Jose R. Mercado, MD
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 Jose R. Mercado, MD.
Dr. Mercado is a hospital medicine physician at Dartmouth-Hitchcock Medical Center (DHMC) in Lebanon, N.H. His leadership roles include regional medical director for inpatient quality for Dartmouth Health, medical director at Alice Peck Day Memorial Hospital, and associate medical director for care management and utilization management at DHMC. He is also an assistant professor at the Geisel School of Medicine at Dartmouth. Before his current leadership roles, he served as the associate hospital epidemiologist and COVID-19 response leader for DHMC. He is also an active member of SHM and is a member of the Education Committee and the Quality Improvement Special Interest Group (SIG) executive council. Most importantly, he is the host/writer/producer of Dartmouth Health’s popular podcast, The Cure.
1. Why did you choose hospital medicine as a specialty?
Initially, it was to fulfill my visa requirement, but I realized soon after I started working as a hospitalist that I love taking care of acute patients and collaborating with various specialties to make the most appropriate treatment plan for the patient in their current condition. My schedule also gives me the ability to pursue hobbies and spend more time with my family when not in clinical service. I still do feel that my decision to become a jack of all trades is better than to be a master of one.
2. What does your typical workday look like?
I spend 80% of my time doing administrative work. This includes reviewing metrics on hospital-acquired conditions, analyzing the data for potential care gaps, and implementing process improvement efforts. I also help teach quality improvement and patient safety concepts to our residents and medical students.
When I am on clinical service with a 7 on 7 off schedule, our program has a variety of roles including triage, admitter, teaching, and non-teaching service. During those times, I enjoy discussing new admissions with learners the most.
3. What’s unique about your career or career path?
I recently had the opportunity to serve as the associate hospital epidemiologist and COVID-19 response leader at my institution. The experience of trying to reduce hospital-acquired infections has solidified my passion for quality improvement and patient safety. It also motivated me to pursue further training in process improvement and project execution through Lean Six Sigma and the Institute for Healthcare Improvement training. I find quality improvement work to be rewarding not only because it improves patient outcomes, but also presents the opportunity to explore how we can conduct clinical operations more efficiently at reduced costs.
4. Describe an important milestone in your career and what made it significant.
Working with population health in rolling out COVID-19 vaccines and COVID-19 therapies has enriched my appreciation of the complexity of the health system as a whole. But more so in trying to ensure equity in health care in the setting of a novel disease, constrained resources, and rapidly changing guidelines. This inspired me to be more involved with efforts to explore how to inspire the transformational change needed to reduce health care disparities and collaborate with subject matter experts in educating other health care professionals. It also reminded me to approach differences in perspectives with empathy, honesty, and a willingness to form partnerships.
5. What’s been the biggest obstacle in your career?
To those who know me, I am the quiet and introverted type. I learned shortly after I took on a leadership role how I needed to be more assertive and empowered to inspire change and help the organization achieve its set goals. This led me to partake in training programs focusing on effectual governance to influence others, management skills, and collective workmanship. As I took on more responsibilities, I also realized the value of sharing what I have learned from this amazing experience and taking a step back to create opportunities for others to lead.
6. What’s surprised you the most about hospital medicine?
We should continue to move away from seeing ourselves as “just hospitalists.” I used to go along with the popular opinion for ease, but later mastered the confidence to express my own ideas and vision based on my personal journey as a hospitalist. I have learned over the years that hospitalists have a distinctive advantage in understanding our organizations, their objectives, workflows, and inefficiencies. Our frontline bedside experience is the core of the health care experience. We have to take this opportunity to participate in measures and interventions to preserve its integrity.
7. Where do you see yourself in 5-10 years?
I hope to continue to grow as a clinician, an educator, and a quality improvement leader in my organization. I have enjoyed being involved with SHM committees and Special Interest Groups and hope to have an opportunity to lead within the Society of Hospital Medicine. I hope to also grow the audience of The Cure podcast and eventually use this as a medium to create a learning health system.
8. What membership benefits offered by the Society of Hospital Medicine have helped you in your career?
I enjoy being able to network the most. There is a wealth of knowledge coming from members of the Society. It’s great to collaborate and find solutions to shared problems. I also frequently use educational materials in the Learning Portal and occasionally answer questions on the SHM education application on my phone. I think course directors of the annual conferences have continued to do a great job of making sure there is a diversity of topics that suits a variety of interests.
9. Do you belong to any other SHM SIGs (special interest groups), chapters, or committees? If so, which ones and why?
I am a member of the Quality Improvement SIG. I joined because it aligns well with the bulk of my responsibilities at my organization. It has been tremendously helpful to learn from its members and the institutions they represent. I am also a member of the Education Committee. It has been very rewarding to work among individuals who are dedicated to making learning more engaging and innovative for our fellow hospitalists. Last but not the least, I serve as the secretary for the New Hampshire/Vermont Chapter. We are a relatively young chapter looking to expand membership through CME and other educational endeavors.
10. What’s the best piece of career advice you’ve ever received?
“Say yes to the things that scare you.” I used to only look at opportunities I was confident I would be successful. Being open to diverse learning and taking on challenges that seem uncertain at a cursory glance really expands your growth and comfort zone. The experience helped me learn how to navigate through obstacles and I am now more accepting of more unconventional opportunities. I believe that as long as you keep an open mind and are willing to put in the hard work, there is always a great opportunity ahead of you.
11. What advice would you give your 18-year-old self?
Stop taking things personally! Like many young adults, I used to think I knew everything I needed to know. I had a hard time accepting constructive feedback. With time, I realized how it is the things we are unaware we did not know that could get us in trouble. I slowly learned how to let things roll off my sleeve and spend more time focusing on the changes I need to make. Reminding ourselves to welcome being questioned and soliciting feedback from colleagues helps us become more aware of our biases and could reduce cognitive errors.
12. If you could trade places for one day with someone else (either a person or profession) in health care, who would it be and why?
Dr. Anthony Fauci. He’s helped us navigate a crisis, while educating the public about a novel virus, and constantly reminded us how to protect ourselves as the science evolved and new variants emerged.
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