Q: After the merger, you spent 18 months as chief medical officer of Sound’s Rocky Mountain Region. How hard was it to balance that role while caring for patients?
A: Incredibly hard. I used to joke I was two-thirds clinician and two-thirds administrative. It was a tremendous time commitment, but I always had a strong belief I could never be an effective physician leader without continuing to see patients in the hospital. I wanted to lead by example, but I also wanted to understand what my fellow physicians were going through on a day-to-day basis.
Q: In September 2008, you reverted strictly to clinical practice. Why did you make that choice?
A: I wanted to be able to have one job, not two. I wasn’t prepared to let go of clinical practice, and there was the issue of my time commitments as a physician leader. I have two young boys, and I wanted more time with my family. As trite as that may sound, it’s completely true.
Q: What did you learn in your leadership role that helps you as a practicing hospitalist?
A: It is imperative for working physicians to understand how the business works, and how it doesn’t work. I try to share—especially with younger physicians—all of the things that go into running a hospitalist practice. It doesn’t just happen by magic. I think it helps to have that perspective.
Q: What other advice would you offer to new physicians?
A: Don’t be afraid to get involved, whether it’s in hospital committee work or in the business of medicine. We are always looking for new leaders, and if that’s something that interests you, there will definitely be a role for you. It’s intimidating to come out of residency and think “Gosh, I didn’t get that much business education.” You can definitely learn it. If you have the interest, it’s worth asking the questions and getting involved.
Q: You say you better understand the value a hospitalist brings to the table. How does that translate into quality of care?
A: By expanding physicians’ view away from just direct clinical care to the quality metrics that need to be followed. What is the documentation appropriate for a patient? What are the hospital’s goals, from time of discharge to patient satisfaction scores, and how can we help meet them? While we all still very much prize our independence, we are part of a larger field of healthcare in general. We can’t make all of our decisions in a vacuum.
Q: What’s the biggest challenge you face?
A: The continual pursuit of the right mix of the right staffing and workload for our program. Having done this for 10 years now, I don’t have any doubt that you can do it, but it’s a continual adjustment to find the right balance.
Q: You gave a talk at an SHM annual meeting about hospitalist burnout. What’s the secret to recognizing it and preventing it?
A: One of the first things—before the hire ever happens—is to make sure the group’s philosophy and the individual’s philosophy about time and money and workload are in agreement. You need to continue to evaluate those principles on an ongoing basis to make sure they continue to agree, because they can diverge over time. It’s a constant focus on the group’s end.
Q: What’s your biggest reward?
A: Taking care of patients. There’s no greater satisfaction than making a complex and frightening hospital stay a little more simple to understand, and a little less frightening, by having an open discussion with the patient and their family to help them get through it. That’s still what gives me the greatest joy.