Atashi Mandal, MD. Photo credit: Calvert Photography
This is the latest in a series of interviews with hospital medicine clinicians connected to the Society of Hospital Medicine (SHM) to share insights, knowledge, and expertise about career opportunities, growth, and development. Today we hear from Atashi Mandal, MD.
I am an adult and pediatric hospitalist based in Southern California. However, I grew up in a smorgasbord of Midwestern and Southern states and attended medical school at Case Western Reserve University in Cleveland. I made my way to Southern California for residency at Loma Linda University Medical Center, followed by a chief resident year in internal medicine. I have a deep interest in community service and advocacy, which very meaningfully complements my clinical activities. I’ve been active in SHM, organized medicine, and other professional organizations with positions on various legislative and policy committees, and I’ve served on the board of my local medical society. I am currently serving on a committee convened by my county sheriff’s office to investigate deaths in our unhoused population with the hopes of forging more successful outreach and preventative efforts. When I’m not on duty, you can find me running in the mountains or on my local beach path, reading, playing piano, and traveling. I have a love for all creatures on four legs, and as I contemplate my glide path into my late career, I hope it involves caring for “all creatures great and small.”
1. What made you decide to choose hospital medicine as a career path, and specifically your specialty?
I chose a career path as a hospitalist for the same reason as I assume many others did — I enjoyed the variety, acuity, and intellectual challenges found in the acute care setting. But as I’ve progressed in my career, what has become more tantamount to my personal mission as a hospitalist is to serve as an anchoring point of trust and transparency, as well as a safe harbor, for all my patients, as many of our patients are meeting us during a time of great uncertainty and fear. I want my patients to know we’re dedicated to relieving all aspects of their suffering — physical and mental.
2. What does a typical workday look like for you?
I initially started as a full-time adult hospitalist and worked during daylight hours. This wasn’t a sustainable path for me. I’ve since transitioned to a full-time nocturnist, dividing my time as an adult and pediatric hospitalist. My time is 100% clinical.
3. What do you consider one of your career successes? How did you achieve it?
My biggest success has been to establish my own hospital medicine practice, whereby I’m employed by no one, but rather am contracted with several different hospital medicine groups. This has allowed me the freedom to practice in a variety of clinical and geographical settings and set my own schedule. The breadth of exposure has not only been interesting, but extremely illuminating and humbling, as I work in a suburban community hospital, a VA, a large managed health care organization, and a 25-bed critical access hospital. But most importantly I’ve been able to maintain my skills as both a pediatrician and an internist.
4. What do you consider a challenge you’ve faced in your career? How did you overcome it?
I’ve practiced exclusively in non-academic settings, and for several years it was very difficult to find a setting that could accommodate my desire to practice as a pediatric and adult hospitalist. Many colleagues and administrators were befuddled by my training, to say the least. I often found myself being tethered to the adult side more frequently due to the larger volume of work, which caused me a great deal of dissatisfaction. But this also provided the impetus for me to break away and become my own locum agency, so to speak. While relinquishing the security of a benefited and salaried position caused some trepidation at first, establishing my own practice was the very best move I could have ever made for my professional satisfaction and longevity.
5. How did the global pandemic affect your day-to-day working life?
As a nocturnist, there’s no lack of work. But initially, my pediatric hospitalist hours were curtailed due to the low patient volumes that were seen nationwide. However, I was able to seamlessly transfer one of my skills that was well-honed on the pediatric side — high flow oxygen therapy — to my adult COVID-19 patients very early on in the pandemic. This practice was eventually widely adopted by adult medicine and undoubtedly saved many patients from unnecessary intubation. I was very fortunate to already have so much experience with high-flow therapy from our perennial viral onslaughts in pediatrics each winter.
While the pandemic undoubtedly tested our personal and professional capabilities, it also highlighted the enormous contributions we make as hospitalists. I truly believe there is no time like the present to remember the tremendous privilege we’ve been conferred to care for our patients and communities, and everyone should harness what we’ve learned to craft a career that brings us satisfaction and joy.
6. Where would you like to see your career path going next?
As I am mid-career, I’ve been contemplating a “glide path” of sorts, considering the physical demands of nighttime work and what would be a sustainable path for me to continue performing to the best of my abilities in an aging body. Stay tuned.
7. What membership benefits offered by the Society of Hospital Medicine have helped you in your career?
As hospitalists, I think it’s safe to surmise we’re all interested in quality and system improvement. The nature of our work is interdisciplinary to its core. However, SHM has offered me so many valuable opportunities to broaden my knowledge in the much wider systems of the legislative, policy, and regulatory realms that have very poignant and sometimes inadvertent deleterious effects that directly affect our work. The conferences and committee work have offered me a wealth of knowledge and networking with outstanding colleagues across the country.
8. Do you belong to any SHM SIGs (special interest groups), chapters, or committees? If so, which ones and why?
I’ve been a member of the Rural Medicine SIG, as I work in a very rural critical access hospital. The challenges faced by these settings are unique, and it’s galvanizing and inspiring to network and share among other colleagues so dedicated to serving rural populations. I’ve also been to meetings of the Nocturnist SIG, which have been very informative and fun.
9. What impact has SHM had in shaping your career?
As a former member of the Public Policy Committee, and now on my third term on the Performance Measure and Reporting Committee, I continue to have many eye-opening moments while learning about the highly complex and at times convoluted interplay of various legislative and regulatory decrees with which we must contend. Yet we also can advocate and change our field for the better through our participation. My time on these committees has imbued a passion for advocacy, which I’ve implemented both locally in California and on several trips to D.C. I can’t wait to continue educating our legislators on what really matters for the health of our patients, communities, and nation.
10. What is a piece of advice you would share with job seekers or offer a new hospitalist just beginning their career?
I think it’s so important for professional satisfaction to find the joy in our work — whether that’s at a patient’s bedside, on teaching rounds, in back-to-back meetings, or wherever we can find that spark that makes us keep coming back for more. But to find our joyful niche, it’s equally important to find our voice and know how to advocate for ourselves. A sense of helplessness, resignation, and worst of all — apathy — are the burnout elephants in the room that no “wellness” measure can address. So, I would encourage everyone from day one to develop your voice and get involved somewhere — your local group/hospital, SHM, or other professional societies, and even local organizations serving your community. The pandemic revealed beyond any doubt the value we bring as hospitalists, and we need to harness our contributions and skills to make ours a better world. Change the mentality from “supposed to” and “have to” to “WANT to.”
11. Is there a particular area of specialty medicine you enjoy working with, such as clinical care, teaching, or research? Why?
I have always been 100% clinical, although I’ve had some limited teaching time on the pediatric side with family practice residents, which I also greatly enjoyed. I love spending time with patients and being the half-covered face and voice, they can count on.
12. Finally, what is something unique about your career, or career path?
I’ve been practicing entirely in community settings, and for the past 12 years have forged my own independent hospitalist practice, whereby I work at several different hospitals, including a Kaiser and VA facility, in addition to a large urban-suburban interfaced community hospital in Los Angeles County and a 25-bed critical access facility in rural Inyo County. I have maintained a 100% clinical practice, as I have always found the most joy in directly caring for patients and their families.
Learn more about SHM and the benefits of membership.