James Levy, PA-C, SFHM, isn’t a doctor. But he’s been a hospitalist for more than 15 years.
A veteran physician assistant (PA), Levy is vice president of human resources (VPHR) for iNDIGO Health Partners of Traverse City, Mich., a firm he has co-owned since it began in 2008. From 2001-2013, he was a PA at Hospitalists of Northern Michigan, also in Traverse City.
A longtime SHM member who serves on the SHM NP/PA Committee and speaks regularly at SHM meetings, Levy finds the joy of HM is simple: It follows a patient from admission to discharge.
“Clinically, I enjoy seeing the patient through the process of initial assessment, enacting a plan, and following the patient through to discharge,” he says. “Making a clinical judgment, acting on it, and being rewarded by an improving patient is deeply satisfying, as is working as part of a team with a common goal.”
His newest team is Team Hospitalist, The Hospitalist newsmagazine’s volunteer editorial advisory group. He is one of seven new members seated this year.
Question: Why did you choose a career in medicine?
Answer: I was interested in biology and science, but after a meandering academic career with the ultimate purpose of avoiding the draft, I was badly injured in a car accident. Having recovered, draft deferment in hand, I wound up as an operating room technician and immediately knew medicine was what I had to do. When I realized I preferred to deal with patients who were actually awake, my direction was established.
Q: Was there a specific person/mentor who steered you to hospital medicine?
persistence, and common decency. —James Levy, PA-C, SFHM
A: The hospitalists I initially encountered when I dipped my toe into inpatient medicine were passionate and engaged. Their understanding of the medicine we were doing was profound, and I was hooked. Several of them are still my partners.
Q: Tell me a little more about your training. What did you like most, dislike during the process? Was there a single moment you knew “I can do this?”
A: I’m a PA, which means I do a great deal of what a physician does with a fraction of the training. Much of what I know I’ve learned from patients, but I’m not sure that separates me from many good, experienced physicians. As the VPHR of my hospitalist company, I’ve hired many physicians, PAs, and NPs. I have come to feel that great clinicians are less about training and more about intelligence, commitment, work ethic, honesty, persistence, and common decency. These are qualities that would predict success in any field.
Q: What do you dislike most about HM?
A: All hospitalists share many of the same frustrations and irritations. The thing I hate most is when I feel I’ve done my best and the patient isn’t improving. Both parties have to do their part in order for the encounter to be successful.
Q: What’s the best advice you ever received?
A: An early physician mentor told me, “Take care of the patient, and the money will take care of itself.” My father taught me to avoid debt and live below my means. My kids taught me that often all you have to do is show up and care.
Q: Did you have a mentor during training or early career? If so, who was the mentor, and what were the most important lessons you learned from him/her?
A: My early mentor was our family doctor. He took a kindly interest in me and convinced me that I could be someone worthy of his respect and my own.
Q: What’s the biggest change you’ve seen in HM in your career?
A: The advent of EHR has done more to change the mechanics of inpatient practice than anything else.
Q: As a hospitalist, seeing most of your patients for the very first time, what aspect of patient care do you find most challenging?
A: It’s a real challenge to try to develop a working, human-to-human relationship with every sick stranger you encounter.
Q: What aspect of patient care is most rewarding?
A: When you acquire the skill of gaining the trust of a complete stranger on an initial encounter, it becomes a rewarding thing to do.
Q: Outside of patient care, tell me about your career interests.
A: I am a partner in, and officer of, the hospitalist company I helped start. Our overarching goal is to strengthen and stabilize the small, rural hospitals where we run programs. Without those hospitals, many patients will not be able to overcome the challenges of distance and winter travel to get the care they need. I am absolutely passionate about seeing this mission succeed in as many places as possible.
Q: What is your biggest professional challenge?
A: I spend lots of time talking to and working with the young physicians, PAs, and NPs I’m trying to recruit. This becomes more and more difficult as more hospitalist opportunities open and the pool of good clinicians does not expand. I’m often in the position of trying to interest a physician trained in an urban center in the advantages of working in an outlying location. Some get it; some don’t.
Q: What is your biggest professional reward?
A: Attracting a great clinician to a program where I’m sure s/he will be successful is a great thing for the individual and for that hospitalist team.
Q: What did it mean for you to be selected a Senior Fellow in Hospital Medicine?
A: This was especially meaningful to me as a PA because it was SHM really meaning it when they aspired to be a “big tent” society. I know of no other medical group that is this inclusive.