Decision-making positions require hard work and long hours, Dr. Goldsholl cautions. “You have to keep a balance between your personal life and your career. And never underestimate the power of networking at regional and national levels as well as locally. Make your voice heard in print and [at] speaking engagements too. Get published in the Journal of Hospital Medicine. People do read these articles.”
Trends for Hospitalists as Decision Makers
Everyone with whom we spoke predicts a bright future for hospitalists who want to become critical decision makers. “Hospitalists understand the important manifestations of the way all pieces fit together to impact even a single event,” says Dr. Goldsholl. “Already hospitalists are vice presidents of medical affairs, chief operating officers, and so forth. This trend toward placing hospitalists in management roles is being driven, in large part, by the institutional knowledge that hospitalists have. I expect the trend will only expand.”
“There is so much overlap in medicine that what I see developing is a spirit of collaboration,” says Dr. Percelay. “What’s good for the hospitalist is good for the hospital and ultimately good for the patient. I believe that an alignment of incentives is driving the trend toward the appointment of hospitalists to general leadership positions.”
Hospitalists can create a healthcare system driven by teams of healthcare professionals and based on delivering measurable quality, according to Dr. Wellikson, who says hospitalists will play a major role in leading the quality revolution in this country. “We are moving to a time when business and Medicare are driving toward pay for performance,” he says. “Not just, ‘Did you do the surgery?’ but, ‘How well did you do the surgery?’ ”
Most importantly, Dr. Wellikson believes hospitalists are positioned incredibly well to be leaders in this movement. “The first thing people have to do is agree there is a problem. Then they have to measure the performance, try to improve the situation, and then measure the performance again. This is the wave of the future. We [hospitalists] are working with the government, with the National Quality Forum, with the Institute for Healthcare Improvement. Improvement in quality of care is the number one trend upon which hospitalist leaders will have an impact.”
Another emerging trend: Hospitalist decision makers will influence a redesigned hospital of the future. (Dr. Wellikson is one of 20 people on the Joint Commission Hospital of the Future Work Group.) “The hospital of the future will be very different,” explains Dr. Wellikson. “There’s going to be a home team in the new hospital. It will consist of the ED doctors, critical-care doctors, and hospitalists, working with nurses, pharmacists, and the administration as a team to deliver more technology and do more for sicker people.”
These efforts will be on a collision course with the hospital’s ability to afford them, he believes, so hospitalist leadership will be key to creating an efficient hospital that uses its resources in the best way possible and works as a team.
As more and more hospitalists gravitate toward hospitalwide leadership positions, they will confront some of their own. “It’s going to be very interesting,” says Dr. Percelay, “when the hospital medicine group leader differs with the vice president of medical affairs and they both share the same background. The hospital medicine group leader will no longer be able to say, ‘You don’t know where I’m coming from.’ ” TH
Joen Kinnan is a medical journalist based in Chicago.