When William D. Atchley Jr., MD, FACP, SFHM, left private practice for hospital medicine in 1995, he didn’t realize he was helping to make history. Dr. Atchley was practicing with an internal-medicine multispecialty group when a medical school withdrew its residency program from the community hospital next door. Soon after, physicians in the group began experiencing frequent disruptions in order to care for a handful of hospitalized patients.
Dr. Atchley and two colleagues, all of whom enjoyed the hospital setting, solved the problem by forming an inpatient rounding team at Sentara Leigh Hospital in Norfolk, Va. They believe it was the first hospitalist program in Virginia.
“When we first started doing this, we were looking at each other saying, ‘Is this something for the long run … or is it going to be something that is a flash in the pan?’ ” says Dr. Atchley, chief of the Division of Hospital Medicine at Sentara Medical Group, which operates hospitalist programs at five sites in southeastern Virginia. “If you had asked me to look into a crystal ball, I would not have projected hospital medicine would have grown so quickly. It truly is phenomenal, and it’s been an exciting ride. It was great to be on the ground floor of this, and it’s been nice to see how things have evolved.”
I’m thinking about what I want to be doing for the next 10 years. I’ll certainly continue to be actively engaged on a national level with SHM, because that’s my passion. … I’m pausing and reflecting on what I’ve been doing, what my options are, and what I want to do for the remainder of the time before I retire.
Question: You studied biomedical engineering prior to medical school. Are there similarities between that field and HM?
Answer: Engineering teaches you how to approach problem-solving. That’s particularly helpful with some of the system issues we talk about, such as dealing with throughput or applications of electronic medical records and computerized physician order entry. It’s given me a good background to understand issues that come up regarding quality and patient safety, and trying to take a systemwide viewpoint about looking at how care is delivered.
Q: What’s the biggest change you’ve seen in HM over the past 16 years?
A: The job I had in 1995 is vastly different from the job I have now. At that time, it was all about taking care of internal-medicine adult patients. We’ve seen the evolution of surgical comanagement, and hospitalists have truly become leaders of change in terms of how care is being delivered in the hospital. Things like patient safety, quality, and learning to deal with the limited resources we have, in terms of the cost of healthcare, were not even on the radar screen 16 years ago.
Q: Why is it important for you to continue seeing patients?
A: To have validity with your fellow hospitalists who are working in the trenches. You can only appreciate what their day-to-day challenges are when you roll up your sleeves and you’re out there with them. I think it gives me “street cred” with them. I still understand the things that are great about the job, but at the same time, I see the things that are frustrating about the job.
Q: What is your biggest professional reward?
A: Being actively engaged in SHM. I served on its board of directors, and I’ve served as secretary and treasurer. I continue to be active in the society. I was honored to be elected as a senior fellow (SFHM) in the organization.