Leadership

Clerk, Scribe, Transporter, Data Manager… a.k.a. the Doctor

We grab some popcorn on the way in. Maybe a drink. The place is bustling, bright lights lead the way, and the kids grab all the new objects at each turn. Another fun Saturday night about to begin. At Target. Yep, spending the weekend evening strolling the aisles of a big box store: family fun at its finest. It is crowded. We are clearly not the only ones who think a night on the town with the kids translates into a stop and shop for milk and new socks. The excursion does have some highlights – in particular, the self-checkout process. The 9-year-old loves to scan the items, bag them, and use the credit card as though she were paying. These machines are enticing, with the promise of efficiency and a way to avoid any chatty cashier – particularly the ones that announce the items as they are scanned. “Hey…

Who Is Driving the Bus?

You are a hospitalist. Like all hospitalists, you struggle with the pace, the hours, the complexity of demands placed upon your clinical time, the dratted medical record, burnout. You sometimes feel the collaborative process with your consulting colleagues could be improved. You often feel that you are treated like a “glorified resident”, with consultants, or others, dictating the care to you. You resent that is seems you are there only to admit or discharge or cover the less appealing weekend and holiday shifts. These feelings are legitimate. They are also common. But allow me to ask: Are you driving the care? Are you owning the hospital space? Are you reaching out to communicate with your consultants? Are you discussing the case? Are you driving the bus? Because as a hospitalist, you can’t have it both ways. You can’t complain that you aren’t treated with the respect that I know your…

Survey Says…

It’s that time of (every other) year! Once again, your hospital medicine group (HMG) has a unique opportunity to contribute to our collective understanding of the current state of hospital medicine in the United States. SHM’s State of Hospital Medicine Survey kicked off this week and will be open until February 16th. I strongly urge you to take the time to participate. I have been integrally involved in SHM’s survey processes since 2006 and am deeply committed to this important work that SHM does on behalf of its members and the entire specialty of hospital medicine. Here are several reasons why it’s more important than ever that your group participate this year. The information contained in the State of Hospital Medicine Report is used by HMGs – and by hospital and physician enterprise leaders – to justify proposals and make operational decisions. The field of hospital medicine is evolving rapidly…

Up Your Game in APP Integration

I receive lots of calls and emails from HM group leaders, APP leads and others looking to up their game in APP integration. The calls fall into certain domains, and I thought it might be a good time to address some of these concerns. Training/Onboarding: This is the number one domain I get questions about. And it is important. Poor onboarding and lack of standardized training for APPs is a major barrier to success in HM practices looking to maximize their APP providers. Didactic that is congruent with SHM’s Core Competencies in Hospital Medicine is a good place to start. But before you embark on this fabulous onboarding program that is the envy of all who survey, realize that another key to success is appropriate expectations.The best onboarding or training program cannot “season” an APP the way time does. New grads can easily take nine months to a year to…

Making the Implicit Explicit

Last month, I wrote about some interesting workplace trends, in particular about how the implied compact between U.S. workers and their employers is evolving rapidly. Few of us in the workforce today can conceive of an employment relationship in which we are guaranteed lifelong employment and a generous benefits package including full healthcare and retirement in exchange for hard work and loyalty to a single employer. Since then, I’ve had several conversations about the term “compact” as I used it in that post. At its most fundamental, a compact is an agreement between two or more parties. In my recent post, I used the term to refer to the generally accepted but rarely articulated set of expectations that workers and their employers have of each other. There is an implied compact between physicians and the hospitals where they practice as well. Historically that compact assumed that doctors would refer lots…
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