He believes administrative skills can be divided into two categories: those related to metrics (the math behind what hospitalists do) and those related to patient care.
In regard to patient care, effective committee participation is an administrative ability that can influence the standard of care. For example, Dr. Khan is participating in committee work in the area of maintaining patients’ glycemic control.
“Historically, that issue was not well addressed,” he says. It is now recognized that patients who have tight glycemic control do much better while hospitalized, irrespective of whether they have diabetes. “But it’s difficult to get other clinicians to change their practice styles,” says Dr. Khan. “You can implement change in your own practice, and others can learn by example. But if you are on a committee that designs new protocols and those get implemented, then you’ve directly changed how medicine is practiced at that hospital.”
Being able to win buy-in for your ideas makes that possible. “Purely speaking, committee participation is not an administrative role,” says Dr. Khan. “But it is an administrative skill in that it is outside the scope of what’s normally required for a hospitalist.”
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Honing one’s receptivity to mentorship is another vital ability for the upwardly mobile hospitalist. Mentors can direct inexperienced physicians to resources that may help them develop proficiency. A mentor who has grappled with the same issues can help open doors to opportunities hospitalists may not know about.
As she reflects on her early career, when she had no mentors and no administrative experience, Sylvia C.W. McKean, MD, realizes she could have used guidance and advocacy. Effective mentorship helps hospitalists reach their goals faster with fewer impediments, she says.
“Mentorship is critical,” says Dr. McKean, medical director, Brigham and Women’s Hospital/Faulkner Hospitalist Service of Brigham and Women’s Hospital in Boston. “But knowing how to receive the information you’re getting and how to apply it to your own specific professional goals can really help you develop the skills that will help you move your career forward. Informal mentorship is one area where there has been less opportunity for women in the past, resulting in more promotions for men.”
Other skills women may especially need are learning the written and unwritten rules of promotion, being more assertive in finding out what they are, and developing diplomacy—including learning to say no with finesse.
“The reality is that if you are in an environment that has predominantly male leadership, it is important for [a woman] to have male advocates to support whatever it is that you are trying to do,” says Dr. McKean. “In some instances they may have to speak for you.”
Efficiency and setting priorities are also important skills.
“I learned very early on that efficiency was critical to managing several roles—administrative, patient care, and raising three boys,” says Dr. McKean. “There were some things, however, that in retrospect I did not need to do. For example, I did my own home-improvement tasks instead of hiring someone else to do them. For women in particular, you don’t have to be a super everything. At different phases in your life your priorities will vary. Get help so that you’re not spending time doing tasks that don’t further your goals.”
Communication
Facility with communication, of course, is paramount in every aspect of medicine. Being poised, articulate, concise, and persuasive to get your message across, says Dr. McKean, goes a long way toward advancing one’s career.
“It took me a long time to realize this,” says Dr. McKean. “For example, whenever I generated reports I tried to have as much information in there as possible because I thought it would look like I was very knowledgeable. A one-page document that summarizes the key points is often more effective in getting people’s attention.”