Working hospitalists frequently find themselves leading quality initiatives, writing care protocols, sitting on a variety of committees, or engaged in other activities aimed at improving the hospital environment as a whole—not just the care of individual patients. Some even direct their hospital medicine group.
For many hospitalists, such activities may be auditions for progressively greater management responsibilities, eventually leading to physician executive positions, perhaps even leaving clinical practice behind. Experience as a hospitalist can be helpful when moving up the career ladder, say those who have followed this path, but advances also pose trade-offs in their working lives.
Hospital medicine can offer some of the best opportunities in all of healthcare for physicians to transition into administrative or executive positions, says SHM CEO Larry Wellikson, MD, FACP. “I believe that in 15 years or less, a quarter of hospital CEOs and half of hospital chief medical officers will have started their careers as hospitalists,” he predicts.
Such demand for hospitalists-turned-executives raises important implications for the field, and for SHM because many who make the transition will lack formal management training, says Dr. Wellikson.
“I keep hearing from 37-year-old hospitalists who are sitting at the table with healthcare management types,” he adds. “They feel they are at a distinct disadvantage because they never learned the essential management skills.”
SHM plans to explore collaborations with other healthcare organizations to develop a comprehensive management curriculum that could be completed by working hospitalists during one weekend a month over the course of several years. SHM already offers a four-day intensive Leadership Academy. (See “Society Pages,” p. 8.)
Some of those who have made the transition say management is the last thing they expected to do when they entered medicine. One of these hospitalists is Russell L. Holman, MD, SHM president-elect and senior vice president and national medical director of Cogent Healthcare, Irvine, Calif.
“I believe my career has been marked by a series of defining moments, with one opportunity following another,” he says. “If you had asked me 15 years ago if I would be in this position, I’d have said, ‘Hell no!’ I had absolutely no interest in the business side of medicine and, frankly, I found it boring.”
Dr. Holman was initially drawn to internal medicine for the opportunity to establish long-term relationships with his patients, but then found that his residency training had really prepared him more for working in the hospital.
“I also found myself drawn to the challenge of the hospital environment and its very ill patients, with the opportunity to establish rapport and trust in a short period of time and achieve significant improvements in their care quickly,” he explains. He was also drawn to the environment. “I viewed the hospital as a complex setting to navigate, and I saw a lot of opportunities for improvement overall—which was also an opportunity for professional growth and accomplishment.”
During Dr. Holman’s year as chief resident, he realized that meetings with administrators and non-physician clinical personnel could be vehicles to accomplish larger goals. “I also began to experience the vicarious rewards that can be achieved from the accomplishments of others through the administrator’s role of making it easier for them to do their jobs,” he says.