Welcome to our 12th annual Top Hospitalists issue! The physicians profiled on the following pages were nominated by their colleagues and chosen by ACP Hospitalist's editorial board for their accomplishments in areas of hospitalist practice such as patient care, quality improvement, and medical education. Read on to learn about their achievements and innovations. Note: ACP Hospitalist's Top Hospitalists feature is not part of the ACP National Awards Program.
Teaching high-value care
Micah W. Beachy, DO, FACP
Medical school: Des Moines University College of Osteopathic Medicine, Iowa
Residency: University of Nebraska Medical Center, Omaha
In high school, Micah W. Beachy, DO, FACP, was sure he was on the track to becoming a teacher. After going to medical school and residency and then making a career in academic medicine, he turned out to be right.
“I was able to find a way to do things that I thought I had attributes for as early as high school, and it came somewhat full circle,” said Dr. Beachy, who is now an associate professor of medicine at the University of Nebraska Medical Center in Omaha and Governor-elect for the ACP Nebraska Chapter.
In his teaching role, he focuses on instructing learners about the importance of getting to the right diagnosis but also how to be thoughtful about which tests, procedures, or radiographs are needed to get there. “I spend a lot of time talking about high-value care, which obviously ACP has helped inform, and being mindful of the health care resources that we're utilizing,” said Dr. Beachy.
One example that often comes up is telemetry. “Telemetry is something that can be very helpful . . . but often, the indication for telemetry is something that resolves in a couple days, or the patient's stay quickly outlasts the utility of telemetry,” he said. Plus, the patient's experience of telemetry can be uncomfortable, Dr. Beachy noted. It's also easy to forget that there is a person on the other side of the telemetry monitor sitting in a room watching for arrhythmias on 30 to 40 monitors. “That's a health care cost that isn't necessarily readily thought of.”
To address unnecessary telemetry use, Dr. Beachy was involved in a quality improvement project that used the electronic health record to remind clinicians to assess the ongoing need for telemetry.
He wanted to make sure the reminders didn't create alert fatigue and contribute to burnout (he's also an ACP Wellness Champion), so the reminders are in an electronic daily checklist that includes other important measures, such as deep venous thrombosis prophylaxis and appropriate catheter management. “If you utilize the checklist, it actually helps document those items in your note as well, so you're not having to double up on work,” Dr. Beachy said. The reminders have reduced the number of days that patients are on telemetry and have also resulted in some cost savings and improvements in patient experience.
Talking about costs of care is becoming the new normal in medical education, Dr. Beachy said. Compared to his first years of practice, conversations about high-value care are less surprising to today's learners. “There's been groundwork that's been laid during the last five years. People are more receptive . . . and I do think that there is a little bit more of an openness and a responsibility that we have to ensure resources are utilized appropriately,” Dr. Beachy said.
As his hospital's medical director for clinical effectiveness, he also works on high-value care at the organizational level, finding areas where there is variation in care delivery and trying to put best practices into place, as well as reducing the cost of care whenever feasible. Rather than taking away from his teaching responsibilities, Dr. Beachy's administrative role has actually helped inform his conversations with patients and learners. “It has further cemented the need to talk about patient cost [and] how we ensure quality of care and safe care while being mindful about the cost of the care for the patient,” he said.
Embracing change as a team
Joanna Bonsall, MD, PhD, ACP Member
Medical school: Emory University School of Medicine, Atlanta
Residency: Emory University, Atlanta
If you're a regular at educational conferences, you may have seen ACP Member Joanna M. Bonsall, MD, PhD, give her lecture on best practices in managing pneumonia.
“I update it every year, but to give it year after year and see how people change their answers to some of the questions that I ask, you can actually see that knowledge improves over time,” she said. “That part has been fun to watch.”
Dr. Bonsall finds similar enjoyment in the progress she's overseen as chief of hospital medicine at Grady Memorial Hospital in Atlanta, where she led the successful launch of a new hospitalist service two years ago. But unlike her interest in pneumonia, which sparked from clinical curiosity, this new service arose from sheer necessity.
The hospital had been staffed entirely by teaching teams, but the volume of patients was beginning to exceed the capacity of the attendings and residents, with residents often being pulled from their elective rotations to care for medicine patients. “The original reach-out to us was to help see all of these extra patients, but of course as hospitalists, we knew we could provide so much more than that,” said Dr. Bonsall, who is also an associate professor of medicine at Emory.
So in July 2017, the hospitalist direct care service launched with five and a half direct care teams and 11 FTEs. Since then, it has grown to include nine and a half direct care teams, one teaching team, and an orthopedics-medicine comanagement team. “I think next year with further expansion, we're going to be up to something close to 30 FTEs. It's been really exciting to see something grow so rapidly and have such success doing it. We've been able to build this incredible group of hospitalists,” said Dr. Bonsall.
There has been substantial engagement and little turnover on the service in the past two years, which she attributes to astute recruitment alongside division director Daniel P. Hunt, MD, FACP. “Grady is a public hospital, and it was important for us to recruit people who wanted to serve an underserved population . . . as well as people that were excited about starting something new,” Dr. Bonsall said. Her leadership of the service was also no small contribution. As Dr. Hunt put it, “She leads on the frontline, juggling clinical care, coordination of resources, and collaboration with multiple stakeholders in a complex hospital system.”
Dr. Bonsall has played an even broader role for Emory by helping to create a faculty development program for the hospitalists across all sites. The initiative includes a mentoring program, a lecture series geared toward career development, an internal visiting professor program, and an awards program that provides additional CME funding for specific career goals. “We've seen a tremendous increase in scholarship, promotions, and overall engagement and projects since we started the program about six years ago,” she said.
A clear theme of Dr. Bonsall's work is forming alliances and working in teams, which happens to be one of her favorite parts of the job. “That is where the magic of patient care happens, when you get talented people together to talk about the same problems and they bring in their different perspectives,” she said.
Improving care with communication
Anupama Goyal, MBChB, MPH
Medical school: Makerere University School of Medicine, Kampala, Uganda
Residency: St. John Hospital & Medical Center, Detroit
Physicians don't always know everything, especially when it comes to other clinicians' jobs. So when Anupama Goyal, MBChB, MPH, became director of the 6B medical unit at the University of Michigan Hospital in Ann Arbor in 2017, she made a point to shadow her nurses to better understand their workflow.
“That was a big eye-opener for me,” said Dr. Goyal. “We tend to work in silos. Physicians put in the order, but it's actually nurses who take it forward.”
For example, she learned that in order to prevent infections in patients with Foley catheters, a nurse has to perform perineal care twice a day for women and once a day for men. “It's really uncomfortable for patients and very personal, thus patients refuse perineal care without truly understanding the need for it, and a lot of nurses will just document patients' refusal.” That changed her approach when talking to patients. “I educate patients on why they need a Foley and the importance of care around that,” Dr. Goyal said.
Patients may also decline another form of nursing care intended to prevent central line-associated bloodstream infections (CLABSIs), which is called a “bath.” “They're like, ‘Well, I don't want a bath,’ but it's really just a particular wipe which has antiseptic properties that is needed to clean the area where there is a catheter,” Dr. Goyal said. “So as a physician, when I reiterate that to a patient, they understand it more and comply with this specific nursing care.”
This enhanced communication, along with daily catheter rounds and implementation of appropriateness criteria for catheter use and removal, helped reduce the incidence of CLABSIs and catheter-associated urinary tract infections (CAUTIs). In fact, Dr. Goyal's medical unit was one of the few units in the hospital to achieve 365 days without a CAUTI.
“Her clinical skills and her approach to building consensus set her apart from others when it comes to safety initiatives. . . . She truly exemplifies what it means to be a patient safety champion,” said Vineet Chopra, MBBS, FACP, her mentor and division chief.
Another way Dr. Goyal has increased communication between clinicians and patients is with whiteboards. “I know we're very tech savvy, and even our patients are very technologically advanced . . . but every room in every hospital has a simple whiteboard. It's really a tool for communication,” she said.
Dr. Goyal was surprised to find that many patients didn't know that they were able to use the whiteboards in their rooms to communicate with the care team about anything, including questions, test results, and the plan for the day. As a quality improvement project, she surveyed more than 400 patients to determine whether they found whiteboards useful. “Most patients do find it helpful, but a lot of patients didn't know they could use it. They looked at it as a tool for the nurse and the physician,” she said.
This led Dr. Goyal to work with the hospital's patient and family advisory committee to revamp the whiteboards. The committee is interested in standardizing the boards throughout the hospital and coming up with best practices for nurses, including a script that lets patients and families know that whiteboards are a tool they can use.
Dr. Goyal is now assistant professor of medicine and assistant director of the hospitalist service. Based on her own experience when she was hired in 2015, she recently helped change the faculty onboarding process to be less confusing and more interactive, helping others in their first week on their hospitalist rotations.
For Dr. Goyal, whose biggest motivator is improvement, the next step is honing her skills as a mentor and taking on more mentees. “That in itself is a great drive and motivation,” she said. “It's not just about improving me, but it's also helping people improve and giving them the skillset that I have learned. . . . I think clear communication is the biggest key to any success.”
Encouraging teamwork through innovation
Daniel Ilie, MD, FACP
Medical school: University of Medicine and Pharmacy, Timişoara, Romania
Residency: Michael Reese Hospital, Chicago
When Daniel Ilie, MD, FACP, first learned he was a Top Hospitalist, he didn't believe it. “It is anyone's dream and very inspiring for me and all of my colleagues, since I like to lead by example,” he said.
In addition to his humbleness, Dr. Ilie is known for his clinical acumen as a hospitalist at St. Tammany Parish Hospital in Covington, La. As senior vice president and chief medical officer Patrick Torcson, MD, FACP, said, “Patients, families, and referring physicians will testify to the skilled and compassionate care that he has demonstrated through his mastery of the diagnosis and treatment of disease. Dr. Ilie is the physician that any of us would want to be caring for ourselves or family members.”
Dr. Ilie is chairman of the medical services committee, a role in which he guides the quality agenda for the hospital's service lines. In this capacity, he has led projects that have, among other achievements, reduced readmissions for high-risk patients from 13.2% in 2017 to 10.9% today. In addition, Dr. Ilie was actively involved in championing the rollout of the hospital's electronic health record and in developing physician order sets, which have led to a reduction in medication errors.
Most recently, one of his most substantial contributions has been implementing the accountable care unit (ACU) model at the hospital, which involves geographic cohorting of patients on a specific nursing unit where he is the assigned hospitalist. The model of care has led to improvements in several Hospital Consumer Assessment of Healthcare Providers and Systems measures.
On the unit, the overall rating of the hospital improved by 22%, likelihood-to-recommend scores improved by 23%, communication with nurses improved by 19%, responsiveness of staff improved by 22%, and communication about medications improved by 35% compared to measures taken before the unit was established.
In April, Dr. Ilie also led the implementation of structured interdisciplinary bedside rounds, a team-based rounding model that includes a pharmacist, a bedside nurse, a social worker, and a care coordinator. “It represents a change in culture regarding the way inpatient rounds are done, where different disciplines act as one, encouraging the patient's involvement in their care at the time that rounds are made at the bedside,” he said. Dr. Ilie's efforts at changing rounds were recognized in July, when the St. Tammany Quality Network presented him with the Medical Director Award.
Now, his charge is spreading his knowledge. In addition to staffing his own ACU, Dr. Ilie is working as a consultant to teach hospitalist colleagues the rounding model and is preparing additional nursing units at the hospital to launch ACUs. As a hospitalist, he loves his hands-on role in patient care improvement most of all. “There is an infinite opportunity for participation, team-approach activities related to patient care, and opportunities for leadership,” Dr. Ilie said.
Promoting social justice through research
Tara Lagu, MD, MPH, FACP
Medical school: Yale University School of Medicine, New Haven, Conn.
Residency: Brown University program at Rhode Island Hospital, Providence, R.I.
In eighth grade, Tara Lagu, MD, MPH, FACP, won a short-story contest. When her teacher told her father what a wonderful writer she was, he jokingly replied, “The only thing my daughter is ever going to write is prescriptions.”
Many high achievers feel pressure to go to medical school, but Dr. Lagu also felt freedom to pursue her passions after graduation. “I was always passionate about social justice, and I wanted to have a career where I could write and think and, in the process, help to create change. Medical school helped me find a purpose for all that energy,” she said.
After completing residency, Dr. Lagu was one of approximately 30 physicians nationwide chosen for the 2005 cohort of the Robert Wood Johnson Clinical Scholars program (now called the National Clinician Scholars program). She focused on health policy research during the training program, which she completed in 2008 at the University of Pennsylvania in Philadelphia. “It's an incredible program that more hospitalists should do,” Dr. Lagu said. “I really do think it shaped my career.”
Ever since, she has spent her career as an academic hospitalist at the University of Massachusetts Medical School–Baystate, where she is also associate professor of medicine, director of resident research, and associate director of the Institute for Healthcare Delivery and Population Science. Dr. Lagu's research has focused on three key areas: patients with disabilities, use of patient comments to improve care, and patients with heart failure.
Her interest in improving care for patients with disabilities was inspired by clinical work. When discharging a patient with a urinary tract problem who had had a stroke, used a wheelchair, and was unable to transfer herself, Dr. Lagu found that no urologists in the area would be able to see her without ambulance transportation. “The family wanted to get her the care she needed, but Medicare doesn't pay for ambulance transfer for patients living in the community. The daughters told me, ‘Doctor, we can't pay $1,000 for an ambulance! This is, like, discrimination or something!’ I agreed with them,” she said. “And in that moment, I realized this is a systemic problem.”
Dr. Lagu then organized a “secret shopper” study, where she and her team called 256 subspecialty practices in four cities and tried to make an appointment for a fictional patient who was obese and hemiparetic, used a wheelchair, and could not self-transfer to an exam table. Overall, 22% of practices were unable to accommodate the patient at all, and many planned to transfer the patient in a way that's considered potentially unsafe, according to results published in March 2013 by Annals of Internal Medicine.
“This was such an eye-opener for me,” Dr. Lagu said. “People with disabilities are among the most vulnerable patients. They have worse outcomes and receive [less] preventive care than patients without disabilities. Our study helped to bring to light that some of these disparities exist because some physicians are refusing to see patients with disabilities.”
Her research on patient narratives about care also aims to improve the patient experience. As part of the transparency committee at her health system, Dr. Lagu has advocated for publishing patient comments on clinicians' biographical webpages. “How do we get patients' voices into the conversation, so that we can connect physicians and patients and we can all better see each other's humanity?” she said.
Finally, Dr. Lagu is researching ways to improve care for patients with heart failure. She recently received two large NIH grants on the topic. The first examines how innovative accountable care organizations are achieving better outcomes, and a second examines strategies that lead to greater uptake of cardiac rehabilitation for patients with heart failure. “I study patients with heart failure because I see a very vulnerable population who could benefit from interventions like cardiac rehabilitation,” she said. “These two grants allow us to learn from the health systems that are providing the highest quality care for patients with heart failure.”
Clearly, Dr. Lagu's medical career involves writing far more than prescriptions. But she wants to take her efforts even further. “The challenge of my work is, how do I take those knotty problems and turn them into interventions that we can test and determine if they actually do improve care?” she said. “That's the thing that gets me out of bed in the morning.”
Creating a patient safety culture
Caitlin Martin Klinger, MD, ACP Member
Medical school: University of Medicine and Dentistry of New Jersey Robert Wood Johnson Medical School, New Brunswick, N.J.
Residency: University of Pennsylvania, Philadelphia
It can be a challenge to get physicians, administrators, nurses, subspecialists, and pharmacists to speak a common language when it comes to patient safety and just culture.
However, the Southeast Louisiana Veterans Healthcare System recognizes the value of having physicians lead patient safety efforts, said ACP Member Caitlin Martin Klinger, MD, who as a staff hospitalist spends 75% of her time on quality work.
“One of the biggest roles that a physician quality champion can play is honestly just translating between these different groups of people and getting everybody on the same page,” said Dr. Martin Klinger. “Every person on the health care team is valuable in bringing up concerns about patient safety, and nobody's going to be faulted for bringing up issues caused by human error or systems failures, even if they're the one that caused it.”
She realized her passion for improving patient safety while redesigning the process for providing outpatient antibiotics using health care failure mode and effect analysis, a prospective way of assessing potential risks to help develop safer processes. The project resulted in a decrease in inpatient length of stay for patients receiving long-term IV antibiotic therapy. “That was one of the early processes I got involved with that really solidified my love for the systems of looking at patient safety events as a way to drive quality improvement. I just loved how systematic it was and how you could see the effect,” said Dr. Martin Klinger.
As the designated faculty mentor for the hospital's chief resident in quality and safety, she shares her passion with learners as well. Dr. Martin Klinger developed a program called Patient Safety and Just Culture Rounds, which started with the residents and has expanded to other units in the hospital. The rounds cover patient safety events and why it's especially important to report near misses and close calls. “If you can see that something is an accident waiting to happen and fix it before it results in an actual patient safety event, that's the best,” Dr. Martin Klinger said.
The rounds also ensure that staff know how to place safety reports in the online system and even provide feedback on past reports, she said. In response to this training, the total number of safety reports at the site has gone up, particularly the proportion of near-miss and close-call reports, as opposed to actual safety events, said Dr. Martin Klinger. The hospital's measures of patient safety culture have also increased, specifically in terms of trust and safety in reporting, she said.
Dr. Martin Klinger said she is motivated most by the VA's mission (her father and grandfather were veterans) and attaining a culture of zero harm. “I don't think anybody can read all the reports of preventable harm that happen and not feel called to action, so I think preventing harm is the biggest thing that motivates me,” she said.
Dr. Martin Klinger's colleagues also motivate her. Hurricane Katrina destroyed the original New Orleans Veterans Medical Center in 2005, and after years of construction, the current hospital opened to inpatients in 2017. “All the hospitalists, nurses, administrative leadership, everyone came to work here because they wanted to build a hospital for their community, so it's a really inspiring group of people to work with,” she said.
Serving the underserved
Maricruz Merino, MD, FACP
Medical school: Brown Medical School, Providence, R.I.
Residency: Brigham and Women's Hospital, Boston
For many new internists, moving to a rural area after residency to practice without many resources would be daunting. For Maricruz Merino, MD, FACP, the challenge was exactly what drew her from the Northeast to Gallup, N.M., in 2009.
“I knew that by coming out here, I would have to rely on myself much more,” she said. “I wouldn't have access to the specialty services that I had in Boston, and that really appealed to me because I wanted to be challenged by hard cases and continue to grow and develop as a physician.”
A generalist at heart, Dr. Merino relishes the opportunity to do critical care, home visits, and just about everything in between. In fact, since 2016, she has overseen all internists as chief of internal medicine at Gallup Indian Medical Center, which has the largest staff of all Navajo Area Indian Health Service (IHS) facilities.
Leading internal medicine at the 99-bed rural hospital has stretched Dr. Merino's responsibilities far past her clinical work. For instance, she rewrote the hospital's restraints and seclusion policy herself and has advocated for a just culture model to help staff feel able to report adverse events and near misses.
Dr. Merino's overall priorities have been to keep the department staffed and operational while making sure that her colleagues maintain healthy, balanced lives. “It's really important to me to recognize people's personal needs and interests and try to accommodate them,” she said. For example, she supports a colleague interested in improving transgender care, who started the only transgender clinic in all of Navajo, which sees more than 100 patients, some who travel hundreds of miles to get there.
In the half of her time spent on clinical work, Dr. Merino has developed strong relationships with patients' families. “Families out here are very important. They're very big, and many decisions are not made by an individual, but by the entire family,” she said, adding that it's not unusual to have 30 people in a family meeting. “You really have to be given the time to spend with these big groups to discuss the aspects of the patient's care so that a decision can be made.”
Goals-of-care conversations are made easier by three palliative care physicians and a patient advocate and social worker, who interpret English for those who speak Navajo only, said Dr. Merino. On the job, she has learned lessons for conducting culturally appropriate meetings on her own, such as the importance of introductions. “When you introduce yourself in Navajo, you say what clan you are, what your mother's clan is, what your father's clan is, so the introduction is quite long,” Dr. Merino said. “I make sure that even if there's 30 people in the room, I introduce myself. Even though I do not have a clan, I tell them who I am, where I come from, and what my background and training is . . . and then I will ask every single person to introduce themselves.”
Another lesson was that in Navajo culture, people are often very uncomfortable talking about death and medical complications. “If you talk about the complications of, say, diabetes, like ‘You might lose your foot if you don't take care of your blood sugar,’ that means you wish it upon them,” Dr. Merino said. She said telling stories about others or speaking to patients in the third person has helped her have important clinical conversations in a culturally competent way.
As director of medical education, Dr. Merino has also kept her clinicians up to date through regular teleconferences with Brigham and Women's subspecialists to provide education that is directly related to clinical challenges the hospital faces and to review hard cases. In addition, a partnership between IHS and the Brigham and Women's Outreach Program sends subspecialists to teach at the hospital about once a year. The programs have been essential for keeping practice current, especially since the hospital's clinicians manage very complex cases because certain subspecialists, like rheumatologists, have a wait time of one year, she said.
Most of all, Dr. Merino said she is driven by the mission of IHS, which is to raise the health of American Indians and Alaska Natives to the highest degree possible. “I just felt like this was a good opportunity for me to contribute, and . . . we have an amazing team of people here,” she said. “I love my job, and I hope other people consider working in a rural area. It's a really special experience.”
Helping others succeed
Mithu Molla, MD, MBA, FACP
Medical school: West Virginia University School of Medicine, Morgantown, W.Va.
Residency: George Washington University, Washington, D.C.
While many physicians reflect on their career achievements in terms of projects or initiatives, Mithu Molla, MD, MBA, FACP, calls to mind an awkward encounter.
He was a teaching attending on the wards, and an intern was presenting a patient. The senior resident in the room thought Dr. Molla was evaluating the interns and medical students, but in fact Dr. Molla was primarily evaluating him. “Afterwards, I went to meet with him and I gave him feedback on managing the team, and it totally floored him,” he said. “Prior to that, he really hadn't gotten much feedback from any of the other attendings, and I didn't realize what an impact my words would have.”
It wasn't exactly glowing feedback. “He needed to take more of an active role in management, and he needed to work with the interns to help organize their presentations. I asked him to self-evaluate, and prior to me giving feedback . . . he felt like he had done very well on the service,” said Dr. Molla. “So he was way too confident for his abilities, and I told him that.”
The rest of their time on service was pretty quiet. “Even up until the time that he graduated, I sort of felt like there was a bit of a coolness there,” Dr. Molla said.
But years later, the resident wrote Dr. Molla a letter. He had gone into fellowship and was now enjoying success as a subspecialty attending at a major academic institution. “He told me that all those years ago, that feedback that I gave him had made such an impact on the way that he looked at himself,” said Dr. Molla. “At that moment, I realized that as teaching physicians . . . there is a lot of weight in what we say and what we do.”
After completing the Stanford faculty development course in 2012, Dr. Molla has remained committed to clinical teaching, leading sessions for faculty on facilitating a positive learning climate, providing feedback, and promoting understanding and retention. Since coming to the University of California, Davis, in 2008, he has been involved in hospital operations and quality improvement, and since 2014 in his role as section chief, he has helped expand the group from about 25 hospitalists to more than 50.
In addition to working with learners and residents, Dr. Molla enjoys mentoring and faculty development. “A lot of hospitalists come out of residency without any clear idea of where they want to take their career, so as the section chief, I take a lot of delight in helping junior faculty use their intrinsic motivation to map out their career,” he said.
Over the years, Dr. Molla has earned several awards for his commitment to education and has also been recognized for 1,000 hours of volunteer service at the Shifa Community Clinic, a student-run nonprofit medical facility that cares for diverse, uninsured patients in the Sacramento area. “Using methods like motivational interviewing and teach-back, Dr. Molla creates a unique and invaluable learning opportunity for medical and integrative medicine students,” said Shagufta Yasmeen, MBBS, FACP, the clinic's medical director.
Despite taking on more leadership roles in his career, Dr. Molla sets an intention each year to carve out time for teaching. “I was reading somewhere that physicians that are in an administrative role find their careers more rewarding if they're able to take some time to teach, so I really try to make sure that I have at least 12 to 14 weeks of teaching time throughout the year,” he said.
Teaching leadership skills
Matthew G. Tuck, MD, MEd, FACP
Medical school: George Washington University School of Medicine and Health Sciences, Washington, D.C.
Residency: George Washington University, Washington, D.C.
With family in Washington, D.C., it was natural for Matthew G. Tuck, MD, MEd, FACP, to complete his medical training in the nation's capital. But after spending medical school, residency, and chief residency at George Washington University, it was time to move on.
“One of my faculty mentors told me, and I think it ended up being a very wise pearl, that ‘If you repot yourself, you'll grow,’” Dr. Tuck said. “So I repotted myself less than five miles away, but I think I have grown tremendously.”
Now, as acting residency site director at the Washington DC Veterans Affairs Medical Center, he oversees five residency programs that are affiliated with the hospital. “I counted it up this year . . . and it was over 500 individuals that rotate through us,” said Dr. Tuck, who also serves as the hospital's physician utilization management advisor.
Managing 500 learners may sound like a tall task, but education is his passion. In 2018, he earned ACP's Sol Katz Teaching Award. “I myself do not have children, so I very much view my legacy in life to be the students and residents I train. I hopefully have imparted on them knowledge that they will continue to impart on to future generations,” said Dr. Tuck, who still has a role at George Washington University as an associate professor of medicine.
In particular, Dr. Tuck has found a niche in teaching others to be leaders in evidence-based medicine. Having completed the Master Teacher Leadership Development Program at George Washington University, he has been able to pass on the leadership skills he's learned to others. “We don't go through medical school with any kind of courses on leadership. But yet when you graduate, you're expected to be a leader,” whether it's of an interdisciplinary care team or a team of residents and students, Dr. Tuck said.
To share his knowledge, he conducts national workshops that provide leadership skills, such as the annual Teaching and Leading Evidence-based Medicine workshop at Duke Health in Durham, N.C. For example, one aspect of team development that he teaches is called “forming and storming,” when people are trying to figure out their roles on the team. “It may lead to chaos if there's not clear delineation of those roles,” Dr. Tuck said.
In practice, any time he joins a new ward team, he sits down with the residents and students to review their roles and set expectations. “I try to get the goals of the trainees, what they hope to get out of the time that we spend together, and that really helps expedite the formation of the team process so that the team then is more highly performing,” Dr. Tuck said. “Tasks get done more easily, and usually faster.”
Although education is his biggest passion, his work ultimately boils down to the betterment of the patient, he said. “I'm training the next generation hopefully to take care of people like me to the standard that I want to see.”
Mentoring future leaders
Charlotta Weaver, MD, MS, ACP Member
Medical school: University of Pittsburgh School of Medicine, Pittsburgh, Pa.
Residency: McGaw Medical Center of Northwestern University, Chicago
When ACP Member Charlotta Weaver, MD, MS, graduated from residency, she knew she wanted to help hospitalized patients with cancer.
“Patient care is compelling in oncology,” she said. “When patients with cancer are hospitalized, they have real medical problems and are dealing with real life-and-death situations.”
As Dr. Weaver debated doing an oncology fellowship after residency, she took a position as an oncology hospitalist at Northwestern Memorial Hospital in Chicago. Initially intended as a two-year position, it's been her clinical job ever since.
Now, as director of operations for oncology at the hospital, she is primarily responsible for managing operations, leading improvement, and mentoring and coaching the unit teams who report to her. “One of the things that I'm really proud of with this operational work is my ability to step outside of my area of expertise and knowledge and be able to drive improvements, even in areas that I didn't know much about in the past,” said Dr. Weaver.
She has focused on professional development throughout her career. One of Dr. Weaver's first efforts was co-creating a clinical coaching program for brand-new hospitalists. The program, which is still active, pairs new attendings with more experienced attendings to help guide them in making big decisions and having long patient lists for the first time on their own. A couple of years after that, Dr. Weaver developed (and continues to lead) an Introduction to Professional Development series, which is aimed at jumpstarting the academic careers of first-year hospitalist attendings.
“One thing we struggle with still in hospital medicine is that it's a very clinical profession, and it doesn't leave a lot of room for academic pursuits,” she said. “So we wanted to have this program to teach all of our new hospitalists the common areas that people typically tend to focus their academic work on and to give them resources, people, and guidance on where to go next.”
In 2017, when Dr. Weaver became director of professional development in hospital medicine, she did a needs assessment across the division to determine what other initiatives were needed. From junior to mid-career to senior faculty, the answer was clear: a mentoring program. So she designed the individualized mentoring program she wished she'd had when she first started.
After forming a steering committee and talking to leaders of mentoring programs across the country, Dr. Weaver developed the program, which initially paired early- and mid-career faculty with more senior hospitalists as part of a one-year relationship. The program also includes didactic sessions for both mentors and mentees.
The first year of the program had nine mentor-mentee pairs. Now, six are continuing into the second year in addition to 11 new pairs, said Dr. Weaver, who serves as a mentor herself. “From the mentee perspective, they really appreciated being paired up with someone and having a go-to person . . . giving them advice and guiding them along, and I think the mentors have really appreciated being able to give back to the program but then also to feel like they're part of something that's a little bit bigger than themselves,” she said.
Dr. Weaver said she is most proud of being able to make improvements and create structures and programs that didn't exist before. “Being able to make work life better for everyone around me so that they can take really great care of patients, that's ultimately what drives me on a daily basis,” she said.