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Alpesh Amin: HM's History maker

The Hospitalist. 2009 March;2009(03):

Are Hospitalists the Logical Choice to Chair Departments of Medicine?

Yes, says Joseph Ming-Wah Li, an SHM board member who heads the hospital medicine group at Beth Israel Deaconess in Boston. “The department chair of medicine of yesterday is very different from today—and that’s due to the changes in academic medical centers. It’s not enough anymore to just be a skilled teacher, or a bright clinician or be able to publish. You actually have to be a very skilled administrator and be able to see the bigger picture. That’s where people like [Dr. Amin] are so valuable. They understand what’s happening in terms of the hospital’s workflow, and he’s had to develop and hone those skills during his years as a hospitalist.”

Perhaps, says Matthew Brenner, MD, professor of medicine and chief of pulmonary and critical-care medicine at UC Irvine, but it’s not just hospitalist training that will project someone into a department chair post. What’s required is specific expertise in the business of healthcare. “It’s hard to be chair of medicine today without knowing how to run a business,” he says.

Yes, says SHM President-elect Scott Flanders, MD, associate professor of medicine and director of the hospital medicine program at the University of Michigan in Ann Arbor. “Many in the hospitalist community, including those at academic medical centers, are required to focus on business and leadership skills. We’re constantly having to juggle clinical tasks and administrative roles, both at a departmental level as well as the institutional level. Those skills are essential for department chairs. As a field, hospital medicine prepares people very well for future leadership roles beyond just the local hospitalist community.”

Yes, says Jeffrey Wiese, MD, FACP, professor of medicine and associate dean for graduate medical education at Tulane University Health Sciences Center in New Orleans and an SHM board member. “There is now an acceptance toward a mentality and culture that is empowered to fix the problems. And that’s our task, as hospitalists—to work as part of the patient-care team.” He also believes the research agenda may also benefit with a hospitalist-trained chair: “The more you can evoke collaboration between all subspecialties of medicine, the better off you will be in terms of fostering meaningful and fruitful research.”

Yes, says Eric Howell, MD, assistant professor of medicine at Johns Hopkins University School of Medicine, where he is also division director of collaborative inpatient medicine service; he is also chair of SHM’s Leadership Committee. “My belief is that hospitalists will be natural leaders of hospitals in the private sector, and also of departments and divisions in some academic environments. All hospitalists are trained to manage teams, so it’s not such a big leap for a hospitalist, as it might be for another specialist who may not be quite so used to managing teams.”

By developing and nurturing the UC Irvine hospitalist program, Dr. Amin has exhibited a deep commitment to the core missions of hospital medicine. “Our multidisciplinary program has nine different specialties managed under one program,” he notes. He has structured the program in such a way that members hold dual appointments in the HM program and their individual departments or divisions, thus creating a bridge between the HM program and other departments.

“We have an integrated group that is working together for the focus of advancement in the hospital setting, in terms of clinical care, teaching, team-building, quality and systems improvement. As a result, we’ve had great outcomes in terms of length of stay, quality, and core measures,” Dr. Amin says. “I’ve been fortunate to work with a team of hospitalist faculty who are spectacular and collectively deserve kudos for the success of our group.”