As a young student and resident, Joshua Allen-Dicker, MD, MPH, was stunned to see the flip side of medicine—miscommunication, disenfranchised patients, unnecessary testing, and, worst of all, medical errors. But then he saw a cast of doctors working against that tide and realized he wanted to be one of them.
“I was shocked at the existence of these problems but struck by the fervor of those physicians who worked to build systems that promoted safe and effective care,” Dr. Allen-Dicker says. “More often than not, these physicians were hospitalists. I was inspired to learn more about hospital medicine. I found that the core skills of the hospitalist—teamwork, problem-solving, communication, and leadership—were key areas that I wanted to develop.”
And so he has. Dr. Allen-Dicker recently joined the division of general medicine and primary care at Beth Israel Deaconess Medical Center in Boston. He’s also an instructor in medicine at Harvard Medical School and was previously in the division of hospital medicine at Icahn School of Medicine at Mount Sinai in New York City. He is a member of SHM’s Physicians in Training Committee, is on the faculty for HM15 in Washington, D.C., and is scheduled to speak as part of the new Young Hospitalists track.
Dr. Allen-Dicker, one of six new members of Team Hospitalist, The Hospitalist’s volunteer editorial advisory group, clearly loves his chosen profession. But as a young doctor in HM, a specialty that is itself often described as being in its adolescence, he admits there is one irksome question he hears a lot.
Hospitalists can be residency program directors, hospital administrators, important academics, lauded teachers, and even the CMO of Medicare. None of those things are possible without first being a good clinical hospitalist, which is what I’m focusing on right now.
“I struggle with the question, ‘So what do you want to be when you grow up?’” he says. “Hospital medicine is a young field, and many patients, families, and occasionally some older physicians are not aware that [it] is a long-term career option. As hospitalists continue to demonstrate leadership in clinical care, academics, and education, this question will fade away.”
Question: What’s the best advice you ever received?
Answer: Just be yourself. People are exceptionally skilled at identifying when you’re not being authentic with them.
Q: What’s the worst advice you ever received?
A: Just be yourself. People rarely get things consistently right in healthcare without the right training. I say, “Be yourself, but practice first.”
Q: Did you have a mentor during training?
A: It wasn’t until I moved to New York City for my hospitalist position that I clearly saw how much I owed my residency mentors. I recognized that, with each interaction we have—with nurses, patients, families, other physicians—we make a decision about what kind of doctor we are going to be that day. For me, choosing to channel little parts of my mentors made my move to a new city less lonely and helped me to figure out how to be the doctor I wanted to be. ‘How would Tony answer that question? What would Anjala do right now?’ And if I didn’t know the answer, I acted as if there were someone who might want to channel me someday.
Q: Have you tried to mentor others?
A: There is a new generation of future hospitalists—students who never experienced a hospital without hospitalists and young physicians who have known they wanted a career in hospital medicine since beginning medical school. They are hungry for guidance and eager to be engaged. We are starting a hospital medicine interest group at my hospital to help create a formal pathway for those interested in hospital medicine mentorship. I am really excited about this project.
Q: What’s the biggest change you would like to see in HM?
A: I’m interested to see how hospital medicine engages students and trainees who are interested in hospital medicine. How we educate them, and how much we allow them to educate and change us, will be a defining issue as hospital medicine comes of age.
Q: What aspect of teaching in the 21st century is most difficult? And, what is most enjoyable?
A: As technology becomes increasingly integrated into healthcare and education, there are so many different modalities for engaging learners. Picking a topic and learning points is easy—picking how to teach it is the tough part! Seeing learners take knowledge you’ve imparted—whether it relates to management of renal failure, high-value care, or the patient experience—and put it into clinical practice is amazing.
Q: What is your biggest professional reward?
A: Remaining open to new ideas is a challenge and reward. It’s easy to get caught up in “this is the way we’ve always done this and thought about this.” For me, part of trying to become a better doctor means learning something new each day. I don’t always succeed, but it feels so good when I do.
Q: What SHM event has made the most lasting impression on you?
A: My first national HM conference as a PGY-2 resident. It was an amazing and energizing feeling to sit in the large plenary session with 3,000 hospitalists. I thought to myself, ‘This is a movement that is changing healthcare. I want in.’
Q: Where do you see yourself in 10 years?
A: One of the great things about hospital medicine is how flexible it can be as a career choice. Hospitalists can be residency program directors, hospital administrators, important academics, lauded teachers, and even the CMO of Medicare. None of those things are possible without first being a good clinical hospitalist, which is what I’m focusing on right now.
Q: What impact do you feel devices like smartphones and tablets have had on HM?
A: It’s amazing to see how much bottom-up innovation Apple and Google have inspired with their products. Without waiting for large, hospital-wide investments (e.g. electronic health records), physicians, start-ups, and patients are empowering themselves and changing healthcare. I would just recommend avoiding the mentality that every problem can be solved by buying patients/physicians/staff an iPad. Technology is not a substitute for well-designed healthcare delivery systems.
Richard Quinn is a freelance writer in New Jersey.