The New Institutional Leadership

Dr. Z has practiced hospital medicine at his local community hospital for the past three years. When he came on staff he quickly volunteered for a committee, and today he is its chair. Though he has a heavy workload, he has found the time to take several business courses at a nearby college, and he rarely turns down an opportunity to address a group.

Since he began his practice, he has never missed a local or national meeting of the professional associations to which he belongs. Dr. Z is a hospitalist with an ardent desire to make a difference. He believes he can be most effective in a hospital-wide administrative position, and he is preparing himself.

Dr. Z is a hypothetical example of a growing number of practicing hospitalists who are moving—or desire to move—into hospital-wide decision-making positions. What is the likelihood for their advancement to the higher echelons of hospital administration? Very good for those who have the right stuff for leadership, according to Larry Wellikson, MD, CEO of SHM.

Consider this: Just a decade ago, there were about 100 pioneering hospitalists caring for patients in 20 hospitals. Today there are 20,000 hospitalists serving patients in 2,500 hospitals across the country. Hospital medicine is the fastest growing medical specialty in the United States. The time is right for hospitalists to rise to the fore—not just as leaders of their hospitalist groups but also as system-wide decision makers.

Stacy Goldsholl, MD, represents the new breed: hospitalist as leader. Dr. Goldsholl has been a hospitalist for 12 years. “I got my first job as a community hospitalist before the term was even coined,” she says. “After about five years, I really hit a low point in my career. I was dissatisfied with the way the system was working; I didn’t feel there was enough emphasis on quality patient care. I was at a crossroad. I even considered giving up medicine altogether and going to rabbinical school,” she says, laughing. “But I was very passionate about making things better, so instead of quitting medicine, I embarked on a solo jaunt around the country trying to interest people in improving hospital medicine.”

Today Dr. Goldsholl is president of the Hospital Medicine Division of TeamHealth (Knoxville, Tenn.), a nationwide outsourcing provider of hospitalists in areas as far flung as Puerto Rico and Hawaii.

Though there are no hard-and-fast statistics on how many hospitalists now have leadership roles, Dr. Wellikson says the numbers are swelling. “It’s getting harder and harder to find someone who has strong leadership skills who’s five years into practice who is still just seeing patients,” he says. “There’s such a crying need for leadership in managing the team, leading the hospital medicine group, improving the hospital, improving the quality of care … there’s an enormous void. The first time somebody shows up who has an interest or an aptitude, someone will say, ‘Why don’t you be in charge?’ ”

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