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The best place to show initiative is on a committee, and the easiest place to start is on a quality-improvement (QI) committee, Dr. Cawley says. If hospitalists are successful in that capacity, they can move on to peer review and credentials committees. From there, the next steps could be becoming first an officer, and then president, of the hospital’s medical staff.

“If you have the leadership skills, you can move up relatively quickly,” Dr. Cawley says. “Some people don’t need a lot of leadership training because they have it innately. But this isn’t true of the vast majority of people.”

Motivation Key to Management Success

Hospitalists can complete a dozen leadership and management courses, but if they can’t motivate other physicians to do good work, they will not advance as managers, according to Dr. Cawley.

“To motivate physicians, you have to be reasonable, know how to communicate, and understand the position the doctors are in,” he says. “You can’t come in really strong-handed, because physicians are independent-minded people.”

New managers often make the mistake of motivating people in a one-size-fits-all approach; genuine leaders recognize that everybody is different and respond to different stimuli, Dr. Keogh says.

Generally speaking, workers can be organized into four groups:

  • Those who are task-oriented and enjoy the sense of accomplishment they feel when they complete an assignment;
  • Those who are inspired to do good work when they are surrounded by people they find interesting and talented;
  • Those who like to manage details; and
  • Those who are low-key and need a patient listener to be a sounding board for their ideas and concerns.

“Leadership involves flexing to those four different styles all day long,” Dr. Keogh says.


Training Opportunities

The good news for the vast majority of hospitalists seeking a managerial role is that opportunities for training abound.

Fellowships are a good idea, but it’s critical that hospitalists interested in management choose the right one, Dr. Howell says. Select a fellowship program that focuses on areas important to the hospital—say, QI projects, patient-care initiatives, and system improvement.

Hospitalist Paul Grant, MD, considers the one-year HM fellowship he completed at the Cleveland Clinic Foundation an asset because he was able to gain expertise in perioperative medicine. The fellowship has served him well at the University of Michigan Health System in Ann Arbor, where he is director of perioperative medicine and consultative medicine.

“The fellowship really gives me an advantage,” says Dr. Grant, who notes he would like to assume a larger management role in the future.

Upward-thinking hospitalists should know something about budgeting, Dr. Keogh points out. Taking a budgetary course or two at a local community or technical college will not only provide a hospitalist the basics needed to understand and prepare budgets, but it also will demonstrate their willingness to master new skills that are important at the next level, he says.

An advanced degree, such as an MBA, a master’s degree in public health (MPH), or a master’s degree in medical management (MMM), can set hospitalists apart from their colleagues, Dr. Keogh says. These courses teach hospitalists how to excel at communication, how to implement change, and how to develop effective strategies.

Hospitalists can gain management-related skills from leadership courses tailored to physicians and healthcare professionals. SHM hosts two Leadership Academies per year (, and the American College of Physician Executives ( and the American College of Healthcare Executives ( also offer leadership training, Dr. Cawley says.

Improve Weaknesses

You might want to consider communicating with upper-level managers (e.g., CMO, chief of staff, or vice president of medical affairs), but proceed cautiously, because there are right ways and wrong ways of reaching out. If you have a suggestion, ask to meet with an upper-level manager face to face to present the idea.

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