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Miguel Angel Villagra Brings Management Skills to The Hospitalist's Volunteer Editorial Advisory Board


Some have called this the “Year of the Hospitalist,” as it’s the 20th anniversary of the New England Journal of Medicine paper by Dr. Robert Wachter and Dr. Lee Goldman that first used the term “hospitalist” to describe physicians who care for hospitalized patients.

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But the paper was more than just that to Miguel Angel Villagra, MD.

He saw it four years ago while training in internal medicine at Texas Tech University Health Sciences Center in El Paso, Texas.

“I was very intrigued,” Dr. Villagra says. “I asked a few of my mentors. They were very skeptical on following a hospitalist career, [but] I saw opportunities for improvement and professional growth in the field, so I decided to jump in. And after four years, I don’t regret my decision of becoming a full-time hospitalist.”

Miguel Angel Villagra, MD

Miguel Angel Villagra, MD

The field doesn’t regret it either. Dr. Villagra was promoted last fall to hospitalist department program medical director at White River Medical Center in Batesville, Ark. And this year, he was named one of eight new members of Team Hospitalist, The Hospitalist’s volunteer editorial advisory board.

Question: Why did you choose a career in medicine?

Answer: At age 11 and after an emergent appendectomy, I decided that I wanted to become a physician. That was one of the best decisions of my life. It is a great combination of art and science, and you get to help people in difficult moments of their life.

Q: Tell us more about your background.

A: I went to medical school in my country of origin at Universidad Autonóma de Nicaragua of Managua, and I did an internal medicine residency at Hospital Militar Escuela Dr. Alejandro Dávila Bolaños. I came to the U.S. for internal medicine residency training at Texas Tech of El Paso. I enjoy learning new skills and this power of knowledge that can help your patients in desperate moments. Most of my challenges during my training involved how to manage stress and sleep deprivation.

Q: Did you have a mentor during your training or early career? If so, who was the mentor, and what were most important lessons you learned from them?

A: Dr. Jorge Cuadra [from Hospital Militar in Nicaragua] and Dr. Manuel Rivera [from Texas Tech], both pulmonologists. They taught me that medicine is a changing field that requires everyday reading. You never end learning new things and approaches. Taking full advantage of your interaction with your patients always improves your clinical skills.

Q: What do you like most about working as a hospitalist?

A: It is an evolving field; we are still trying to “figure it out.” That creates challenges but also opportunities for growth and career development, [for example], how to tackle the readmission problem, how to improve quality at lower cost while keeping patient satisfaction, how to face the burnout challenge and improve physician engagement, just to name a few.

Q: What do you dislike most?

A: In the beginning of my career as a hospitalist, I was exposed constantly to high patient loads that were more than I should have. I also dislike the difficulties at times of electronic medical records. You have to spend excessive time sitting in front of a monitor.

Q: You note the challenges the field of HM is facing. How exciting is it to hopefully be part of the solutions?

A: I feel pumped having been part of this amazing movement of hospital medicine. I think we are leading the change from the acute-care setting front line, helping to take better care of our patients. The current healthcare changes create multiple challenges and, along with that, endless opportunities for professional growth and career development.

Q: You’ve said you see being a chief quality officer in the future. Why? What appeals about those C-suite positions?

A: I think that physicians as leaders are in a great position to drive the change within a healthcare organization toward high-value care. We are at the front line, at the bedside taking care of patients. That gives us firsthand information on what needs to be done. With appropriate training, we can be the executives the institution needs. When I started my role as medical director, initially I focused mainly on managing the group, but rapidly I was involved in several quality projects and academic activities. And soon I realized that I can have a broader impact on what I was doing, going beyond the bedside where you try to offer the best care possible for your patients to an organizational level of change.

Q: How has your journey from Nicaragua to the U.S. shaped you, and how has it shaped the way you practice medicine?

A: Certainly it shaped what I am today, coming from a country that struggles with poverty. During medical school, you lack advances in technology and depend mainly on your desire to excel and be better for the benefit of your patients. You build strong clinical skills from history to physical exam. When you move to the U.S. and have access to so many technological advances, from new diagnostic tests to top-of the-line imaging studies, you combine the best of both worlds, and [that] makes you a better physician. I am very proud of my heritage, and definitely I wouldn’t change anything on my path thus far. I believe the more you overcome difficulties and adversities, the more you appreciate what you accomplished.

Q: As a group leader, why is it important for you to continue seeing patients?

A: We lead our teams by example, and that requires treating patients. I am also a clinician, and I love my profession, so I don’t foresee myself only in an administrative role. Finding the sweet spot of clinician-administrative time is very difficult, and I am still working on it.

Q: What’s the best advice you ever received?

A: Read and learn every day, be good to people, and also dream big.

Q: What’s the worst advice you ever received?

A: Never get married. I didn’t listen.

Richard Quinn is a freelance writer in New Jersey.

Meet Team Hospitalist

Team Hospitalist is a voluntary editorial advisory board composed of physicians, physician assistants, nurse practitioners, and administrators working in hospitalist groups all across the United States. The 12-member group meets monthly to discuss hot topics in hospital medicine and meets annually at the SHM annual meeting.

Joshua LaBrin, MD, FACP, SFHM

Dr. LaBrin is an assistant professor of medicine at the University of Utah in Salt Lake City, working as an academic hospitalist. He completed his medical degree at Temple University School of Medicine in Philadelphia and then an internal medicine/pediatrics residency at the University of Pittsburgh, where he served as chief resident. He served as a hospital medicine fellow at Mayo Clinic (Hospital Medicine), Rochester, Minn., in the Department of Medicine, Division of Hospital Internal Medicine. He is actively involved in medical education, both in faculty development and in the clinical education of students and residents on the teaching services at the University of Utah Hospital.

Elizabeth Cook, MD

Dr. Cook is medical director of Hospitalist Associates of Virginia, where she provides management and coordination of care of acutely ill medical and surgical patients. She also serves as supervising physician at Matrix Medical Network, where she provides oversight to nurse practitioners through monthly chart reviews.

Lisa Courtney

Courtney serves as director of operations at Baptist Health Systems in Birmingham, Ala. She is responsible for accounts receivable management across a multisite hospitalist program; develops, maintains, and attains budget objectives; and works with the medical directors and hospital staff on quality initiatives and process improvement opportunities.


Trask is national vice president of the hospital medicine service line for Catholic Health Initiatives, a nonprofit faith-based health system formed in 1996 and based in Englewood, Colo.

Robert Zipper, MD, MMM, SFHM

Dr. Zipper is a regional chief medical officer at Tacoma, Wash.–based Sound Physicians, where he provides clinical and operational oversight of Sound’s various service lines in the Pacific Northwest. An active SHM member, he has served as chairman of the SHM Leadership Committee.

James Levy, PA-C, SFHM

Levy has been a clinician for 40 years and a hospitalist for nearly 20 years. He is a founder and currently managing partner and vice president of human resources of iNDIGO Health Partners, a rapidly expanding Midwestern hospitalist company also active in post-acute care and inpatient telemedicine. He has been active in SHM for seven years and is especially interested in the preservation and strengthening of rural hospitals.

Michael Beck, MD, FAAP

Dr. Beck has been an academic hospitalist since 2001. He is board-certified in internal medicine/pediatrics and a certified green belt in Six Sigma. His research interests include applying Lean/Six Sigma to healthcare quality. His clinical interests include hypercoagulability, rheumatic diseases, and orthostatic intolerance/postural orthostatic tachycardia syndrome. He started a pediatric diagnostic dilemma service and pediatric post-acute-care hospital-to-home transition service.

Geeta Arora, MD

Dr. Arora is board-certified in internal medicine and integrative holistic medicine. She practices locum tenens hospitalist medicine, telemedicine, and integrative holistic medicine. She also consults physicians interested in locum tenens medicine. Her integrative medicine work is based out of New York City.

Sarah Stella, MD

Dr. Stella is a hospitalist and physician adviser at an academically affiliated safety-net hospital in Denver. She is an assistant professor of medicine at the University of Colorado School of Medicine.

Miguel Angel Villagra, MD

Dr. Villagra is a hospitalist based in Batesville, Ark. He is medical director of the hospitalist medicine program at White River Medical Center.

David Weidig, MD

Dr. Weidig is a regional medical director for Sound Physicians, based in Tacoma, Wash.

Benjamin Frizner, MD

Dr. Frizner is a former hospitalist and now a post-acute-care physician. He is the director of the long-term ventilator unit at Future Care Irvington in Baltimore for CEP America.

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