when people were not together and more isolated,” Dr. Unaka said. “I think being able to be visible when you can, in order to deliver really complicated or tough news or communicate about uncertainty, for instance. Being here for our residents – many of our interns moved here sight unseen. I think they needed to feel like they had some sense of normalcy and a sense of community. I really learned how important it was to be visible, and available, and how important the little things mattered.”

Dr. Martinez said that worrying about her patients with COVID-19 in the hospital and the uncertainty around the disease kept her up at night. “I think we always have a hard time leaving work at work and getting a good night’s sleep. I just could not let go of worrying about these patients and having terrible insomnia, trying to leave work at work and I couldn’t – even after they were discharged.”

Dr. Mark Shapiro

Dr. Shapiro said the skill he most needed to work on during the pandemic was his courage. “I remember the first time I took care of COVID patients. I was scared. I have no problems saying that out loud. That was a scary experience.”

The demeanor of the nurses on his unit, who had already seen patients with COVID-19, helped ground him during those moments and gave him the courage to move forward. “They’d already been doing it and they were the same. Same affect, same jokes, same everything,” he said. “That actually really helped, and I’ve leaned on that every time I’ve been back on our COVID service.”
 

Importance of mental health

The COVID-19 pandemic has also shined a light on the importance of mental health. “I think it is important to acknowledge that as hospitalists who have been out on the bleeding edge for a year, mental health is critically important, and we know that we face shortages in that space for the public at large and also for our profession,” Dr. Shapiro said.

When asked about what mental health and self-care looks like for her, Dr. Kumar referenced the need for exercise, meditation, and yoga. “My mental health was better knowing that the people closest to me – whether they be colleagues or friends or family – their mental health was also in a good place and they were also in a good place. And that helped to build me up,” she said.

Dr. Unaka called attention to the stigma around mental health, particularly among physicians, and the lack of resources to address the issue. “It’s a real problem,” she said. “I think it’s at a point where we as a profession need to advocate on behalf of each other and on behalf of our trainees. And honestly, I think we need to view mental health as just ‘health’ and stop separating it out in order for us to move to a place where people feel like they can access what they need without feeling shame about it.”
 

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Editor’s note: National Hospitalist Day occurs the first Thursday in March annually, and serves to celebrate the fastest growing specialty in modern medicine and hospitalists’ enduring contributions to the evolving health care landscape. On National Hospitalist Day in 2021, SHM convened a virtual roundtable with a diverse group of hospitalists to discuss skill set, wellness, and other key issues for hospitalists. To listen to the entire roundtable discussion, visit this Explore The Space podcast episode.

A hospitalist isn’t just a physician who happens to work in a hospital. They are medical professionals with a robust skill set that they use both inside and outside the hospital setting. But what skill sets do hospitalists need to become successful in their careers? And what skill sets does a “pluripotent” hospitalist need in their armamentarium?

Dr. Maylyn S. Martinez

These were the issues discussed by participants of a virtual roundtable discussion on National Hospitalist Day – March 4, 2021 – as part of a joint effort of the Society of Hospital Medicine and the Explore the Space podcast.

Maylyn S. Martinez, MD, clinician-researcher and clinical associate at the University of Chicago, sees her hospitalist and research skill sets as two “buckets” of skills she can sort through, with diagnostic, knowledge-based care coordination, and interpersonal skills as lanes where she can focus and improve. “I’m always trying to work in, and sharpen, and find ways to get better at something in each of those every day,” she said.

For Anika Kumar, MD, FHM, pediatric editor of the Hospitalist and clinical assistant professor of pediatrics at the Cleveland Clinic Lerner College of Medicine, much of her work is focused on problem solving. “I approach that as: ‘How do I come up with my differential diagnosis, and how do I diagnose the patient?’ I think that the lanes are a little bit different, but there is some overlap.”

Dr. Ndidi Unaka

Adaptability is another important part of the skill set for the hospitalist, Ndidi Unaka, MD, MEd, associate professor in the division of hospital medicine at Cincinnati Children’s Hospital Medical Center, said during the discussion. “I think we all really value teamwork, and we take on the role of being the coordinator and making sure things are getting done in a seamless and thoughtful manner. Communicating with families, communicating with our research team, communicating with primary care physicians. I think that is something we’re very used to doing, and I think we do it well. I think we don’t shy away from difficult conversations with consultants. And I think that’s what makes being a hospitalist so amazing.”
 

Achieving wellness as a hospitalist

Another topic discussed during the roundtable was “comprehensive care for the hospitalist” and how they can achieve a sense of wellness for themselves. Gurpreet Dhaliwal, MD, clinician-educator and professor of medicine at the University of California, San Francisco, said long-term satisfaction in one’s career is less about compensation and more about autonomy, mastery, and purpose.

Dr. Gurpreet Dhaliwal

“Autonomy is shrinking a little bit in health care. But if we connect to our purpose – ‘what are we doing here and how do we connect?’ – it’s either learning about patients and their stories, being with a team of people that you work with, that really builds that purpose,” he said.

Regarding mastery, there’s “tremendous joy if you’re in an environment where people value your mastery, whether it is working in a team or communicating or diagnosing or doing a procedure. If you think of setting up the work environment and those things are in place, I think a lot of wellness can actually happen at work, even though another component, of course, is balancing your life outside of work,” Dr. Dhaliwal said.

This may seem out of reach during COVID-19, but wellness is still achievable during the pandemic, Dr. Martinez said. Her time is spent 75% as a researcher and 25% as a clinician, which is her ideal balance. “I enjoy doing my research, doing my own statistics and writing grants and just learning about this problem that I’ve developed an interest in,” she said. “I just think that’s an important piece for people to focus on as far as health care for the hospitalist, is that there’s no no-one-size-fits-all, that’s for sure.”

Dr. Anika Kumar

Dr. Kumar noted that her clinical time gives her energy for nonclinical work. “I love my clinical time. It’s one of my favorite things that I do,” she said. Although she is tired at the end of the week, “I feel like I am not only giving back to my patients and my team, but I’m also giving back to myself and reminding myself why it is I do what I do every day,” she said.

Wellness for Dr. Unaka meant remembering what drew her to medicine. “It was definitely the opportunity to build strong relationships with patients and families,” she said. While these encounters can sometimes be heavy and stay with a hospitalist, “the fact that we’re in it with them is something that gives a lot of us purpose. I think that when I reflect on all of those things, I’m so happy that I’m in the role that I am.”
 

Unique skills during COVID-19

Mark Shapiro, MD, hospitalist and host of the roundtable and the Explore the Space podcast, also asked the panelists what skills they unexpectedly leveraged during the pandemic. Communication – with colleagues and with the community they serve – was a universal answer among the panelists.

“I learned – really from seeing some of our senior leaders here do it so well – the importance of being visible, particularly at a time when people were not together and more isolated,” Dr. Unaka said. “I think being able to be visible when you can, in order to deliver really complicated or tough news or communicate about uncertainty, for instance. Being here for our residents – many of our interns moved here sight unseen. I think they needed to feel like they had some sense of normalcy and a sense of community. I really learned how important it was to be visible, and available, and how important the little things mattered.”

Dr. Martinez said that worrying about her patients with COVID-19 in the hospital and the uncertainty around the disease kept her up at night. “I think we always have a hard time leaving work at work and getting a good night’s sleep. I just could not let go of worrying about these patients and having terrible insomnia, trying to leave work at work and I couldn’t – even after they were discharged.”

Dr. Mark Shapiro

Dr. Shapiro said the skill he most needed to work on during the pandemic was his courage. “I remember the first time I took care of COVID patients. I was scared. I have no problems saying that out loud. That was a scary experience.”

The demeanor of the nurses on his unit, who had already seen patients with COVID-19, helped ground him during those moments and gave him the courage to move forward. “They’d already been doing it and they were the same. Same affect, same jokes, same everything,” he said. “That actually really helped, and I’ve leaned on that every time I’ve been back on our COVID service.”
 

Importance of mental health

The COVID-19 pandemic has also shined a light on the importance of mental health. “I think it is important to acknowledge that as hospitalists who have been out on the bleeding edge for a year, mental health is critically important, and we know that we face shortages in that space for the public at large and also for our profession,” Dr. Shapiro said.

When asked about what mental health and self-care looks like for her, Dr. Kumar referenced the need for exercise, meditation, and yoga. “My mental health was better knowing that the people closest to me – whether they be colleagues or friends or family – their mental health was also in a good place and they were also in a good place. And that helped to build me up,” she said.

Dr. Unaka called attention to the stigma around mental health, particularly among physicians, and the lack of resources to address the issue. “It’s a real problem,” she said. “I think it’s at a point where we as a profession need to advocate on behalf of each other and on behalf of our trainees. And honestly, I think we need to view mental health as just ‘health’ and stop separating it out in order for us to move to a place where people feel like they can access what they need without feeling shame about it.”
 

Editor’s note: National Hospitalist Day occurs the first Thursday in March annually, and serves to celebrate the fastest growing specialty in modern medicine and hospitalists’ enduring contributions to the evolving health care landscape. On National Hospitalist Day in 2021, SHM convened a virtual roundtable with a diverse group of hospitalists to discuss skill set, wellness, and other key issues for hospitalists. To listen to the entire roundtable discussion, visit this Explore The Space podcast episode.

A hospitalist isn’t just a physician who happens to work in a hospital. They are medical professionals with a robust skill set that they use both inside and outside the hospital setting. But what skill sets do hospitalists need to become successful in their careers? And what skill sets does a “pluripotent” hospitalist need in their armamentarium?

Dr. Maylyn S. Martinez

These were the issues discussed by participants of a virtual roundtable discussion on National Hospitalist Day – March 4, 2021 – as part of a joint effort of the Society of Hospital Medicine and the Explore the Space podcast.

Maylyn S. Martinez, MD, clinician-researcher and clinical associate at the University of Chicago, sees her hospitalist and research skill sets as two “buckets” of skills she can sort through, with diagnostic, knowledge-based care coordination, and interpersonal skills as lanes where she can focus and improve. “I’m always trying to work in, and sharpen, and find ways to get better at something in each of those every day,” she said.

For Anika Kumar, MD, FHM, pediatric editor of the Hospitalist and clinical assistant professor of pediatrics at the Cleveland Clinic Lerner College of Medicine, much of her work is focused on problem solving. “I approach that as: ‘How do I come up with my differential diagnosis, and how do I diagnose the patient?’ I think that the lanes are a little bit different, but there is some overlap.”

Dr. Ndidi Unaka

Adaptability is another important part of the skill set for the hospitalist, Ndidi Unaka, MD, MEd, associate professor in the division of hospital medicine at Cincinnati Children’s Hospital Medical Center, said during the discussion. “I think we all really value teamwork, and we take on the role of being the coordinator and making sure things are getting done in a seamless and thoughtful manner. Communicating with families, communicating with our research team, communicating with primary care physicians. I think that is something we’re very used to doing, and I think we do it well. I think we don’t shy away from difficult conversations with consultants. And I think that’s what makes being a hospitalist so amazing.”
 

Achieving wellness as a hospitalist

Another topic discussed during the roundtable was “comprehensive care for the hospitalist” and how they can achieve a sense of wellness for themselves. Gurpreet Dhaliwal, MD, clinician-educator and professor of medicine at the University of California, San Francisco, said long-term satisfaction in one’s career is less about compensation and more about autonomy, mastery, and purpose.

Dr. Gurpreet Dhaliwal

“Autonomy is shrinking a little bit in health care. But if we connect to our purpose – ‘what are we doing here and how do we connect?’ – it’s either learning about patients and their stories, being with a team of people that you work with, that really builds that purpose,” he said.

Regarding mastery, there’s “tremendous joy if you’re in an environment where people value your mastery, whether it is working in a team or communicating or diagnosing or doing a procedure. If you think of setting up the work environment and those things are in place, I think a lot of wellness can actually happen at work, even though another component, of course, is balancing your life outside of work,” Dr. Dhaliwal said.

This may seem out of reach during COVID-19, but wellness is still achievable during the pandemic, Dr. Martinez said. Her time is spent 75% as a researcher and 25% as a clinician, which is her ideal balance. “I enjoy doing my research, doing my own statistics and writing grants and just learning about this problem that I’ve developed an interest in,” she said. “I just think that’s an important piece for people to focus on as far as health care for the hospitalist, is that there’s no no-one-size-fits-all, that’s for sure.”

Dr. Anika Kumar

Dr. Kumar noted that her clinical time gives her energy for nonclinical work. “I love my clinical time. It’s one of my favorite things that I do,” she said. Although she is tired at the end of the week, “I feel like I am not only giving back to my patients and my team, but I’m also giving back to myself and reminding myself why it is I do what I do every day,” she said.

Wellness for Dr. Unaka meant remembering what drew her to medicine. “It was definitely the opportunity to build strong relationships with patients and families,” she said. While these encounters can sometimes be heavy and stay with a hospitalist, “the fact that we’re in it with them is something that gives a lot of us purpose. I think that when I reflect on all of those things, I’m so happy that I’m in the role that I am.”
 

Unique skills during COVID-19

Mark Shapiro, MD, hospitalist and host of the roundtable and the Explore the Space podcast, also asked the panelists what skills they unexpectedly leveraged during the pandemic. Communication – with colleagues and with the community they serve – was a universal answer among the panelists.

“I learned – really from seeing some of our senior leaders here do it so well – the importance of being visible, particularly at a time when people were not together and more isolated,” Dr. Unaka said. “I think being able to be visible when you can, in order to deliver really complicated or tough news or communicate about uncertainty, for instance. Being here for our residents – many of our interns moved here sight unseen. I think they needed to feel like they had some sense of normalcy and a sense of community. I really learned how important it was to be visible, and available, and how important the little things mattered.”

Dr. Martinez said that worrying about her patients with COVID-19 in the hospital and the uncertainty around the disease kept her up at night. “I think we always have a hard time leaving work at work and getting a good night’s sleep. I just could not let go of worrying about these patients and having terrible insomnia, trying to leave work at work and I couldn’t – even after they were discharged.”

Dr. Mark Shapiro

Dr. Shapiro said the skill he most needed to work on during the pandemic was his courage. “I remember the first time I took care of COVID patients. I was scared. I have no problems saying that out loud. That was a scary experience.”

The demeanor of the nurses on his unit, who had already seen patients with COVID-19, helped ground him during those moments and gave him the courage to move forward. “They’d already been doing it and they were the same. Same affect, same jokes, same everything,” he said. “That actually really helped, and I’ve leaned on that every time I’ve been back on our COVID service.”
 

Importance of mental health

The COVID-19 pandemic has also shined a light on the importance of mental health. “I think it is important to acknowledge that as hospitalists who have been out on the bleeding edge for a year, mental health is critically important, and we know that we face shortages in that space for the public at large and also for our profession,” Dr. Shapiro said.

When asked about what mental health and self-care looks like for her, Dr. Kumar referenced the need for exercise, meditation, and yoga. “My mental health was better knowing that the people closest to me – whether they be colleagues or friends or family – their mental health was also in a good place and they were also in a good place. And that helped to build me up,” she said.

Dr. Unaka called attention to the stigma around mental health, particularly among physicians, and the lack of resources to address the issue. “It’s a real problem,” she said. “I think it’s at a point where we as a profession need to advocate on behalf of each other and on behalf of our trainees. And honestly, I think we need to view mental health as just ‘health’ and stop separating it out in order for us to move to a place where people feel like they can access what they need without feeling shame about it.”
 

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Hospitalist movers and shakers – March 2021

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Mon, 03/15/2021 - 14:24

Vivek H. Murthy, MD, was named by President Joe Biden as his selection for Surgeon General of the United States. Dr. Murthy filled the same role from 2014-17 during President Barack Obama’s administration.

Dr. Vivek H. Murthy

Dr. Murthy was a hospitalist and an instructor at Brigham and Women’s Hospital at Harvard Medical School prior to becoming surgeon general the first time. He also is the founder of Doctors for America.
 

David Tupponce, MD, recently was named the new president of Allegheny Health Network’s Grove City (Pa.) Medical Center. He takes over for interim president Allan Klapper, MD, who filled the position since August 2020.

Dr. Tupponce comes to Grove City Medical Center after a successful tenure as president of Central Maine Medical Center (Lewiston, Maine), where he grew its physician group and fine-tuned the hospital quality program. Prior to that, he was chief executive officer at Tenet Healthcare’s Abrazo Scottsdale (Ariz.) Campus and CEO at Paradise Valley Hospital (Phoenix, Ariz.).

Dr. David Tupponce


Dr. Tupponce is familiar with western Pennsylvania, having earned a master’s degree in medical management from Carnegie Mellon University in Pittsburgh. He also was chief resident at the University of Pittsburgh Medical Center.

Malcolm Mar Fan, MD, has been elevated to medical director of the Hospitalist Group at Evangelical Community Hospital (Lewisburg, Pa.). In the newly established position, Dr. Mar Fan will oversee all operations for the facility’s hospitalist program.

Dr. Mar Fan has been a hospitalist at Evangelical since 2014 after completing his internist residency at Albert Einstein Medical Center in Philadelphia. He has played a major role on Evangelical’s Peri-operative Glucose Management Committee and its Informatics Committee for Impatient and Outpatient Electronic Health Records.
 

Lyon County (Kansas) recently announced that Ladun Oyenuga, MD, has been appointed as public health officer for the county. She began her tenure on January 1.

Dr. Oyenuga is a hospitalist at Newman Regional Health (Emporia, Kan.). She is a native of Nigeria and did her residency at Harlem (N.Y.) Hospital Center. She has been with Newman since 2017.
 

Cherese Mari Laulhere BirthCare Center (Long Beach, Calif.) recently announced the addition of an OB hospitalist program at Miller Children’s & Women’s Hospital. OB hospitalists, or laborists, care for women with obstetrical issues while in the hospital.

At Cherese Mari Laulhere, OB hospitalists will be on hand 24 hours a day to assist patients’ OB/GYNs or to fill in if the personal physician cannot get to the hospital quickly.
 

Hospitalists at Nationwide Children’s (Columbus, Ohio) are now providing care for children who are hospitalized at Adena Regional Medical Center (Chillicothe, Ohio).

It is an expansion of an ongoing partnership between the two hospitals. Adena and Nationwide Children’s have been working together in helping to care for children in the south central and southern Ohio region since 2011. Nationwide Children’s hospitalists will round in special care and the well-baby nursery at Adena, as well as provide education programs for Adena providers and staff.
 

MultiCare Health System (Tacoma, Wash.) has announced that it will expand its hospitalist program partnership with Sound Physicians, also based in Tacoma, to create a region-wide, cohesive group of providers. The goal is to help ensure efficient management of inpatient populations as a region instead of at the individual hospital level, and will allow MultiCare to implement standard tools, processes and regionwide best practices.

The hospitalist programs at Tacoma General Hospital, Allenmore Hospital and Covington Medical Center will transition to Sound Physicians on April 5, 2021. Sound hospitalists are already working at three other MultiCare facilities – Tacoma General Hospital, Allenmore Hospital, and Covington Medical Center.

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Vivek H. Murthy, MD, was named by President Joe Biden as his selection for Surgeon General of the United States. Dr. Murthy filled the same role from 2014-17 during President Barack Obama’s administration.

Dr. Vivek H. Murthy

Dr. Murthy was a hospitalist and an instructor at Brigham and Women’s Hospital at Harvard Medical School prior to becoming surgeon general the first time. He also is the founder of Doctors for America.
 

David Tupponce, MD, recently was named the new president of Allegheny Health Network’s Grove City (Pa.) Medical Center. He takes over for interim president Allan Klapper, MD, who filled the position since August 2020.

Dr. Tupponce comes to Grove City Medical Center after a successful tenure as president of Central Maine Medical Center (Lewiston, Maine), where he grew its physician group and fine-tuned the hospital quality program. Prior to that, he was chief executive officer at Tenet Healthcare’s Abrazo Scottsdale (Ariz.) Campus and CEO at Paradise Valley Hospital (Phoenix, Ariz.).

Dr. David Tupponce


Dr. Tupponce is familiar with western Pennsylvania, having earned a master’s degree in medical management from Carnegie Mellon University in Pittsburgh. He also was chief resident at the University of Pittsburgh Medical Center.

Malcolm Mar Fan, MD, has been elevated to medical director of the Hospitalist Group at Evangelical Community Hospital (Lewisburg, Pa.). In the newly established position, Dr. Mar Fan will oversee all operations for the facility’s hospitalist program.

Dr. Mar Fan has been a hospitalist at Evangelical since 2014 after completing his internist residency at Albert Einstein Medical Center in Philadelphia. He has played a major role on Evangelical’s Peri-operative Glucose Management Committee and its Informatics Committee for Impatient and Outpatient Electronic Health Records.
 

Lyon County (Kansas) recently announced that Ladun Oyenuga, MD, has been appointed as public health officer for the county. She began her tenure on January 1.

Dr. Oyenuga is a hospitalist at Newman Regional Health (Emporia, Kan.). She is a native of Nigeria and did her residency at Harlem (N.Y.) Hospital Center. She has been with Newman since 2017.
 

Cherese Mari Laulhere BirthCare Center (Long Beach, Calif.) recently announced the addition of an OB hospitalist program at Miller Children’s & Women’s Hospital. OB hospitalists, or laborists, care for women with obstetrical issues while in the hospital.

At Cherese Mari Laulhere, OB hospitalists will be on hand 24 hours a day to assist patients’ OB/GYNs or to fill in if the personal physician cannot get to the hospital quickly.
 

Hospitalists at Nationwide Children’s (Columbus, Ohio) are now providing care for children who are hospitalized at Adena Regional Medical Center (Chillicothe, Ohio).

It is an expansion of an ongoing partnership between the two hospitals. Adena and Nationwide Children’s have been working together in helping to care for children in the south central and southern Ohio region since 2011. Nationwide Children’s hospitalists will round in special care and the well-baby nursery at Adena, as well as provide education programs for Adena providers and staff.
 

MultiCare Health System (Tacoma, Wash.) has announced that it will expand its hospitalist program partnership with Sound Physicians, also based in Tacoma, to create a region-wide, cohesive group of providers. The goal is to help ensure efficient management of inpatient populations as a region instead of at the individual hospital level, and will allow MultiCare to implement standard tools, processes and regionwide best practices.

The hospitalist programs at Tacoma General Hospital, Allenmore Hospital and Covington Medical Center will transition to Sound Physicians on April 5, 2021. Sound hospitalists are already working at three other MultiCare facilities – Tacoma General Hospital, Allenmore Hospital, and Covington Medical Center.

Vivek H. Murthy, MD, was named by President Joe Biden as his selection for Surgeon General of the United States. Dr. Murthy filled the same role from 2014-17 during President Barack Obama’s administration.

Dr. Vivek H. Murthy

Dr. Murthy was a hospitalist and an instructor at Brigham and Women’s Hospital at Harvard Medical School prior to becoming surgeon general the first time. He also is the founder of Doctors for America.
 

David Tupponce, MD, recently was named the new president of Allegheny Health Network’s Grove City (Pa.) Medical Center. He takes over for interim president Allan Klapper, MD, who filled the position since August 2020.

Dr. Tupponce comes to Grove City Medical Center after a successful tenure as president of Central Maine Medical Center (Lewiston, Maine), where he grew its physician group and fine-tuned the hospital quality program. Prior to that, he was chief executive officer at Tenet Healthcare’s Abrazo Scottsdale (Ariz.) Campus and CEO at Paradise Valley Hospital (Phoenix, Ariz.).

Dr. David Tupponce


Dr. Tupponce is familiar with western Pennsylvania, having earned a master’s degree in medical management from Carnegie Mellon University in Pittsburgh. He also was chief resident at the University of Pittsburgh Medical Center.

Malcolm Mar Fan, MD, has been elevated to medical director of the Hospitalist Group at Evangelical Community Hospital (Lewisburg, Pa.). In the newly established position, Dr. Mar Fan will oversee all operations for the facility’s hospitalist program.

Dr. Mar Fan has been a hospitalist at Evangelical since 2014 after completing his internist residency at Albert Einstein Medical Center in Philadelphia. He has played a major role on Evangelical’s Peri-operative Glucose Management Committee and its Informatics Committee for Impatient and Outpatient Electronic Health Records.
 

Lyon County (Kansas) recently announced that Ladun Oyenuga, MD, has been appointed as public health officer for the county. She began her tenure on January 1.

Dr. Oyenuga is a hospitalist at Newman Regional Health (Emporia, Kan.). She is a native of Nigeria and did her residency at Harlem (N.Y.) Hospital Center. She has been with Newman since 2017.
 

Cherese Mari Laulhere BirthCare Center (Long Beach, Calif.) recently announced the addition of an OB hospitalist program at Miller Children’s & Women’s Hospital. OB hospitalists, or laborists, care for women with obstetrical issues while in the hospital.

At Cherese Mari Laulhere, OB hospitalists will be on hand 24 hours a day to assist patients’ OB/GYNs or to fill in if the personal physician cannot get to the hospital quickly.
 

Hospitalists at Nationwide Children’s (Columbus, Ohio) are now providing care for children who are hospitalized at Adena Regional Medical Center (Chillicothe, Ohio).

It is an expansion of an ongoing partnership between the two hospitals. Adena and Nationwide Children’s have been working together in helping to care for children in the south central and southern Ohio region since 2011. Nationwide Children’s hospitalists will round in special care and the well-baby nursery at Adena, as well as provide education programs for Adena providers and staff.
 

MultiCare Health System (Tacoma, Wash.) has announced that it will expand its hospitalist program partnership with Sound Physicians, also based in Tacoma, to create a region-wide, cohesive group of providers. The goal is to help ensure efficient management of inpatient populations as a region instead of at the individual hospital level, and will allow MultiCare to implement standard tools, processes and regionwide best practices.

The hospitalist programs at Tacoma General Hospital, Allenmore Hospital and Covington Medical Center will transition to Sound Physicians on April 5, 2021. Sound hospitalists are already working at three other MultiCare facilities – Tacoma General Hospital, Allenmore Hospital, and Covington Medical Center.

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SHM Fellowship Class of 2021

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Fri, 03/12/2021 - 10:35

 

The Society of Hospital Medicine has announced its 2021 class of Master Fellows, Senior Fellows, and Fellows in Hospital Medicine.

All Fellowship classes are listed in alphabetical order.
 

Master Fellows Class of 2021

Nasim Afsar, MD, MBA, MHM

Shaun D. Frost, MD, MHM

Jeffrey L. Schnipper, MD, MPH, MHM

Senior Fellows Class of 2021

Akindele Adaramola, MD, MPH, SFHM

Ramesh Adhikari, MD, SFHM

Pankaj Agrawal, MD, SFHM

Robert L. Anderson, MD, SFHM

Glenda B. Atilano, MD, SFHM

Bi A. Awosika, MD, FACP, SFHM

David N. Aymond, MD, SFHM

Paula Bailey, MD, SFHM

Amit B. Bansal, MD, MBA, SFHM

Jamie K. Bartley, DO, FACP, SFHM

Stephen J. Behnke, MD, SFHM

Christina A. Beyer, MD, SFHM

Vinil K. Bhuma, MD, SFHM

John P. Biebelhausen, MD, MBA, SFHM

Matthew T. Calestino, MD, FACP, SFHM

Domingo Caparas Jr., MD, FAAFP, SFHM

Darren Caudill, DO, FACP, SFHM

Julie M. Cernanec, MD, FAAP, SFHM

Will Cushing, PA-C, SFHM

Douglas A. Dodds II, MD, FAAP, SFHM

Coley B. Duncan, MD, CPE, MMM, SFHM

Noah Finkel, MD, SFHM

Justin Glasgow, MD, PhD, SFHM

Taylor Goot, MD, SFHM

Craig G. Gunderson, MD, SFHM

Alan Hall, MD, SFHM

Vivian Hamlett, MD, SFHM

Kathrin Harrington, MD, SFHM

Hossan Hassan, MD, SFHM

Anand D. Hongalgi, MD, FACP, SFHM

Akshata Hopkins, MD, FAAP, SFHM

Neelima Kamineni, MD, SFHM

Sudheer R. Kantharajpur, MBBS, MD, MHA, SFHM

Prakash Karki, MD, SFHM

Susrutha Kotwal, MD, SFHM

Ethan Kuperman, MD, SFHM

Rumman A. Langah, MD, FACP, SFHM

Sean LaVine, MD, FACP, SFHM

Don S. Lee, MD, FACP, SFHM

Charmaine A. Lewis, MD, MPH, CLHM, SFHM

Rishi Likhi, MD, SFHM

Lenny Lopez, MD, MPH, SFHM

Anthony Macchiavelli, MD, SFHM

Brian McGillen, MD, FACP, SFHM

Parth H. Mehta, MBBS, MD, MPH, SFHM

Anuj Mehta, MBBS, MD, MBA, SFHM

Prem Nair, MD, FACP, SFHM

Don J. Neer, MD, FACP, SFHM

Shyam Odeti, MD, FAAFP, SFHM

Amy T. O’Linn, DO, SFHM

Mihir Patel, MD, FACP, MBA, MPH, SFHM

Kimberly S. Pedram, MD, FACP, SFHM

Thomas Pineo, DO, SFHM

Mauricio Pinto, MD, SFHM

Lakmali C. Ranathunga, MBBS, SFHM

Matthew Reuter, MD, SFHM

Erik P. Rufa, MD, SFHM

Dipali Ruby Sahoo, DO, MBA, SFHM

Chady Sarraf, MD, SFHM

Suchita S. Sata, MD, SFHM

Klint Schwenk, MD, FAAP, MBA, SFHM

Aaron M. Sebach, CRNP, DNP, MBA, PhD, SFHM

Kevin Sowti, MD, MBA, SFHM

Joseph G. Surber, DO, FAAFP, SFHM

Bright Thilagar, MD, SFHM

Thomas S. Trawick Jr., MD, SFHM

Rehman Usmani, MD, SFHM

Arash Velayati, MD, SFHM

Jose A. Ventura, MD, FAAFP, SFHM

Andre Wajner, MD, PhD, SFHM

Phillip D. Warr, MD, SFHM

Virginia E. Watson, MD, SFHM

Kristin R. Wise, MD, SFHM

Elham A. Yousef, MD, FACP, MBA, MSc, SFHM

Fellows Class of 2021

Elizabeth M. Aarons, MD, FHM

Suhail A. Abbasi, MD, FACP, FHM

Waqas Adeel, MD, FHM

Rajender K. Agarwal, MD, MBA, MPH, FHM

Khaalisha Ajala, MD, MBA, FHM

Faraz S. Alam, MD, FHM

Amee Amin, MD, FHM

Muhammad W. Amir, MD, FACP, FHM

Saba Asad, MD, FHM

Logan Atkins, MD, FHM

Navneet Attri, MD, FHM

Jennifer Barnett, PA, FHM

Karyn Baum, MD, FHM

Prabhjot Bedi, MD, FHM

Nicolle R. Benz, DO, FHM

Ricky Bhimani, MD, FHM

Elizabeth Blankenship, PA-C, FHM

Rahul Borsadia, MD, FHM

Kalpana Chalasani, MD, FHM

Rani Chikkanna, MD, FHM

Venu Chippa, MBBS, MD, FHM

Lisa M. Coontz, FNP, FHM

Christie Crawford, MD, FHM

Rene Daniel, MD, PhD, FHM

Elda Dede, FHM

Radha Denmark, CNP, FHM

Alvine N. Nwehla Desamours, PA-C, FHM

Satyendra Dhar, MD, FHM

Manuel Jose Diaz, MD, FHM

Tiffany Egbe, MD, FHM

Chinwe Egbo, MD, FHM

Mohammad A. Farkhondehpour, MD, FACP, FHM

Shaheen Faruque, MBBS, FHM

Chris W. Fellin, MD, FACP, FHM

Juan Carlos Fuentes-Rosales, MD, FACP, MPH, FHM

Evelyn W. Gathecha, MD, FHM

Benjamin P. Geisler, MD, FACP, MPH, FHM

Matthew George, MD, FHM

Sonia George, DO, FHM

Mirna Giordano, MD, FHM

Rebecca Gomez, MD, FHM

David Gonzales, MD, FHM

Maria A. Guevara Hernandez, MD, FACP, FHM

Shubhra Gupta, MBBS, FHM

Rohini Harvey, MD, FHM

Allison Heinen, DO, FHM

Hollie L. Hurner, PA-C, FHM

Doug Hutcheon, MD, FHM

Varalakshmi Janamanchi, MD, FHM

Brian Keegan, MD, FACP, FHM

Qasim Khalil, MD, FHM

Irfana Khan, MD, FHM

Muhammad O. Khan, MD, FAAFP, MBA, FHM

Smita Kohli, MD, FHM

Julie Kolinski, MD, FAAP, FHM

Ewa Kontny, MD, FHM

Sungmi Lian, MD, FHM

Brian Lichtenstein, MD, FHM

Fernando Madero Gorostieta, MD, FHM

Vipul Mahajan, MD, FACP, FHM

Neetu Mahendraker, MD, FHM

Victoria McCurry, MD, FHM

Bridget McGrath, PA-C, FHM

Evan Meadors, MD, FHM

 

 

Kapil Mehta, MD, FACP, MBA, FHM

Waseem Mohamed, MD, FHM

Ernest Murray, MD, FHM

Murali K. Nagubandi, MD, FHM

Jessica Nave Allen, MD, FHM

Peter Nwafor, MD, FACP, FHM

Ike Anthony Nwaobi, MBBS, MBA, FHM

Olugbenga B. Ojo, MD, FACP, MBA, FHM

Jacqueline Okere, MD, FHM

Ifedolapo S. Olanrewaju, MD, MBchB, FHM

Mobolaji Olulade, MD, FHM

Elizabeth H. Papetti, MBA, FHM

Love Patel, MBBS, FHM

Kamakshya P. Patra, MD, MMM, FHM

Charles Pizanis, MD, FHM

Rajat Prakash, MD, FHM

Chris Pribula, MD, FHM

Michael Puchaev, MD, FHM

Ryan Punsalan, MD, FHM

Bhavya Rajanna, MD, FHM

Miguel A. Ramirez, MD, FHM

Raymund Ramirez, MD, FHM

Sandeep Randhawa, MBBS, FHM

Rohit Rattan, MD, FHM

Denisha Powell Rawlings, MD, FHM

Praveen K. Reddy, MD, MPH, FHM

Michael Ree, DO, MPH, FHM

Patrick Rendon, MD, FHM

David J. Rizk, MD, FAAFP, MBA, FHM

Michael Roberts, MD, FHM

Edwin Rosas, MD, FHM

Devjit Roy, MD, FHM

Sabyasachi Roy, MD, FHM

Paul Sandroni, CMPE, MSM, FHM

Vijairam Selvaraj, MD, MPH, FHM

Megha Shah, MD, MMM, FHM

Edie Shen, MD, FHM

Gurpinder Singh, MD, FACP, FHM

Vishwas A. Singh, MD, FHM

Karen Slatkovsky, MD, FHM

Sean M. Snyder, MD, FHM

Jaclyn Spiegel, MD, FHM

Dale Stapler Jr., MD, FHM

Christina E. Stovall, MD, FHM

Daniel Suders, DO, FHM

Clayton Swalstad, CMPE, MSM, FHM

Harshil Swaminarayan, MD, FHM

Keniesha Thompson, MD, FHM

Tet Toe, MD, FACP, FHM

Christine Tsai, MD, FHM

Ajay Vaikuntam, MD, FHM

Valerie Vaughn, MD, FHM

Jane N. Wainaina, FACP, MBchB, FHM

Neshahthari Wijeyakuhan, MD, FACP, FHM

Chia-Shing Yang, MD, FHM

Jennifer Zagursky, MD, FHM

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The Society of Hospital Medicine has announced its 2021 class of Master Fellows, Senior Fellows, and Fellows in Hospital Medicine.

All Fellowship classes are listed in alphabetical order.
 

Master Fellows Class of 2021

Nasim Afsar, MD, MBA, MHM

Shaun D. Frost, MD, MHM

Jeffrey L. Schnipper, MD, MPH, MHM

Senior Fellows Class of 2021

Akindele Adaramola, MD, MPH, SFHM

Ramesh Adhikari, MD, SFHM

Pankaj Agrawal, MD, SFHM

Robert L. Anderson, MD, SFHM

Glenda B. Atilano, MD, SFHM

Bi A. Awosika, MD, FACP, SFHM

David N. Aymond, MD, SFHM

Paula Bailey, MD, SFHM

Amit B. Bansal, MD, MBA, SFHM

Jamie K. Bartley, DO, FACP, SFHM

Stephen J. Behnke, MD, SFHM

Christina A. Beyer, MD, SFHM

Vinil K. Bhuma, MD, SFHM

John P. Biebelhausen, MD, MBA, SFHM

Matthew T. Calestino, MD, FACP, SFHM

Domingo Caparas Jr., MD, FAAFP, SFHM

Darren Caudill, DO, FACP, SFHM

Julie M. Cernanec, MD, FAAP, SFHM

Will Cushing, PA-C, SFHM

Douglas A. Dodds II, MD, FAAP, SFHM

Coley B. Duncan, MD, CPE, MMM, SFHM

Noah Finkel, MD, SFHM

Justin Glasgow, MD, PhD, SFHM

Taylor Goot, MD, SFHM

Craig G. Gunderson, MD, SFHM

Alan Hall, MD, SFHM

Vivian Hamlett, MD, SFHM

Kathrin Harrington, MD, SFHM

Hossan Hassan, MD, SFHM

Anand D. Hongalgi, MD, FACP, SFHM

Akshata Hopkins, MD, FAAP, SFHM

Neelima Kamineni, MD, SFHM

Sudheer R. Kantharajpur, MBBS, MD, MHA, SFHM

Prakash Karki, MD, SFHM

Susrutha Kotwal, MD, SFHM

Ethan Kuperman, MD, SFHM

Rumman A. Langah, MD, FACP, SFHM

Sean LaVine, MD, FACP, SFHM

Don S. Lee, MD, FACP, SFHM

Charmaine A. Lewis, MD, MPH, CLHM, SFHM

Rishi Likhi, MD, SFHM

Lenny Lopez, MD, MPH, SFHM

Anthony Macchiavelli, MD, SFHM

Brian McGillen, MD, FACP, SFHM

Parth H. Mehta, MBBS, MD, MPH, SFHM

Anuj Mehta, MBBS, MD, MBA, SFHM

Prem Nair, MD, FACP, SFHM

Don J. Neer, MD, FACP, SFHM

Shyam Odeti, MD, FAAFP, SFHM

Amy T. O’Linn, DO, SFHM

Mihir Patel, MD, FACP, MBA, MPH, SFHM

Kimberly S. Pedram, MD, FACP, SFHM

Thomas Pineo, DO, SFHM

Mauricio Pinto, MD, SFHM

Lakmali C. Ranathunga, MBBS, SFHM

Matthew Reuter, MD, SFHM

Erik P. Rufa, MD, SFHM

Dipali Ruby Sahoo, DO, MBA, SFHM

Chady Sarraf, MD, SFHM

Suchita S. Sata, MD, SFHM

Klint Schwenk, MD, FAAP, MBA, SFHM

Aaron M. Sebach, CRNP, DNP, MBA, PhD, SFHM

Kevin Sowti, MD, MBA, SFHM

Joseph G. Surber, DO, FAAFP, SFHM

Bright Thilagar, MD, SFHM

Thomas S. Trawick Jr., MD, SFHM

Rehman Usmani, MD, SFHM

Arash Velayati, MD, SFHM

Jose A. Ventura, MD, FAAFP, SFHM

Andre Wajner, MD, PhD, SFHM

Phillip D. Warr, MD, SFHM

Virginia E. Watson, MD, SFHM

Kristin R. Wise, MD, SFHM

Elham A. Yousef, MD, FACP, MBA, MSc, SFHM

Fellows Class of 2021

Elizabeth M. Aarons, MD, FHM

Suhail A. Abbasi, MD, FACP, FHM

Waqas Adeel, MD, FHM

Rajender K. Agarwal, MD, MBA, MPH, FHM

Khaalisha Ajala, MD, MBA, FHM

Faraz S. Alam, MD, FHM

Amee Amin, MD, FHM

Muhammad W. Amir, MD, FACP, FHM

Saba Asad, MD, FHM

Logan Atkins, MD, FHM

Navneet Attri, MD, FHM

Jennifer Barnett, PA, FHM

Karyn Baum, MD, FHM

Prabhjot Bedi, MD, FHM

Nicolle R. Benz, DO, FHM

Ricky Bhimani, MD, FHM

Elizabeth Blankenship, PA-C, FHM

Rahul Borsadia, MD, FHM

Kalpana Chalasani, MD, FHM

Rani Chikkanna, MD, FHM

Venu Chippa, MBBS, MD, FHM

Lisa M. Coontz, FNP, FHM

Christie Crawford, MD, FHM

Rene Daniel, MD, PhD, FHM

Elda Dede, FHM

Radha Denmark, CNP, FHM

Alvine N. Nwehla Desamours, PA-C, FHM

Satyendra Dhar, MD, FHM

Manuel Jose Diaz, MD, FHM

Tiffany Egbe, MD, FHM

Chinwe Egbo, MD, FHM

Mohammad A. Farkhondehpour, MD, FACP, FHM

Shaheen Faruque, MBBS, FHM

Chris W. Fellin, MD, FACP, FHM

Juan Carlos Fuentes-Rosales, MD, FACP, MPH, FHM

Evelyn W. Gathecha, MD, FHM

Benjamin P. Geisler, MD, FACP, MPH, FHM

Matthew George, MD, FHM

Sonia George, DO, FHM

Mirna Giordano, MD, FHM

Rebecca Gomez, MD, FHM

David Gonzales, MD, FHM

Maria A. Guevara Hernandez, MD, FACP, FHM

Shubhra Gupta, MBBS, FHM

Rohini Harvey, MD, FHM

Allison Heinen, DO, FHM

Hollie L. Hurner, PA-C, FHM

Doug Hutcheon, MD, FHM

Varalakshmi Janamanchi, MD, FHM

Brian Keegan, MD, FACP, FHM

Qasim Khalil, MD, FHM

Irfana Khan, MD, FHM

Muhammad O. Khan, MD, FAAFP, MBA, FHM

Smita Kohli, MD, FHM

Julie Kolinski, MD, FAAP, FHM

Ewa Kontny, MD, FHM

Sungmi Lian, MD, FHM

Brian Lichtenstein, MD, FHM

Fernando Madero Gorostieta, MD, FHM

Vipul Mahajan, MD, FACP, FHM

Neetu Mahendraker, MD, FHM

Victoria McCurry, MD, FHM

Bridget McGrath, PA-C, FHM

Evan Meadors, MD, FHM

 

 

Kapil Mehta, MD, FACP, MBA, FHM

Waseem Mohamed, MD, FHM

Ernest Murray, MD, FHM

Murali K. Nagubandi, MD, FHM

Jessica Nave Allen, MD, FHM

Peter Nwafor, MD, FACP, FHM

Ike Anthony Nwaobi, MBBS, MBA, FHM

Olugbenga B. Ojo, MD, FACP, MBA, FHM

Jacqueline Okere, MD, FHM

Ifedolapo S. Olanrewaju, MD, MBchB, FHM

Mobolaji Olulade, MD, FHM

Elizabeth H. Papetti, MBA, FHM

Love Patel, MBBS, FHM

Kamakshya P. Patra, MD, MMM, FHM

Charles Pizanis, MD, FHM

Rajat Prakash, MD, FHM

Chris Pribula, MD, FHM

Michael Puchaev, MD, FHM

Ryan Punsalan, MD, FHM

Bhavya Rajanna, MD, FHM

Miguel A. Ramirez, MD, FHM

Raymund Ramirez, MD, FHM

Sandeep Randhawa, MBBS, FHM

Rohit Rattan, MD, FHM

Denisha Powell Rawlings, MD, FHM

Praveen K. Reddy, MD, MPH, FHM

Michael Ree, DO, MPH, FHM

Patrick Rendon, MD, FHM

David J. Rizk, MD, FAAFP, MBA, FHM

Michael Roberts, MD, FHM

Edwin Rosas, MD, FHM

Devjit Roy, MD, FHM

Sabyasachi Roy, MD, FHM

Paul Sandroni, CMPE, MSM, FHM

Vijairam Selvaraj, MD, MPH, FHM

Megha Shah, MD, MMM, FHM

Edie Shen, MD, FHM

Gurpinder Singh, MD, FACP, FHM

Vishwas A. Singh, MD, FHM

Karen Slatkovsky, MD, FHM

Sean M. Snyder, MD, FHM

Jaclyn Spiegel, MD, FHM

Dale Stapler Jr., MD, FHM

Christina E. Stovall, MD, FHM

Daniel Suders, DO, FHM

Clayton Swalstad, CMPE, MSM, FHM

Harshil Swaminarayan, MD, FHM

Keniesha Thompson, MD, FHM

Tet Toe, MD, FACP, FHM

Christine Tsai, MD, FHM

Ajay Vaikuntam, MD, FHM

Valerie Vaughn, MD, FHM

Jane N. Wainaina, FACP, MBchB, FHM

Neshahthari Wijeyakuhan, MD, FACP, FHM

Chia-Shing Yang, MD, FHM

Jennifer Zagursky, MD, FHM

 

The Society of Hospital Medicine has announced its 2021 class of Master Fellows, Senior Fellows, and Fellows in Hospital Medicine.

All Fellowship classes are listed in alphabetical order.
 

Master Fellows Class of 2021

Nasim Afsar, MD, MBA, MHM

Shaun D. Frost, MD, MHM

Jeffrey L. Schnipper, MD, MPH, MHM

Senior Fellows Class of 2021

Akindele Adaramola, MD, MPH, SFHM

Ramesh Adhikari, MD, SFHM

Pankaj Agrawal, MD, SFHM

Robert L. Anderson, MD, SFHM

Glenda B. Atilano, MD, SFHM

Bi A. Awosika, MD, FACP, SFHM

David N. Aymond, MD, SFHM

Paula Bailey, MD, SFHM

Amit B. Bansal, MD, MBA, SFHM

Jamie K. Bartley, DO, FACP, SFHM

Stephen J. Behnke, MD, SFHM

Christina A. Beyer, MD, SFHM

Vinil K. Bhuma, MD, SFHM

John P. Biebelhausen, MD, MBA, SFHM

Matthew T. Calestino, MD, FACP, SFHM

Domingo Caparas Jr., MD, FAAFP, SFHM

Darren Caudill, DO, FACP, SFHM

Julie M. Cernanec, MD, FAAP, SFHM

Will Cushing, PA-C, SFHM

Douglas A. Dodds II, MD, FAAP, SFHM

Coley B. Duncan, MD, CPE, MMM, SFHM

Noah Finkel, MD, SFHM

Justin Glasgow, MD, PhD, SFHM

Taylor Goot, MD, SFHM

Craig G. Gunderson, MD, SFHM

Alan Hall, MD, SFHM

Vivian Hamlett, MD, SFHM

Kathrin Harrington, MD, SFHM

Hossan Hassan, MD, SFHM

Anand D. Hongalgi, MD, FACP, SFHM

Akshata Hopkins, MD, FAAP, SFHM

Neelima Kamineni, MD, SFHM

Sudheer R. Kantharajpur, MBBS, MD, MHA, SFHM

Prakash Karki, MD, SFHM

Susrutha Kotwal, MD, SFHM

Ethan Kuperman, MD, SFHM

Rumman A. Langah, MD, FACP, SFHM

Sean LaVine, MD, FACP, SFHM

Don S. Lee, MD, FACP, SFHM

Charmaine A. Lewis, MD, MPH, CLHM, SFHM

Rishi Likhi, MD, SFHM

Lenny Lopez, MD, MPH, SFHM

Anthony Macchiavelli, MD, SFHM

Brian McGillen, MD, FACP, SFHM

Parth H. Mehta, MBBS, MD, MPH, SFHM

Anuj Mehta, MBBS, MD, MBA, SFHM

Prem Nair, MD, FACP, SFHM

Don J. Neer, MD, FACP, SFHM

Shyam Odeti, MD, FAAFP, SFHM

Amy T. O’Linn, DO, SFHM

Mihir Patel, MD, FACP, MBA, MPH, SFHM

Kimberly S. Pedram, MD, FACP, SFHM

Thomas Pineo, DO, SFHM

Mauricio Pinto, MD, SFHM

Lakmali C. Ranathunga, MBBS, SFHM

Matthew Reuter, MD, SFHM

Erik P. Rufa, MD, SFHM

Dipali Ruby Sahoo, DO, MBA, SFHM

Chady Sarraf, MD, SFHM

Suchita S. Sata, MD, SFHM

Klint Schwenk, MD, FAAP, MBA, SFHM

Aaron M. Sebach, CRNP, DNP, MBA, PhD, SFHM

Kevin Sowti, MD, MBA, SFHM

Joseph G. Surber, DO, FAAFP, SFHM

Bright Thilagar, MD, SFHM

Thomas S. Trawick Jr., MD, SFHM

Rehman Usmani, MD, SFHM

Arash Velayati, MD, SFHM

Jose A. Ventura, MD, FAAFP, SFHM

Andre Wajner, MD, PhD, SFHM

Phillip D. Warr, MD, SFHM

Virginia E. Watson, MD, SFHM

Kristin R. Wise, MD, SFHM

Elham A. Yousef, MD, FACP, MBA, MSc, SFHM

Fellows Class of 2021

Elizabeth M. Aarons, MD, FHM

Suhail A. Abbasi, MD, FACP, FHM

Waqas Adeel, MD, FHM

Rajender K. Agarwal, MD, MBA, MPH, FHM

Khaalisha Ajala, MD, MBA, FHM

Faraz S. Alam, MD, FHM

Amee Amin, MD, FHM

Muhammad W. Amir, MD, FACP, FHM

Saba Asad, MD, FHM

Logan Atkins, MD, FHM

Navneet Attri, MD, FHM

Jennifer Barnett, PA, FHM

Karyn Baum, MD, FHM

Prabhjot Bedi, MD, FHM

Nicolle R. Benz, DO, FHM

Ricky Bhimani, MD, FHM

Elizabeth Blankenship, PA-C, FHM

Rahul Borsadia, MD, FHM

Kalpana Chalasani, MD, FHM

Rani Chikkanna, MD, FHM

Venu Chippa, MBBS, MD, FHM

Lisa M. Coontz, FNP, FHM

Christie Crawford, MD, FHM

Rene Daniel, MD, PhD, FHM

Elda Dede, FHM

Radha Denmark, CNP, FHM

Alvine N. Nwehla Desamours, PA-C, FHM

Satyendra Dhar, MD, FHM

Manuel Jose Diaz, MD, FHM

Tiffany Egbe, MD, FHM

Chinwe Egbo, MD, FHM

Mohammad A. Farkhondehpour, MD, FACP, FHM

Shaheen Faruque, MBBS, FHM

Chris W. Fellin, MD, FACP, FHM

Juan Carlos Fuentes-Rosales, MD, FACP, MPH, FHM

Evelyn W. Gathecha, MD, FHM

Benjamin P. Geisler, MD, FACP, MPH, FHM

Matthew George, MD, FHM

Sonia George, DO, FHM

Mirna Giordano, MD, FHM

Rebecca Gomez, MD, FHM

David Gonzales, MD, FHM

Maria A. Guevara Hernandez, MD, FACP, FHM

Shubhra Gupta, MBBS, FHM

Rohini Harvey, MD, FHM

Allison Heinen, DO, FHM

Hollie L. Hurner, PA-C, FHM

Doug Hutcheon, MD, FHM

Varalakshmi Janamanchi, MD, FHM

Brian Keegan, MD, FACP, FHM

Qasim Khalil, MD, FHM

Irfana Khan, MD, FHM

Muhammad O. Khan, MD, FAAFP, MBA, FHM

Smita Kohli, MD, FHM

Julie Kolinski, MD, FAAP, FHM

Ewa Kontny, MD, FHM

Sungmi Lian, MD, FHM

Brian Lichtenstein, MD, FHM

Fernando Madero Gorostieta, MD, FHM

Vipul Mahajan, MD, FACP, FHM

Neetu Mahendraker, MD, FHM

Victoria McCurry, MD, FHM

Bridget McGrath, PA-C, FHM

Evan Meadors, MD, FHM

 

 

Kapil Mehta, MD, FACP, MBA, FHM

Waseem Mohamed, MD, FHM

Ernest Murray, MD, FHM

Murali K. Nagubandi, MD, FHM

Jessica Nave Allen, MD, FHM

Peter Nwafor, MD, FACP, FHM

Ike Anthony Nwaobi, MBBS, MBA, FHM

Olugbenga B. Ojo, MD, FACP, MBA, FHM

Jacqueline Okere, MD, FHM

Ifedolapo S. Olanrewaju, MD, MBchB, FHM

Mobolaji Olulade, MD, FHM

Elizabeth H. Papetti, MBA, FHM

Love Patel, MBBS, FHM

Kamakshya P. Patra, MD, MMM, FHM

Charles Pizanis, MD, FHM

Rajat Prakash, MD, FHM

Chris Pribula, MD, FHM

Michael Puchaev, MD, FHM

Ryan Punsalan, MD, FHM

Bhavya Rajanna, MD, FHM

Miguel A. Ramirez, MD, FHM

Raymund Ramirez, MD, FHM

Sandeep Randhawa, MBBS, FHM

Rohit Rattan, MD, FHM

Denisha Powell Rawlings, MD, FHM

Praveen K. Reddy, MD, MPH, FHM

Michael Ree, DO, MPH, FHM

Patrick Rendon, MD, FHM

David J. Rizk, MD, FAAFP, MBA, FHM

Michael Roberts, MD, FHM

Edwin Rosas, MD, FHM

Devjit Roy, MD, FHM

Sabyasachi Roy, MD, FHM

Paul Sandroni, CMPE, MSM, FHM

Vijairam Selvaraj, MD, MPH, FHM

Megha Shah, MD, MMM, FHM

Edie Shen, MD, FHM

Gurpinder Singh, MD, FACP, FHM

Vishwas A. Singh, MD, FHM

Karen Slatkovsky, MD, FHM

Sean M. Snyder, MD, FHM

Jaclyn Spiegel, MD, FHM

Dale Stapler Jr., MD, FHM

Christina E. Stovall, MD, FHM

Daniel Suders, DO, FHM

Clayton Swalstad, CMPE, MSM, FHM

Harshil Swaminarayan, MD, FHM

Keniesha Thompson, MD, FHM

Tet Toe, MD, FACP, FHM

Christine Tsai, MD, FHM

Ajay Vaikuntam, MD, FHM

Valerie Vaughn, MD, FHM

Jane N. Wainaina, FACP, MBchB, FHM

Neshahthari Wijeyakuhan, MD, FACP, FHM

Chia-Shing Yang, MD, FHM

Jennifer Zagursky, MD, FHM

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Owning all aspects of patient care: Bridget McGrath, PA-C, FHM

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Thu, 08/12/2021 - 13:43

Editor’s note: This profile is part of the Society of Hospital Medicine’s celebration of National Hospitalist Day on March 4. National Hospitalist Day occurs the first Thursday in March annually and celebrates the fastest growing specialty in modern medicine and hospitalists’ enduring contributions to the evolving health care landscape.

Bridget McGrath, PA-C, FHM, is a physician assistant and director of the nurse practitioner/physician assistant service line for the section of hospital medicine at the University of Chicago. She is a cochair of SHM’s NP/PA Special Interest Group.

Where did you receive your PA education/training? Was your intention always to be a PA?

Bridget McGrath

I graduated from the PA program at Butler University, Indianapolis, in 2014. In college, whenever I shadowed a PA, I was always impressed that each one loved their job and said they would never change it. That universal passion for the PA profession really made an impression on me.

At what point in your PA education/training did you decide to practice hospital medicine? What about it appealed to you?

That occurred during my clinical rotation year at Butler. I had always thought I wanted to practice neonatology, but during my clinical rotation I really fell in love with adult medicine. I recall that during my clinical rotation, the preceptor said to me that the goal was not to have me understand every aspect of medicine, but to learn how to exist in a hospital setting. I was exposed to the breadth of hospital medicine practice and I fell in love with the complexity, the variety, and the environment itself.

I initially accepted a job as a med-peds hospitalist PA – which brought both of my passions together at that time – at Schneck Medical Center in Seymour, Ind. During that time, Schneck was a 100-bed rural community hospital which had recently been the recipient of the Malcolm Baldrige National Quality Award. It was there that I was able to practice with a phenomenal group of physicians, nurses, and social workers who really took me under their wing and taught me how to be a hospitalist PA. I practiced at Schneck for 3 years, and then moved to the University of Chicago in 2017.

I am now the director of NP/PA services for the section of hospital medicine, overseeing a group of seven on our NP/PA team, within a larger group of about 60 physicians.
 

What are your favorite areas of clinical practice?

Like many hospitalists, I enjoy the variety of medicine that hospitalists practice. One area that I find especially rewarding is my time in our transplant comanagement services. To be able to walk with patients on their transplant journey is very rewarding, and I am very appreciative of the mentoring I have received from some of my colleagues with a deeper understanding of transplant medicine.

In my administrative role, I have the privilege of helping to expand the professional education and training of my colleagues. I have a passion for medical education, and we have been working to develop interprofessional educational opportunities within our section. I have had time to think about the imprint of NPs and PAs in academic medicine, and how we can continue to meet the professional educational needs of our section while improving the care of our patients.
 

 

 

What are the most challenging aspects of practicing hospital medicine?

The volume of diagnoses that we are expected to manage on a daily basis can be challenging. This challenges you to continue learning. The complexity of discharge planning, particularly for patients in underserved communities, can also be challenging. You have to make sure your patients are ready mentally, physically and emotionally for discharge. As a hospitalist, you are continuously thinking about how to optimize patients to leave your care. For example, patients have different insurance situations, different access to care at home – you are always managing the medical needs of your patient in the context of these other issues.

How does a hospitalist PA work differently from a PA in other care settings?

We are meant to be generalists. We serve as the main provider in owning our patients’ care. A hospitalist PA serves as a cog in the wheel, with connections to specialists, consultants, nurses, social workers, pharmacists, etc., and we are tasked with synthesizing all aspects of patient care to ensure the best outcome.

What has your experience taught you about how NPs and PAs can best fit into hospital medicine groups?

Each hospital medicine group will know how to best integrate their NPs and PAs based on the skillsets of their NPs and PAs, and the needs of the section and the hospital. I personally feel that the best way to utilize NPs and PAs is to allow them to own all aspects of patient care and work at the highest scope of practice. By doing this you empower the NP or PA to continue to develop their skill set and set a precedent of collaboration and respect for interprofessional care models within your section’s culture.

Scope of practice for an NP or PA is going to be based on a conglomeration of roles and bylaws. We are certified nationally, and our scope of practice is determined at the state level and the hospital by level. For the individual NP and PA, it really depends on the hospital medicine group, and how well a practice incorporates a sense of collegiality.
 

What kind of resources do hospitalist PAs need to succeed, either from SHM or from their own institutions?

There are a few key things that need to happen in order for hospital medicine groups to set up their NPs and PAs for success. The first is for PAs to have exposure to inpatient rotations during clinical rotations. A hospital medicine group also should have a very intentional onboarding process for NPs and PAs. They should also establish a culture of acceptance. To do this, they should utilize resources like SHM’s NP/PA Hospital Medicine Onboarding Toolkit and the SHM/American Academy of Physician Assistants Hospitalist Bootcamp On Demand.

Mentoring is also remarkably important. I have been incredibly blessed to have mentors that helped make me into the PA that I am. I could not have done what I did in the field without people taking a chance on me, and it is important to pass that on to the next generation of PAs.
 

 

 

How has COVID-19 changed the practice of hospital medicine, specifically for advanced practice providers?

The pandemic has demonstrated opportunities for teamwork and utilization of NPs and PAs. The COVID pandemic forced everyone to reflect on why they originally got into medicine – to help patients. I think there will be many doors opening for NPs and PAs, and many pathways for leadership.

The hospitalist leadership at the University of Chicago truly identified that we needed to make wellness a main priority during the beginning of the pandemic. We developed a wellness work group that I have been coleading.
 

What’s on the horizon for NPs and PAs in hospital medicine?

We are seeing significant increases in hospitalist program utilization, so this is a time where NPs and PAs can be advocates for our profession and articulate how we can use our backgrounds and training to build better care models in order to meet the needs of our patients.

I hope we will see more NPs and PAs assuming leadership roles to ensure that our voices are heard. We should also be advocating for more collaboration and teamwork with our MD and DO colleagues.
 

Do you have any advice for PA students interested in hospital medicine?

I always tell my students that they should be sponges – you are not expected to know everything as a hospitalist PA, but you are expected to continue learning in order to develop into the best PA you can be. Always be open to where your career path can take you. Hospital medicine is a relatively young field within medicine, and the diversity of our field is very exciting looking forward.

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Editor’s note: This profile is part of the Society of Hospital Medicine’s celebration of National Hospitalist Day on March 4. National Hospitalist Day occurs the first Thursday in March annually and celebrates the fastest growing specialty in modern medicine and hospitalists’ enduring contributions to the evolving health care landscape.

Bridget McGrath, PA-C, FHM, is a physician assistant and director of the nurse practitioner/physician assistant service line for the section of hospital medicine at the University of Chicago. She is a cochair of SHM’s NP/PA Special Interest Group.

Where did you receive your PA education/training? Was your intention always to be a PA?

Bridget McGrath

I graduated from the PA program at Butler University, Indianapolis, in 2014. In college, whenever I shadowed a PA, I was always impressed that each one loved their job and said they would never change it. That universal passion for the PA profession really made an impression on me.

At what point in your PA education/training did you decide to practice hospital medicine? What about it appealed to you?

That occurred during my clinical rotation year at Butler. I had always thought I wanted to practice neonatology, but during my clinical rotation I really fell in love with adult medicine. I recall that during my clinical rotation, the preceptor said to me that the goal was not to have me understand every aspect of medicine, but to learn how to exist in a hospital setting. I was exposed to the breadth of hospital medicine practice and I fell in love with the complexity, the variety, and the environment itself.

I initially accepted a job as a med-peds hospitalist PA – which brought both of my passions together at that time – at Schneck Medical Center in Seymour, Ind. During that time, Schneck was a 100-bed rural community hospital which had recently been the recipient of the Malcolm Baldrige National Quality Award. It was there that I was able to practice with a phenomenal group of physicians, nurses, and social workers who really took me under their wing and taught me how to be a hospitalist PA. I practiced at Schneck for 3 years, and then moved to the University of Chicago in 2017.

I am now the director of NP/PA services for the section of hospital medicine, overseeing a group of seven on our NP/PA team, within a larger group of about 60 physicians.
 

What are your favorite areas of clinical practice?

Like many hospitalists, I enjoy the variety of medicine that hospitalists practice. One area that I find especially rewarding is my time in our transplant comanagement services. To be able to walk with patients on their transplant journey is very rewarding, and I am very appreciative of the mentoring I have received from some of my colleagues with a deeper understanding of transplant medicine.

In my administrative role, I have the privilege of helping to expand the professional education and training of my colleagues. I have a passion for medical education, and we have been working to develop interprofessional educational opportunities within our section. I have had time to think about the imprint of NPs and PAs in academic medicine, and how we can continue to meet the professional educational needs of our section while improving the care of our patients.
 

 

 

What are the most challenging aspects of practicing hospital medicine?

The volume of diagnoses that we are expected to manage on a daily basis can be challenging. This challenges you to continue learning. The complexity of discharge planning, particularly for patients in underserved communities, can also be challenging. You have to make sure your patients are ready mentally, physically and emotionally for discharge. As a hospitalist, you are continuously thinking about how to optimize patients to leave your care. For example, patients have different insurance situations, different access to care at home – you are always managing the medical needs of your patient in the context of these other issues.

How does a hospitalist PA work differently from a PA in other care settings?

We are meant to be generalists. We serve as the main provider in owning our patients’ care. A hospitalist PA serves as a cog in the wheel, with connections to specialists, consultants, nurses, social workers, pharmacists, etc., and we are tasked with synthesizing all aspects of patient care to ensure the best outcome.

What has your experience taught you about how NPs and PAs can best fit into hospital medicine groups?

Each hospital medicine group will know how to best integrate their NPs and PAs based on the skillsets of their NPs and PAs, and the needs of the section and the hospital. I personally feel that the best way to utilize NPs and PAs is to allow them to own all aspects of patient care and work at the highest scope of practice. By doing this you empower the NP or PA to continue to develop their skill set and set a precedent of collaboration and respect for interprofessional care models within your section’s culture.

Scope of practice for an NP or PA is going to be based on a conglomeration of roles and bylaws. We are certified nationally, and our scope of practice is determined at the state level and the hospital by level. For the individual NP and PA, it really depends on the hospital medicine group, and how well a practice incorporates a sense of collegiality.
 

What kind of resources do hospitalist PAs need to succeed, either from SHM or from their own institutions?

There are a few key things that need to happen in order for hospital medicine groups to set up their NPs and PAs for success. The first is for PAs to have exposure to inpatient rotations during clinical rotations. A hospital medicine group also should have a very intentional onboarding process for NPs and PAs. They should also establish a culture of acceptance. To do this, they should utilize resources like SHM’s NP/PA Hospital Medicine Onboarding Toolkit and the SHM/American Academy of Physician Assistants Hospitalist Bootcamp On Demand.

Mentoring is also remarkably important. I have been incredibly blessed to have mentors that helped make me into the PA that I am. I could not have done what I did in the field without people taking a chance on me, and it is important to pass that on to the next generation of PAs.
 

 

 

How has COVID-19 changed the practice of hospital medicine, specifically for advanced practice providers?

The pandemic has demonstrated opportunities for teamwork and utilization of NPs and PAs. The COVID pandemic forced everyone to reflect on why they originally got into medicine – to help patients. I think there will be many doors opening for NPs and PAs, and many pathways for leadership.

The hospitalist leadership at the University of Chicago truly identified that we needed to make wellness a main priority during the beginning of the pandemic. We developed a wellness work group that I have been coleading.
 

What’s on the horizon for NPs and PAs in hospital medicine?

We are seeing significant increases in hospitalist program utilization, so this is a time where NPs and PAs can be advocates for our profession and articulate how we can use our backgrounds and training to build better care models in order to meet the needs of our patients.

I hope we will see more NPs and PAs assuming leadership roles to ensure that our voices are heard. We should also be advocating for more collaboration and teamwork with our MD and DO colleagues.
 

Do you have any advice for PA students interested in hospital medicine?

I always tell my students that they should be sponges – you are not expected to know everything as a hospitalist PA, but you are expected to continue learning in order to develop into the best PA you can be. Always be open to where your career path can take you. Hospital medicine is a relatively young field within medicine, and the diversity of our field is very exciting looking forward.

Editor’s note: This profile is part of the Society of Hospital Medicine’s celebration of National Hospitalist Day on March 4. National Hospitalist Day occurs the first Thursday in March annually and celebrates the fastest growing specialty in modern medicine and hospitalists’ enduring contributions to the evolving health care landscape.

Bridget McGrath, PA-C, FHM, is a physician assistant and director of the nurse practitioner/physician assistant service line for the section of hospital medicine at the University of Chicago. She is a cochair of SHM’s NP/PA Special Interest Group.

Where did you receive your PA education/training? Was your intention always to be a PA?

Bridget McGrath

I graduated from the PA program at Butler University, Indianapolis, in 2014. In college, whenever I shadowed a PA, I was always impressed that each one loved their job and said they would never change it. That universal passion for the PA profession really made an impression on me.

At what point in your PA education/training did you decide to practice hospital medicine? What about it appealed to you?

That occurred during my clinical rotation year at Butler. I had always thought I wanted to practice neonatology, but during my clinical rotation I really fell in love with adult medicine. I recall that during my clinical rotation, the preceptor said to me that the goal was not to have me understand every aspect of medicine, but to learn how to exist in a hospital setting. I was exposed to the breadth of hospital medicine practice and I fell in love with the complexity, the variety, and the environment itself.

I initially accepted a job as a med-peds hospitalist PA – which brought both of my passions together at that time – at Schneck Medical Center in Seymour, Ind. During that time, Schneck was a 100-bed rural community hospital which had recently been the recipient of the Malcolm Baldrige National Quality Award. It was there that I was able to practice with a phenomenal group of physicians, nurses, and social workers who really took me under their wing and taught me how to be a hospitalist PA. I practiced at Schneck for 3 years, and then moved to the University of Chicago in 2017.

I am now the director of NP/PA services for the section of hospital medicine, overseeing a group of seven on our NP/PA team, within a larger group of about 60 physicians.
 

What are your favorite areas of clinical practice?

Like many hospitalists, I enjoy the variety of medicine that hospitalists practice. One area that I find especially rewarding is my time in our transplant comanagement services. To be able to walk with patients on their transplant journey is very rewarding, and I am very appreciative of the mentoring I have received from some of my colleagues with a deeper understanding of transplant medicine.

In my administrative role, I have the privilege of helping to expand the professional education and training of my colleagues. I have a passion for medical education, and we have been working to develop interprofessional educational opportunities within our section. I have had time to think about the imprint of NPs and PAs in academic medicine, and how we can continue to meet the professional educational needs of our section while improving the care of our patients.
 

 

 

What are the most challenging aspects of practicing hospital medicine?

The volume of diagnoses that we are expected to manage on a daily basis can be challenging. This challenges you to continue learning. The complexity of discharge planning, particularly for patients in underserved communities, can also be challenging. You have to make sure your patients are ready mentally, physically and emotionally for discharge. As a hospitalist, you are continuously thinking about how to optimize patients to leave your care. For example, patients have different insurance situations, different access to care at home – you are always managing the medical needs of your patient in the context of these other issues.

How does a hospitalist PA work differently from a PA in other care settings?

We are meant to be generalists. We serve as the main provider in owning our patients’ care. A hospitalist PA serves as a cog in the wheel, with connections to specialists, consultants, nurses, social workers, pharmacists, etc., and we are tasked with synthesizing all aspects of patient care to ensure the best outcome.

What has your experience taught you about how NPs and PAs can best fit into hospital medicine groups?

Each hospital medicine group will know how to best integrate their NPs and PAs based on the skillsets of their NPs and PAs, and the needs of the section and the hospital. I personally feel that the best way to utilize NPs and PAs is to allow them to own all aspects of patient care and work at the highest scope of practice. By doing this you empower the NP or PA to continue to develop their skill set and set a precedent of collaboration and respect for interprofessional care models within your section’s culture.

Scope of practice for an NP or PA is going to be based on a conglomeration of roles and bylaws. We are certified nationally, and our scope of practice is determined at the state level and the hospital by level. For the individual NP and PA, it really depends on the hospital medicine group, and how well a practice incorporates a sense of collegiality.
 

What kind of resources do hospitalist PAs need to succeed, either from SHM or from their own institutions?

There are a few key things that need to happen in order for hospital medicine groups to set up their NPs and PAs for success. The first is for PAs to have exposure to inpatient rotations during clinical rotations. A hospital medicine group also should have a very intentional onboarding process for NPs and PAs. They should also establish a culture of acceptance. To do this, they should utilize resources like SHM’s NP/PA Hospital Medicine Onboarding Toolkit and the SHM/American Academy of Physician Assistants Hospitalist Bootcamp On Demand.

Mentoring is also remarkably important. I have been incredibly blessed to have mentors that helped make me into the PA that I am. I could not have done what I did in the field without people taking a chance on me, and it is important to pass that on to the next generation of PAs.
 

 

 

How has COVID-19 changed the practice of hospital medicine, specifically for advanced practice providers?

The pandemic has demonstrated opportunities for teamwork and utilization of NPs and PAs. The COVID pandemic forced everyone to reflect on why they originally got into medicine – to help patients. I think there will be many doors opening for NPs and PAs, and many pathways for leadership.

The hospitalist leadership at the University of Chicago truly identified that we needed to make wellness a main priority during the beginning of the pandemic. We developed a wellness work group that I have been coleading.
 

What’s on the horizon for NPs and PAs in hospital medicine?

We are seeing significant increases in hospitalist program utilization, so this is a time where NPs and PAs can be advocates for our profession and articulate how we can use our backgrounds and training to build better care models in order to meet the needs of our patients.

I hope we will see more NPs and PAs assuming leadership roles to ensure that our voices are heard. We should also be advocating for more collaboration and teamwork with our MD and DO colleagues.
 

Do you have any advice for PA students interested in hospital medicine?

I always tell my students that they should be sponges – you are not expected to know everything as a hospitalist PA, but you are expected to continue learning in order to develop into the best PA you can be. Always be open to where your career path can take you. Hospital medicine is a relatively young field within medicine, and the diversity of our field is very exciting looking forward.

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A ‘hospitalist plus’: Grace C. Huang, MD

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Editor’s note: This profile is part of SHM’s celebration of National Hospitalist Day on March 4. National Hospitalist Day occurs the first Thursday in March annually, and celebrates the fastest growing specialty in modern medicine and hospitalists’ enduring contributions to the evolving health care landscape.

Grace C. Huang, MD, is a hospitalist at Beth Israel Deaconess Medical Center and an associate professor of medicine at Harvard Medical School, both in Boston.

Dr. Grace C. Huang

Dr. Huang currently serves as vice chair for career development and mentoring in the department of medicine at Beth Israel Deaconess as well as director of the Office of Academic Careers and Faculty Development, and codirector of the Beth Israel Deaconess Academy of Medical Educators. She is also director of the Rabkin Fellowship in Medical Education, a program for Harvard Medical School faculty designed to help develop the skills needed to launch or advance academic careers in medical education or academic leadership.

Additionally, Dr. Huang is the editor in chief of MedEdPORTAL, a MEDLINE-indexed, open-access journal of the Association of American Medical Colleges.
 

At what point in your training did you decide to practice hospital medicine, and what about it appealed to you?

I trained at a point in time where it was rare for people to aspire to go in to hospital medicine. It just wasn’t that common, and there were so few examples of what a career trajectory in hospital medicine would look like. So I don’t know that I actively chose to go into hospital medicine; I chose it because it was what I knew how to do, based on my residency experience.

But it is really easy and authentic for me now to share about what makes hospital medicine such a vibrant career choice. I’m doing a lot of things in my job other than hospital medicine, but when I am on service, it reminds me acutely what it means to stay connected to why I became a doctor. The practice of hospital medicine means to be there at the most intense time of many people’s lives, to shoulder the responsibility of knowing that what I say to my patients will be remembered forever, and to be challenged by some of medicine’s hardest problems.

Hospital medicine has a way of putting you at the nexus of individual, family, society, government, and planet. But it also means that, even while I am witness to disease, suffering, broken relationships, social injustice, and environmental issues, I get a privileged look at what it means to comfort, to identify what really matters to people, to understand what gives us dignity as human beings. Lastly, I always come back to the fact that working as a team has made my clinical job so much more enriching; it’s not trench warfare, but you do create bonds quickly with learners, colleagues, and other health professionals in such an intense, fast-paced environment.
 

What is your current role at Beth Israel Deaconess Medical Center?

At Beth Israel Deaconess, I’m holding four different jobs. It’s sometimes hard for me to keep track of them, but they all center on career and faculty development. I’m a vice chair for career development within the department of medicine, and I also have an institutional role for faculty development for clinicians, educators, and researchers. I provide academic promotion support for the faculty, provide ad hoc mentorship, and run professional development programming. I also direct a year-long medical education fellowship. On the side, I am the editor in chief for a medical education journal.

What are your favorite areas of clinical practice and research?

Being a generalist means I love a lot of areas of clinical practice. I’m not sure there’s a particular area that I enjoy more than others. I love teaching specific topics – antibiotics, pharmacology, direct oral anticoagulants, the microbiology of common infections. I love thinking about how the heart and kidney battle for dominance each day and being the mediator. I have a particular interest in high-value care and lab ordering (or the fact that we should do much less of it). I love complex diagnostic problems and mapping them out on paper for my team.

The research that I’ve been doing over the past 20 years has focused on how we train internists and internists-to-be to do bedside procedures. It stemmed from my own ineptitude in doing procedures, and it caused me to question the age-old approach we took in sticking needles into patients without standardized training, supervision, or safety measures.

I’ve been proud of the small role I’ve been able to play in influencing how residents are taught to do procedures, and now I’m working with others to focus on how we should teach procedures to hospitalists, who don’t do procedures on a regular basis, and aren’t under the same expectations for ongoing skill development.
 

What are the most challenging aspects of practicing hospital medicine, and what are the most rewarding?

The intensity is probably what’s hardest for me about hospital medicine. At this point in my career, if I’m on service for a week, it takes me just as long to recover. It’s the cognitive load of needing to keep track of details that can make a big difference, the rapidity at which patients can deteriorate, the need to change course in an instant because of new information, and wanting to be mentally present and available for my patients and my learners.

It’s also hard to see suffering up close and personal and to leave feeling helpless to change the course of severe illness or to optimize care within the constraints of the health care system. This is why I do – and have to – extract satisfaction from the smallest of wins and brief moments of connection. Like seeing a patient turn the corner after being on the brink. Or gaining trust from an initially upset family member. Getting a copy of the eulogy from the daughter of my patient. A phone call from a patient I cared for 18 months ago, thanking me for my care. Visiting patients in the hospital socially that I had gotten to know over the years.
 

 

 

How has COVID-19 impacted hospitalist practice, and what changes will outlast the pandemic?

What you read in the lay press has put a spotlight on hospital-based work. What has been shared resonates with my own experience – the loss of connection from visitor restrictions, the isolation patients experience when everyone is wearing personal protective equipment, the worsening of everything that was already hard to begin with, like health care disparities, mental health, access to community supports, financial challenges, the disproportionate burden on unpaid caregivers, etc.

After the pandemic is “over,” I hope that we will retain a sense of intentionality how we address limited resources, the importance of social connection, the structural racism that has disadvantaged patients and physicians of color.
 

How will hospital medicine as a field change in the next decade or 2?

The hospitalist model has already influenced other specialties, like ob.gyn., neurology, and cardiology, and I expect that to continue. Hospitalists have already become leaders at the highest levels, and we will see them in higher numbers throughout health care leadership.

Are there any particular mentors who have been influential in your journey as a hospitalist?

Because I’m one of the older hospitalists in my group, there were fewer mentors, other than my boss, Joe Li, MD, SFHM, [section chief in hospital medicine at Beth Israel Deaconess], who has been an amazing role model. I think also of my colleagues as peer mentors, who continue to push me to be a better doctor. Whether it means remaining curious during the physical exam, or inspiring me with their excitement about clinical cases.

Do you have any advice for students and residents interested in hospital medicine?

When I talk to trainees about career development as a hospitalist, I encourage them to think about what will make them a “Hospitalist Plus.” Whether that Plus is teaching, research, or leadership, being a hospitalist gives you an opportunity to extend your impact as a physician into related realm.

I look around at our hospital medicine group, and every person has their Plus. We have educators, quality improvement leaders, a health services researcher, a health policy expert, a textbook editor – everyone brings special expertise to the group. My Plus now is much bigger than my footprint as a hospitalist, but I would never have gotten here had I not chosen a career path that would allow me to explore the farthest reaches of my potential as a physician.
 

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Editor’s note: This profile is part of SHM’s celebration of National Hospitalist Day on March 4. National Hospitalist Day occurs the first Thursday in March annually, and celebrates the fastest growing specialty in modern medicine and hospitalists’ enduring contributions to the evolving health care landscape.

Grace C. Huang, MD, is a hospitalist at Beth Israel Deaconess Medical Center and an associate professor of medicine at Harvard Medical School, both in Boston.

Dr. Grace C. Huang

Dr. Huang currently serves as vice chair for career development and mentoring in the department of medicine at Beth Israel Deaconess as well as director of the Office of Academic Careers and Faculty Development, and codirector of the Beth Israel Deaconess Academy of Medical Educators. She is also director of the Rabkin Fellowship in Medical Education, a program for Harvard Medical School faculty designed to help develop the skills needed to launch or advance academic careers in medical education or academic leadership.

Additionally, Dr. Huang is the editor in chief of MedEdPORTAL, a MEDLINE-indexed, open-access journal of the Association of American Medical Colleges.
 

At what point in your training did you decide to practice hospital medicine, and what about it appealed to you?

I trained at a point in time where it was rare for people to aspire to go in to hospital medicine. It just wasn’t that common, and there were so few examples of what a career trajectory in hospital medicine would look like. So I don’t know that I actively chose to go into hospital medicine; I chose it because it was what I knew how to do, based on my residency experience.

But it is really easy and authentic for me now to share about what makes hospital medicine such a vibrant career choice. I’m doing a lot of things in my job other than hospital medicine, but when I am on service, it reminds me acutely what it means to stay connected to why I became a doctor. The practice of hospital medicine means to be there at the most intense time of many people’s lives, to shoulder the responsibility of knowing that what I say to my patients will be remembered forever, and to be challenged by some of medicine’s hardest problems.

Hospital medicine has a way of putting you at the nexus of individual, family, society, government, and planet. But it also means that, even while I am witness to disease, suffering, broken relationships, social injustice, and environmental issues, I get a privileged look at what it means to comfort, to identify what really matters to people, to understand what gives us dignity as human beings. Lastly, I always come back to the fact that working as a team has made my clinical job so much more enriching; it’s not trench warfare, but you do create bonds quickly with learners, colleagues, and other health professionals in such an intense, fast-paced environment.
 

What is your current role at Beth Israel Deaconess Medical Center?

At Beth Israel Deaconess, I’m holding four different jobs. It’s sometimes hard for me to keep track of them, but they all center on career and faculty development. I’m a vice chair for career development within the department of medicine, and I also have an institutional role for faculty development for clinicians, educators, and researchers. I provide academic promotion support for the faculty, provide ad hoc mentorship, and run professional development programming. I also direct a year-long medical education fellowship. On the side, I am the editor in chief for a medical education journal.

What are your favorite areas of clinical practice and research?

Being a generalist means I love a lot of areas of clinical practice. I’m not sure there’s a particular area that I enjoy more than others. I love teaching specific topics – antibiotics, pharmacology, direct oral anticoagulants, the microbiology of common infections. I love thinking about how the heart and kidney battle for dominance each day and being the mediator. I have a particular interest in high-value care and lab ordering (or the fact that we should do much less of it). I love complex diagnostic problems and mapping them out on paper for my team.

The research that I’ve been doing over the past 20 years has focused on how we train internists and internists-to-be to do bedside procedures. It stemmed from my own ineptitude in doing procedures, and it caused me to question the age-old approach we took in sticking needles into patients without standardized training, supervision, or safety measures.

I’ve been proud of the small role I’ve been able to play in influencing how residents are taught to do procedures, and now I’m working with others to focus on how we should teach procedures to hospitalists, who don’t do procedures on a regular basis, and aren’t under the same expectations for ongoing skill development.
 

What are the most challenging aspects of practicing hospital medicine, and what are the most rewarding?

The intensity is probably what’s hardest for me about hospital medicine. At this point in my career, if I’m on service for a week, it takes me just as long to recover. It’s the cognitive load of needing to keep track of details that can make a big difference, the rapidity at which patients can deteriorate, the need to change course in an instant because of new information, and wanting to be mentally present and available for my patients and my learners.

It’s also hard to see suffering up close and personal and to leave feeling helpless to change the course of severe illness or to optimize care within the constraints of the health care system. This is why I do – and have to – extract satisfaction from the smallest of wins and brief moments of connection. Like seeing a patient turn the corner after being on the brink. Or gaining trust from an initially upset family member. Getting a copy of the eulogy from the daughter of my patient. A phone call from a patient I cared for 18 months ago, thanking me for my care. Visiting patients in the hospital socially that I had gotten to know over the years.
 

 

 

How has COVID-19 impacted hospitalist practice, and what changes will outlast the pandemic?

What you read in the lay press has put a spotlight on hospital-based work. What has been shared resonates with my own experience – the loss of connection from visitor restrictions, the isolation patients experience when everyone is wearing personal protective equipment, the worsening of everything that was already hard to begin with, like health care disparities, mental health, access to community supports, financial challenges, the disproportionate burden on unpaid caregivers, etc.

After the pandemic is “over,” I hope that we will retain a sense of intentionality how we address limited resources, the importance of social connection, the structural racism that has disadvantaged patients and physicians of color.
 

How will hospital medicine as a field change in the next decade or 2?

The hospitalist model has already influenced other specialties, like ob.gyn., neurology, and cardiology, and I expect that to continue. Hospitalists have already become leaders at the highest levels, and we will see them in higher numbers throughout health care leadership.

Are there any particular mentors who have been influential in your journey as a hospitalist?

Because I’m one of the older hospitalists in my group, there were fewer mentors, other than my boss, Joe Li, MD, SFHM, [section chief in hospital medicine at Beth Israel Deaconess], who has been an amazing role model. I think also of my colleagues as peer mentors, who continue to push me to be a better doctor. Whether it means remaining curious during the physical exam, or inspiring me with their excitement about clinical cases.

Do you have any advice for students and residents interested in hospital medicine?

When I talk to trainees about career development as a hospitalist, I encourage them to think about what will make them a “Hospitalist Plus.” Whether that Plus is teaching, research, or leadership, being a hospitalist gives you an opportunity to extend your impact as a physician into related realm.

I look around at our hospital medicine group, and every person has their Plus. We have educators, quality improvement leaders, a health services researcher, a health policy expert, a textbook editor – everyone brings special expertise to the group. My Plus now is much bigger than my footprint as a hospitalist, but I would never have gotten here had I not chosen a career path that would allow me to explore the farthest reaches of my potential as a physician.
 

Editor’s note: This profile is part of SHM’s celebration of National Hospitalist Day on March 4. National Hospitalist Day occurs the first Thursday in March annually, and celebrates the fastest growing specialty in modern medicine and hospitalists’ enduring contributions to the evolving health care landscape.

Grace C. Huang, MD, is a hospitalist at Beth Israel Deaconess Medical Center and an associate professor of medicine at Harvard Medical School, both in Boston.

Dr. Grace C. Huang

Dr. Huang currently serves as vice chair for career development and mentoring in the department of medicine at Beth Israel Deaconess as well as director of the Office of Academic Careers and Faculty Development, and codirector of the Beth Israel Deaconess Academy of Medical Educators. She is also director of the Rabkin Fellowship in Medical Education, a program for Harvard Medical School faculty designed to help develop the skills needed to launch or advance academic careers in medical education or academic leadership.

Additionally, Dr. Huang is the editor in chief of MedEdPORTAL, a MEDLINE-indexed, open-access journal of the Association of American Medical Colleges.
 

At what point in your training did you decide to practice hospital medicine, and what about it appealed to you?

I trained at a point in time where it was rare for people to aspire to go in to hospital medicine. It just wasn’t that common, and there were so few examples of what a career trajectory in hospital medicine would look like. So I don’t know that I actively chose to go into hospital medicine; I chose it because it was what I knew how to do, based on my residency experience.

But it is really easy and authentic for me now to share about what makes hospital medicine such a vibrant career choice. I’m doing a lot of things in my job other than hospital medicine, but when I am on service, it reminds me acutely what it means to stay connected to why I became a doctor. The practice of hospital medicine means to be there at the most intense time of many people’s lives, to shoulder the responsibility of knowing that what I say to my patients will be remembered forever, and to be challenged by some of medicine’s hardest problems.

Hospital medicine has a way of putting you at the nexus of individual, family, society, government, and planet. But it also means that, even while I am witness to disease, suffering, broken relationships, social injustice, and environmental issues, I get a privileged look at what it means to comfort, to identify what really matters to people, to understand what gives us dignity as human beings. Lastly, I always come back to the fact that working as a team has made my clinical job so much more enriching; it’s not trench warfare, but you do create bonds quickly with learners, colleagues, and other health professionals in such an intense, fast-paced environment.
 

What is your current role at Beth Israel Deaconess Medical Center?

At Beth Israel Deaconess, I’m holding four different jobs. It’s sometimes hard for me to keep track of them, but they all center on career and faculty development. I’m a vice chair for career development within the department of medicine, and I also have an institutional role for faculty development for clinicians, educators, and researchers. I provide academic promotion support for the faculty, provide ad hoc mentorship, and run professional development programming. I also direct a year-long medical education fellowship. On the side, I am the editor in chief for a medical education journal.

What are your favorite areas of clinical practice and research?

Being a generalist means I love a lot of areas of clinical practice. I’m not sure there’s a particular area that I enjoy more than others. I love teaching specific topics – antibiotics, pharmacology, direct oral anticoagulants, the microbiology of common infections. I love thinking about how the heart and kidney battle for dominance each day and being the mediator. I have a particular interest in high-value care and lab ordering (or the fact that we should do much less of it). I love complex diagnostic problems and mapping them out on paper for my team.

The research that I’ve been doing over the past 20 years has focused on how we train internists and internists-to-be to do bedside procedures. It stemmed from my own ineptitude in doing procedures, and it caused me to question the age-old approach we took in sticking needles into patients without standardized training, supervision, or safety measures.

I’ve been proud of the small role I’ve been able to play in influencing how residents are taught to do procedures, and now I’m working with others to focus on how we should teach procedures to hospitalists, who don’t do procedures on a regular basis, and aren’t under the same expectations for ongoing skill development.
 

What are the most challenging aspects of practicing hospital medicine, and what are the most rewarding?

The intensity is probably what’s hardest for me about hospital medicine. At this point in my career, if I’m on service for a week, it takes me just as long to recover. It’s the cognitive load of needing to keep track of details that can make a big difference, the rapidity at which patients can deteriorate, the need to change course in an instant because of new information, and wanting to be mentally present and available for my patients and my learners.

It’s also hard to see suffering up close and personal and to leave feeling helpless to change the course of severe illness or to optimize care within the constraints of the health care system. This is why I do – and have to – extract satisfaction from the smallest of wins and brief moments of connection. Like seeing a patient turn the corner after being on the brink. Or gaining trust from an initially upset family member. Getting a copy of the eulogy from the daughter of my patient. A phone call from a patient I cared for 18 months ago, thanking me for my care. Visiting patients in the hospital socially that I had gotten to know over the years.
 

 

 

How has COVID-19 impacted hospitalist practice, and what changes will outlast the pandemic?

What you read in the lay press has put a spotlight on hospital-based work. What has been shared resonates with my own experience – the loss of connection from visitor restrictions, the isolation patients experience when everyone is wearing personal protective equipment, the worsening of everything that was already hard to begin with, like health care disparities, mental health, access to community supports, financial challenges, the disproportionate burden on unpaid caregivers, etc.

After the pandemic is “over,” I hope that we will retain a sense of intentionality how we address limited resources, the importance of social connection, the structural racism that has disadvantaged patients and physicians of color.
 

How will hospital medicine as a field change in the next decade or 2?

The hospitalist model has already influenced other specialties, like ob.gyn., neurology, and cardiology, and I expect that to continue. Hospitalists have already become leaders at the highest levels, and we will see them in higher numbers throughout health care leadership.

Are there any particular mentors who have been influential in your journey as a hospitalist?

Because I’m one of the older hospitalists in my group, there were fewer mentors, other than my boss, Joe Li, MD, SFHM, [section chief in hospital medicine at Beth Israel Deaconess], who has been an amazing role model. I think also of my colleagues as peer mentors, who continue to push me to be a better doctor. Whether it means remaining curious during the physical exam, or inspiring me with their excitement about clinical cases.

Do you have any advice for students and residents interested in hospital medicine?

When I talk to trainees about career development as a hospitalist, I encourage them to think about what will make them a “Hospitalist Plus.” Whether that Plus is teaching, research, or leadership, being a hospitalist gives you an opportunity to extend your impact as a physician into related realm.

I look around at our hospital medicine group, and every person has their Plus. We have educators, quality improvement leaders, a health services researcher, a health policy expert, a textbook editor – everyone brings special expertise to the group. My Plus now is much bigger than my footprint as a hospitalist, but I would never have gotten here had I not chosen a career path that would allow me to explore the farthest reaches of my potential as a physician.
 

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SHM CEO Eric Howell likes to fix things

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Mon, 03/01/2021 - 14:09

Engineering provided a foundation for hospital medicine

Editor’s note: This profile is part of SHM’s celebration of National Hospitalist Day on March 4. National Hospitalist Day occurs the first Thursday in March annually, and celebrates the fastest growing specialty in modern medicine and hospitalists’ enduring contributions to the evolving health care landscape.

For Eric E. Howell, MD, MHM, CEO since July 2020 for the Society of Hospital Medicine, an undergraduate degree in electrical engineering and a lifelong proclivity for figuring out puzzles, solving problems, and taking things apart to see how they fit back together were building blocks for an exemplary career as a hospitalist, group administrator, and medical educator.

Dr. Eric E. Howell

When he was growing up in historic Annapolis, Md., near the shores of Chesapeake Bay, things to put back together included remote control airplanes, small boat engines, and cars. As a hospitalist, his interest in solving problems and facility with numbers and systems led him to become an expert on quality improvement, transitions of care, and conflict management.

Courtesy Dr. Eric Howell
Dr. Eric Howell was raised on the shores of the Chesapeake Bay in Maryland, and continues to spend time on the water.


“One thing about engineering, you’re always having to fix things. It helps you learn to assess complex situations,” said Dr. Howell, who is 52. “It was helpful for me to bring an engineering approach into the hospital. One of my earliest successes was reengineering admissions processes to dramatically reduce the amount of time patients were spending in the emergency room before they could be admitted to the hospital.”

But his career path in hospital medicine came about by a lucky chance, following residency and a year as chief resident at Johns Hopkins Bayview Medical Center in Baltimore. “One of my duties as chief resident was taking care of hospitalized patients. I didn’t know it but I was becoming a de facto hospitalist,” he recalled.

At the time, he thought he might end up choosing to specialize in something like cardiology or critical care medicine, but in 2000 he was invited to join the new “non-house-staff” medical service at Bayview. Also called a general medicine inpatient service, it eventually evolved into the hospitalist service.

His residency program director, Roy Ziegelstein, MD, a cardiologist and now the vice dean of education at Johns Hopkins, created a job for him.

Dr. Roy Ziegelstein

“I was one of the first four doctors hired. I thought I’d just do it for a year, but I loved inpatient work, so I stayed,” Dr. Howell said. “Roy mentored me for the next 20 years and helped me to become an above average hospitalist.”

Early on, Dr. Howell’s department chair, David Hellman, MD, who had worked at the University of California–San Francisco with hospital medicine pioneer Robert Wachter, MD, MHM, sent Dr. Howell to San Francisco to be mentored by Dr. Wachter, since there were few hospital mentors on the East Coast at that time.

“What I took away from that experience was how important it was to professionalize hospital medicine – in order to develop specialized expertise,” Dr. Howell recalled. “Dr. Wachter taught me that hospitalists need to have a professional focus. Quality improvement, systems-based improvement, and value all became part of that,” he said.

“Many people thought to be a hospitalist all you had to know was basic medicine. But it turns out medicine in the hospital is just as specialized as any other specialty. The hospital itself requires specialized knowledge that didn’t even exist 20 years ago.” Because of complicated disease states and clinical systems, hospitalists have to be better at navigating the software of today’s hospital.
 

 

 

New job opportunities

Dr. Howell describes his career path as a new job focus opening up every 5 years or so, redefining what he does and trying something new and exciting with better pay. His first was a focus on clinical hospital medicine and learning how to be a better doctor. Then in 2005 he began work as a teacher at Johns Hopkins School of Medicine. There he mastered the teaching of medical trainees, winning awards as an instructor, including SHM’s award for excellence in teaching.

In 2010 he again changed his focus to program building, leading the expansion of the hospitalist service for Bayview and three other hospitals in the Johns Hopkins system. Dr. Howell helped grow the service to nearly 200 clinicians while becoming skilled at operational and program development.

His fourth job incarnation, starting in 2015, was the obsessive pursuit of quality improvement, marshaling data to measure and improve clinical and other outcomes on the quality dashboard – mortality, length of stay, readmissions, rates of adverse events – and putting quality improvement strategies in place.

“Our mortality rates at Bayview were well below national standards. We came up with an amazing program. A lot of hospital medicine programs pursue improvement, but we really measured it. We benchmarked ourselves against other programs at Hopkins,” he said. “I set up a dedicated conference room, as many QI programs do. We called it True North, and each wall had a different QI focus, with updates on the reported metrics. Every other week we met there to talk about the metrics,” he said.

That experience led to working with SHM, which he had joined as a member early in his career and for which he had previously served as president. He became SHM’s quality improvement liaison and a co-principal investigator on Project BOOST (Better Outcomes for Older adults through Safe Transitions), SHM’s pioneering, national mentored-implementation model aimed at improving transitions of care from participating hospitals to reduce readmissions. “BOOST really established SHM’s reputation as a quality improvement-oriented organization. It was a stake in the ground for quality and led to SHM receiving the Joint Commission’s 2011 John M. Eisenberg Award for Innovation in Patient Safety and Quality,” he said.

Dr. Howell’s fifth career phase, medical society management, emerged when he was recruited to apply for the SHM chief executive position – held since its inception by retiring CEO Larry Wellikson, MD, MHM. Dr. Howell started work at SHM in the midst of the pandemic, spending much of his time working from home – especially when Philadelphia implemented stricter COVID-19 restrictions. Once pandemic restrictions are loosened, he expects to do a lot of traveling. But for now, the external-facing part of his job is mainly on Zoom.
 

Making the world a better place

Dr. Howell said he has held fast to three mottos in life, which have guided his career path as well as his personal life: (1) to make the world a better place; (2) to be ethical and transparent; and (3) to invest in people. His wife of 19 years, Heather Howell, an Annapolis realtor, says making the world a better place is what they taught their children, Mason, 18, who starts college at Rice University in fall 2021 with an interest in premed, and Anna, 16, a competitive sailor. “We always had a poster hanging in our house extolling that message,” Ms. Howell said.

Dr. Howell grew up in a nautical family, with many of his relatives working in the maritime business. His kids grew up on the water, learning to pilot a powerboat before driving a car, as he did. “We boat all the time on the bay” in his lobster boat, which he often works on to keep it seaworthy, Ms. Howell said.

“There’s nothing like taking care of hospitalized patients to make you feel you’re making the world a better place,” Dr. Howell observed. “Very often you can make a huge difference for the patients you do care for, and that is incredibly rewarding.” Although the demands of his SHM leadership position required relinquishing most of his responsibilities at Johns Hopkins, he continues to see patients and teach residents there 2-4 weeks a year on a teaching service.

“Why do I still see patients? I find it so rewarding. And I get to teach, which I love,” he said. “To be honest, I don’t think you truly need to see patients to be head of a professional medical society like SHM. Maybe someday I’ll give that up. But only if it’s necessary to make the society more successful.”

Half of Dr. Howell’s Society work now is planned and half is “putting out fires” – while learning members’ needs in real time. “Right now, we’re worried about burnout and PTSD, because frankly it’s stressful to take care of COVID patients. It’s scary for a lot of clinicians. I’m working with our members to make sure they have what they need to be clinically prepared, including resources to be more resilient professionally.”

Every step of his career, Dr. Howell said, has seemed like the best job he ever had. “Making the world a better place is still important to me. I tell SHM members that it’s important to know they are making a difference. What they’re doing is really important, especially with COVID, and it needs to be sustainable,” he said.

“SHM has such a powerful mission – it’s about making patient care better, and making hospitalists better clinicians. I know the Society is having a powerful impact, and that’s good enough for me. I’m into teams. Hospital medicine is a team sport, but so is SHM, interacting with its members, staff, and board.”
 

Initiating another new program

One of Dr. Howell’s last major projects for Hopkins was to launch and be chief medical officer for the Joint Commission–accredited Baltimore Civic Center Field Hospital for COVID-19 patients, opened in March 2020.

Courtesy Dr. Eric Howell
Dr. Eric Howell was chief medical officer for the Joint Commission-accredited Baltimore Civic Center Field Hospital for COVID-19 patients, opened in March 2020.

With a surge capacity of 250 beds, and a negative pressure ward set up in the center’s exhibit hall, it is jointly operated by the University of Maryland Medical System and Johns Hopkins Hospital. The field hospital’s mission has since expanded to include viral tests, infusions of monoclonal antibodies, and COVID-19 vaccinations.

Planning for a smooth transition, Dr. Howell brought Melinda E. Kantsiper, MD, director of clinical operations, Division of Hospital Medicine at Johns Hopkins Bayview, on board as associate medical officer, to eventually replace him as CMO after a few months working alongside him. “Eric brings that logical engineering eye to problem solving,” Dr. Kantsiper said.

Courtesy Johns Hopkins Medicine
Dr. Melinda E. Kantsiper is director of clinical operations in the division of hospital medicine at Johns Hopkins Bayview Medical Center, Baltimore.


“We wanted to build a very safe, high-quality hospital setting but had to do it very quickly. Watching him once again do what he does best, initiating a new program, building things carefully and thoughtfully, without being overly cautious, I could see his years of experience and good judgment about how hospitals run. He’s very logical but very caring. He’s also good at spotting young leaders and their talents.”

Some people have a knack for solving problems, added Dr. Ziegelstein, Dr. Howell’s mentor from his early days at Bayview. “Eric is different. He’s someone who’s able to identify gaps, problem areas, and vulnerabilities within an organization and then come up with a potential menu of solutions, think about which would be most likely to succeed, implement it, and assess the outcome. That’s the difference between a skilled manager and a true leader, and I’d say Eric had that ability while still in training,” Dr. Ziegelstein said.

“Eric understood early on not only what the field of hospital medicine could offer, he also understood how to catalyze change, without taking on too much change at one time,” Dr. Ziegelstein said. “He understood people’s sensibilities and concerns about this new service, and he catalyzed its growth through incremental change.”

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Engineering provided a foundation for hospital medicine

Engineering provided a foundation for hospital medicine

Editor’s note: This profile is part of SHM’s celebration of National Hospitalist Day on March 4. National Hospitalist Day occurs the first Thursday in March annually, and celebrates the fastest growing specialty in modern medicine and hospitalists’ enduring contributions to the evolving health care landscape.

For Eric E. Howell, MD, MHM, CEO since July 2020 for the Society of Hospital Medicine, an undergraduate degree in electrical engineering and a lifelong proclivity for figuring out puzzles, solving problems, and taking things apart to see how they fit back together were building blocks for an exemplary career as a hospitalist, group administrator, and medical educator.

Dr. Eric E. Howell

When he was growing up in historic Annapolis, Md., near the shores of Chesapeake Bay, things to put back together included remote control airplanes, small boat engines, and cars. As a hospitalist, his interest in solving problems and facility with numbers and systems led him to become an expert on quality improvement, transitions of care, and conflict management.

Courtesy Dr. Eric Howell
Dr. Eric Howell was raised on the shores of the Chesapeake Bay in Maryland, and continues to spend time on the water.


“One thing about engineering, you’re always having to fix things. It helps you learn to assess complex situations,” said Dr. Howell, who is 52. “It was helpful for me to bring an engineering approach into the hospital. One of my earliest successes was reengineering admissions processes to dramatically reduce the amount of time patients were spending in the emergency room before they could be admitted to the hospital.”

But his career path in hospital medicine came about by a lucky chance, following residency and a year as chief resident at Johns Hopkins Bayview Medical Center in Baltimore. “One of my duties as chief resident was taking care of hospitalized patients. I didn’t know it but I was becoming a de facto hospitalist,” he recalled.

At the time, he thought he might end up choosing to specialize in something like cardiology or critical care medicine, but in 2000 he was invited to join the new “non-house-staff” medical service at Bayview. Also called a general medicine inpatient service, it eventually evolved into the hospitalist service.

His residency program director, Roy Ziegelstein, MD, a cardiologist and now the vice dean of education at Johns Hopkins, created a job for him.

Dr. Roy Ziegelstein

“I was one of the first four doctors hired. I thought I’d just do it for a year, but I loved inpatient work, so I stayed,” Dr. Howell said. “Roy mentored me for the next 20 years and helped me to become an above average hospitalist.”

Early on, Dr. Howell’s department chair, David Hellman, MD, who had worked at the University of California–San Francisco with hospital medicine pioneer Robert Wachter, MD, MHM, sent Dr. Howell to San Francisco to be mentored by Dr. Wachter, since there were few hospital mentors on the East Coast at that time.

“What I took away from that experience was how important it was to professionalize hospital medicine – in order to develop specialized expertise,” Dr. Howell recalled. “Dr. Wachter taught me that hospitalists need to have a professional focus. Quality improvement, systems-based improvement, and value all became part of that,” he said.

“Many people thought to be a hospitalist all you had to know was basic medicine. But it turns out medicine in the hospital is just as specialized as any other specialty. The hospital itself requires specialized knowledge that didn’t even exist 20 years ago.” Because of complicated disease states and clinical systems, hospitalists have to be better at navigating the software of today’s hospital.
 

 

 

New job opportunities

Dr. Howell describes his career path as a new job focus opening up every 5 years or so, redefining what he does and trying something new and exciting with better pay. His first was a focus on clinical hospital medicine and learning how to be a better doctor. Then in 2005 he began work as a teacher at Johns Hopkins School of Medicine. There he mastered the teaching of medical trainees, winning awards as an instructor, including SHM’s award for excellence in teaching.

In 2010 he again changed his focus to program building, leading the expansion of the hospitalist service for Bayview and three other hospitals in the Johns Hopkins system. Dr. Howell helped grow the service to nearly 200 clinicians while becoming skilled at operational and program development.

His fourth job incarnation, starting in 2015, was the obsessive pursuit of quality improvement, marshaling data to measure and improve clinical and other outcomes on the quality dashboard – mortality, length of stay, readmissions, rates of adverse events – and putting quality improvement strategies in place.

“Our mortality rates at Bayview were well below national standards. We came up with an amazing program. A lot of hospital medicine programs pursue improvement, but we really measured it. We benchmarked ourselves against other programs at Hopkins,” he said. “I set up a dedicated conference room, as many QI programs do. We called it True North, and each wall had a different QI focus, with updates on the reported metrics. Every other week we met there to talk about the metrics,” he said.

That experience led to working with SHM, which he had joined as a member early in his career and for which he had previously served as president. He became SHM’s quality improvement liaison and a co-principal investigator on Project BOOST (Better Outcomes for Older adults through Safe Transitions), SHM’s pioneering, national mentored-implementation model aimed at improving transitions of care from participating hospitals to reduce readmissions. “BOOST really established SHM’s reputation as a quality improvement-oriented organization. It was a stake in the ground for quality and led to SHM receiving the Joint Commission’s 2011 John M. Eisenberg Award for Innovation in Patient Safety and Quality,” he said.

Dr. Howell’s fifth career phase, medical society management, emerged when he was recruited to apply for the SHM chief executive position – held since its inception by retiring CEO Larry Wellikson, MD, MHM. Dr. Howell started work at SHM in the midst of the pandemic, spending much of his time working from home – especially when Philadelphia implemented stricter COVID-19 restrictions. Once pandemic restrictions are loosened, he expects to do a lot of traveling. But for now, the external-facing part of his job is mainly on Zoom.
 

Making the world a better place

Dr. Howell said he has held fast to three mottos in life, which have guided his career path as well as his personal life: (1) to make the world a better place; (2) to be ethical and transparent; and (3) to invest in people. His wife of 19 years, Heather Howell, an Annapolis realtor, says making the world a better place is what they taught their children, Mason, 18, who starts college at Rice University in fall 2021 with an interest in premed, and Anna, 16, a competitive sailor. “We always had a poster hanging in our house extolling that message,” Ms. Howell said.

Dr. Howell grew up in a nautical family, with many of his relatives working in the maritime business. His kids grew up on the water, learning to pilot a powerboat before driving a car, as he did. “We boat all the time on the bay” in his lobster boat, which he often works on to keep it seaworthy, Ms. Howell said.

“There’s nothing like taking care of hospitalized patients to make you feel you’re making the world a better place,” Dr. Howell observed. “Very often you can make a huge difference for the patients you do care for, and that is incredibly rewarding.” Although the demands of his SHM leadership position required relinquishing most of his responsibilities at Johns Hopkins, he continues to see patients and teach residents there 2-4 weeks a year on a teaching service.

“Why do I still see patients? I find it so rewarding. And I get to teach, which I love,” he said. “To be honest, I don’t think you truly need to see patients to be head of a professional medical society like SHM. Maybe someday I’ll give that up. But only if it’s necessary to make the society more successful.”

Half of Dr. Howell’s Society work now is planned and half is “putting out fires” – while learning members’ needs in real time. “Right now, we’re worried about burnout and PTSD, because frankly it’s stressful to take care of COVID patients. It’s scary for a lot of clinicians. I’m working with our members to make sure they have what they need to be clinically prepared, including resources to be more resilient professionally.”

Every step of his career, Dr. Howell said, has seemed like the best job he ever had. “Making the world a better place is still important to me. I tell SHM members that it’s important to know they are making a difference. What they’re doing is really important, especially with COVID, and it needs to be sustainable,” he said.

“SHM has such a powerful mission – it’s about making patient care better, and making hospitalists better clinicians. I know the Society is having a powerful impact, and that’s good enough for me. I’m into teams. Hospital medicine is a team sport, but so is SHM, interacting with its members, staff, and board.”
 

Initiating another new program

One of Dr. Howell’s last major projects for Hopkins was to launch and be chief medical officer for the Joint Commission–accredited Baltimore Civic Center Field Hospital for COVID-19 patients, opened in March 2020.

Courtesy Dr. Eric Howell
Dr. Eric Howell was chief medical officer for the Joint Commission-accredited Baltimore Civic Center Field Hospital for COVID-19 patients, opened in March 2020.

With a surge capacity of 250 beds, and a negative pressure ward set up in the center’s exhibit hall, it is jointly operated by the University of Maryland Medical System and Johns Hopkins Hospital. The field hospital’s mission has since expanded to include viral tests, infusions of monoclonal antibodies, and COVID-19 vaccinations.

Planning for a smooth transition, Dr. Howell brought Melinda E. Kantsiper, MD, director of clinical operations, Division of Hospital Medicine at Johns Hopkins Bayview, on board as associate medical officer, to eventually replace him as CMO after a few months working alongside him. “Eric brings that logical engineering eye to problem solving,” Dr. Kantsiper said.

Courtesy Johns Hopkins Medicine
Dr. Melinda E. Kantsiper is director of clinical operations in the division of hospital medicine at Johns Hopkins Bayview Medical Center, Baltimore.


“We wanted to build a very safe, high-quality hospital setting but had to do it very quickly. Watching him once again do what he does best, initiating a new program, building things carefully and thoughtfully, without being overly cautious, I could see his years of experience and good judgment about how hospitals run. He’s very logical but very caring. He’s also good at spotting young leaders and their talents.”

Some people have a knack for solving problems, added Dr. Ziegelstein, Dr. Howell’s mentor from his early days at Bayview. “Eric is different. He’s someone who’s able to identify gaps, problem areas, and vulnerabilities within an organization and then come up with a potential menu of solutions, think about which would be most likely to succeed, implement it, and assess the outcome. That’s the difference between a skilled manager and a true leader, and I’d say Eric had that ability while still in training,” Dr. Ziegelstein said.

“Eric understood early on not only what the field of hospital medicine could offer, he also understood how to catalyze change, without taking on too much change at one time,” Dr. Ziegelstein said. “He understood people’s sensibilities and concerns about this new service, and he catalyzed its growth through incremental change.”

Editor’s note: This profile is part of SHM’s celebration of National Hospitalist Day on March 4. National Hospitalist Day occurs the first Thursday in March annually, and celebrates the fastest growing specialty in modern medicine and hospitalists’ enduring contributions to the evolving health care landscape.

For Eric E. Howell, MD, MHM, CEO since July 2020 for the Society of Hospital Medicine, an undergraduate degree in electrical engineering and a lifelong proclivity for figuring out puzzles, solving problems, and taking things apart to see how they fit back together were building blocks for an exemplary career as a hospitalist, group administrator, and medical educator.

Dr. Eric E. Howell

When he was growing up in historic Annapolis, Md., near the shores of Chesapeake Bay, things to put back together included remote control airplanes, small boat engines, and cars. As a hospitalist, his interest in solving problems and facility with numbers and systems led him to become an expert on quality improvement, transitions of care, and conflict management.

Courtesy Dr. Eric Howell
Dr. Eric Howell was raised on the shores of the Chesapeake Bay in Maryland, and continues to spend time on the water.


“One thing about engineering, you’re always having to fix things. It helps you learn to assess complex situations,” said Dr. Howell, who is 52. “It was helpful for me to bring an engineering approach into the hospital. One of my earliest successes was reengineering admissions processes to dramatically reduce the amount of time patients were spending in the emergency room before they could be admitted to the hospital.”

But his career path in hospital medicine came about by a lucky chance, following residency and a year as chief resident at Johns Hopkins Bayview Medical Center in Baltimore. “One of my duties as chief resident was taking care of hospitalized patients. I didn’t know it but I was becoming a de facto hospitalist,” he recalled.

At the time, he thought he might end up choosing to specialize in something like cardiology or critical care medicine, but in 2000 he was invited to join the new “non-house-staff” medical service at Bayview. Also called a general medicine inpatient service, it eventually evolved into the hospitalist service.

His residency program director, Roy Ziegelstein, MD, a cardiologist and now the vice dean of education at Johns Hopkins, created a job for him.

Dr. Roy Ziegelstein

“I was one of the first four doctors hired. I thought I’d just do it for a year, but I loved inpatient work, so I stayed,” Dr. Howell said. “Roy mentored me for the next 20 years and helped me to become an above average hospitalist.”

Early on, Dr. Howell’s department chair, David Hellman, MD, who had worked at the University of California–San Francisco with hospital medicine pioneer Robert Wachter, MD, MHM, sent Dr. Howell to San Francisco to be mentored by Dr. Wachter, since there were few hospital mentors on the East Coast at that time.

“What I took away from that experience was how important it was to professionalize hospital medicine – in order to develop specialized expertise,” Dr. Howell recalled. “Dr. Wachter taught me that hospitalists need to have a professional focus. Quality improvement, systems-based improvement, and value all became part of that,” he said.

“Many people thought to be a hospitalist all you had to know was basic medicine. But it turns out medicine in the hospital is just as specialized as any other specialty. The hospital itself requires specialized knowledge that didn’t even exist 20 years ago.” Because of complicated disease states and clinical systems, hospitalists have to be better at navigating the software of today’s hospital.
 

 

 

New job opportunities

Dr. Howell describes his career path as a new job focus opening up every 5 years or so, redefining what he does and trying something new and exciting with better pay. His first was a focus on clinical hospital medicine and learning how to be a better doctor. Then in 2005 he began work as a teacher at Johns Hopkins School of Medicine. There he mastered the teaching of medical trainees, winning awards as an instructor, including SHM’s award for excellence in teaching.

In 2010 he again changed his focus to program building, leading the expansion of the hospitalist service for Bayview and three other hospitals in the Johns Hopkins system. Dr. Howell helped grow the service to nearly 200 clinicians while becoming skilled at operational and program development.

His fourth job incarnation, starting in 2015, was the obsessive pursuit of quality improvement, marshaling data to measure and improve clinical and other outcomes on the quality dashboard – mortality, length of stay, readmissions, rates of adverse events – and putting quality improvement strategies in place.

“Our mortality rates at Bayview were well below national standards. We came up with an amazing program. A lot of hospital medicine programs pursue improvement, but we really measured it. We benchmarked ourselves against other programs at Hopkins,” he said. “I set up a dedicated conference room, as many QI programs do. We called it True North, and each wall had a different QI focus, with updates on the reported metrics. Every other week we met there to talk about the metrics,” he said.

That experience led to working with SHM, which he had joined as a member early in his career and for which he had previously served as president. He became SHM’s quality improvement liaison and a co-principal investigator on Project BOOST (Better Outcomes for Older adults through Safe Transitions), SHM’s pioneering, national mentored-implementation model aimed at improving transitions of care from participating hospitals to reduce readmissions. “BOOST really established SHM’s reputation as a quality improvement-oriented organization. It was a stake in the ground for quality and led to SHM receiving the Joint Commission’s 2011 John M. Eisenberg Award for Innovation in Patient Safety and Quality,” he said.

Dr. Howell’s fifth career phase, medical society management, emerged when he was recruited to apply for the SHM chief executive position – held since its inception by retiring CEO Larry Wellikson, MD, MHM. Dr. Howell started work at SHM in the midst of the pandemic, spending much of his time working from home – especially when Philadelphia implemented stricter COVID-19 restrictions. Once pandemic restrictions are loosened, he expects to do a lot of traveling. But for now, the external-facing part of his job is mainly on Zoom.
 

Making the world a better place

Dr. Howell said he has held fast to three mottos in life, which have guided his career path as well as his personal life: (1) to make the world a better place; (2) to be ethical and transparent; and (3) to invest in people. His wife of 19 years, Heather Howell, an Annapolis realtor, says making the world a better place is what they taught their children, Mason, 18, who starts college at Rice University in fall 2021 with an interest in premed, and Anna, 16, a competitive sailor. “We always had a poster hanging in our house extolling that message,” Ms. Howell said.

Dr. Howell grew up in a nautical family, with many of his relatives working in the maritime business. His kids grew up on the water, learning to pilot a powerboat before driving a car, as he did. “We boat all the time on the bay” in his lobster boat, which he often works on to keep it seaworthy, Ms. Howell said.

“There’s nothing like taking care of hospitalized patients to make you feel you’re making the world a better place,” Dr. Howell observed. “Very often you can make a huge difference for the patients you do care for, and that is incredibly rewarding.” Although the demands of his SHM leadership position required relinquishing most of his responsibilities at Johns Hopkins, he continues to see patients and teach residents there 2-4 weeks a year on a teaching service.

“Why do I still see patients? I find it so rewarding. And I get to teach, which I love,” he said. “To be honest, I don’t think you truly need to see patients to be head of a professional medical society like SHM. Maybe someday I’ll give that up. But only if it’s necessary to make the society more successful.”

Half of Dr. Howell’s Society work now is planned and half is “putting out fires” – while learning members’ needs in real time. “Right now, we’re worried about burnout and PTSD, because frankly it’s stressful to take care of COVID patients. It’s scary for a lot of clinicians. I’m working with our members to make sure they have what they need to be clinically prepared, including resources to be more resilient professionally.”

Every step of his career, Dr. Howell said, has seemed like the best job he ever had. “Making the world a better place is still important to me. I tell SHM members that it’s important to know they are making a difference. What they’re doing is really important, especially with COVID, and it needs to be sustainable,” he said.

“SHM has such a powerful mission – it’s about making patient care better, and making hospitalists better clinicians. I know the Society is having a powerful impact, and that’s good enough for me. I’m into teams. Hospital medicine is a team sport, but so is SHM, interacting with its members, staff, and board.”
 

Initiating another new program

One of Dr. Howell’s last major projects for Hopkins was to launch and be chief medical officer for the Joint Commission–accredited Baltimore Civic Center Field Hospital for COVID-19 patients, opened in March 2020.

Courtesy Dr. Eric Howell
Dr. Eric Howell was chief medical officer for the Joint Commission-accredited Baltimore Civic Center Field Hospital for COVID-19 patients, opened in March 2020.

With a surge capacity of 250 beds, and a negative pressure ward set up in the center’s exhibit hall, it is jointly operated by the University of Maryland Medical System and Johns Hopkins Hospital. The field hospital’s mission has since expanded to include viral tests, infusions of monoclonal antibodies, and COVID-19 vaccinations.

Planning for a smooth transition, Dr. Howell brought Melinda E. Kantsiper, MD, director of clinical operations, Division of Hospital Medicine at Johns Hopkins Bayview, on board as associate medical officer, to eventually replace him as CMO after a few months working alongside him. “Eric brings that logical engineering eye to problem solving,” Dr. Kantsiper said.

Courtesy Johns Hopkins Medicine
Dr. Melinda E. Kantsiper is director of clinical operations in the division of hospital medicine at Johns Hopkins Bayview Medical Center, Baltimore.


“We wanted to build a very safe, high-quality hospital setting but had to do it very quickly. Watching him once again do what he does best, initiating a new program, building things carefully and thoughtfully, without being overly cautious, I could see his years of experience and good judgment about how hospitals run. He’s very logical but very caring. He’s also good at spotting young leaders and their talents.”

Some people have a knack for solving problems, added Dr. Ziegelstein, Dr. Howell’s mentor from his early days at Bayview. “Eric is different. He’s someone who’s able to identify gaps, problem areas, and vulnerabilities within an organization and then come up with a potential menu of solutions, think about which would be most likely to succeed, implement it, and assess the outcome. That’s the difference between a skilled manager and a true leader, and I’d say Eric had that ability while still in training,” Dr. Ziegelstein said.

“Eric understood early on not only what the field of hospital medicine could offer, he also understood how to catalyze change, without taking on too much change at one time,” Dr. Ziegelstein said. “He understood people’s sensibilities and concerns about this new service, and he catalyzed its growth through incremental change.”

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SHM Converge to be an ‘intellectual feast’

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Course director Dr. Daniel Steinberg highlights top content

The weeks leading up to our Annual Conference always trigger certain rituals for me.

Dr. Daniel I. Steinberg

Deciding which sessions to attend feels like planning an intellectual feast mixed with an exercise in compromise, as I realize there is just no way to attend every session that I want to. Scheduling all my plans to connect over dinner and drinks with current and former colleagues is a logistical challenge I undertake with anticipation and some stress, especially when I’m the one tasked with making restaurant reservations. Thinking about how to pay for it all means digging out the rules around my CME faculty allowance, after first figuring out if I still even have a CME allowance, of course.

In the years that I am presenting, there are the last-minute emails with my co-presenters to arrange a time to run through our slides together on site. The prospect of seeing cherished colleagues and friends from SHM mixes with the fact that I know I will miss my wife and young son while I am away. Overall though, I am filled with a tremendous sense of excitement, a feeling that I enjoy in a sustained way for weeks before the meeting.

My excitement for SHM Converge is just as strong, but different in some great and important ways. The availability of on-demand content means I won’t have to choose one session over another this year – I can have my cake and eat it, too. Without the need to travel, expenses will be considerably less, and I won’t need to be away from my family.

But what I am most thrilled about when I think about SHM Converge is the content. A year of planning by our outstanding SHM staff, leadership, and Annual Conference Committee has produced a lineup of world-class speakers. Our virtual platform will offer a rich interactive and networking experience. Perennial favorite sessions, such as the Great Debate, Rapid Fire, and Update sessions will provide attendees the chance to update their core clinical knowledge across the breadth of hospital medicine.

Many aspects of health equity will be explored. Over 15 sessions and four special-interest forums covering topics such as racial and gender inequities, implicit bias, vulnerable populations, and ethics will help attendees not only understand the issues but also will show them how they can take action to make a difference.

Clinical and operational aspects of COVID-19 will also be covered at SHM Converge as speakers share the tremendous innovation, triumphs, and challenges that have taken place over the past year. Wellness and resilience are, of course, as relevant as ever, and sessions on balancing parenthood and work, learning from personal failures, and how to handle uncertainty and be resilient are among the topics that will be covered.

The essence of what we will do at SHM Converge in May is captured in our new meeting logo, an animation of nodes connecting with each other through lines that travel short and long, and intersect along the way. It’s a great representation of the togetherness, community, and mutual support that is at the core of who we are as SHM – now, more than ever. Thank you for joining us!

Dr. Steinberg is chief patient safety officer at Mount Sinai Downtown, and associate dean for quality/patient safety in GME, Mount Sinai Health System, New York. He is professor of medicine and medical education at the Icahn School of Medicine at Mount Sinai, and course director of SHM Converge.

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Course director Dr. Daniel Steinberg highlights top content

Course director Dr. Daniel Steinberg highlights top content

The weeks leading up to our Annual Conference always trigger certain rituals for me.

Dr. Daniel I. Steinberg

Deciding which sessions to attend feels like planning an intellectual feast mixed with an exercise in compromise, as I realize there is just no way to attend every session that I want to. Scheduling all my plans to connect over dinner and drinks with current and former colleagues is a logistical challenge I undertake with anticipation and some stress, especially when I’m the one tasked with making restaurant reservations. Thinking about how to pay for it all means digging out the rules around my CME faculty allowance, after first figuring out if I still even have a CME allowance, of course.

In the years that I am presenting, there are the last-minute emails with my co-presenters to arrange a time to run through our slides together on site. The prospect of seeing cherished colleagues and friends from SHM mixes with the fact that I know I will miss my wife and young son while I am away. Overall though, I am filled with a tremendous sense of excitement, a feeling that I enjoy in a sustained way for weeks before the meeting.

My excitement for SHM Converge is just as strong, but different in some great and important ways. The availability of on-demand content means I won’t have to choose one session over another this year – I can have my cake and eat it, too. Without the need to travel, expenses will be considerably less, and I won’t need to be away from my family.

But what I am most thrilled about when I think about SHM Converge is the content. A year of planning by our outstanding SHM staff, leadership, and Annual Conference Committee has produced a lineup of world-class speakers. Our virtual platform will offer a rich interactive and networking experience. Perennial favorite sessions, such as the Great Debate, Rapid Fire, and Update sessions will provide attendees the chance to update their core clinical knowledge across the breadth of hospital medicine.

Many aspects of health equity will be explored. Over 15 sessions and four special-interest forums covering topics such as racial and gender inequities, implicit bias, vulnerable populations, and ethics will help attendees not only understand the issues but also will show them how they can take action to make a difference.

Clinical and operational aspects of COVID-19 will also be covered at SHM Converge as speakers share the tremendous innovation, triumphs, and challenges that have taken place over the past year. Wellness and resilience are, of course, as relevant as ever, and sessions on balancing parenthood and work, learning from personal failures, and how to handle uncertainty and be resilient are among the topics that will be covered.

The essence of what we will do at SHM Converge in May is captured in our new meeting logo, an animation of nodes connecting with each other through lines that travel short and long, and intersect along the way. It’s a great representation of the togetherness, community, and mutual support that is at the core of who we are as SHM – now, more than ever. Thank you for joining us!

Dr. Steinberg is chief patient safety officer at Mount Sinai Downtown, and associate dean for quality/patient safety in GME, Mount Sinai Health System, New York. He is professor of medicine and medical education at the Icahn School of Medicine at Mount Sinai, and course director of SHM Converge.

The weeks leading up to our Annual Conference always trigger certain rituals for me.

Dr. Daniel I. Steinberg

Deciding which sessions to attend feels like planning an intellectual feast mixed with an exercise in compromise, as I realize there is just no way to attend every session that I want to. Scheduling all my plans to connect over dinner and drinks with current and former colleagues is a logistical challenge I undertake with anticipation and some stress, especially when I’m the one tasked with making restaurant reservations. Thinking about how to pay for it all means digging out the rules around my CME faculty allowance, after first figuring out if I still even have a CME allowance, of course.

In the years that I am presenting, there are the last-minute emails with my co-presenters to arrange a time to run through our slides together on site. The prospect of seeing cherished colleagues and friends from SHM mixes with the fact that I know I will miss my wife and young son while I am away. Overall though, I am filled with a tremendous sense of excitement, a feeling that I enjoy in a sustained way for weeks before the meeting.

My excitement for SHM Converge is just as strong, but different in some great and important ways. The availability of on-demand content means I won’t have to choose one session over another this year – I can have my cake and eat it, too. Without the need to travel, expenses will be considerably less, and I won’t need to be away from my family.

But what I am most thrilled about when I think about SHM Converge is the content. A year of planning by our outstanding SHM staff, leadership, and Annual Conference Committee has produced a lineup of world-class speakers. Our virtual platform will offer a rich interactive and networking experience. Perennial favorite sessions, such as the Great Debate, Rapid Fire, and Update sessions will provide attendees the chance to update their core clinical knowledge across the breadth of hospital medicine.

Many aspects of health equity will be explored. Over 15 sessions and four special-interest forums covering topics such as racial and gender inequities, implicit bias, vulnerable populations, and ethics will help attendees not only understand the issues but also will show them how they can take action to make a difference.

Clinical and operational aspects of COVID-19 will also be covered at SHM Converge as speakers share the tremendous innovation, triumphs, and challenges that have taken place over the past year. Wellness and resilience are, of course, as relevant as ever, and sessions on balancing parenthood and work, learning from personal failures, and how to handle uncertainty and be resilient are among the topics that will be covered.

The essence of what we will do at SHM Converge in May is captured in our new meeting logo, an animation of nodes connecting with each other through lines that travel short and long, and intersect along the way. It’s a great representation of the togetherness, community, and mutual support that is at the core of who we are as SHM – now, more than ever. Thank you for joining us!

Dr. Steinberg is chief patient safety officer at Mount Sinai Downtown, and associate dean for quality/patient safety in GME, Mount Sinai Health System, New York. He is professor of medicine and medical education at the Icahn School of Medicine at Mount Sinai, and course director of SHM Converge.

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SHM Converge: New format, fresh content

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Wed, 02/24/2021 - 11:08

The Society of Hospital Medicine team (myself included) is very excited to get geared up for the 2021 SHM Annual Conference, now known as SHM Converge. While we all long for a traditional in-person meeting “like the good old days”, there are some significant advantages to a virtual meeting like Converge.

Dr. Danielle B. Scheurer

The most significant advantage is the ability to review more content than ever before, as we offer a combination of live and recorded “on-demand” sessions. This allows for incredible flexibility in garnering “top-shelf” content from hospital medicine experts around the country, without having to choose from competing sessions. We are especially looking forward to new sessions this year focused on COVID-19; diversity, equity, and inclusion; and resilience.

The Converge conference will still be offering networking sessions throughout – even in the virtual conference environment. We consider networking a vital and endearing part of the value equation for SHM members. For example, we now can participate in several Special Interest Forums, since many of us have several niche interests and want to take advantage of more than one of these networking opportunities. We also carefully preserved the signature “Update in Hospital Medicine” session, as well as the scientific abstract poster reception and the Best of Research and Innovation sessions. These are long-term favorites at the annual conference and lend themselves well to virtual transformation. Some of the workshops and special sessions have exclusive audience engagement and are not offered on demand, so signing up early for these sessions is highly recommended.

SHM remains the professional home for hospitalists, and we rely on the annual conference to keep us all informed on current and forward-thinking clinical practice, practice management, leadership, academics, research, and other topics. This is one of many examples of how SHM has been able to pivot to meet the needs of hospitalists throughout the pandemic. Not only have we successfully converted “traditional” meetings into virtual meetings, but we have been able to curate and deliver content faster and more seamlessly than ever before.

Whether via The Hospitalist, the Journal of Hospital Medicine, the SHM website, or our other educational platforms, SHM has remained committed to being the single “source of truth” for all things hospital medicine. Within the tumultuous political landscape of the past year, the SHM advocacy team has been more active and engaged than ever, in advocating for a myriad of hospitalist-related legislative changes. These are just a few of the ways SHM continues to add value to hospitalist members every day.

Although we will certainly miss seeing each other in person, we are confident that the SHM team will meet and exceed expectations on content delivery and will take advantage of the virtual format to improve content access. We look forward to “seeing” you at SHM Converge this year and hope you take advantage of the enhanced delivery and access to an array of amazing content!

 

Dr. Scheurer is president of the Society of Hospital Medicine. She is a hospitalist and chief quality officer, MUSC Health System, Medical University of South Carolina, Charleston.

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The Society of Hospital Medicine team (myself included) is very excited to get geared up for the 2021 SHM Annual Conference, now known as SHM Converge. While we all long for a traditional in-person meeting “like the good old days”, there are some significant advantages to a virtual meeting like Converge.

Dr. Danielle B. Scheurer

The most significant advantage is the ability to review more content than ever before, as we offer a combination of live and recorded “on-demand” sessions. This allows for incredible flexibility in garnering “top-shelf” content from hospital medicine experts around the country, without having to choose from competing sessions. We are especially looking forward to new sessions this year focused on COVID-19; diversity, equity, and inclusion; and resilience.

The Converge conference will still be offering networking sessions throughout – even in the virtual conference environment. We consider networking a vital and endearing part of the value equation for SHM members. For example, we now can participate in several Special Interest Forums, since many of us have several niche interests and want to take advantage of more than one of these networking opportunities. We also carefully preserved the signature “Update in Hospital Medicine” session, as well as the scientific abstract poster reception and the Best of Research and Innovation sessions. These are long-term favorites at the annual conference and lend themselves well to virtual transformation. Some of the workshops and special sessions have exclusive audience engagement and are not offered on demand, so signing up early for these sessions is highly recommended.

SHM remains the professional home for hospitalists, and we rely on the annual conference to keep us all informed on current and forward-thinking clinical practice, practice management, leadership, academics, research, and other topics. This is one of many examples of how SHM has been able to pivot to meet the needs of hospitalists throughout the pandemic. Not only have we successfully converted “traditional” meetings into virtual meetings, but we have been able to curate and deliver content faster and more seamlessly than ever before.

Whether via The Hospitalist, the Journal of Hospital Medicine, the SHM website, or our other educational platforms, SHM has remained committed to being the single “source of truth” for all things hospital medicine. Within the tumultuous political landscape of the past year, the SHM advocacy team has been more active and engaged than ever, in advocating for a myriad of hospitalist-related legislative changes. These are just a few of the ways SHM continues to add value to hospitalist members every day.

Although we will certainly miss seeing each other in person, we are confident that the SHM team will meet and exceed expectations on content delivery and will take advantage of the virtual format to improve content access. We look forward to “seeing” you at SHM Converge this year and hope you take advantage of the enhanced delivery and access to an array of amazing content!

 

Dr. Scheurer is president of the Society of Hospital Medicine. She is a hospitalist and chief quality officer, MUSC Health System, Medical University of South Carolina, Charleston.

The Society of Hospital Medicine team (myself included) is very excited to get geared up for the 2021 SHM Annual Conference, now known as SHM Converge. While we all long for a traditional in-person meeting “like the good old days”, there are some significant advantages to a virtual meeting like Converge.

Dr. Danielle B. Scheurer

The most significant advantage is the ability to review more content than ever before, as we offer a combination of live and recorded “on-demand” sessions. This allows for incredible flexibility in garnering “top-shelf” content from hospital medicine experts around the country, without having to choose from competing sessions. We are especially looking forward to new sessions this year focused on COVID-19; diversity, equity, and inclusion; and resilience.

The Converge conference will still be offering networking sessions throughout – even in the virtual conference environment. We consider networking a vital and endearing part of the value equation for SHM members. For example, we now can participate in several Special Interest Forums, since many of us have several niche interests and want to take advantage of more than one of these networking opportunities. We also carefully preserved the signature “Update in Hospital Medicine” session, as well as the scientific abstract poster reception and the Best of Research and Innovation sessions. These are long-term favorites at the annual conference and lend themselves well to virtual transformation. Some of the workshops and special sessions have exclusive audience engagement and are not offered on demand, so signing up early for these sessions is highly recommended.

SHM remains the professional home for hospitalists, and we rely on the annual conference to keep us all informed on current and forward-thinking clinical practice, practice management, leadership, academics, research, and other topics. This is one of many examples of how SHM has been able to pivot to meet the needs of hospitalists throughout the pandemic. Not only have we successfully converted “traditional” meetings into virtual meetings, but we have been able to curate and deliver content faster and more seamlessly than ever before.

Whether via The Hospitalist, the Journal of Hospital Medicine, the SHM website, or our other educational platforms, SHM has remained committed to being the single “source of truth” for all things hospital medicine. Within the tumultuous political landscape of the past year, the SHM advocacy team has been more active and engaged than ever, in advocating for a myriad of hospitalist-related legislative changes. These are just a few of the ways SHM continues to add value to hospitalist members every day.

Although we will certainly miss seeing each other in person, we are confident that the SHM team will meet and exceed expectations on content delivery and will take advantage of the virtual format to improve content access. We look forward to “seeing” you at SHM Converge this year and hope you take advantage of the enhanced delivery and access to an array of amazing content!

 

Dr. Scheurer is president of the Society of Hospital Medicine. She is a hospitalist and chief quality officer, MUSC Health System, Medical University of South Carolina, Charleston.

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