Richard Quinn

The Centers for Medicare & Medicaid Services (CMS) has wrapped up a test run of a new measure for readmission of heart failure patients as the federal agency tries to educate hospitals and hospitalists before formally including it as a quality metric in fiscal year 2018.

The trial concludes October 7, 2015, for the new claims-based measurement, excess days in acute care (EDAC) after hospitalization for heart failure. It captures the number of days within the 30-day postdischarge period that a patient spends in acute care following an index admission for heart failure. The measure will be included in CMS’ Hospital Inpatient Quality Reporting Program in fiscal year 2018, but the agency plans to publicly report hospitals’ results on Hospital Compare next year.

CMS hopes the new measure will help educate hospitals and hospitalists about 30-day postdischarge outcomes for patients with heart failure and provide a better understanding of what services are utilized, which could translate to better interventions. CMS spokesperson Alper Ozinal says that hospitalists currently get “little feedback about what happens to their patients after discharge.”

“CMS found substantial variation in utilization across hospitals, which suggests an opportunity for improvement in transitional care practices,” Ozinal says. “CMS anticipates that the measure will support hospital efforts to further optimize quality of care, particularly the quality of transitional care, by providing a more comprehensive picture of postdischarge events.”

The measure’s trial run, which began September 8, 2015, measured Medicare fee-for-service patients age 65 and older who were hospitalized with a principal discharge diagnosis of heart failure. The outcomes are risk-adjusted, taking into account age, sex, and comorbidities.

Once the results are calculated, CMS will post a report on the QualityNet website. Comments are welcome as CMS is expected to discuss whether tweaks are needed in the measure’s methodology.

Visit our website for more information on hospital readmissions.

The Centers for Medicare & Medicaid Services (CMS) has wrapped up a test run of a new measure for readmission of heart failure patients as the federal agency tries to educate hospitals and hospitalists before formally including it as a quality metric in fiscal year 2018.

The trial concludes October 7, 2015, for the new claims-based measurement, excess days in acute care (EDAC) after hospitalization for heart failure. It captures the number of days within the 30-day postdischarge period that a patient spends in acute care following an index admission for heart failure. The measure will be included in CMS’ Hospital Inpatient Quality Reporting Program in fiscal year 2018, but the agency plans to publicly report hospitals’ results on Hospital Compare next year.

CMS hopes the new measure will help educate hospitals and hospitalists about 30-day postdischarge outcomes for patients with heart failure and provide a better understanding of what services are utilized, which could translate to better interventions. CMS spokesperson Alper Ozinal says that hospitalists currently get “little feedback about what happens to their patients after discharge.”

“CMS found substantial variation in utilization across hospitals, which suggests an opportunity for improvement in transitional care practices,” Ozinal says. “CMS anticipates that the measure will support hospital efforts to further optimize quality of care, particularly the quality of transitional care, by providing a more comprehensive picture of postdischarge events.”

The measure’s trial run, which began September 8, 2015, measured Medicare fee-for-service patients age 65 and older who were hospitalized with a principal discharge diagnosis of heart failure. The outcomes are risk-adjusted, taking into account age, sex, and comorbidities.

Once the results are calculated, CMS will post a report on the QualityNet website. Comments are welcome as CMS is expected to discuss whether tweaks are needed in the measure’s methodology.

Visit our website for more information on hospital readmissions.

The Centers for Medicare & Medicaid Services (CMS) has wrapped up a test run of a new measure for readmission of heart failure patients as the federal agency tries to educate hospitals and hospitalists before formally including it as a quality metric in fiscal year 2018.

The trial concludes October 7, 2015, for the new claims-based measurement, excess days in acute care (EDAC) after hospitalization for heart failure. It captures the number of days within the 30-day postdischarge period that a patient spends in acute care following an index admission for heart failure. The measure will be included in CMS’ Hospital Inpatient Quality Reporting Program in fiscal year 2018, but the agency plans to publicly report hospitals’ results on Hospital Compare next year.

CMS hopes the new measure will help educate hospitals and hospitalists about 30-day postdischarge outcomes for patients with heart failure and provide a better understanding of what services are utilized, which could translate to better interventions. CMS spokesperson Alper Ozinal says that hospitalists currently get “little feedback about what happens to their patients after discharge.”

“CMS found substantial variation in utilization across hospitals, which suggests an opportunity for improvement in transitional care practices,” Ozinal says. “CMS anticipates that the measure will support hospital efforts to further optimize quality of care, particularly the quality of transitional care, by providing a more comprehensive picture of postdischarge events.”

The measure’s trial run, which began September 8, 2015, measured Medicare fee-for-service patients age 65 and older who were hospitalized with a principal discharge diagnosis of heart failure. The outcomes are risk-adjusted, taking into account age, sex, and comorbidities.

Once the results are calculated, CMS will post a report on the QualityNet website. Comments are welcome as CMS is expected to discuss whether tweaks are needed in the measure’s methodology.

Visit our website for more information on hospital readmissions.

Most people think a career in hospital medicine means a medical degree that confers those two ubiquitous letters after your name.

Amanda Trask blazed her own path.

She got to her job—vice president of the national hospitalist service line for Catholic Health Initiatives of Englewood, Colo.—by following a slightly different path. In her case, it was a master’s of business administration (MBA), a master’s in health administration (MHA), and a few fellowships to boot.

“Many years ago I chose to move forward in my education and attain advanced degrees,” says Trask, MBA, MHA, SFHM, FACHE, CMPE. “Through that, you get a really broad perspective of healthcare and the business of healthcare.”

It’s a perspective Dr. Trask is bringing to Team Hospitalist, as one of seven new members of The Hospitalist’s volunteer editorial advisory board. She sees HM as a vital specialty in a changing healthcare landscape.

“Hospital medicine is uniquely positioned to truly impact a very large breadth of patients and improve the continuum of care,” she says.

Question: Tell me about your role at Catholic Health Initiatives.

Answer: CHI operates in 19 states and 105 hospitals. We have a variety of hospitalist models in our hospitals, everything from direct employed with our local medical groups to contracted with hospitalist companies to independent groups that provide hospitalist services to their patients. At CHI, my role is to coordinate hospitalist efforts to improve clinical and efficiency outcomes in our hospitals and in other pre- and post-acute care settings where hospitalists play a role.

Q: People like to say, “If you’ve seen one hospitalist group, you’ve seen one hospitalist group.” How difficult is it to replicate commonalities in different buildings?

A: I definitely agree that “if you’ve seen one hospitalist group, you’ve seen one hospitalist group”; however, a great percentage of the work is common among hospitalists. We have a national hospital medicine leadership team composed of our divisional medical directors and dyad administrative partners to oversee the efforts of hospital medicine at CHI. That leadership team identifies the commonalities of opportunities across our hospital medicine markets. How can we support local innovation while maximizing the opportunity for standardization? What are the things that are fairly consistent no matter where you practice? What are those things that might have a substantial amount of difference? The focus of CHI’s national hospital medicine service line is to align standards that improve the practice of hospital medicine across CHI.

What’s great about hospitalists is that they have an innate desire to improve the health and well-being of our communities. Hospitalists are truly passionate about improving the way we care for patients, advancing quality outcomes, and leading the shift from volume to value for the communities we serve.

—Dr. Trask

Q: How important is it to find those commonalities?

A: In this day and age of healthcare, as we consider new payment models, we look at population health and what that means in a future state for healthcare. In the future, hospitalists are a critical component of ensuring we deliver higher clinical quality outcomes and better efficiencies to care for our population as a whole. As opposed to having each of our practices continuing to work individually and, in many cases, on many of the same exact issues, we identified the opportunity to bring those efforts together and try to do so in a more efficient fashion.

I’ll give an example: When we look at clinical documentation, much of that is related to electronic health records. How can we work together to identify opportunities to improve the use of our electronic health record when we have the same health record in different divisions?

Q: Where do you see yourself in five years, 10 years?

A: It’s funny you ask that question, as that is the question I always ask people I’m interviewing. My answer to that is not always as concrete as others’ answers.

I look at what doors might open, and I look at what opportunities present themselves. I think, looking at opportunities like we have in hospital medicine and looking at opportunities to really expand beyond current state, many of my experiences have led me to realize that I like to be involved in improvements, change in evolving the healthcare industry, and bringing teams together to improve the status quo.

Q: You work with some 900 hospitalists. What’s your favorite thing about working with them and the role they play?

A: Every single hospitalist I’ve encountered has demonstrated such a strong desire to make improvements in the patients that they’re caring for. What’s great about hospitalists is that they have an innate desire to improve the health and well-being of our communities. Hospitalists are truly passionate about improving the way we care for patients, advancing quality outcomes, and leading the shift from volume to value for the communities we serve. For me, this role is not simply a task or a job that I do, but it really is a passion.

Q: The flip side of that is nobody’s job is perfect. What’s the toughest thing about working with hospitalists?

A: One of the toughest things in this particular industry is the fact that it has been the fastest growing of all of time [in medicine], and there are times when supply and demand are not well balanced. There are a lot of demands placed on hospitalists, and there are a lot of expectations by hospital leaders and health system leaders, that hospitalists can solve many of the problems that may exist. Because of that, sometimes the supply of hospitalists, or the ability to have top talent, is really challenging.

The balance is not yet perfect between the availability of top talent and the ability to meet the needs of the organization and community.

Richard Quinn is a freelance writer in New Jersey.

Most people think a career in hospital medicine means a medical degree that confers those two ubiquitous letters after your name.

Amanda Trask blazed her own path.

She got to her job—vice president of the national hospitalist service line for Catholic Health Initiatives of Englewood, Colo.—by following a slightly different path. In her case, it was a master’s of business administration (MBA), a master’s in health administration (MHA), and a few fellowships to boot.

“Many years ago I chose to move forward in my education and attain advanced degrees,” says Trask, MBA, MHA, SFHM, FACHE, CMPE. “Through that, you get a really broad perspective of healthcare and the business of healthcare.”

It’s a perspective Dr. Trask is bringing to Team Hospitalist, as one of seven new members of The Hospitalist’s volunteer editorial advisory board. She sees HM as a vital specialty in a changing healthcare landscape.

“Hospital medicine is uniquely positioned to truly impact a very large breadth of patients and improve the continuum of care,” she says.

Question: Tell me about your role at Catholic Health Initiatives.

Answer: CHI operates in 19 states and 105 hospitals. We have a variety of hospitalist models in our hospitals, everything from direct employed with our local medical groups to contracted with hospitalist companies to independent groups that provide hospitalist services to their patients. At CHI, my role is to coordinate hospitalist efforts to improve clinical and efficiency outcomes in our hospitals and in other pre- and post-acute care settings where hospitalists play a role.

Q: People like to say, “If you’ve seen one hospitalist group, you’ve seen one hospitalist group.” How difficult is it to replicate commonalities in different buildings?

A: I definitely agree that “if you’ve seen one hospitalist group, you’ve seen one hospitalist group”; however, a great percentage of the work is common among hospitalists. We have a national hospital medicine leadership team composed of our divisional medical directors and dyad administrative partners to oversee the efforts of hospital medicine at CHI. That leadership team identifies the commonalities of opportunities across our hospital medicine markets. How can we support local innovation while maximizing the opportunity for standardization? What are the things that are fairly consistent no matter where you practice? What are those things that might have a substantial amount of difference? The focus of CHI’s national hospital medicine service line is to align standards that improve the practice of hospital medicine across CHI.

What’s great about hospitalists is that they have an innate desire to improve the health and well-being of our communities. Hospitalists are truly passionate about improving the way we care for patients, advancing quality outcomes, and leading the shift from volume to value for the communities we serve.

—Dr. Trask

Q: How important is it to find those commonalities?

A: In this day and age of healthcare, as we consider new payment models, we look at population health and what that means in a future state for healthcare. In the future, hospitalists are a critical component of ensuring we deliver higher clinical quality outcomes and better efficiencies to care for our population as a whole. As opposed to having each of our practices continuing to work individually and, in many cases, on many of the same exact issues, we identified the opportunity to bring those efforts together and try to do so in a more efficient fashion.

I’ll give an example: When we look at clinical documentation, much of that is related to electronic health records. How can we work together to identify opportunities to improve the use of our electronic health record when we have the same health record in different divisions?

Q: Where do you see yourself in five years, 10 years?

A: It’s funny you ask that question, as that is the question I always ask people I’m interviewing. My answer to that is not always as concrete as others’ answers.

I look at what doors might open, and I look at what opportunities present themselves. I think, looking at opportunities like we have in hospital medicine and looking at opportunities to really expand beyond current state, many of my experiences have led me to realize that I like to be involved in improvements, change in evolving the healthcare industry, and bringing teams together to improve the status quo.

Q: You work with some 900 hospitalists. What’s your favorite thing about working with them and the role they play?

A: Every single hospitalist I’ve encountered has demonstrated such a strong desire to make improvements in the patients that they’re caring for. What’s great about hospitalists is that they have an innate desire to improve the health and well-being of our communities. Hospitalists are truly passionate about improving the way we care for patients, advancing quality outcomes, and leading the shift from volume to value for the communities we serve. For me, this role is not simply a task or a job that I do, but it really is a passion.

Q: The flip side of that is nobody’s job is perfect. What’s the toughest thing about working with hospitalists?

A: One of the toughest things in this particular industry is the fact that it has been the fastest growing of all of time [in medicine], and there are times when supply and demand are not well balanced. There are a lot of demands placed on hospitalists, and there are a lot of expectations by hospital leaders and health system leaders, that hospitalists can solve many of the problems that may exist. Because of that, sometimes the supply of hospitalists, or the ability to have top talent, is really challenging.

The balance is not yet perfect between the availability of top talent and the ability to meet the needs of the organization and community.

Richard Quinn is a freelance writer in New Jersey.

Most people think a career in hospital medicine means a medical degree that confers those two ubiquitous letters after your name.

Amanda Trask blazed her own path.

She got to her job—vice president of the national hospitalist service line for Catholic Health Initiatives of Englewood, Colo.—by following a slightly different path. In her case, it was a master’s of business administration (MBA), a master’s in health administration (MHA), and a few fellowships to boot.

“Many years ago I chose to move forward in my education and attain advanced degrees,” says Trask, MBA, MHA, SFHM, FACHE, CMPE. “Through that, you get a really broad perspective of healthcare and the business of healthcare.”

It’s a perspective Dr. Trask is bringing to Team Hospitalist, as one of seven new members of The Hospitalist’s volunteer editorial advisory board. She sees HM as a vital specialty in a changing healthcare landscape.

“Hospital medicine is uniquely positioned to truly impact a very large breadth of patients and improve the continuum of care,” she says.

Question: Tell me about your role at Catholic Health Initiatives.

Answer: CHI operates in 19 states and 105 hospitals. We have a variety of hospitalist models in our hospitals, everything from direct employed with our local medical groups to contracted with hospitalist companies to independent groups that provide hospitalist services to their patients. At CHI, my role is to coordinate hospitalist efforts to improve clinical and efficiency outcomes in our hospitals and in other pre- and post-acute care settings where hospitalists play a role.

Q: People like to say, “If you’ve seen one hospitalist group, you’ve seen one hospitalist group.” How difficult is it to replicate commonalities in different buildings?

A: I definitely agree that “if you’ve seen one hospitalist group, you’ve seen one hospitalist group”; however, a great percentage of the work is common among hospitalists. We have a national hospital medicine leadership team composed of our divisional medical directors and dyad administrative partners to oversee the efforts of hospital medicine at CHI. That leadership team identifies the commonalities of opportunities across our hospital medicine markets. How can we support local innovation while maximizing the opportunity for standardization? What are the things that are fairly consistent no matter where you practice? What are those things that might have a substantial amount of difference? The focus of CHI’s national hospital medicine service line is to align standards that improve the practice of hospital medicine across CHI.

What’s great about hospitalists is that they have an innate desire to improve the health and well-being of our communities. Hospitalists are truly passionate about improving the way we care for patients, advancing quality outcomes, and leading the shift from volume to value for the communities we serve.

—Dr. Trask

Q: How important is it to find those commonalities?

A: In this day and age of healthcare, as we consider new payment models, we look at population health and what that means in a future state for healthcare. In the future, hospitalists are a critical component of ensuring we deliver higher clinical quality outcomes and better efficiencies to care for our population as a whole. As opposed to having each of our practices continuing to work individually and, in many cases, on many of the same exact issues, we identified the opportunity to bring those efforts together and try to do so in a more efficient fashion.

I’ll give an example: When we look at clinical documentation, much of that is related to electronic health records. How can we work together to identify opportunities to improve the use of our electronic health record when we have the same health record in different divisions?

Q: Where do you see yourself in five years, 10 years?

A: It’s funny you ask that question, as that is the question I always ask people I’m interviewing. My answer to that is not always as concrete as others’ answers.

I look at what doors might open, and I look at what opportunities present themselves. I think, looking at opportunities like we have in hospital medicine and looking at opportunities to really expand beyond current state, many of my experiences have led me to realize that I like to be involved in improvements, change in evolving the healthcare industry, and bringing teams together to improve the status quo.

Q: You work with some 900 hospitalists. What’s your favorite thing about working with them and the role they play?

A: Every single hospitalist I’ve encountered has demonstrated such a strong desire to make improvements in the patients that they’re caring for. What’s great about hospitalists is that they have an innate desire to improve the health and well-being of our communities. Hospitalists are truly passionate about improving the way we care for patients, advancing quality outcomes, and leading the shift from volume to value for the communities we serve. For me, this role is not simply a task or a job that I do, but it really is a passion.

Q: The flip side of that is nobody’s job is perfect. What’s the toughest thing about working with hospitalists?

A: One of the toughest things in this particular industry is the fact that it has been the fastest growing of all of time [in medicine], and there are times when supply and demand are not well balanced. There are a lot of demands placed on hospitalists, and there are a lot of expectations by hospital leaders and health system leaders, that hospitalists can solve many of the problems that may exist. Because of that, sometimes the supply of hospitalists, or the ability to have top talent, is really challenging.

The balance is not yet perfect between the availability of top talent and the ability to meet the needs of the organization and community.

Richard Quinn is a freelance writer in New Jersey.

Earning credit for continuing medical education (CME) is a little easier for hospitalists and other physicians.

A collaboration between the American Board of Internal Medicine (ABIM) and the Accreditation Council for Continuing Medical Education (ACCME) will enable physicians who are engaged in lifelong learning to use those activities toward completion of requirements for ABIM’s Maintenance of Certification (MOC) program.

The collaboration expands physicians’ options to receive MOC credit and helps CME providers to “offer more lifelong learning options with MOC credit to internists and subspecialties,” according to an ABIM announcement.

The ABIM-ACCME collaboration exempts CME providers from applying for ABIM approval for each MOC activity. Instead, CME providers can use a shared system to record information about CME and ABIM MOC activities.

“I think the ABIM wanted to recognize this CME as fulfilling the spirit of MOC, but up until now, it was really hard to ensure that the ‘CME’ was meaningful and not tainted by third-party sponsorship,” writes ABIM Council member and former SHM President Jeffrey Wiese, MD, MHM, in an email to The Hospitalist. “This collaboration enables physicians to get MOC credit for the CME that they are acquiring and, importantly, ensures that the CME that counts toward MOC meets the standards of the ABIM without having to go through an extensive approval process.”

Hospitalists also have the option to use the Focused Practice in Hospital Medicine exam, but not all do. Therefore, the streamlined network for reporting activity means that hospitalists will see a real benefit.

“There haven’t been a lot of modules built for hospital medicine like there have been for ambulatory medicine or the subspecialties,” Dr. Wiese adds. “Hospitalists have struggled to find medical knowledge modules that gave MOC credit and [that] fit with what they were doing in their practice. This collaboration solves that, as it opens a door for many CME activities that will satisfy both MOC credit and speak to the practice of hospital medicine.”

Visit our website for more information on continuing medical education in hospital medicine.

Earning credit for continuing medical education (CME) is a little easier for hospitalists and other physicians.

A collaboration between the American Board of Internal Medicine (ABIM) and the Accreditation Council for Continuing Medical Education (ACCME) will enable physicians who are engaged in lifelong learning to use those activities toward completion of requirements for ABIM’s Maintenance of Certification (MOC) program.

The collaboration expands physicians’ options to receive MOC credit and helps CME providers to “offer more lifelong learning options with MOC credit to internists and subspecialties,” according to an ABIM announcement.

The ABIM-ACCME collaboration exempts CME providers from applying for ABIM approval for each MOC activity. Instead, CME providers can use a shared system to record information about CME and ABIM MOC activities.

“I think the ABIM wanted to recognize this CME as fulfilling the spirit of MOC, but up until now, it was really hard to ensure that the ‘CME’ was meaningful and not tainted by third-party sponsorship,” writes ABIM Council member and former SHM President Jeffrey Wiese, MD, MHM, in an email to The Hospitalist. “This collaboration enables physicians to get MOC credit for the CME that they are acquiring and, importantly, ensures that the CME that counts toward MOC meets the standards of the ABIM without having to go through an extensive approval process.”

Hospitalists also have the option to use the Focused Practice in Hospital Medicine exam, but not all do. Therefore, the streamlined network for reporting activity means that hospitalists will see a real benefit.

“There haven’t been a lot of modules built for hospital medicine like there have been for ambulatory medicine or the subspecialties,” Dr. Wiese adds. “Hospitalists have struggled to find medical knowledge modules that gave MOC credit and [that] fit with what they were doing in their practice. This collaboration solves that, as it opens a door for many CME activities that will satisfy both MOC credit and speak to the practice of hospital medicine.”

Visit our website for more information on continuing medical education in hospital medicine.

Earning credit for continuing medical education (CME) is a little easier for hospitalists and other physicians.

A collaboration between the American Board of Internal Medicine (ABIM) and the Accreditation Council for Continuing Medical Education (ACCME) will enable physicians who are engaged in lifelong learning to use those activities toward completion of requirements for ABIM’s Maintenance of Certification (MOC) program.

The collaboration expands physicians’ options to receive MOC credit and helps CME providers to “offer more lifelong learning options with MOC credit to internists and subspecialties,” according to an ABIM announcement.

The ABIM-ACCME collaboration exempts CME providers from applying for ABIM approval for each MOC activity. Instead, CME providers can use a shared system to record information about CME and ABIM MOC activities.

“I think the ABIM wanted to recognize this CME as fulfilling the spirit of MOC, but up until now, it was really hard to ensure that the ‘CME’ was meaningful and not tainted by third-party sponsorship,” writes ABIM Council member and former SHM President Jeffrey Wiese, MD, MHM, in an email to The Hospitalist. “This collaboration enables physicians to get MOC credit for the CME that they are acquiring and, importantly, ensures that the CME that counts toward MOC meets the standards of the ABIM without having to go through an extensive approval process.”

Hospitalists also have the option to use the Focused Practice in Hospital Medicine exam, but not all do. Therefore, the streamlined network for reporting activity means that hospitalists will see a real benefit.

“There haven’t been a lot of modules built for hospital medicine like there have been for ambulatory medicine or the subspecialties,” Dr. Wiese adds. “Hospitalists have struggled to find medical knowledge modules that gave MOC credit and [that] fit with what they were doing in their practice. This collaboration solves that, as it opens a door for many CME activities that will satisfy both MOC credit and speak to the practice of hospital medicine.”

Visit our website for more information on continuing medical education in hospital medicine.

Physicians are lifelong learners by definition. But Elizabeth Cook, MD, is still an actual student.

Dr. Cook, medical director of the hospitalist division of Medical Associates of Central Virginia in Lynchburg, Va., is working toward her master’s degree in public health (MPH) leadership at the University of North Carolina in Chapel Hill, N.C. She is on target to graduate in 2016.

“I am interested in health policy and how the big decisions made at high levels are translated into day-to-day operations,” she says. “Oftentimes the unintended consequences are substantial for some of these decisions. I think it is important for those who do the daily provider work to be a part of the process to help inform the decisions.”

That day-to-day work for Dr. Cook now includes serving as one of seven new members of Team Hospitalist, the volunteer editorial advisory board of The Hospitalist.

Question: Why did you choose a career in medicine?

Answer: A long series of events. My undergrad degree was in television/film/radio production. I was working in the field but was exposed to the field of medicine for the first time after I tore an ACL [anterior cruciate ligament] and had knee surgery. Some friends worked in medicine and, between their encouragement and my fascination with medicine and the way the body works, I decided to change directions and pursued a medical degree.

After so many years, the management and diagnosis can lose their sense of impact for providers, as it is daily routine. It is important to remember the patients’ perspective and learn ways to reassure and inform to defuse some of the high emotions. –Elizabeth Cook, MD

Q: How/when did you decide to become a hospitalist?

A: I hated inpatient medicine when I was in medical school and as a family practice resident. I intended to open a private practice (family practice) office, but a mentor convinced me to take a job as hospitalist as an interim step while working on putting together the office. I did open the office with intention to transition to just that long term. After doing both for a while, I started to really enjoy the collegiality and pace of hospitalist work and decided to close the office and do hospitalist work full time. That was 14 years ago, and I’ve never second-guessed my decision.

Q: Was there a specific person who steered you to hospital medicine?

A: A part-time faculty member at the residency where I trained really encouraged me to try hospitalist work. He felt like I would enjoy the pace and the ability to interact with specialists and colleagues, and he was absolutely right. I still thank him and sometimes rib him about it when things are really crazy.

Q: What do you like most about working as a hospitalist?

A: I love the pace and the constant interaction with specialists, nursing staff, and other providers. I also have a great group of fellow hospitalists. We have been a very stable group, and some of us have been together for a long time doing this. Almost feels like family. I also like the constant learning that takes place in the interactions with specialists. They keep us on the cutting edge of medicine, and the patients always provide a new and interesting challenge to learn from.

Q: What do you dislike most?

A: We have a very flexible schedule, but it does require lots of weekends and evenings. It makes it hard to have a social life and do things with people outside of medicine who maintain the usual (Monday to Friday) life.

Q: What’s the best advice you ever received?

A: Have fun with whatever you are doing.

Q: What’s the biggest change you’ve seen in HM in your career?

A: The patients are much sicker and more complicated than when I first started. We have become really good at managing a lot of things as outpatients, so what is left is a lot of really challenging, time-consuming patients. It’s intellectually rewarding but can be exhausting when you are seeing 16 to 20 patients a day like that.

Q: What’s the biggest change you would like to see in HM?

A: I think we need better coordination with care and more connection to the outpatient setting. I often feel like I am sending my patients out into a black hole, and I just hope they end up with all the things I have ordered and recommended.

Q: For group leaders, why is it important for you to continue seeing patients?

A: Seeing patients is critical. It keeps me in touch with the issues and challenges that my providers deal with. It also creates a sense of teamwork and puts us on equal footing rather than my being perceived as a distant administrator.

Q: As a hospitalist, seeing most of your patients for the very first time, what aspect of patient care is most challenging?

A: Being in the hospital, by its very nature, places patients and families in circumstances that are often scary and out of their control. It creates a lot of emotions that can charge interactions. After so many years, the management and diagnosis can lose their sense of impact for providers, as it is daily routine. It is important to remember the patients’ perspective and learn ways to reassure and inform to defuse some of the high emotions.

Q: What aspect of patient care is most rewarding?

A: When a patient comes in very sick and I am able to identify and treat the problem and watch them make a good recovery. It feels like I am doing something meaningful and important in life.

Q: What is your biggest professional challenge?

A: Interacting with hospital administration, as there are often competing demands and desires that require politics, collaboration, and people skills to get everyone pulling in the same direction.

Q: What’s next professionally?

A: I am not sure. I am eager to see what doors the MPH opens for me. I would be interested in consulting work, helping smaller programs look at opportunities for growth and ways to collaborate and align interests with their hospital administrators. Also, working in health policy interests me.

Q: If you weren’t a doctor, what would you be doing right now?

A: I have written a book and a screenplay and really enjoy that. In my dream world, I would be able to work full time as an author.

Richard Quinn is a freelance journalist in New Jersey.

Physicians are lifelong learners by definition. But Elizabeth Cook, MD, is still an actual student.

Dr. Cook, medical director of the hospitalist division of Medical Associates of Central Virginia in Lynchburg, Va., is working toward her master’s degree in public health (MPH) leadership at the University of North Carolina in Chapel Hill, N.C. She is on target to graduate in 2016.

“I am interested in health policy and how the big decisions made at high levels are translated into day-to-day operations,” she says. “Oftentimes the unintended consequences are substantial for some of these decisions. I think it is important for those who do the daily provider work to be a part of the process to help inform the decisions.”

That day-to-day work for Dr. Cook now includes serving as one of seven new members of Team Hospitalist, the volunteer editorial advisory board of The Hospitalist.

Question: Why did you choose a career in medicine?

Answer: A long series of events. My undergrad degree was in television/film/radio production. I was working in the field but was exposed to the field of medicine for the first time after I tore an ACL [anterior cruciate ligament] and had knee surgery. Some friends worked in medicine and, between their encouragement and my fascination with medicine and the way the body works, I decided to change directions and pursued a medical degree.

After so many years, the management and diagnosis can lose their sense of impact for providers, as it is daily routine. It is important to remember the patients’ perspective and learn ways to reassure and inform to defuse some of the high emotions. –Elizabeth Cook, MD

Q: How/when did you decide to become a hospitalist?

A: I hated inpatient medicine when I was in medical school and as a family practice resident. I intended to open a private practice (family practice) office, but a mentor convinced me to take a job as hospitalist as an interim step while working on putting together the office. I did open the office with intention to transition to just that long term. After doing both for a while, I started to really enjoy the collegiality and pace of hospitalist work and decided to close the office and do hospitalist work full time. That was 14 years ago, and I’ve never second-guessed my decision.

Q: Was there a specific person who steered you to hospital medicine?

A: A part-time faculty member at the residency where I trained really encouraged me to try hospitalist work. He felt like I would enjoy the pace and the ability to interact with specialists and colleagues, and he was absolutely right. I still thank him and sometimes rib him about it when things are really crazy.

Q: What do you like most about working as a hospitalist?

A: I love the pace and the constant interaction with specialists, nursing staff, and other providers. I also have a great group of fellow hospitalists. We have been a very stable group, and some of us have been together for a long time doing this. Almost feels like family. I also like the constant learning that takes place in the interactions with specialists. They keep us on the cutting edge of medicine, and the patients always provide a new and interesting challenge to learn from.

Q: What do you dislike most?

A: We have a very flexible schedule, but it does require lots of weekends and evenings. It makes it hard to have a social life and do things with people outside of medicine who maintain the usual (Monday to Friday) life.

Q: What’s the best advice you ever received?

A: Have fun with whatever you are doing.

Q: What’s the biggest change you’ve seen in HM in your career?

A: The patients are much sicker and more complicated than when I first started. We have become really good at managing a lot of things as outpatients, so what is left is a lot of really challenging, time-consuming patients. It’s intellectually rewarding but can be exhausting when you are seeing 16 to 20 patients a day like that.

Q: What’s the biggest change you would like to see in HM?

A: I think we need better coordination with care and more connection to the outpatient setting. I often feel like I am sending my patients out into a black hole, and I just hope they end up with all the things I have ordered and recommended.

Q: For group leaders, why is it important for you to continue seeing patients?

A: Seeing patients is critical. It keeps me in touch with the issues and challenges that my providers deal with. It also creates a sense of teamwork and puts us on equal footing rather than my being perceived as a distant administrator.

Q: As a hospitalist, seeing most of your patients for the very first time, what aspect of patient care is most challenging?

A: Being in the hospital, by its very nature, places patients and families in circumstances that are often scary and out of their control. It creates a lot of emotions that can charge interactions. After so many years, the management and diagnosis can lose their sense of impact for providers, as it is daily routine. It is important to remember the patients’ perspective and learn ways to reassure and inform to defuse some of the high emotions.

Q: What aspect of patient care is most rewarding?

A: When a patient comes in very sick and I am able to identify and treat the problem and watch them make a good recovery. It feels like I am doing something meaningful and important in life.

Q: What is your biggest professional challenge?

A: Interacting with hospital administration, as there are often competing demands and desires that require politics, collaboration, and people skills to get everyone pulling in the same direction.

Q: What’s next professionally?

A: I am not sure. I am eager to see what doors the MPH opens for me. I would be interested in consulting work, helping smaller programs look at opportunities for growth and ways to collaborate and align interests with their hospital administrators. Also, working in health policy interests me.

Q: If you weren’t a doctor, what would you be doing right now?

A: I have written a book and a screenplay and really enjoy that. In my dream world, I would be able to work full time as an author.

Richard Quinn is a freelance journalist in New Jersey.

Physicians are lifelong learners by definition. But Elizabeth Cook, MD, is still an actual student.

Dr. Cook, medical director of the hospitalist division of Medical Associates of Central Virginia in Lynchburg, Va., is working toward her master’s degree in public health (MPH) leadership at the University of North Carolina in Chapel Hill, N.C. She is on target to graduate in 2016.

“I am interested in health policy and how the big decisions made at high levels are translated into day-to-day operations,” she says. “Oftentimes the unintended consequences are substantial for some of these decisions. I think it is important for those who do the daily provider work to be a part of the process to help inform the decisions.”

That day-to-day work for Dr. Cook now includes serving as one of seven new members of Team Hospitalist, the volunteer editorial advisory board of The Hospitalist.

Question: Why did you choose a career in medicine?

Answer: A long series of events. My undergrad degree was in television/film/radio production. I was working in the field but was exposed to the field of medicine for the first time after I tore an ACL [anterior cruciate ligament] and had knee surgery. Some friends worked in medicine and, between their encouragement and my fascination with medicine and the way the body works, I decided to change directions and pursued a medical degree.

After so many years, the management and diagnosis can lose their sense of impact for providers, as it is daily routine. It is important to remember the patients’ perspective and learn ways to reassure and inform to defuse some of the high emotions. –Elizabeth Cook, MD

Q: How/when did you decide to become a hospitalist?

A: I hated inpatient medicine when I was in medical school and as a family practice resident. I intended to open a private practice (family practice) office, but a mentor convinced me to take a job as hospitalist as an interim step while working on putting together the office. I did open the office with intention to transition to just that long term. After doing both for a while, I started to really enjoy the collegiality and pace of hospitalist work and decided to close the office and do hospitalist work full time. That was 14 years ago, and I’ve never second-guessed my decision.

Q: Was there a specific person who steered you to hospital medicine?

A: A part-time faculty member at the residency where I trained really encouraged me to try hospitalist work. He felt like I would enjoy the pace and the ability to interact with specialists and colleagues, and he was absolutely right. I still thank him and sometimes rib him about it when things are really crazy.

Q: What do you like most about working as a hospitalist?

A: I love the pace and the constant interaction with specialists, nursing staff, and other providers. I also have a great group of fellow hospitalists. We have been a very stable group, and some of us have been together for a long time doing this. Almost feels like family. I also like the constant learning that takes place in the interactions with specialists. They keep us on the cutting edge of medicine, and the patients always provide a new and interesting challenge to learn from.

Q: What do you dislike most?

A: We have a very flexible schedule, but it does require lots of weekends and evenings. It makes it hard to have a social life and do things with people outside of medicine who maintain the usual (Monday to Friday) life.

Q: What’s the best advice you ever received?

A: Have fun with whatever you are doing.

Q: What’s the biggest change you’ve seen in HM in your career?

A: The patients are much sicker and more complicated than when I first started. We have become really good at managing a lot of things as outpatients, so what is left is a lot of really challenging, time-consuming patients. It’s intellectually rewarding but can be exhausting when you are seeing 16 to 20 patients a day like that.

Q: What’s the biggest change you would like to see in HM?

A: I think we need better coordination with care and more connection to the outpatient setting. I often feel like I am sending my patients out into a black hole, and I just hope they end up with all the things I have ordered and recommended.

Q: For group leaders, why is it important for you to continue seeing patients?

A: Seeing patients is critical. It keeps me in touch with the issues and challenges that my providers deal with. It also creates a sense of teamwork and puts us on equal footing rather than my being perceived as a distant administrator.

Q: As a hospitalist, seeing most of your patients for the very first time, what aspect of patient care is most challenging?

A: Being in the hospital, by its very nature, places patients and families in circumstances that are often scary and out of their control. It creates a lot of emotions that can charge interactions. After so many years, the management and diagnosis can lose their sense of impact for providers, as it is daily routine. It is important to remember the patients’ perspective and learn ways to reassure and inform to defuse some of the high emotions.

Q: What aspect of patient care is most rewarding?

A: When a patient comes in very sick and I am able to identify and treat the problem and watch them make a good recovery. It feels like I am doing something meaningful and important in life.

Q: What is your biggest professional challenge?

A: Interacting with hospital administration, as there are often competing demands and desires that require politics, collaboration, and people skills to get everyone pulling in the same direction.

Q: What’s next professionally?

A: I am not sure. I am eager to see what doors the MPH opens for me. I would be interested in consulting work, helping smaller programs look at opportunities for growth and ways to collaborate and align interests with their hospital administrators. Also, working in health policy interests me.

Q: If you weren’t a doctor, what would you be doing right now?

A: I have written a book and a screenplay and really enjoy that. In my dream world, I would be able to work full time as an author.

Richard Quinn is a freelance journalist in New Jersey.

Nearly one-third of hospitalized patients who survive severe sepsis or septic shock require readmission within 30 days, according to a new report in the Journal of Hospital Medicine. Between 660,000 and 750,000 sepsis hospitalizations occur annually, with the direct costs surpassing $24 billion, the paper notes.

The study, which examined 1697 sepsis survivors from 2008 to 2012, links several clinical factors with increased 30-day readmission risk, including infection with Bacteroides spp and extended-spectrum beta-lactamases organisms and puts sepsis survivors with mild-to-moderate acute kidney injury (AKI) at nearly double the risk of readmission.

Study lead author Marya Zilberberg, MD, MPH, notes that efforts to reduce AKI in sepsis survivors might affect patient outcomes but that more research needs to be done to help decrease readmission rates.

“The hypothesis that reducing the occurrence of AKI would in turn reduce the risk of a 30-day hospitalization needs to be validated,” Dr. Zilberberg writes in an email to The Hospitalist. “Furthermore, it is a difficult goal among the critically ill. So, what this means to me is … this quality metric may be yet another that is putting the cart (the metric) before the horse (evidence to support its use).”

Dr. Zilberberg, founder and president of EviMed Research Group, LLC, an evidence-based medicine and outcomes research firm based in Goshen, Mass., says the study’s results were not completely unexpected as resistant infections are associated with worsening of all outcomes, and “we just showed that 30-day readmission was not immune to that,” she notes.

“We are not sure what effective strategies [there] may be to achieve this goal,” she notes. “In general, delivery of best-known care is the best that can be done. The most that can be said from our study is that antimicrobial resistance is bad even vis-à-vis this outcome, so reducing the burden of antimicrobial resistance, in addition to AKI prevention, is a strategy that might impact this outcome, along with many others.”

Visit our website for more information on sepsis and HM.

Nearly one-third of hospitalized patients who survive severe sepsis or septic shock require readmission within 30 days, according to a new report in the Journal of Hospital Medicine. Between 660,000 and 750,000 sepsis hospitalizations occur annually, with the direct costs surpassing $24 billion, the paper notes.

The study, which examined 1697 sepsis survivors from 2008 to 2012, links several clinical factors with increased 30-day readmission risk, including infection with Bacteroides spp and extended-spectrum beta-lactamases organisms and puts sepsis survivors with mild-to-moderate acute kidney injury (AKI) at nearly double the risk of readmission.

Study lead author Marya Zilberberg, MD, MPH, notes that efforts to reduce AKI in sepsis survivors might affect patient outcomes but that more research needs to be done to help decrease readmission rates.

“The hypothesis that reducing the occurrence of AKI would in turn reduce the risk of a 30-day hospitalization needs to be validated,” Dr. Zilberberg writes in an email to The Hospitalist. “Furthermore, it is a difficult goal among the critically ill. So, what this means to me is … this quality metric may be yet another that is putting the cart (the metric) before the horse (evidence to support its use).”

Dr. Zilberberg, founder and president of EviMed Research Group, LLC, an evidence-based medicine and outcomes research firm based in Goshen, Mass., says the study’s results were not completely unexpected as resistant infections are associated with worsening of all outcomes, and “we just showed that 30-day readmission was not immune to that,” she notes.

“We are not sure what effective strategies [there] may be to achieve this goal,” she notes. “In general, delivery of best-known care is the best that can be done. The most that can be said from our study is that antimicrobial resistance is bad even vis-à-vis this outcome, so reducing the burden of antimicrobial resistance, in addition to AKI prevention, is a strategy that might impact this outcome, along with many others.”

Visit our website for more information on sepsis and HM.

Nearly one-third of hospitalized patients who survive severe sepsis or septic shock require readmission within 30 days, according to a new report in the Journal of Hospital Medicine. Between 660,000 and 750,000 sepsis hospitalizations occur annually, with the direct costs surpassing $24 billion, the paper notes.

The study, which examined 1697 sepsis survivors from 2008 to 2012, links several clinical factors with increased 30-day readmission risk, including infection with Bacteroides spp and extended-spectrum beta-lactamases organisms and puts sepsis survivors with mild-to-moderate acute kidney injury (AKI) at nearly double the risk of readmission.

Study lead author Marya Zilberberg, MD, MPH, notes that efforts to reduce AKI in sepsis survivors might affect patient outcomes but that more research needs to be done to help decrease readmission rates.

“The hypothesis that reducing the occurrence of AKI would in turn reduce the risk of a 30-day hospitalization needs to be validated,” Dr. Zilberberg writes in an email to The Hospitalist. “Furthermore, it is a difficult goal among the critically ill. So, what this means to me is … this quality metric may be yet another that is putting the cart (the metric) before the horse (evidence to support its use).”

Dr. Zilberberg, founder and president of EviMed Research Group, LLC, an evidence-based medicine and outcomes research firm based in Goshen, Mass., says the study’s results were not completely unexpected as resistant infections are associated with worsening of all outcomes, and “we just showed that 30-day readmission was not immune to that,” she notes.

“We are not sure what effective strategies [there] may be to achieve this goal,” she notes. “In general, delivery of best-known care is the best that can be done. The most that can be said from our study is that antimicrobial resistance is bad even vis-à-vis this outcome, so reducing the burden of antimicrobial resistance, in addition to AKI prevention, is a strategy that might impact this outcome, along with many others.”

Visit our website for more information on sepsis and HM.

Two deals involving hospitalist management firms were announced in the past week, further consolidating the ranks of staffing companies in the specialty.

In the bigger deal, TeamHealth Holdings, Inc., last week agreed to acquire IPC Healthcare Inc. of North Hollywood, Calif., for $1.6 billion. The deal announcement highlighted IPC's stake in both hospital and post-acute care settings as a motivational factor for the acquisition.

"Combining emergency department staffing with hospitalist presence creates the opportunity to effectively manage patients from the emergency department through the inpatient discharge and beyond," the deal announcement notes. "This will allow TeamHealth to lower costs and increase quality, and, as a result, drive better patient experiences."

TeamHealth’s acquisition of IPC Healthcare is the latest deal to combine large hospital management groups, perpetuating a consolidation trend among companies seeking cost efficiencies.

Also last week, private equity firm Onex Corporation announced an agreement to acquire Hospital Physician Partners (HPP) of Hollywood, Fla., which bills itself as the fourth-largest provider of emergency and hospitalist clinical staffing services. Financial terms were not released.

Both deals are expected to close by year's end. They follow 2014's acquisition by Sound Physicians of Cogent Healthcare. The combined entity, which retained the Sound name, created the largest hospital management group in the country.

John Nelson, MD, MHM, a principal in Nelson Flores Hospital Medicine Consultants and regular practice management columnist for The Hospitalist, says consolidation is a double-edged sword.

"They may have the scale to come up with new valuable ways to organize care that can be adopted … by others," Dr. Nelson writes in an email to The Hospitalist. "But a marketplace that moves from multiple competing companies to a few very large ones faces the usual negatives of fewer competitors in the marketplace."

Dr. Nelson compares such deals to the airline industry, where consolidation has shrunk the playing field to a handful of major carriers. While larger HM firms may carry more weight in contract negotiations with institutions, individual practitioners need not worry that consolidation as a trend will negatively impact their daily rounds, he notes.

"Any efficiencies large companies have will likely have little effect on the work life of rank-and-file hospitalists, at least for foreseeable future," he adds. TH

Visit our website for more information on consolidation in hospital medicine.

Two deals involving hospitalist management firms were announced in the past week, further consolidating the ranks of staffing companies in the specialty.

In the bigger deal, TeamHealth Holdings, Inc., last week agreed to acquire IPC Healthcare Inc. of North Hollywood, Calif., for $1.6 billion. The deal announcement highlighted IPC's stake in both hospital and post-acute care settings as a motivational factor for the acquisition.

"Combining emergency department staffing with hospitalist presence creates the opportunity to effectively manage patients from the emergency department through the inpatient discharge and beyond," the deal announcement notes. "This will allow TeamHealth to lower costs and increase quality, and, as a result, drive better patient experiences."

TeamHealth’s acquisition of IPC Healthcare is the latest deal to combine large hospital management groups, perpetuating a consolidation trend among companies seeking cost efficiencies.

Also last week, private equity firm Onex Corporation announced an agreement to acquire Hospital Physician Partners (HPP) of Hollywood, Fla., which bills itself as the fourth-largest provider of emergency and hospitalist clinical staffing services. Financial terms were not released.

Both deals are expected to close by year's end. They follow 2014's acquisition by Sound Physicians of Cogent Healthcare. The combined entity, which retained the Sound name, created the largest hospital management group in the country.

John Nelson, MD, MHM, a principal in Nelson Flores Hospital Medicine Consultants and regular practice management columnist for The Hospitalist, says consolidation is a double-edged sword.

"They may have the scale to come up with new valuable ways to organize care that can be adopted … by others," Dr. Nelson writes in an email to The Hospitalist. "But a marketplace that moves from multiple competing companies to a few very large ones faces the usual negatives of fewer competitors in the marketplace."

Dr. Nelson compares such deals to the airline industry, where consolidation has shrunk the playing field to a handful of major carriers. While larger HM firms may carry more weight in contract negotiations with institutions, individual practitioners need not worry that consolidation as a trend will negatively impact their daily rounds, he notes.

"Any efficiencies large companies have will likely have little effect on the work life of rank-and-file hospitalists, at least for foreseeable future," he adds. TH

Visit our website for more information on consolidation in hospital medicine.

Two deals involving hospitalist management firms were announced in the past week, further consolidating the ranks of staffing companies in the specialty.

In the bigger deal, TeamHealth Holdings, Inc., last week agreed to acquire IPC Healthcare Inc. of North Hollywood, Calif., for $1.6 billion. The deal announcement highlighted IPC's stake in both hospital and post-acute care settings as a motivational factor for the acquisition.

"Combining emergency department staffing with hospitalist presence creates the opportunity to effectively manage patients from the emergency department through the inpatient discharge and beyond," the deal announcement notes. "This will allow TeamHealth to lower costs and increase quality, and, as a result, drive better patient experiences."

TeamHealth’s acquisition of IPC Healthcare is the latest deal to combine large hospital management groups, perpetuating a consolidation trend among companies seeking cost efficiencies.

Also last week, private equity firm Onex Corporation announced an agreement to acquire Hospital Physician Partners (HPP) of Hollywood, Fla., which bills itself as the fourth-largest provider of emergency and hospitalist clinical staffing services. Financial terms were not released.

Both deals are expected to close by year's end. They follow 2014's acquisition by Sound Physicians of Cogent Healthcare. The combined entity, which retained the Sound name, created the largest hospital management group in the country.

John Nelson, MD, MHM, a principal in Nelson Flores Hospital Medicine Consultants and regular practice management columnist for The Hospitalist, says consolidation is a double-edged sword.

"They may have the scale to come up with new valuable ways to organize care that can be adopted … by others," Dr. Nelson writes in an email to The Hospitalist. "But a marketplace that moves from multiple competing companies to a few very large ones faces the usual negatives of fewer competitors in the marketplace."

Dr. Nelson compares such deals to the airline industry, where consolidation has shrunk the playing field to a handful of major carriers. While larger HM firms may carry more weight in contract negotiations with institutions, individual practitioners need not worry that consolidation as a trend will negatively impact their daily rounds, he notes.

"Any efficiencies large companies have will likely have little effect on the work life of rank-and-file hospitalists, at least for foreseeable future," he adds. TH

Visit our website for more information on consolidation in hospital medicine.

Any hospitalist working for the largest HM group (HMG) in the country has one heck of a top-down perspective. And if you’re Robert Zipper, MD, MMM, SFHM, a regional chief medical officer (CMO) overseeing 25 hospitalist programs in the Pacific Northwest and Northern California for Sound Physicians, you love it.

“In my role, I really like working with younger leaders and those that are the future of the specialty,” he says, “but mostly I like knowing that I am supporting people that are doing incredible work, day in and day out.

“And I am never, ever bored.”

And, while never unengaged in his day-to-day job, Dr. Zipper has also been an active member of SHM. A former member of the Hospital Quality and Patient Safety (HQPS) Committee, Dr. Zipper currently chairs the Leadership Committee. The latest line on his resume is his role as one of seven new members of Team Hospitalist, the volunteer editorial advisory board of SHM’s official newsmagazine.

Many physicians at that time were jaded, feeling that the golden era of being a doctor had come and gone. The best advice I ever received was to ignore their negativity and to make my own future.

–Dr. Zipper

Question: Why did you choose a career in medicine?

Answer: Both of my parents were psychotherapists, and I knew that I wanted to do something in healthcare…but not that!

Q: How/when did you decide to become a hospitalist?

A: I always liked inpatient medicine. I did 50/50 inpatient and outpatient for my first three years out of training, and the hospitalist part of that crumbled. That led to the opportunity to do pure hospital medicine in the same community in 2002, and I took it!

Q: Tell me a little more about medical school, residency, etc. Was there a single moment you knew “I can do this?”

A: I chose a single large institution because I wanted to know the people I worked with, as healthcare is all about relationships. In medical school, I didn’t spend more than two months at any given hospital doing rotations, and that didn’t seem like the best way to learn. It wasn’t like the real world. I never had self doubt that I would finish what I had started, partly because I had to work so hard to get into medical school in the first place.

Q: What do you like most about working as a hospitalist?

A: I enjoy the high acuity, but miss the longer-term relationships of outpatient care.

Q: What do you dislike most?

A: My role as regional CMO for a large management company never ends. I’m never “done with my shift,” so to speak. I love my job but would love more family time, too.

Q: What’s the best advice you ever received?

A: I was applying for medical school in the late 1990s, and I worked as a tech in an emergency department in Michigan. Many physicians at that time were jaded, feeling that the golden era of being a doctor had come and gone. The best advice I ever received was to ignore their negativity and to make my own future. This came from an emergency medicine resident named Paul Blackburn, who later went on to be the ED residency director at University of Arizona.

Q: Did you have a mentor during training or early career?

A: Not really, though I thought about oncology, and one of my oncology attendings played a special role for me. I ultimately chose not to do that specialty because I couldn’t deal with the high mortality—I took the grim reality that so many patients face home with me.

Q: What’s the biggest change you’ve seen in HM in your career?

A: Where to start? HM used to be a “thing,” requiring a lot of explanation. Now we have a peer-reviewed journal, and some of the best internists and family physicians in the U.S. choose hospital medicine as a career. Patients are more accepting.

Q: What’s the biggest change you would like to see in HM?

A: This may sound odd, but I would like compensation to stabilize. It will happen, but the continuous upward climb, while benefitting physicians on one hand, also serves to destabilize programs and create difficult financial situations for hospitals, particularly smaller hospitals that are at risk of closing nowadays.

Q: As a leader, why is it important for you to continue seeing patients?

A: I think that being able to see things from a variety of perspectives is very important.

Q: As a hospitalist, seeing most of your patients for the very first time, what aspect of patient care is most challenging?

A: Time management on a hospitalist’s first day is a challenge, as it always takes more time to really understand a patient and their course. Patients generally don’t like being asked the same questions repetitively.

Q: What aspect of patient care is most rewarding?

A: The human connection and feeling that you’ve played an important part in a patient’s and their family’s lives.

Q: What is your biggest professional challenge?

A: The very rapid pace of change when working with several hospitals and systems that each have their own set of strengths and challenges.

Q: What is your biggest professional reward?

A: Feeling like a part of something really meaningful. I am proud of being a leader in my organization, and I have never felt that way in any other job.

Q: What did it mean to you to be elected a Senior Fellow in Hospital Medicine?

A: I was elected SFHM in the first cohort, and I was not sure what to make of it. It has become something that is more meaningful over time as it is more widely recognized.

Q: What’s next professionally?

A: Transitional care. We are working hard to improve care in the post-acute period. The variability there is incredible, and where there is variability, there is waste. Making it work as a business, though, is another matter.

Q: If you weren’t a doctor, what would you be doing right now?

A: Probably either in information technology in some fashion—I built my first PC back when the 386 processor was king—or in music. I’ve played drums for a long time and still do whenever I get the chance.

Q: When you aren’t working, what is important to you?

A: Given that I travel quite a bit, I like to spend time with my family. We live in Bend, Ore., which offers great outdoor activities like mountain biking and skiing. We like to stay active as a family.

Q: What’s the best book you’ve read recently?

A: Being Mortal by Atul Gawande.

Any hospitalist working for the largest HM group (HMG) in the country has one heck of a top-down perspective. And if you’re Robert Zipper, MD, MMM, SFHM, a regional chief medical officer (CMO) overseeing 25 hospitalist programs in the Pacific Northwest and Northern California for Sound Physicians, you love it.

“In my role, I really like working with younger leaders and those that are the future of the specialty,” he says, “but mostly I like knowing that I am supporting people that are doing incredible work, day in and day out.

“And I am never, ever bored.”

And, while never unengaged in his day-to-day job, Dr. Zipper has also been an active member of SHM. A former member of the Hospital Quality and Patient Safety (HQPS) Committee, Dr. Zipper currently chairs the Leadership Committee. The latest line on his resume is his role as one of seven new members of Team Hospitalist, the volunteer editorial advisory board of SHM’s official newsmagazine.

Many physicians at that time were jaded, feeling that the golden era of being a doctor had come and gone. The best advice I ever received was to ignore their negativity and to make my own future.

–Dr. Zipper

Question: Why did you choose a career in medicine?

Answer: Both of my parents were psychotherapists, and I knew that I wanted to do something in healthcare…but not that!

Q: How/when did you decide to become a hospitalist?

A: I always liked inpatient medicine. I did 50/50 inpatient and outpatient for my first three years out of training, and the hospitalist part of that crumbled. That led to the opportunity to do pure hospital medicine in the same community in 2002, and I took it!

Q: Tell me a little more about medical school, residency, etc. Was there a single moment you knew “I can do this?”

A: I chose a single large institution because I wanted to know the people I worked with, as healthcare is all about relationships. In medical school, I didn’t spend more than two months at any given hospital doing rotations, and that didn’t seem like the best way to learn. It wasn’t like the real world. I never had self doubt that I would finish what I had started, partly because I had to work so hard to get into medical school in the first place.

Q: What do you like most about working as a hospitalist?

A: I enjoy the high acuity, but miss the longer-term relationships of outpatient care.

Q: What do you dislike most?

A: My role as regional CMO for a large management company never ends. I’m never “done with my shift,” so to speak. I love my job but would love more family time, too.

Q: What’s the best advice you ever received?

A: I was applying for medical school in the late 1990s, and I worked as a tech in an emergency department in Michigan. Many physicians at that time were jaded, feeling that the golden era of being a doctor had come and gone. The best advice I ever received was to ignore their negativity and to make my own future. This came from an emergency medicine resident named Paul Blackburn, who later went on to be the ED residency director at University of Arizona.

Q: Did you have a mentor during training or early career?

A: Not really, though I thought about oncology, and one of my oncology attendings played a special role for me. I ultimately chose not to do that specialty because I couldn’t deal with the high mortality—I took the grim reality that so many patients face home with me.

Q: What’s the biggest change you’ve seen in HM in your career?

A: Where to start? HM used to be a “thing,” requiring a lot of explanation. Now we have a peer-reviewed journal, and some of the best internists and family physicians in the U.S. choose hospital medicine as a career. Patients are more accepting.

Q: What’s the biggest change you would like to see in HM?

A: This may sound odd, but I would like compensation to stabilize. It will happen, but the continuous upward climb, while benefitting physicians on one hand, also serves to destabilize programs and create difficult financial situations for hospitals, particularly smaller hospitals that are at risk of closing nowadays.

Q: As a leader, why is it important for you to continue seeing patients?

A: I think that being able to see things from a variety of perspectives is very important.

Q: As a hospitalist, seeing most of your patients for the very first time, what aspect of patient care is most challenging?

A: Time management on a hospitalist’s first day is a challenge, as it always takes more time to really understand a patient and their course. Patients generally don’t like being asked the same questions repetitively.

Q: What aspect of patient care is most rewarding?

A: The human connection and feeling that you’ve played an important part in a patient’s and their family’s lives.

Q: What is your biggest professional challenge?

A: The very rapid pace of change when working with several hospitals and systems that each have their own set of strengths and challenges.

Q: What is your biggest professional reward?

A: Feeling like a part of something really meaningful. I am proud of being a leader in my organization, and I have never felt that way in any other job.

Q: What did it mean to you to be elected a Senior Fellow in Hospital Medicine?

A: I was elected SFHM in the first cohort, and I was not sure what to make of it. It has become something that is more meaningful over time as it is more widely recognized.

Q: What’s next professionally?

A: Transitional care. We are working hard to improve care in the post-acute period. The variability there is incredible, and where there is variability, there is waste. Making it work as a business, though, is another matter.

Q: If you weren’t a doctor, what would you be doing right now?

A: Probably either in information technology in some fashion—I built my first PC back when the 386 processor was king—or in music. I’ve played drums for a long time and still do whenever I get the chance.

Q: When you aren’t working, what is important to you?

A: Given that I travel quite a bit, I like to spend time with my family. We live in Bend, Ore., which offers great outdoor activities like mountain biking and skiing. We like to stay active as a family.

Q: What’s the best book you’ve read recently?

A: Being Mortal by Atul Gawande.

Any hospitalist working for the largest HM group (HMG) in the country has one heck of a top-down perspective. And if you’re Robert Zipper, MD, MMM, SFHM, a regional chief medical officer (CMO) overseeing 25 hospitalist programs in the Pacific Northwest and Northern California for Sound Physicians, you love it.

“In my role, I really like working with younger leaders and those that are the future of the specialty,” he says, “but mostly I like knowing that I am supporting people that are doing incredible work, day in and day out.

“And I am never, ever bored.”

And, while never unengaged in his day-to-day job, Dr. Zipper has also been an active member of SHM. A former member of the Hospital Quality and Patient Safety (HQPS) Committee, Dr. Zipper currently chairs the Leadership Committee. The latest line on his resume is his role as one of seven new members of Team Hospitalist, the volunteer editorial advisory board of SHM’s official newsmagazine.

Many physicians at that time were jaded, feeling that the golden era of being a doctor had come and gone. The best advice I ever received was to ignore their negativity and to make my own future.

–Dr. Zipper

Question: Why did you choose a career in medicine?

Answer: Both of my parents were psychotherapists, and I knew that I wanted to do something in healthcare…but not that!

Q: How/when did you decide to become a hospitalist?

A: I always liked inpatient medicine. I did 50/50 inpatient and outpatient for my first three years out of training, and the hospitalist part of that crumbled. That led to the opportunity to do pure hospital medicine in the same community in 2002, and I took it!

Q: Tell me a little more about medical school, residency, etc. Was there a single moment you knew “I can do this?”

A: I chose a single large institution because I wanted to know the people I worked with, as healthcare is all about relationships. In medical school, I didn’t spend more than two months at any given hospital doing rotations, and that didn’t seem like the best way to learn. It wasn’t like the real world. I never had self doubt that I would finish what I had started, partly because I had to work so hard to get into medical school in the first place.

Q: What do you like most about working as a hospitalist?

A: I enjoy the high acuity, but miss the longer-term relationships of outpatient care.

Q: What do you dislike most?

A: My role as regional CMO for a large management company never ends. I’m never “done with my shift,” so to speak. I love my job but would love more family time, too.

Q: What’s the best advice you ever received?

A: I was applying for medical school in the late 1990s, and I worked as a tech in an emergency department in Michigan. Many physicians at that time were jaded, feeling that the golden era of being a doctor had come and gone. The best advice I ever received was to ignore their negativity and to make my own future. This came from an emergency medicine resident named Paul Blackburn, who later went on to be the ED residency director at University of Arizona.

Q: Did you have a mentor during training or early career?

A: Not really, though I thought about oncology, and one of my oncology attendings played a special role for me. I ultimately chose not to do that specialty because I couldn’t deal with the high mortality—I took the grim reality that so many patients face home with me.

Q: What’s the biggest change you’ve seen in HM in your career?

A: Where to start? HM used to be a “thing,” requiring a lot of explanation. Now we have a peer-reviewed journal, and some of the best internists and family physicians in the U.S. choose hospital medicine as a career. Patients are more accepting.

Q: What’s the biggest change you would like to see in HM?

A: This may sound odd, but I would like compensation to stabilize. It will happen, but the continuous upward climb, while benefitting physicians on one hand, also serves to destabilize programs and create difficult financial situations for hospitals, particularly smaller hospitals that are at risk of closing nowadays.

Q: As a leader, why is it important for you to continue seeing patients?

A: I think that being able to see things from a variety of perspectives is very important.

Q: As a hospitalist, seeing most of your patients for the very first time, what aspect of patient care is most challenging?

A: Time management on a hospitalist’s first day is a challenge, as it always takes more time to really understand a patient and their course. Patients generally don’t like being asked the same questions repetitively.

Q: What aspect of patient care is most rewarding?

A: The human connection and feeling that you’ve played an important part in a patient’s and their family’s lives.

Q: What is your biggest professional challenge?

A: The very rapid pace of change when working with several hospitals and systems that each have their own set of strengths and challenges.

Q: What is your biggest professional reward?

A: Feeling like a part of something really meaningful. I am proud of being a leader in my organization, and I have never felt that way in any other job.

Q: What did it mean to you to be elected a Senior Fellow in Hospital Medicine?

A: I was elected SFHM in the first cohort, and I was not sure what to make of it. It has become something that is more meaningful over time as it is more widely recognized.

Q: What’s next professionally?

A: Transitional care. We are working hard to improve care in the post-acute period. The variability there is incredible, and where there is variability, there is waste. Making it work as a business, though, is another matter.

Q: If you weren’t a doctor, what would you be doing right now?

A: Probably either in information technology in some fashion—I built my first PC back when the 386 processor was king—or in music. I’ve played drums for a long time and still do whenever I get the chance.

Q: When you aren’t working, what is important to you?

A: Given that I travel quite a bit, I like to spend time with my family. We live in Bend, Ore., which offers great outdoor activities like mountain biking and skiing. We like to stay active as a family.

Q: What’s the best book you’ve read recently?

A: Being Mortal by Atul Gawande.

The Society of Hospital Medicine has launched a new scholarship program to bring the "best and brightest" medical students into the specialty.

The Student Hospitalist Scholar Grant program awards eligible students a $5,000 summer stipend for scholarly work on a project related to patient safety, quality improvement (QI), or other areas relevant to the field of hospital medicine. The program also provides up to $1,500 in travel-related reimbursement for students to attend the SHM annual meeting.

This summer's inaugural class has three students, all going into their second year of medical school: Frank Zadravecz Jr. of the University of Illinois College of Medicine at Chicago, Miriam Zander of Touro College of Osteopathic Medicine in New York City, and Monica Shah of Wayne State University School of Medicine in Detroit.

"Getting medical students involved is important for us," says hospitalist Darlene Tad-y, MD, an assistant professor of medicine at the University of Colorado in Denver and chair of SHM's Physicians in Training Committee. It means "the future of medicine will have people who know how to do this work, people who will be more skilled and effective at this work."

Dr. Tad-y says it makes sense to merge efforts to recruit the "best and brightest" medical students to HM with QI research. This year's projects include examinations of post-hospital syndrome and physiologic alarm responses.

The program drew about a dozen applicants in its first year. Over the next few years, SHM hopes to award 10 scholarships each summer.

"QI work is really only getting off the ground broadly with people who've been in the field for a really long time," Dr. Tad-y says. "To have that many students early on in their medical school career already understand some of these concepts and be aware that this is going on, for us, it's really exciting." TH

Visit our website for more information on engaging young physicians in HM.

The Society of Hospital Medicine has launched a new scholarship program to bring the "best and brightest" medical students into the specialty.

The Student Hospitalist Scholar Grant program awards eligible students a $5,000 summer stipend for scholarly work on a project related to patient safety, quality improvement (QI), or other areas relevant to the field of hospital medicine. The program also provides up to $1,500 in travel-related reimbursement for students to attend the SHM annual meeting.

This summer's inaugural class has three students, all going into their second year of medical school: Frank Zadravecz Jr. of the University of Illinois College of Medicine at Chicago, Miriam Zander of Touro College of Osteopathic Medicine in New York City, and Monica Shah of Wayne State University School of Medicine in Detroit.

"Getting medical students involved is important for us," says hospitalist Darlene Tad-y, MD, an assistant professor of medicine at the University of Colorado in Denver and chair of SHM's Physicians in Training Committee. It means "the future of medicine will have people who know how to do this work, people who will be more skilled and effective at this work."

Dr. Tad-y says it makes sense to merge efforts to recruit the "best and brightest" medical students to HM with QI research. This year's projects include examinations of post-hospital syndrome and physiologic alarm responses.

The program drew about a dozen applicants in its first year. Over the next few years, SHM hopes to award 10 scholarships each summer.

"QI work is really only getting off the ground broadly with people who've been in the field for a really long time," Dr. Tad-y says. "To have that many students early on in their medical school career already understand some of these concepts and be aware that this is going on, for us, it's really exciting." TH

Visit our website for more information on engaging young physicians in HM.

The Society of Hospital Medicine has launched a new scholarship program to bring the "best and brightest" medical students into the specialty.

The Student Hospitalist Scholar Grant program awards eligible students a $5,000 summer stipend for scholarly work on a project related to patient safety, quality improvement (QI), or other areas relevant to the field of hospital medicine. The program also provides up to $1,500 in travel-related reimbursement for students to attend the SHM annual meeting.

This summer's inaugural class has three students, all going into their second year of medical school: Frank Zadravecz Jr. of the University of Illinois College of Medicine at Chicago, Miriam Zander of Touro College of Osteopathic Medicine in New York City, and Monica Shah of Wayne State University School of Medicine in Detroit.

"Getting medical students involved is important for us," says hospitalist Darlene Tad-y, MD, an assistant professor of medicine at the University of Colorado in Denver and chair of SHM's Physicians in Training Committee. It means "the future of medicine will have people who know how to do this work, people who will be more skilled and effective at this work."

Dr. Tad-y says it makes sense to merge efforts to recruit the "best and brightest" medical students to HM with QI research. This year's projects include examinations of post-hospital syndrome and physiologic alarm responses.

The program drew about a dozen applicants in its first year. Over the next few years, SHM hopes to award 10 scholarships each summer.

"QI work is really only getting off the ground broadly with people who've been in the field for a really long time," Dr. Tad-y says. "To have that many students early on in their medical school career already understand some of these concepts and be aware that this is going on, for us, it's really exciting." TH

Visit our website for more information on engaging young physicians in HM.

As a child, Courtney, director of operations for a multi-site hospitalist program at Baptist Health System in Birmingham, Ala., knew a boy who was diagnosed with leukemia.

“I often visited him in the hospital,” she says. “Those visits made me want to be in medicine. As I grew up, I knew I had more of a business mindset verses clinical, but my passion for healthcare remained.”

She’s not kidding. In 2000, she earned a bachelor of science degree in business administration from Mississippi University for Women in Columbus. Five years later, she earned an MBA in healthcare administration from the University of Phoenix. Her career started in marketing in North Carolina, but after five years in her current role, she has been involved in developing new hospitalist programs at three hospital sites.

Courtney is an active SHM member and is in her second year as a member of SHM’s Practice Administrators Committee. Now she is bringing that nonphysician perspective to Team Hospitalist. She is one of seven new members of The Hospitalist’s volunteer editorial advisory board.

Question: Was there a specific person/mentor who steered you to hospital medicine?

Answer: I was over operations of outpatient clinics and one hospitalist location when the opportunity to help start our system-wide hospitalist program became available. My boss approached me with the opportunity. She had once helped start a hospital medicine program and thought I would enjoy the challenge it would bring.

Helping start our system hospitalist program has been both my biggest professional challenge and biggest professional reward. It was tough. With one established program already in place, it was decided to bring our two largest hospital medicine programs in-house.

Q: What do you like most about working in hospital medicine?

A: My favorite part of hospital medicine is working with my medical directors, physicians, and hospital leadership to improve quality and outcomes for our patients. It’s great to see initiatives start from the group up and then watch the improved outcomes take place.

Q: What do you dislike most?

A: Navigating the staffing challenges is the least enjoyable part of my job.

Q: What’s the best advice you ever received?

A: My father always was kind to everyone and [was] respected because of his character. I was taught a person’s character is more important than any professional achievement.

Q: What’s the biggest change you’ve seen in HM in your career?

A: It seems I’ve seen an uptick of specialists wanting to model their practice after hospitalists. I’ve seen neurologists and nephrologists who only want to do inpatient care. I believe this stems from the [interest in] work-/home life balance that is more important to the newest generation of physicians.

Q: What is your biggest professional challenge?

A: Helping start our system hospitalist program has been both my biggest professional challenge and biggest professional reward. It was tough. With one established program already in place, it was decided to bring our two largest hospital medicine programs in-house. The programs were literally starting over from scratch within one month of each other. We started with six (full-time) FT physicians, two office managers, and me between the two locations. There was lots of locum usage, heavy recruiting, physicians working crazy hours to help out, and sleepless nights.

Q: And since then?

A: We have maintained good staffing/quality physicians at our initial location, fully staffed with 28 full-time physicians, four nurse practitioners, and several other support staff at our two startup locations, and have started a program at the fourth hospital. The hospital medicine group and the hospitals have worked together on clinical documentation improvement [and] geographic interdisciplinary rounding and have gone through an EPIC EHR install. It’s been a very challenging but rewarding road to be on.

Q: What SHM event (i.e., Leadership Academy, annual meeting) made the most lasting impression on you?

A: The “Leadership Essentials” course [part of SHM’s three-course Leadership Academy] was very important to me. I look forward to continuing the Leadership Academy courses.

Q: Where do you see yourself in 10 years?

A: I love the organization I currently work for. I hope to continue on my current career path and grow as a leader within the organization.

Q: When you aren’t working, what is important to you?

Answer: My family life is very important. I’m married, and we have one son who is nine. My off time revolves around traveling and sports my son participates in.

Q: Apple or Android?

A: As much as I hate to admit it, I’m an Apple fan. It took me a long time to make the switch, but I’m like the masses and addicted.

Q: What show is sitting in your Netflix queue that you can’t wait to binge watch?

A: I’m a “Walking Dead” fan and am working my way through all of the seasons now. I’ve made it up to last season.

As a child, Courtney, director of operations for a multi-site hospitalist program at Baptist Health System in Birmingham, Ala., knew a boy who was diagnosed with leukemia.

“I often visited him in the hospital,” she says. “Those visits made me want to be in medicine. As I grew up, I knew I had more of a business mindset verses clinical, but my passion for healthcare remained.”

She’s not kidding. In 2000, she earned a bachelor of science degree in business administration from Mississippi University for Women in Columbus. Five years later, she earned an MBA in healthcare administration from the University of Phoenix. Her career started in marketing in North Carolina, but after five years in her current role, she has been involved in developing new hospitalist programs at three hospital sites.

Courtney is an active SHM member and is in her second year as a member of SHM’s Practice Administrators Committee. Now she is bringing that nonphysician perspective to Team Hospitalist. She is one of seven new members of The Hospitalist’s volunteer editorial advisory board.

Question: Was there a specific person/mentor who steered you to hospital medicine?

Answer: I was over operations of outpatient clinics and one hospitalist location when the opportunity to help start our system-wide hospitalist program became available. My boss approached me with the opportunity. She had once helped start a hospital medicine program and thought I would enjoy the challenge it would bring.

Helping start our system hospitalist program has been both my biggest professional challenge and biggest professional reward. It was tough. With one established program already in place, it was decided to bring our two largest hospital medicine programs in-house.

Q: What do you like most about working in hospital medicine?

A: My favorite part of hospital medicine is working with my medical directors, physicians, and hospital leadership to improve quality and outcomes for our patients. It’s great to see initiatives start from the group up and then watch the improved outcomes take place.

Q: What do you dislike most?

A: Navigating the staffing challenges is the least enjoyable part of my job.

Q: What’s the best advice you ever received?

A: My father always was kind to everyone and [was] respected because of his character. I was taught a person’s character is more important than any professional achievement.

Q: What’s the biggest change you’ve seen in HM in your career?

A: It seems I’ve seen an uptick of specialists wanting to model their practice after hospitalists. I’ve seen neurologists and nephrologists who only want to do inpatient care. I believe this stems from the [interest in] work-/home life balance that is more important to the newest generation of physicians.

Q: What is your biggest professional challenge?

A: Helping start our system hospitalist program has been both my biggest professional challenge and biggest professional reward. It was tough. With one established program already in place, it was decided to bring our two largest hospital medicine programs in-house. The programs were literally starting over from scratch within one month of each other. We started with six (full-time) FT physicians, two office managers, and me between the two locations. There was lots of locum usage, heavy recruiting, physicians working crazy hours to help out, and sleepless nights.

Q: And since then?

A: We have maintained good staffing/quality physicians at our initial location, fully staffed with 28 full-time physicians, four nurse practitioners, and several other support staff at our two startup locations, and have started a program at the fourth hospital. The hospital medicine group and the hospitals have worked together on clinical documentation improvement [and] geographic interdisciplinary rounding and have gone through an EPIC EHR install. It’s been a very challenging but rewarding road to be on.

Q: What SHM event (i.e., Leadership Academy, annual meeting) made the most lasting impression on you?

A: The “Leadership Essentials” course [part of SHM’s three-course Leadership Academy] was very important to me. I look forward to continuing the Leadership Academy courses.

Q: Where do you see yourself in 10 years?

A: I love the organization I currently work for. I hope to continue on my current career path and grow as a leader within the organization.

Q: When you aren’t working, what is important to you?

Answer: My family life is very important. I’m married, and we have one son who is nine. My off time revolves around traveling and sports my son participates in.

Q: Apple or Android?

A: As much as I hate to admit it, I’m an Apple fan. It took me a long time to make the switch, but I’m like the masses and addicted.

Q: What show is sitting in your Netflix queue that you can’t wait to binge watch?

A: I’m a “Walking Dead” fan and am working my way through all of the seasons now. I’ve made it up to last season.

As a child, Courtney, director of operations for a multi-site hospitalist program at Baptist Health System in Birmingham, Ala., knew a boy who was diagnosed with leukemia.

“I often visited him in the hospital,” she says. “Those visits made me want to be in medicine. As I grew up, I knew I had more of a business mindset verses clinical, but my passion for healthcare remained.”

She’s not kidding. In 2000, she earned a bachelor of science degree in business administration from Mississippi University for Women in Columbus. Five years later, she earned an MBA in healthcare administration from the University of Phoenix. Her career started in marketing in North Carolina, but after five years in her current role, she has been involved in developing new hospitalist programs at three hospital sites.

Courtney is an active SHM member and is in her second year as a member of SHM’s Practice Administrators Committee. Now she is bringing that nonphysician perspective to Team Hospitalist. She is one of seven new members of The Hospitalist’s volunteer editorial advisory board.

Question: Was there a specific person/mentor who steered you to hospital medicine?

Answer: I was over operations of outpatient clinics and one hospitalist location when the opportunity to help start our system-wide hospitalist program became available. My boss approached me with the opportunity. She had once helped start a hospital medicine program and thought I would enjoy the challenge it would bring.

Helping start our system hospitalist program has been both my biggest professional challenge and biggest professional reward. It was tough. With one established program already in place, it was decided to bring our two largest hospital medicine programs in-house.

Q: What do you like most about working in hospital medicine?

A: My favorite part of hospital medicine is working with my medical directors, physicians, and hospital leadership to improve quality and outcomes for our patients. It’s great to see initiatives start from the group up and then watch the improved outcomes take place.

Q: What do you dislike most?

A: Navigating the staffing challenges is the least enjoyable part of my job.

Q: What’s the best advice you ever received?

A: My father always was kind to everyone and [was] respected because of his character. I was taught a person’s character is more important than any professional achievement.

Q: What’s the biggest change you’ve seen in HM in your career?

A: It seems I’ve seen an uptick of specialists wanting to model their practice after hospitalists. I’ve seen neurologists and nephrologists who only want to do inpatient care. I believe this stems from the [interest in] work-/home life balance that is more important to the newest generation of physicians.

Q: What is your biggest professional challenge?

A: Helping start our system hospitalist program has been both my biggest professional challenge and biggest professional reward. It was tough. With one established program already in place, it was decided to bring our two largest hospital medicine programs in-house. The programs were literally starting over from scratch within one month of each other. We started with six (full-time) FT physicians, two office managers, and me between the two locations. There was lots of locum usage, heavy recruiting, physicians working crazy hours to help out, and sleepless nights.

Q: And since then?

A: We have maintained good staffing/quality physicians at our initial location, fully staffed with 28 full-time physicians, four nurse practitioners, and several other support staff at our two startup locations, and have started a program at the fourth hospital. The hospital medicine group and the hospitals have worked together on clinical documentation improvement [and] geographic interdisciplinary rounding and have gone through an EPIC EHR install. It’s been a very challenging but rewarding road to be on.

Q: What SHM event (i.e., Leadership Academy, annual meeting) made the most lasting impression on you?

A: The “Leadership Essentials” course [part of SHM’s three-course Leadership Academy] was very important to me. I look forward to continuing the Leadership Academy courses.

Q: Where do you see yourself in 10 years?

A: I love the organization I currently work for. I hope to continue on my current career path and grow as a leader within the organization.

Q: When you aren’t working, what is important to you?

Answer: My family life is very important. I’m married, and we have one son who is nine. My off time revolves around traveling and sports my son participates in.

Q: Apple or Android?

A: As much as I hate to admit it, I’m an Apple fan. It took me a long time to make the switch, but I’m like the masses and addicted.

Q: What show is sitting in your Netflix queue that you can’t wait to binge watch?

A: I’m a “Walking Dead” fan and am working my way through all of the seasons now. I’ve made it up to last season.

James Levy, PA-C, SFHM, isn’t a doctor. But he’s been a hospitalist for more than 15 years.

A veteran physician assistant (PA), Levy is vice president of human resources (VPHR) for iNDIGO Health Partners of Traverse City, Mich., a firm he has co-owned since it began in 2008. From 2001-2013, he was a PA at Hospitalists of Northern Michigan, also in Traverse City.

A longtime SHM member who serves on the SHM NP/PA Committee and speaks regularly at SHM meetings, Levy finds the joy of HM is simple: It follows a patient from admission to discharge.

“Clinically, I enjoy seeing the patient through the process of initial assessment, enacting a plan, and following the patient through to discharge,” he says. “Making a clinical judgment, acting on it, and being rewarded by an improving patient is deeply satisfying, as is working as part of a team with a common goal.”

His newest team is Team Hospitalist, The Hospitalist newsmagazine’s volunteer editorial advisory group. He is one of seven new members seated this year.

Question: Why did you choose a career in medicine?

Answer: I was interested in biology and science, but after a meandering academic career with the ultimate purpose of avoiding the draft, I was badly injured in a car accident. Having recovered, draft deferment in hand, I wound up as an operating room technician and immediately knew medicine was what I had to do. When I realized I preferred to deal with patients who were actually awake, my direction was established.

Q: Was there a specific person/mentor who steered you to hospital medicine?

I have come to feel that great clinicians are less about training and more about intelligence, commitment, work ethic, honesty,

persistence, and common decency. —James Levy, PA-C, SFHM

A: The hospitalists I initially encountered when I dipped my toe into inpatient medicine were passionate and engaged. Their understanding of the medicine we were doing was profound, and I was hooked. Several of them are still my partners.

Q: Tell me a little more about your training. What did you like most, dislike during the process? Was there a single moment you knew “I can do this?”

A: I’m a PA, which means I do a great deal of what a physician does with a fraction of the training. Much of what I know I’ve learned from patients, but I’m not sure that separates me from many good, experienced physicians. As the VPHR of my hospitalist company, I’ve hired many physicians, PAs, and NPs. I have come to feel that great clinicians are less about training and more about intelligence, commitment, work ethic, honesty, persistence, and common decency. These are qualities that would predict success in any field.

Q: What do you dislike most about HM?

A: All hospitalists share many of the same frustrations and irritations. The thing I hate most is when I feel I’ve done my best and the patient isn’t improving. Both parties have to do their part in order for the encounter to be successful.

Q: What’s the best advice you ever received?

A: An early physician mentor told me, “Take care of the patient, and the money will take care of itself.” My father taught me to avoid debt and live below my means. My kids taught me that often all you have to do is show up and care.

Q: Did you have a mentor during training or early career? If so, who was the mentor, and what were the most important lessons you learned from him/her?

A: My early mentor was our family doctor. He took a kindly interest in me and convinced me that I could be someone worthy of his respect and my own.

Q: What’s the biggest change you’ve seen in HM in your career?

A: The advent of EHR has done more to change the mechanics of inpatient practice than anything else.

Q: As a hospitalist, seeing most of your patients for the very first time, what aspect of patient care do you find most challenging?

A: It’s a real challenge to try to develop a working, human-to-human relationship with every sick stranger you encounter.

Q: What aspect of patient care is most rewarding?

A: When you acquire the skill of gaining the trust of a complete stranger on an initial encounter, it becomes a rewarding thing to do.

Q: Outside of patient care, tell me about your career interests.

A: I am a partner in, and officer of, the hospitalist company I helped start. Our overarching goal is to strengthen and stabilize the small, rural hospitals where we run programs. Without those hospitals, many patients will not be able to overcome the challenges of distance and winter travel to get the care they need. I am absolutely passionate about seeing this mission succeed in as many places as possible.

Q: What is your biggest professional challenge?

A: I spend lots of time talking to and working with the young physicians, PAs, and NPs I’m trying to recruit. This becomes more and more difficult as more hospitalist opportunities open and the pool of good clinicians does not expand. I’m often in the position of trying to interest a physician trained in an urban center in the advantages of working in an outlying location. Some get it; some don’t.

Q: What is your biggest professional reward?

A: Attracting a great clinician to a program where I’m sure s/he will be successful is a great thing for the individual and for that hospitalist team.

Q: What did it mean for you to be selected a Senior Fellow in Hospital Medicine?

A: This was especially meaningful to me as a PA because it was SHM really meaning it when they aspired to be a “big tent” society. I know of no other medical group that is this inclusive.

James Levy, PA-C, SFHM, isn’t a doctor. But he’s been a hospitalist for more than 15 years.

A veteran physician assistant (PA), Levy is vice president of human resources (VPHR) for iNDIGO Health Partners of Traverse City, Mich., a firm he has co-owned since it began in 2008. From 2001-2013, he was a PA at Hospitalists of Northern Michigan, also in Traverse City.

A longtime SHM member who serves on the SHM NP/PA Committee and speaks regularly at SHM meetings, Levy finds the joy of HM is simple: It follows a patient from admission to discharge.

“Clinically, I enjoy seeing the patient through the process of initial assessment, enacting a plan, and following the patient through to discharge,” he says. “Making a clinical judgment, acting on it, and being rewarded by an improving patient is deeply satisfying, as is working as part of a team with a common goal.”

His newest team is Team Hospitalist, The Hospitalist newsmagazine’s volunteer editorial advisory group. He is one of seven new members seated this year.

Question: Why did you choose a career in medicine?

Answer: I was interested in biology and science, but after a meandering academic career with the ultimate purpose of avoiding the draft, I was badly injured in a car accident. Having recovered, draft deferment in hand, I wound up as an operating room technician and immediately knew medicine was what I had to do. When I realized I preferred to deal with patients who were actually awake, my direction was established.

Q: Was there a specific person/mentor who steered you to hospital medicine?

I have come to feel that great clinicians are less about training and more about intelligence, commitment, work ethic, honesty,

persistence, and common decency. —James Levy, PA-C, SFHM

A: The hospitalists I initially encountered when I dipped my toe into inpatient medicine were passionate and engaged. Their understanding of the medicine we were doing was profound, and I was hooked. Several of them are still my partners.

Q: Tell me a little more about your training. What did you like most, dislike during the process? Was there a single moment you knew “I can do this?”

A: I’m a PA, which means I do a great deal of what a physician does with a fraction of the training. Much of what I know I’ve learned from patients, but I’m not sure that separates me from many good, experienced physicians. As the VPHR of my hospitalist company, I’ve hired many physicians, PAs, and NPs. I have come to feel that great clinicians are less about training and more about intelligence, commitment, work ethic, honesty, persistence, and common decency. These are qualities that would predict success in any field.

Q: What do you dislike most about HM?

A: All hospitalists share many of the same frustrations and irritations. The thing I hate most is when I feel I’ve done my best and the patient isn’t improving. Both parties have to do their part in order for the encounter to be successful.

Q: What’s the best advice you ever received?

A: An early physician mentor told me, “Take care of the patient, and the money will take care of itself.” My father taught me to avoid debt and live below my means. My kids taught me that often all you have to do is show up and care.

Q: Did you have a mentor during training or early career? If so, who was the mentor, and what were the most important lessons you learned from him/her?

A: My early mentor was our family doctor. He took a kindly interest in me and convinced me that I could be someone worthy of his respect and my own.

Q: What’s the biggest change you’ve seen in HM in your career?

A: The advent of EHR has done more to change the mechanics of inpatient practice than anything else.

Q: As a hospitalist, seeing most of your patients for the very first time, what aspect of patient care do you find most challenging?

A: It’s a real challenge to try to develop a working, human-to-human relationship with every sick stranger you encounter.

Q: What aspect of patient care is most rewarding?

A: When you acquire the skill of gaining the trust of a complete stranger on an initial encounter, it becomes a rewarding thing to do.

Q: Outside of patient care, tell me about your career interests.

A: I am a partner in, and officer of, the hospitalist company I helped start. Our overarching goal is to strengthen and stabilize the small, rural hospitals where we run programs. Without those hospitals, many patients will not be able to overcome the challenges of distance and winter travel to get the care they need. I am absolutely passionate about seeing this mission succeed in as many places as possible.

Q: What is your biggest professional challenge?

A: I spend lots of time talking to and working with the young physicians, PAs, and NPs I’m trying to recruit. This becomes more and more difficult as more hospitalist opportunities open and the pool of good clinicians does not expand. I’m often in the position of trying to interest a physician trained in an urban center in the advantages of working in an outlying location. Some get it; some don’t.

Q: What is your biggest professional reward?

A: Attracting a great clinician to a program where I’m sure s/he will be successful is a great thing for the individual and for that hospitalist team.

Q: What did it mean for you to be selected a Senior Fellow in Hospital Medicine?

A: This was especially meaningful to me as a PA because it was SHM really meaning it when they aspired to be a “big tent” society. I know of no other medical group that is this inclusive.

James Levy, PA-C, SFHM, isn’t a doctor. But he’s been a hospitalist for more than 15 years.

A veteran physician assistant (PA), Levy is vice president of human resources (VPHR) for iNDIGO Health Partners of Traverse City, Mich., a firm he has co-owned since it began in 2008. From 2001-2013, he was a PA at Hospitalists of Northern Michigan, also in Traverse City.

A longtime SHM member who serves on the SHM NP/PA Committee and speaks regularly at SHM meetings, Levy finds the joy of HM is simple: It follows a patient from admission to discharge.

“Clinically, I enjoy seeing the patient through the process of initial assessment, enacting a plan, and following the patient through to discharge,” he says. “Making a clinical judgment, acting on it, and being rewarded by an improving patient is deeply satisfying, as is working as part of a team with a common goal.”

His newest team is Team Hospitalist, The Hospitalist newsmagazine’s volunteer editorial advisory group. He is one of seven new members seated this year.

Question: Why did you choose a career in medicine?

Answer: I was interested in biology and science, but after a meandering academic career with the ultimate purpose of avoiding the draft, I was badly injured in a car accident. Having recovered, draft deferment in hand, I wound up as an operating room technician and immediately knew medicine was what I had to do. When I realized I preferred to deal with patients who were actually awake, my direction was established.

Q: Was there a specific person/mentor who steered you to hospital medicine?

I have come to feel that great clinicians are less about training and more about intelligence, commitment, work ethic, honesty,

persistence, and common decency. —James Levy, PA-C, SFHM

A: The hospitalists I initially encountered when I dipped my toe into inpatient medicine were passionate and engaged. Their understanding of the medicine we were doing was profound, and I was hooked. Several of them are still my partners.

Q: Tell me a little more about your training. What did you like most, dislike during the process? Was there a single moment you knew “I can do this?”

A: I’m a PA, which means I do a great deal of what a physician does with a fraction of the training. Much of what I know I’ve learned from patients, but I’m not sure that separates me from many good, experienced physicians. As the VPHR of my hospitalist company, I’ve hired many physicians, PAs, and NPs. I have come to feel that great clinicians are less about training and more about intelligence, commitment, work ethic, honesty, persistence, and common decency. These are qualities that would predict success in any field.

Q: What do you dislike most about HM?

A: All hospitalists share many of the same frustrations and irritations. The thing I hate most is when I feel I’ve done my best and the patient isn’t improving. Both parties have to do their part in order for the encounter to be successful.

Q: What’s the best advice you ever received?

A: An early physician mentor told me, “Take care of the patient, and the money will take care of itself.” My father taught me to avoid debt and live below my means. My kids taught me that often all you have to do is show up and care.

Q: Did you have a mentor during training or early career? If so, who was the mentor, and what were the most important lessons you learned from him/her?

A: My early mentor was our family doctor. He took a kindly interest in me and convinced me that I could be someone worthy of his respect and my own.

Q: What’s the biggest change you’ve seen in HM in your career?

A: The advent of EHR has done more to change the mechanics of inpatient practice than anything else.

Q: As a hospitalist, seeing most of your patients for the very first time, what aspect of patient care do you find most challenging?

A: It’s a real challenge to try to develop a working, human-to-human relationship with every sick stranger you encounter.

Q: What aspect of patient care is most rewarding?

A: When you acquire the skill of gaining the trust of a complete stranger on an initial encounter, it becomes a rewarding thing to do.

Q: Outside of patient care, tell me about your career interests.

A: I am a partner in, and officer of, the hospitalist company I helped start. Our overarching goal is to strengthen and stabilize the small, rural hospitals where we run programs. Without those hospitals, many patients will not be able to overcome the challenges of distance and winter travel to get the care they need. I am absolutely passionate about seeing this mission succeed in as many places as possible.

Q: What is your biggest professional challenge?

A: I spend lots of time talking to and working with the young physicians, PAs, and NPs I’m trying to recruit. This becomes more and more difficult as more hospitalist opportunities open and the pool of good clinicians does not expand. I’m often in the position of trying to interest a physician trained in an urban center in the advantages of working in an outlying location. Some get it; some don’t.

Q: What is your biggest professional reward?

A: Attracting a great clinician to a program where I’m sure s/he will be successful is a great thing for the individual and for that hospitalist team.

Q: What did it mean for you to be selected a Senior Fellow in Hospital Medicine?

A: This was especially meaningful to me as a PA because it was SHM really meaning it when they aspired to be a “big tent” society. I know of no other medical group that is this inclusive.