What does it take to advance your career in the community hospital setting? Good communication and relationship skills top the list, according to Joe Metcalf, MD, director of the Hospital Medicine Service at Faith Regional Health Services in Norfolk, Neb. When Dr. Metcalf started the hospitalist service at the 227-bed regional referral center three and a half years ago, he was not looking for "brilliant" physicians. Instead, he says, "I was looking for excellent communicators."
"Patients are not interested in exceedingly smart clinicians," Dr. Metcalf says. "They are interested in clinicians who are willing to sit at the bedside, hold the elderly patient’s hand, listen to their concerns, and communicate the plans of care in ways they can understand."
Listening is a part of communication that is often neglected, he says.
Versatile and Teachable
Family-practice-trained, ED-hospitalist Joseph Babbitt, MD, works at 22-bed Blue Hill Memorial Hospital in Blue Hill, Maine. The key to success for hospitalists in the small-community-hospital setting is versatility, he says. It’s not unusual for hospitalists at Blue Hill to perform cardiac stress tests for a cardiology colleague or provide perioperative comanagement for surgical colleagues, he adds.
Dr. Babbitt underscores the willingness to acquire a broad range of skills. Dr. Metcalf agrees, and explains it’s one of the reasons he looks for "teachability" in hospitalist job candidates.
"It goes without saying that physicians must be proficient clinicians," he says, "but what I’m also listening for is whether they truly have a passion for patient-centered care."
Dr. Metcalf values honesty in his team members, and respects hospitalists who ask for help with their difficult cases.
Wired for Small
When it comes to community hospital settings, size matters. The hospital setting and job description should fit your preferences. Dr. Babbitt advises candidates to "listen to your gut" when interviewing for community hospital jobs. "If your reaction after checking out a job prospect is, ‘Well, I think I can make this work,’ then don’t try to make it work, because it probably won’t," he says. "You’re either ‘wired for small’ or you’re not."
Residents can prepare for a new job at a small community hospital. Dr. Babbitt recalls one young physician who, after a medical school rotation in a small hospital, realized that he was interested in becoming a "small-hospital hospitalist." He acquired additional training in emergency medicine because he identified it as a skill set that he needed to strengthen.
One thing is for sure: Variety is the order of the day in community settings. "You can bet," Dr. Babbitt says, "that the job you’re hired for is not going to be the job you’re doing in a year. Something about it will have changed."
Gretchen Henkel is a frequent contributor to The Hospitalist.