Many physicians use traditional practice as their stepping stone to a hospitalist career. David M. Grace, MD, took a far more unconventional path.
He served as a combat medic in the Army National Guard, joined a disaster medical assistance team at the Federal Emergency Management Agency (FEMA), and volunteered to help the American Red Cross in times of crisis—all before entering medical school.
Dr. Grace became a hospitalist in 2002, and now serves as hospitalist division area medical officer for The Schumacher Group, a staffing and consulting firm in Lafayette, La., that hires physicians as independent contractors to work in hospitals across the country.
But 21 years into his healthcare career, he continues to seek opportunities that offer the same two rewards: “I want to be filled with Adrenalin,” he says, “but I still want to use my brains.”
—David M. Grace, MD, The Schumacher Group, Lafayette, La.
Question: Given your varied background, how did you wind up becoming a hospitalist?
Answer: My predoctoring resume reads like a fast track of becoming an emergency physician. In residency, I had heard the term “hospitalist.” I knew I liked dealing with sick patients. Emergency departments act as a fairly good filter, and anyone who gets through and upstairs truly is a sick patient. I figured if I were a hospitalist, all my patients would be sick, as opposed to just some. That really drove me to hospital medicine.
Q: You founded your own hospitalist company in 2005, but within two years, you joined The Schumacher Group. Why did you make the switch?
A: With the speed with which hospital medicine is growing, I thought if I could tap into their resources and infrastructure … I’d be able to do things I couldn’t do in my own group for years, if not decades. I really thought I would be able to impact a far larger portion of patient lives with them than I could in my own smaller, somewhat homemade group.
Q: When The Schumacher Group formed, it focused on emergency departments. In 2007, it launched a hospitalist service. What’s the benefit?
A: If you put good hospitalist systems under the same umbrella as good emergency department systems, you can do things to boost the synergy between the two disciplines and improve patient care. In the facilities where we’re managing both the ED and the hospitalists, we can effect patient care from the moment the patient swings through the ambulance bay doors until the moment they are discharged.
Q: How successful has the HM effort been?
A: The hospitalist side, by the end of the year, will have about 20 to 25 practices up and running, with growth in the neighborhood of 10 to 15 practices a year expected to come on line.
Q: What are the advantages to a private corporation setup?
A: At the end of the day, doctors need to be patient-care advocates. But if you are employed by a hospital, they sign your check. When push comes to shove on a quality issue, I think there’s a tendency not to shove as hard when the person you’re shoving is the person employing you.
Q: Could this approach be the wave of the future?
A: I think so. It goes back to the idea of focusing all of your resources into one small area, such as hospital medicine or inpatient medicine, so there’s far fewer distractions than for a hospital that runs its own hospitalist program. We saw that in the 1970s, when hospitals were buying primary-care practices left and right. They realized they didn’t have the skills or the resources to make that effective, and they rapidly divested.