Medicolegal Issues

Lessons in Leadership


For hospitalists attending SHM’s Leadership Academy, the final day isn’t the end of the experience. It’s just the beginning.

Now in its fifth year, the Leadership Academy provides hospitalists of all backgrounds the opportunity to come together and address the managerial and practical issues of HM that aren’t covered in medical school. The demand for leadership training within the specialty has been so great that the Leadership Academy is now split into two levels; Level II is reserved for hospitalists who have completed the Level I program or have an MBA.

Level I covers the fundamental elements for leading groups—and change—within a hospital. Hospitalists learn how to take on leadership roles, better understand group dynamics, manage conflict, and improve communication.

Level II, which traditionally has had smaller class sizes, goes deeper into managerial issues that relate to hospital administration and leadership. The advanced program features such all-day sessions as “Financial Storytelling” and the popular “Meta-Leadership in Hospital Medicine.”

Leadership Academy’s true impact is felt shortly after hospitalists return to their hospitals. “Hospitalists send e-mails within a week of the end of Leadership Academy,” says Larry Wellikson, MD, FHM, CEO of SHM. “They tell us about the tangible actions that they’ve already taken as a result of what they’ve learned over the four days of Leadership Academy. … In just a few days, hospitalists learn from some of the best in the specialty and thought leaders outside of the field, too.”

It’s absolutely worth it. Both levels are worth the time and investment. And “leadership” doesn’t necessarily mean being a leader of your group. It can also mean being a leader of change and initiatives within the hospital.

—Rachel George, MD, regional medical director, vice president of operations, Cogent Healthcare, Brentwood, Tenn.

Immediate Results

Hospitalists—and those who work with them—often see the change the academy has on a physician soon after the attendee returns to work. “It’s like a light bulb goes on,” says Rachel George, MD, regional medical director and vice president for operations at Brentwood, Tenn.-based Cogent Healthcare. “They get it. They come back from the Leadership Academy with an understanding of how to lead their own groups and manage through change.”

Dr. George, who attended Level I and Level II programs and now facilitates academy sessions, says Leadership Academy is “almost mandatory” for Cogent’s medical directors. The company encourages all of its physicians to attend.

One of the most valuable aspects of the program, she says, is the long-term impact. Dr. George completed the advanced course in 2005 and still enjoys catching up with her fellow academy attendees, as well as learning about what they have achieved in the subsequent years. Many classmates have become medical directors, and she says they credit the academy for many of the positive changes in their groups.

“It’s absolutely worth it,” she says. “Both levels are worth the time and investment. And ‘leadership’ doesn’t necessarily mean being a leader of your group. It can also mean being a leader of change and initiatives within the hospital.”

Dr. Silversin will lead a course on "Leading and Managing Change." WENDY HOLDEN/ISTOCKPHOTO

Dr. Silversin will lead a course on “Leading and Managing Change.”

Active Training for Active Leaders

Although the word “academy” might conjure ideas of long-winded seminars or Socratic debate, SHM’s Leadership Academy emphasizes a hands-on learning style. Hospitalists are divided into groups to tackle real-world issues that affect hospitals, hospitalists, and patients, such as QI initiatives and ED throughput.

The courses feature some of the most engaging speakers in HM and insightful presentations from experts outside of the specialty.

The faculty also includes nonphysicians; for example, Tim Keogh, PhD, who teaches postgraduate managerial communications at The Citadel School of Business Administration in Charleston, S.C., and Tulane University’s School of Public Health and Tropical Medicine in New Orleans, offers a unique perspective to hospitalists who are often accustomed to learning only from those within the specialty.

SHM Leadership Academy

WHEN: September 14-17, 2009

WHERE: Fontainebleau Hotel, Miami Beach, Fla.

FORE MORE INFO: Visit SHM’s online event list at

GET INVOLVED: Call 800.843.3360, go to, or e-mail

Young Specialty Grows Leaders

The Leadership Academy’s origins stem from HM’s youthful roots; the average age of a hospitalist is 40, and the average age of a hospitalist leader is 43, according to SHM’s 2007-2008 “Bi-Annual Survey on the State of the Hospital Medicine Movement.” Unlike more established medical fields, HM is in the unique position of cultivating the first generation of the specialty’s leadership. Through mentorship and motivation, the academy is arming hospitalists with the tools they’ll need to become leaders in a still-developing field.

Individuals within HM benefit from leadership training, too. “I see Leadership Academy as filling a real void in hospital medicine,” Dr. George says. “We’re still a young profession. We don’t have a lot of gray hair in the field, but we’re in the unusual position to work closely with hospital administrators.”

That paradigm means hospitalists have to learn to speak the language of administration, she says. And they need to learn it quick if they want to create real change and value. For Dr. George, who sees the academy’s impact from the hospitalist and executive perspectives, the academy prepares hospitalists to fill a necessary role in the hospital.

“As a relatively new profession, we still have to prove ourselves on a regular basis,” she says. TH

Brendon Shank is a freelance writer based in Philadelphia.


SHM’s Leadership Academy faculty includes a number of the specialty’s top thought leaders. Previews of the 2009 academy, including audio interviews with presenters, video of previous sessions, faculty biographies, and other details, are available at Here is a sneak peek at the course lineups for the Sept. 14-17 program in Miami Beach:


  • “Leadership Challenges in Hospital Medicine,” Laurence Wellikson, MD, FHM, CEO of SHM;
  • “Understanding the Business Drivers for Hospital Survival and Success,” Michael Guthrie, MD, MBA, executive-in-residence at the University of Colorado Denver School of Business program in health administration;
  • “CEO Mindset,” Dr. Guthrie;
  • “Effective Communication,” Tim Keogh, PhD, professor of managerial communications at The Citadel School of Business Administration, Charleston, S.C.
  • “Leading and Managing Change,” Jack Silversin, DMD, DrPH, president of Amicus, a Cambridge, Mass.-based management consulting firm;
  • “Strategic Planning,” Russell L. Holman, MD, FHM, chief operating officer of Cogent Healthcare;
  • “Application of Effective Conflict Management for Hospitalists,” Eric Howell, MD, FHM, director of the division of hospital medicine at Johns Hopkins Bayview Medical Center in Baltimore; and
  • “Achieving Success as Leader: How to Use What You’ve Learned,” Dr. Holman.


  • “Financial Storytelling,” Dr. Guthrie;
  • “Leadership Roundtable,” Dr. Holman;
  • “Meta-Leadership in Hospital Medicine,” Leonard Marcus, PhD, director of the program for health care negotiation and conflict resolution at the Harvard School of Public Health, Cambridge, Mass.; and
  • “Managing Conflict and Maintaining Effective Relationships,” Dr. Keogh.

Chapter Updates

Southwest Wisconsin Chapter


Hospitalists from five HM groups met May 7 in Madison. Julia Wright, MD, FHM, clinical associate professor of medicine and director of hospital medicine at the University of Wisconsin School of Medicine and Public Health in Madison, spoke about “The State of Hospital Medicine.” Her presentation included an exploration of factors that influence and drive the specialty, as well as a look at HM demographics.

Northern Nevada

The Northern Nevada chapter met April 7 at the Charlie Palmer Steakhouse in Reno. The 36 attendees represented five HM groups. The meeting topic was “Difficult Decisions in Anticoagulation,” with guest speaker Christine Tankersley, PharmD, from Sanofi-Aventis Pharmaceuticals.

The chapter provided Tankersley with several real-patient cases that involved challenging decisions, and she led a step-wise discussion within the context of new American College of Clinial Pharmacy guidelines for anticoagulation.

Chapter President Phil Goodman, MD, FHM, stressed the importance of joining SHM and attending the annual meeting. It was decided to continue the community SHM journal club, which enjoyed a successful debut in September 2008, with 15 attendees reviewing a pair of New England Journal of Medicine articles at P.F. Chang’s in Reno.

Annual chapter elections were planned for the next meeting.

Long Island

The March 19 meeting provided SHM updates on the national meeting, advancement to fellowship opportunities, and a call to encourage HM group leaders to promote SHM membership.

A presentation on antibiotic stewardship revealed data on the improved clinical and economical outcomes of such a program in the hospital setting.


Joseph Ming-Wah Li, MD, FHM, director of the hospital medicine program at Beth Israel Deaconess Medical Center in Boston and an SHM board member, spoke at the March 25 chapter meeting. He discussed the exponential growth of HM as a specialty and reviewed data on hospitalist numbers past, present, and future.

Dr. Li also analyzed data from SHM’s 2007-2008 “Bi-Annual Survey on the State of Hospital Medicine,” and provided benchmarks for hospitalist productivity, night scheduling, administrative work, use of physician extenders, and residents.

Dr. Li’s talk was followed by a presentation on billing-capture software by Courtney Shickel from Ingenious Med Company. The demonstration touted the benefits of using the software for charge capture and some quality measures. The data showed the software can increase hospital revenues within 30 to 60 days of implementation, and lost charges were almost completely mitigated.

Upstate South Carolina

The March 19 meeting brought together nearly 20 attendees representing five hospitals in upstate South Carolina. Bruce Friedman, MD, of Doctor’s Hospital presented information on doripenem (Doribax).

Following the presentation, chapter President Imran Shaikh, MD, a hospitalist with Inpatient Medicine Service, directed the business meeting. Members discussed development of a chapter newsletter as well as an online forum to allow discussion of clinical and administrative issues.

Sanjeev Kumar, MD, a hospitalist with Hospital Medicine Consultants, will query members as to which portal would be most accessible to members, then proceed with establishing the forum.

Georgia Coastal


The April 16 chapter meeting featured SHM board member and president-elect Jeff Wiese, MD, FHM, speaking on the direction of HM and the progress of a board certification in hospital medicine.

This meeting was well attended by SHM members, including physician assistants and nurse practitioners.

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