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.