Administrative Ambition

The Hospitalist. 2007 November;2007(11):

November 1, 2007|The Hospitalist

Interested in a promotion? If you have your eye on an administrative career, go ahead and think big—because the opportunities for today’s hospitalists are there for the taking, with some planning and the careful acquisition of skills, experience, and training.

“Any hospitalist who has any desire to be a leader, whether in a medical practice or in a hospital, has numerous opportunities,” says Patrick Cawley, MD, chief medical officer of Medical University of South Carolina (MUSC) Medical Center in Charleston. “If you’re willing to step up, you can attain that leadership position.”

Plan Your Path

Ambitious hospitalists must consider the administrative positions available to them in the long run.

“Within a hospital medicine practice, you have just one director,” says Joan C. Faro, MD, FACP, MBA, chief medical officer, John T. Mather Memorial Hospital, Port Jefferson, N.Y. “So people working in the ranks need to be creative and come up with ideas on gaining experience, such as creating a QA position.” She advises hospitalists to look at the job description and the performance measures of the director’s position to see what expectations come with the job.

The promotion to director may involve switching practices. “If you want to move quickly, you have to be able to move [to a different group],” explains Dr. Cawley. “In a local community, there will be others ahead of you. If you’re willing to move to a less-than-ideal location, you can find better opportunities.” For community-based hospitalists especially, the director’s position is a necessary one before moving higher up the administrative ladder.

“You need to be managing some people before you become a CMO [chief medical officer] or administrator,” explains Dr. Faro. “You really have to show that you can do some significant work. In academia, you can do this as a division chief or something like that.” As the director of a hospital medicine program, she says, “you can broaden your scope and move higher up into hospital administration.”

CAREER NUGGETS

Hospitalists and Burnout: The Jury’s Still Out

According to an article in the January issue of Resident & Staff Physician (“Hospitalist Careers: A Field of Growing Opportunity”), the possibility of hospitalist burnout is still in question. “Many skeptics suggest that a hospitalist career is suitable only for young physicians,” say authors Robert M. Wachter, MD, professor and associate chairman, department of medicine, and chief of the Medical Service, University of California, San Francisco (UCSF), and Niraj L. Sehgal, MD, MPH, assistant professor, department of medicine, and medical director, UCSF at Mount Zion. “They have a difficult time envisioning a mid- or late-career hospitalist.” But there is little evidence of burnout, the authors say, citing a 2001 study that found 13% of hospitalists met the criteria for burnout and another 25% were at risk for burnout—rates that compare favorably with other medical specialties. At the time this study was published, the authors had speculated that the relative novelty of the hospitalist specialty could, in part, be responsible for the relatively low burnout rates.

How to chair a committee

When tasked with leading a committee, you may not be able to choose the members. However, you can assess their skills and interests, then match each to appropriate tasks based on individual skills, interests, and willingness. Pay special attention to the motivation and personal goals of each person. Keep in mind, too, that the more dissimilar the contributions, the more likely committee members will feel that their work is necessary.—JJ

First Steps

How do you move from working hospitalist to director or department head? Start small.

“You can start with easy committee assignments,” says Dr. Cawley. “Even while you’re getting leadership training, you can be building those skills on the job. Start with small projects, such as small committee roles or quality management projects. You can then move up, but consider that you’ll need new skills as you do. Before you chair your first committee, you’ll have to brush up on how to run a meeting. You can progressively take on larger, broader roles.”