Committee work may be the best way for hospitalists new on staff to get a leg up on the administrative career ladder and, fortunately, opportunities abound. If you express an interest in serving, expect to be recruited by at least one committee. Your biggest concerns may be sorting through the options to find the right fit.
“We are the ones here all the time, so we understand the inner workings of our hospital on a front-line level better than any other physician,” said Kate Goodrich, FACP, director of the division of hospital medicine and clinical director of inpatient hospital medicine at George Washington University Hospital in Washington, D.C. “Expressing an interest in committee work should get you invited to participate.”
“Being everywhere in the hospital, we can to a certain extent compare how the care is on different units, with different leadership, different forms, different charting, and so on,” agreed Martin Izakovic, FACP, medical director of the hospitalist program at Mercy Hospital in Iowa City, Iowa. “We can be fairly good judges of what works and what doesn't and help the administration and staff with a well-rounded opinion.”
Why sign up?
Committee work can be a savvy long-term career move. It allows physicians to see how hospital decision making works and to have their voices heard.
“Committee participation can be, for some hospitalists, their earliest entry point into a physician leadership role,” said Russell Holman, MD, president of the Society of Hospital Medicine and COO of Cogent Healthcare. “If you want to aspire to a leadership position, committee work is a great vehicle to gain a form of management experience and show yourself to be a viable candidate for other positions.”
While committee participation isn't required at most hospitals, some say that failing to volunteer may hurt your chances for advancement.
“There's no one who advances in administrative circles within a hospital who has done no committee work,” said Daniel Brotman, FACP, director of the hospitalist program at Johns Hopkins Hospital and associate professor of medicine at Johns Hopkins University School of Medicine in Baltimore. Hospitalists are starting to be viewed as natural candidates for “directors of clinical operations, leaders of departments and divisions, and even of hospitals,” he said. “The way to get a feel for how your institution works is to participate in committees when asked to do so.”
Even if you're happy right where you are and have no leadership ambitions, you may not be entirely happy with how things are run in your institution. If you want the opportunity to make changes, committees offer that chance.
“Here's where you can actually have an impact on how people are cared for,” Dr. Brotman said. “Many of the people on these committees are not necessarily those who deal with things firsthand. If the system takes 12 steps where it should take three, you can be the one to help drive that change.”
Even if there are hospital policies and processes you can't change, participation in committees may help you understand the system better. “My committee work has helped me to make the residents understand why we have only two blood draws a day instead of four or five, for example,” said Dr. Goodrich. “It helps if you're really involved with the inner workings of the hospital to understand why things work the way they do, and perhaps improve your own work flow.”
Once you've decided that committee work is right for you, the next step is to decide which committees best suit your interests and skills. Many hospital committees are particularly well suited to hospitalist participation. “Among them would be committees on quality, patient safety, pharmacy and therapeutics. Some hospitals have what's called a patient care committee, and there are other committees related to clinical processes, like the code or cardiac arrest committee,” said Dr. Holman. “Hospitalists are also particularly well suited to participate in IT committees, as well as interdepartmental committees.”
You may not be certain right away which committees are right for you, especially if you're new to the hospital. There can be some trial and error involved in the process.
“I got assigned to a lot of different committees, and discovered what I liked and what I didn't,” said Dr. Goodrich. “At one point I chaired the medical records committee because no one else wanted to do it, but I discovered I didn't enjoy it. So I recommended a colleague with more of an interest for that committee, and got more involved with the infection and quality control committee, which I do enjoy.”
Most hospitalists are on more than one committee. The hospitalists in Dr. Goodrich's group, for example, each serve on two or three committees; as division director, she is on seven or eight. Most committees meet once a month for about an hour or so, but others can take up much more time—and it's not wise to show up at the meeting without having prepared for it first.
“It's important to understand up front what the commitments are to participate—not just the meetings themselves, but other service that may be involved,” Dr. Holman said. “You should also understand how long you're committing yourself. Is it a one-year appointment, a standing appointment, tenured?”
Leonard Feldman, ACP Member, a hospitalist in Dr. Brotman's group, joined the residency application committee two years ago, about a year and a half after arriving at Hopkins. Since then, he's also become involved in three other committees. “It's hard to say no,” he admitted. “Your name gets out there as someone who's interested in helping improve things.”
Resist the temptation to overcommit, cautioned Dr. Brotman. “It's tempting to just say yes when you're invited, but if you agree to join a committee you don't think you can do a good job on, you can be shooting yourself in the foot. And if you're spread too thin, you won't be as effective as you could be.”
This means learning to say no if necessary, rather than participating halfheartedly and missing half the meetings. “There may be someone else in your group you can recommend,” Dr. Brotman said. “Or if it's something you really want to do but it's particularly time-consuming—like 10 or more hours a month—you can lobby for either salary support or decreased clinical time to pay for it. It never hurts to ask.”
Dr. Feldman's committee work hasn't interfered with his patient care responsibilities—he puts patient care first, letting the committee know when he'll be missing a meeting and asking if his input is needed ahead of time. “Where it has more of an effect is eating into my research time and other administrative responsibilities,” he said. He noted that hospitalists who have recently come on board with his group may soon take on some new committee responsibilities and help lighten his load.
Once you're on a committee, how can you make the most of it? There are a few key tenets for good committee participation, according to Dr. Holman:
- Understand the scope and purpose of the committee you're serving on. Is it a body that can make decisions, or is it more of a think tank or advisory body? Was it created to accomplish specific goals, or is it an ongoing committee?
- Understand the ground rules for participation: Discuss, analyze or attack problems, but don't do that to people.
- Understand consensus decision making, which is usually how most hospital committees operate. Everyone gets their say, but not everyone gets their way. And once the committee has reached consensus, it should speak with one voice.
- Speak up—and listen in turn.
- Review materials in advance, rather than scrambling through briefing materials once you're in the room.
- Represent more than just your own views. “You represent a certain constituency—hospitalists or the medical staff,” said Dr. Holman. “The opinions you express should represent the collective input from your constituency.”
If you choose committees wisely and participate effectively, said Dr. Izakovic, committee work can be very rewarding. “That's been my experience,” he said. “You can see things happening, and can shape and mold them instead of being a bystander. Actually having input into what's happening at my hospital and will become policy, to me, that's worth my time and effort.”