Rachel George, MD, MBA, FHM, CPE, acknowledges she found her calling through a fluke. After completing an internal-medicine residency in Chicago in 2002, she knew she wanted to stay in the region. She hadn’t decided much else.
“I was not excited about private practice, and I had thought about a cardiology fellowship,” Dr. George recalls. “I was trying to figure out what I wanted to do when I grew up, so to speak.”
She found a job as the lone hospitalist with OSF Medical Group in Rockford, Ill. Despite knowing she’d see “a ridiculous number of patients”—up to 30 per day on weekends—she liked it enough to sign on. “I decided I’d give it a chance for six months or a year while I figured out what I was really going to do,” she says.
Before long, she realized she already was doing it.
“I absolutely loved it,” says Dr. George, one of six new Team Hospitalist members who joined our reader advisory group in April. She now oversees five hospitalist programs in three states as regional medical director and vice president of operations for Brentwood, Tenn.-based Cogent Healthcare. “It was perfect. It was the niche I was looking for.”
Question: What did you enjoy so much about being a hospitalist?
Answer: The acuity of care, the instant gratification of fixing someone and sending them on their way, the intensity in the hospital, not feeling like I was being pulled in 15 different directions like you are in primary-care practice—all the good things about being a hospitalist.
Q: Within a year of joining OSF, you became medical director of its hospitalist service and oversaw its expansion. Did you always envision yourself moving into a leadership role?
A: When I started, I probably would have said my ultimate goal was to get my MBA and think about hospital administration. That was the 10-year plan, or maybe even the 15- or 20-year plan. But when people at the hospital began talking about expanding the [HM] program, I got thrust into the [medical director] role. By that point, I was hooked.
Q: Within three years, you grew the service from one physician to nine. How did you approach expansion?
A: The goal was sustainable growth—growth without sacrificing quality of patient care. When PCPs approached me about taking over their patient population, I’d say we’d take them on as we hired more people. I didn’t want to take off more than we could chew, and I didn’t want to have ridiculous turnover. That wouldn’t do anybody any good.
Q: You joined Cogent in 2006. What prompted the move?
A: I knew Cogent through SHM, and it was too good of an opportunity to pass up. The chance to expand my management responsibilities also was very appealing.
Q: What do you see as the biggest advantage of Cogent’s model?
A: I was part of an in-house program, and I think they’re great in a lot of ways. What they can’t do is economies of scale. There are certain things you can’t do just because it doesn’t make sense financially.
Q: Can you give an example?
A: The classic example I’ll give is discharge summaries in less than 24 hours. [At OSF], I did everything short of getting on my hands and knees and begging them to transcribe discharge summaries in less than 24 hours. They wouldn’t, and I understand why. It was a financial decision.