I believe there is no better field than hospital medicine to find your career path, and there’s no better organization than SHM to support you as you follow that path. My path is probably similar to most, a little unplanned and a little unexpected, but I am sure each member has their story. Hospital medicine made an early impact on me during an internship where I was exposed to physician role models with terrific leadership skills. They were blazing trails by challenging long-held beliefs about the care of hospitalized patients.
The term “hospitalist” had not yet quite penetrated national consciousness, but Dr. Bob Wachter and Dr. Lee Goldman had already started implementing the model at the University of California, San Francisco, where I was privileged to be an intern during an exciting time. There, I learned directly from some of the individuals who would quickly become pioneers in hospital medicine, influencing a generation of physicians by putting definition and structure around the concept of a hospitalist.
During residency, I saw these hospitalists demonstrate key leadership attributes that distinguished from other physicians. They had an appreciation for the team, a collaborative approach, and an ability to understand the complexity of coordinating acute care. They led from the front, not from behind the lines. So it was no wonder that so many of my colleagues gravitated toward this new field.
After residency, my first job was at a community hospital in Marin, Calif., where a new hospitalist program had started just a year or two earlier. The same collaborative skills that created better patient care with nurses, pharmacists, and the medical staff were positively reinforced and recognized. I got married and had my first child, and my path took a turn east to the Cleveland Clinic. Now back in the academic world and after two more children, that path for me turned in highly unexpected ways—as a department chair, then as medical director for data and analytics, then briefly overseeing population health, and now as head of a hospital in the Cleveland Clinic system.
Stories like mine are not at all extraordinary. At HM16 in San Diego, I heard stories of hospitalists ascendant in their organizations, being given incredible responsibilities and a long rope. The day-to-day work we have done as hospitalists has been our training for all these roles. This daily practice demands a level of growth, development, and exposure that no other specialty requires. There is no better environment to learn about leadership, teaching, and complex systems than perhaps the most complex system of all—the hospital. In this environment, we have innumerable opportunities to find, pick, and create our own paths to improve our healthcare system at every level from the bedside to the top of the Centers for Medicare & Medicaid Services (CMS).
Hospital medicine puts so many components and challenges of healthcare in our daily practice: complex team problem-solving; relationships up, down, and across a hierarchy; IT; education; process improvement; ethics; medical staff politics. The successful hospitalist, by definition, has to be able to learn and attain mastery across a broad set of knowledge and skills. We have become naturals in a world of “matrixes management” because it is how we live our lives every day. This is why when our medical staffs and administration come looking for a project leader, a new department chair, a head of patient experience, a leader, or an educator, they come looking for us.
As SHM’s new president, I commit to SHM being the organization that is dedicated to helping you. It’s impossible to see around every corner, but starting in the coming year, I think SHM and hospitalists have to move forward in four key directions: