Q: What advice would you give to the director of a program experiencing similar growth?
A: Be very stringent on the doctors you choose. For a lot of groups, retention/recruitment is the No. 1, No. 2, and No. 3 problem. We’ve been fortunate we haven’t made many bad hires. But the time and effort it takes to get rid of a bad hire can really end up bogging you down. I’d rather have everyone pull up their bootstraps and work a bit harder and take an extra few months to find the right person than go ahead with a bad hire simply to have another body.
Q: Were there other keys behind the program’s success?
A: There are several. I owe a great deal of the success of the program to the great doctors I work with. I received tremendous support from the department of internal medicine when I arrived, and that ensured a smooth transition. Another big component is good communication.
Q: What role has communication played?
A: Hospitals are very siloed. One group doesn’t speak to another. We’re taught to stick our head in the sand, fix the problem, and move on to the next problem. That gets you crucified in the world of HM. As hospitalists, we have to be the glue that brings all these silos together. In our profession, to be a good leader, you don’t have to be the smartest or best clinician. But you do have to have the attributes of communication and teambuilding. The key is to meet people and talk to them. Try to get to know every key hospital administrator. Don’t just write an order and go away; talk to the nurse. If you forge relationships and try to get the group more fully implemented, it will be more likely to reach its full potential.
Q: At 35, you are slightly younger than the average U.S. hospitalist, yet you’re nearly three years into your first true leadership role. Has your age ever been an issue?
A: Initially, it was a hindrance. It took four months for Temple to interview me. The biggest negative they gave to Cogent was, “He’s so young.” In any other field, 35 would not be considered a child. We’d be in the workforce for 13 years, and we’d be considered middle or senior management. Medicine in general is steeped in, “If you don’t have gray hair, you’re not able to sit at the table.” In our specialty, you can. … It doesn’t have to hinder you, but you have to be willing and able to do the right things. If you are, you will be noticed.
Q: You consider HM program marketing and branding one of your specialties. Why are those efforts necessary?
A: If you don’t market yourself, you’ll die, particularly in a competitive market. Whether you are at an academic center or a small community hospital or even a larger hospital, you could have two or three hospitalist groups all vying for the same patient volume. You need to give yourself a differential advantage.
Q: How do you do that?
A: You have to get out and meet people and shake some hands. You have to meet all of your customers, and you have to find out if they are happy or displeased. You have to communicate with them. You have to think about your customers, and they’re not just the patients in the bed. Your customers also are your administration, your PCPs, your subspecialists. … It’s no different than a vendor selling fax machines. We are a business, and if doctors don’t think that, they’re very naive.