Growing up in America’s heartland, Julie Fedderson, MD, realized at an early age that something wasn’t right with the U.S. healthcare system. Her grandmother, a “headstrong” immigrant from the Czech Republic, died of colon cancer when Dr. Fedderson was young, and that experience—watching a loved one “reduced to tears” trying to navigate a complicated and impersonal healthcare system in rural Nebraska—made her realize “how important having dedicated physicians is.”
“It may sound naïve, but I really wanted to help people,” says Dr. Fedderson, who grew up and went to high school in a small town two hours from an urban center. She eventually attended college in what she saw as the big city—Lincoln, Nebraska. After attending the University of Nebraska, Dr. Fedderson went to medical school at the University of Nebraska Medical School (UNMC) in Omaha. She did her residency at Baylor College of Medicine in Houston, then returned to Nebraska.
Since 2003, she has worked as a hospitalist and is currently an assistant professor in the department of internal medicine at the UNMC. Her story, practicing as a “traditional” internist for several years before making the switch to HM, is similar to many in hospital medicine.
“I wanted to make an impact on the seamless transition of in-house care to outpatient care,” says one of the newest members of Team Hospitalist, the volunteer editorial advisory board of The Hospitalist. “The two are so intricately intertwined, yet so siloed, and many times the patient—who is the least capable of navigating our complex systems—is the one who is left with the responsibility to do it. I wanted to improve that.”
Dr. Fedderson is working toward her master’s degree from the University of Colorado’s Executive MBA Program. She is the resident supervisor for UNMC’s Physicians Midtown Clinic, serves as the Nebraska Medical Center’s enterprise chief quality and outcomes officer, and is on the board of directors of Nebraska Health Partners. She is also a member of the department of internal medicine’s executive committee.
Question: What do you like most about working as a hospitalist?
Answer: The ability to implement rapid change of process in a controlled environment.
Q: What do you dislike most?
A: The regulatory ties placed on hospitals that may not be quality oriented [and] the difficulty of handling the outpatient care of uninsured or underinsured patients.
Q: What’s the best advice you ever received?
A: For life: Shut up and listen. From one of my attendings during my residency: Piss, pus, and hostility all must come out eventually.
Q: What’s the biggest change you’ve seen in hospital medicine in your career?
A: The shift to technology as a basis of care. When done well, it is phenomenal. When done without appropriate thought, it can be disastrous for patients and providers alike.
Q: Why is it important for you, as a hospitalist group leader, to continue seeing patients?
A: How do you implement change if you have no skin in the game? I stay current and see patients to see the system work firsthand and to provide innovative—but practical—solutions.
Q: Outside of patient care, what are your career interests?
A: I am currently our new chief quality and outcomes officer at The Nebraska Medical Center Enterprise. I am also involved as a physician champion for our electronic health record [EHR] implementation and in clinical documentation improvement at all levels.
Q: What is your biggest professional challenge?
A: There are a lot of daunting things coming from entities that don’t necessarily have a patient’s best interests at heart. Keeping sane doing the “regulatory” quality while still providing good quality care is a challenge. Sometimes it feels like a game—but obviously a game with serious consequences.
Q: What is your biggest professional reward?
A: Frankly, [it is] when one of my colleagues relates to me a success story with a new process or plan. I hear so many of my medical friends so dissatisfied with healthcare’s trajectory—they’re burned out, telling their kids to not go into medicine. When I see someone get that spark back for their career and their reason for choosing it, that makes me feel fantastic.
Q: When you aren’t working, what is important to you?
A: I have two boys, and they hung the moon. We hang out as much as possible. I am also into physical fitness, so I try to run, do yoga, and hike as much as I can.
Q: Where do you see yourself in 10 years?
A: I would like to continue to be a chief quality officer, potentially for an entire healthcare system.
Q: If you weren’t a doctor, what would you be doing right now?
A: Writing romance novels.
Q: What’s the best book you’ve read recently? Why?
A: “Mountains Beyond Mountains” by Tracy Kidder. It’s about Dr. Paul Farmer’s work in Haiti. Really exemplifies that one person can change lives.
Q: How many Apple products (phones, iPods, tablets, iTunes, etc.) do you interface with in a given week?
A: I’ve been infiltrated with Apples. My iPhone seldom leaves my hand. I use an iPad for notes and to chart. I run three miles a day with my iPod. I own two Macs.
Q: What’s next in your Netflix queue?
A: I have a six- and a seven-year-old, so anything with animation. Last great movie I saw was “Silver Linings Playbook.”
Richard Quinn is a freelance writer in New Jersey.