Along the way, Dr. Holman’s mentors encouraged him to recognize an aptitude for management and seek additional opportunities to practice it. On his own, he recognized his need for professional development opportunities to acquire management skills. He took weekend seminars and attended conferences to help him learn how to run effective team meetings, communicate with colleagues, and approach financial reports. Combined interests in teaching and management led Dr. Holman to the chair of the SHM Leadership Development Task Force. He became course director for its Leadership Academy, first offered in 2005.
The Ideal Hospitalist Program
Stacy Goldsholl, MD, president of the Hospital Medicine Division of TeamHealth, Knoxville, Tenn., was a working hospitalist for 11 years before making the move.
“Along the way, I started to develop a real sense of what my own ideal hospital medicine program would look like, not just in terms of clinical excellence, but also physician professional satisfaction,” she says. Dr. Goldsholl worked in several hospitalist groups in different parts of the country, running one group and later setting up an 11-member hospitalist practice from scratch in Pennsylvania, with a 50% time commitment for administrative work.
“How did I prepare for that role? A lot of it is seat-of-your-pants, although a mentor had pointed me toward a physician management training course,” she said. Last year Dr. Goldsholl joined TeamHealth and became 100% administrative. “It’s a double-edged sword, giving up the clinical piece. Part of the success of any physician executive is having a passion for patient care. Clinical work is something I definitely miss. But the higher goal is to impact larger health systems.”
Dr. Goldsholl’s current job includes standardizing TeamHealth’s hospitalist practices nationwide, providing leadership for regional directors, and reporting on quality indicators. “But the biggest piece of my current job is business development—going out to meet with clients,” she explains. Those clients include hospital executives and potential acquisition partners.
“Is this a path for other hospitalists?” asks Dr. Goldsholl. “Absolutely. Not necessarily my exact role, but jobs like vice president of medical affairs for a hospital, patient safety officer, CEO, or medical director of a medical company. Those positions will be filled by hospitalists. Physicians who choose to be hospitalists already see themselves as change agents, so many will gravitate toward a leadership role. Young hospitalists with that same passion, once they come to understand the health care system, it ignites their passion to make things better on a larger scale.”
Hospitalist David Bowman, MD, has been executive director of the Tucson, Ariz., Region of IPC—the Hospitalist Company since 2000, after playing major roles in establishing medical practices and a physician’s organization. Today he is the only physician among the company’s executive directors. “Those guys are smart,” he says. “They look at medicine from a higher level.”
Dr. Bowman, like Drs. Holman and Goldsholl, sometimes thinks about pursuing a master’s degree. But he is reluctant to take the time away from what he is now doing.
“I don’t think I could go further than I have without the letters MBA after my name,” he speculates. “But I’m happy enough where I am and, if need be, I could still go back to hospitalist work.”
Dr. Bowman found his initial foray into administration as head of a five-member group practice. “At 7:30 at night I’d be signing checks,” he recalls. “If there was any money left over, the last check would be my own salary.”
Today his position is 75% administrative and 25% clinical. He has been able to get his fill of clinical work by taking hospitalist shifts evenings and weekends. “I don’t want to lose my medical skills, but I like administration much more than I thought I would,” he says. “What I have learned is just how much it takes to support the physician who walks up to the patient’s chart, opens it, writes an order for an MRI of the brain, and then closes the chart again. It’s mind-boggling how complex the system is in supporting that 30-second action—how many other people are involved in making it happen, all of the areas for potential error. That’s why we work so hard on patient safety—which has to start at the top and flow from there.”