Eric Howell, MD, SFHM, is the first to admit how quickly it happened. Shortly after he became a hospitalist in 2000 at Johns Hopkins Bayview Medical Center in Baltimore, lower- and midlevel managers began to notice the quality of his daily clinical work. They reported their observations up the line, and soon Dr. Howell was rewarded with a small leadership role. He succeeded in that role, was given more responsibility, and in six short years he had worked his way up the management chain, becoming director of the medical center’s HM division.

“In hospital medicine, it’s fairly common to see young physicians stepping up into management,” says Patrick Cawley, MD, SFHM, a former SHM president who now directs the hospitalist program at the Medical University of South Carolina in Charleston and serves as medical director of the Medical University Hospital Authority. “The bottom line is they are there and they are getting noticed.”

On average, it takes about five years for a hospitalist to move into management; the average time for physicians in more established medical fields is 15 years or more, Dr. Cawley says. Part of the reason for the quick management rise in HM has to do with demographics. Because most hospitalists are younger, there is greater occasion for younger physicians who want to be in management to advance, says Timothy Keogh, PhD, an adjunct associate professor in the Department of Health Systems Management at Tulane University’s School of Public Health and Tropical Medicine in New Orleans, where he also directs the Master of Health Administration Program.

Another reason is that because hospitalists work in the hospital every day, they have innumerable opportunities to make an impression, Dr. Cawley says. They also know hospital culture, which gives them an advantage. “This is why hospitalists often get leadership positions,” he says. “Only by knowing the culture can you change the culture.”

Take the First Step

Although hospitalists are well positioned to assume management positions, it doesn’t mean an opportunity is going to fall into your lap. The best recipe for getting recognized—and promoted—is “doing the job you are currently doing really well,” Dr. Howell explains. “You have to do a good job on the basics.”

Often, physicians have their eye on a long-term goal and forget to focus on succeeding at their present work, Dr. Howell adds. That includes building relationships with lower- and mid-level managers like charge nurses, unit directors, and social work managers. That said, hospitalists who want to advance have to be proactive, Dr. Keogh says.

“Leadership is not only about hard work; leadership is about seeing the big picture and going above and beyond,” says Dr. Keogh, who is a member of the SHM Leadership Academy faculty.