Photo credit: May_Chanikran/Adobe Stock
September is Women in Medicine Month, a time to inspire, elevate, and recognize women and their roles in medicine. The following SHM members—recommended by members of The Hospitalist’s editorial board—shared their thoughts on a variety of topics, including challenges they’ve overcome, inspiring mentors, successes they’ve attained, advice for the next generation, and what they hope to accomplish next.
Building programs and connecting people are the most rewarding parts of being a hospitalist for Rachel E. Thompson, MD, MPH, FACP, SFHM, chief medical officer at Snoqualmie Valley Hospital and Public Health District in Snoqualmie, Wash., and the president of SHM. During her career, Dr. Thompson founded an inpatient consultative medicine program, developed a section of hospital medicine, and convened a division of acute care medicine. She is currently helping to transform a public health district in Washington State.
“The most rewarding part is getting to know people, bringing people together, and making improvements by harnessing the energy that groups create,” she said.
At the onset of building a hospital medicine program at the University of Nebraska Medical Center in 2015, 22 clinicians were practicing in four separate groups. When Dr. Thompson left in 2019, they had unified and grown to create a formal section of hospital medicine with 70 clinicians. “The true win is seeing their continued innovations and successes today,” Dr. Thompson said.
“For me, a big part of being a hospitalist is looking for opportunities to engage and make health systems better at the local, regional, national, and international levels,” Dr. Thompson said. She advises her colleagues to seek out opportunities and get involved in something bigger than just today.
Some pearls of wisdom
Now that she has close to a decade in hospital medicine under her belt, Meghana A. Gadgil, MD, MPH, FACP, assistant professor in the division of hospital medicine at San Francisco General Hospital, has some advice for the next generation of hospitalists. “First of all, it’s okay to be unsure about your career path,” she said. “In fact, that can actually be good because it sparks curiosity and a drive to explore new things. Use challenges and experiences to discover what you want to do. Figure out which problems you like solving.”
Secondly, “Expand your horizons beyond your field; you’re likely to find that you can draw a lot from philosophy, art, history, and so forth which can provide perspective and inspiration,” she said.
Further, “Build a network of friends and mentors who support and advocate for you,” Dr. Gadgil said. “Look outside of your own institution; find a way to meet new people who will help you.”
Finally, expect moments of intense beauty and wonder, but also some really hard times. “Sometimes bad things happen even when you did everything right,” she said. “Remember that difficult times are inevitable and impermanent. Learn from them and know that you will get through them.”
Moving from Salt Lake City to New York to become part of a new hospital medicine division in a hospital that didn’t have hospitalists previously was one of the biggest challenges that Laura Nell Hodo, MD, a pediatric hospitalist at Icahn School of Medicine at Mount Sinai in New York, faced in her career.
“Starting from scratch, not knowing any of the other physicians, and working in an environment where co-workers in other disciplines and patients weren’t really sure what a hospitalist was or did, was difficult,” she said. “It took time for people to trust us as individuals and as a group.”
“Having patience and approaching people with a listening ear and desire to understand their perspective went a long way,” she said. “Putting patients first by working hard to provide the best care, communication, and patient experience helped us to become accepted, trusted, and valued.”
Thankful for guidance
Christine Hrach, MD, FAAP, SFHM, medical director of inpatient general pediatric medicine and co-interim pediatric residency program director at Washington University School of Medicine in St. Louis, Mo., owes a lot to her mentor, Douglas Carlson, MD, who was the division chief of pediatric hospital medicine when she started there.
“He has been a terrific mentor and sponsor, both early in my career and currently,” she said. “The hospital started a new inpatient service several years after I began working there, and Doug asked me to co-lead this new service. He believed in me to take on a leadership role, which meant a lot to me.”
Dr. Carlson also has a knack for getting others involved in national organizations. “I joined the Society of Hospital Medicine because of his advice to get involved in a national organization,” Dr. Hrach said. “I have loved my work with SHM.”
Among her greatest accomplishments, Flora Kisuule, MD, MPH, SFHM, director of the division of hospital medicine at Johns Hopkins Bayview Medical Center in Baltimore, cites building multiple hospital medicine programs internationally. She helped create programs in Saudi Arabia, United Arab Emirates, Panama, and most recently Puerto Rico. “I believe in hospital medicine and how we add to the value equation, and I love promoting our specialty beyond our borders,” Dr. Kisuule said.
She is also proud of her work and that of other hospitalists during the pandemic. She estimates that at her medical center, hospitalists cared for about 70% of patients hospitalized with COVID-19. “Beyond clinical care, my team and I led the operations of COVID-19 care, quality initiatives, and partnered in the provision of patient-centered care,” she said.
Further, Dr. Kisuule led the division and efforts to build a fellowship program for physician assistant and advanced practice practitioner (APP) hospitalists as well as multiple service lines that optimize APP clinical practice. “We also helped to develop a tool to assess the readiness of freshly graduating APPs to practice,” she said.
Mentors shape her future
While reflecting on her career in quality improvement and research, Gopi J. Astik, MD, MS, assistant professor of medicine in the division of hospital medicine at Northwestern University Feinberg School of Medicine in Chicago, fondly recalls two instrumental mentors. David Wooldridge, MD, program director of the internal medicine residency at the University of Missouri-Kansas City School of Medicine in Kansas City, Mo., not only inspired her to become an academic hospitalist but also pushed her to leave her hometown.
“He encouraged me to gain experience in a different city and larger institution to diversify my skills and grow personally,” she said. “He knew I was motivated and wanted to conquer the world, but I didn’t have a perspective outside of my own bubble.”
Kevin O’Leary, MD, MS, Northwestern’s division chief of hospital medicine, whose passion for working in quality improvement was infectious, sparked Dr. Astik to pursue this field as well. “Doing research has brought me so much joy because I know it is bigger than just me,” she said. “Adding to the literature and studying things to provide better patient care is a great use of my time and efforts.”
Mixing it up
What would be helpful for the next generation of hospitalists to do early on? Maylyn Martinez, MD, MSc, clinical instructor of medicine at the University of Chicago, recommends trying to experience a wide range of ways to work in hospital medicine, early in your career, beyond clinical care, such as quality improvement, medical education, research, and medical decision making.
Currently, Dr. Martinez is focused on studying mobility impairments due to hospitalization and acute medical illness. “This is way too often overlooked but has very serious, long-lasting, and life-changing effects on patients,” she said. “When someone is newly disabled and unable to care for themselves and has to be institutionalized in a nursing home just because we weren’t able to mobilize and rehabilitate them appropriately during their hospitalization, it’s just devastating—especially because it’s preventable.”
Dr. Martinez believes that it’s important to advocate for some formalized guidance for hospitalists on how to recognize, diagnose, and treat mobility impairments in patients who are hospitalized for acute medical illnesses.
Solving organizational needs
Kris P. Rehm, MD, MMHC, SFHM, associate chief medical officer of Children’s Services in the Department of Pediatrics at Vanderbilt University Medical Center in Nashville, Tenn., believes that hospitalists are in a special position to help solve organizational or institutional needs in order to care for every patient. Although this has its challenges, the successes have been very rewarding.
“One example of a win for our patients and hospital was creating a multidisciplinary team to care for patients admitted to our acute care hospital who were awaiting admission to an inpatient psychiatric facility,” she said. “We started with hospitalists working both in acute care and attending treatment rounds at our inpatient psychiatric facility, and now have a team of psychologists, nurse practitioners, and case managers to help treat these patients.”
Another initiative involved developing individualized, unique partnerships with many hospitals across the region over the last five years. “Each hospital requested help in bringing in high-quality care to their institutions; we modified our models to meet their demands. For those of us in pediatric hospital medicine, this has included inpatient care for children, as well as newborn support or delivery attendance.”
As a hospitalist and assistant professor of medicine at Emory Saint Joseph’s Hospital in Atlanta, Shobhna Singh, MD, MPH, said her biggest challenge has been to recognize signs of burnout and muster the courage to remediate it.
“As a working mother of three, I was walking a tightrope balancing work and my personal life,” Dr. Singh said. “As the pandemic slogged on, I started feeling a loss of motivation and decreased satisfaction.”
“To avoid full burnout, I looked for opportunities to grow and excel in areas I’m passionate about,” she said. “I signed up for Emory’s Quality Academy with the belief that learning something I was passionate about would boost my job satisfaction.” The academy aims to provide practical tools and learnings to enable clinicians to develop skills and expertise to lead quality improvement projects independently.
Dr. Singh also decided to modify her work schedule. She takes more time off, alternating seven days on and then seven off.
“This allows me to spend quality time with my family and gives me more time to devote to quality,” she said. “Burnout is real and I implore every frontline worker to recognize and take remedial steps.”
Lora Sowunmi, MD, a staff physician in the departments of hospital medicine and pediatric hospital medicine at the Cleveland Clinic, considers her greatest successes in hospital medicine to be delivering care and performing clinical medicine.
“I enjoy being there for patients in their most vulnerable times, which is often during a hospitalization,” she said. “I can be empathetic, provide education on their disease process and illness trajectory, and consult with my brilliant colleagues to deliver the best possible care plan. It’s fulfilling to know that even when a cure is not possible, patients will receive the tools and support they need to cope with their illness and move forward in their lives.”
Looking ahead, Dr. Sowunmi wants to focus on growing within SHM, including applying for fellowship designation to show her dedication and expertise in the field.
“Being a part of SHM has helped me build relationships with colleagues at other institutions and better understand our shared challenges and successes,” she said. “I think these relationships work to fulfill SHM’s mission of promoting excellent care of hospitalized patients and improving patient care while promoting progress in our specialty.”
Breaking free of cultural norms
The cultural norms for Farzana Hoque MD, MRCP, FACP, and other girls growing up in Bangladesh were to finish school, get married by the time you were 20, and start a family…you get the idea.
Dr. Hoque had other plans.
Plans that took her to the University of Dhaka for medical school. Plans that included studying 16 hours a day to become board certified in the U.S. Plans that included waiting patiently and then waiting patiently even longer for her Green Card. Plans that took her to a one-room apartment on the south side of Chicago where she volunteered at a local hospital waiting for her certification to come through. Plans that included…well, you get the idea.
These days Dr. Hoque is a hospitalist—the first physician in her extended family—who treats adult patients at SSM Health St. Louis University Hospital, St. Louis, Mo. These days her plans are to empower and equip other women to follow her into medicine. Those plans play out every day, mentoring others and sharing on social media what she’s learned—including on her own YouTube channel that helps women back in Bangladesh and across the world who want to become physicians.
“The perception is females don’t want to help each other out, but I just don’t see that,” she said. “We want to be there for each other. We need to be. If I’m able to help one woman make it to where I am, that fulfills me.”
Celebrating women in hospital medicine—and all of health care—is easy. There are thousands of inspiring stories of accomplishment, dedication, resourcefulness, and success. There are also thousands of women in hospital medicine to champion, advocate for, ally for and with, and empower. SHM and The Hospitalist recognize the invaluable contributions made every day by women in hospital medicine.
Karen Appold is an award-winning journalist based in Lehigh Valley, Pa. She has more than 25 years of editorial experience, including as a newspaper reporter, and newspaper and magazine editor.
This article was originally published by The Hospitalist.