Perspectives on the Acute Care Continuum

The Acute Care Continuum is the integration of urgent, emergent, inpatient and post-discharge care of patients with acute medical conditions.

Hospitalists, Here's One Way to Fast-Track Your Leadership Career

8/14/2017 1:27:01 PM | 4 comments

As you're finishing residency training, the worry over what to do next really starts to set in. You want to pursue an opportunity where you can utilize your leadership skills and really grow your career.
Or maybe you’re like me. You have a few years of work experience as a hospitalist under your belt, but you want to push your practice to the next level, affect change on a larger scale, and grow into a higher leadership role.
I decided a natural next step for me was to pursue the CEP America Hospital Medicine Administrative Fellowship.
In today’s post, I'll share what I learned from the fellowship and talk about some of the policies and programs I helped implement while I was a fellow. I'll also discuss how the fellowship led me to my current role as Medical Director and supported me as a new leader.

How It Started

Ryan Johnston, DO, CEP AmericaI'd been working with CEP America for a few years at Palomar Medical Center when our medical director, Sabiha Pasha, MD, nominated me for the brand new hospital medicine (HM)-focused fellowship program.
CEP America has run an emergency medicine (EM) administrative fellowship program for over a decade. But with the demand for more HM leaders, CEP developed a hospitalist version and launched it in 2016. I was fortunate to be the inaugural HM fellow. I was excited about the opportunity. I knew that getting more administrative training and learning more about CEP would have a positive impact on my career trajectory.

Getting to Know the CEP America Team

While at Palomar Medical Center, I worked with about 40 CEP providers. My understanding of CEP was very much at the hospital level.
But as a fellow, I was able to see CEP on the enterprise level. I had visibility into our network of 1,600 physicians and 1,400 advanced providers, as well as our medical services organization (MedAmerica), and billing company (MedAmerica Billing Services, Inc.).
One of my fellowship mentors, Rick Newell, MD, explained the program as a chance to squeeze four or five years of relationship building into one year. And it was true; I formed strong relationships with many key decision makers in the organization through regular leadership meetings and retreats.
To say the least, my perspective was broadened. 

Day-to-Day as a Fellow

At the beginning of my fellowship year, I worked weekends at my home hospital near San Diego. Then I would fly up to CEP headquarters midweek and stay for a few days for fellowship commitments.
As a fellow, I attended Board of Directors and operational meetings every other month. I also participated in leadership programs like the Medical Director Academy and the Leadership Development Series. I learned about our MedAmerica administrative support teams, met with members of our MBSI billing service, and took risk management courses to expand my professional development.
Many of these leadership development programs are very popular throughout the Partnership, and admission is competitive. But as a fellow, not only was I able to jump ahead of the waitlist and attend these programs, but I was also able to attend the planning sessions and see the inner workings of how they develop.
Throughout my training, I had a lot of support from fellow physicians and advanced providers. I was able to pick their brains and learn the business side of medicine from the best minds in our organization. For me, the mentoring I received was one of the most valuable parts of the fellowship.

Opportunity for Leadership and Organizational Change

Another highlight of the administrative fellowship was the chance to complete a project related to my clinical and leadership interests.
I worked with Prentice Tom, MD, Chief Innovation Officer, on one of his passion projects — improving patient mortality at all CEP sites. In collaboration with my colleagues, I surveyed our hospital medicine providers and hospital clients to see what could be improved.
To track and reduce mortality, all CEP hospitalists participate in monthly quality assurance calls with Jeffrey Frank, MD, Director of Quality and Performance. To support this initiative, I implemented a new role at all HM sites. The Mortality Champion advocates for processes and best practices shown to improve patient safety and outcomes. This initiative is currently being implemented throughout our hospitalist sites nationwide. So far, the program has been a success. We've found that in addition to clinical improvements, The Mortality Champions help to raise patient satisfaction scores. Patients' confidence increases when they see us communicating and rounding together to discuss safety precautions.
Championing mortality reduction will continue to have a huge impact on how we are able to grow and improve our enterprise. When we demonstrate improved quality, hospitals are willing to partner with us on initiatives. They also allocate new resources to our HM programs that help save the lives of more patients.

Becoming a CEP America Leader

At the beginning of my fellowship, I was told my project would prepare me for my next role at CEP. I figured that might be in a year or two. But about three months into my fellowship, I stepped into the role of Medical Director at Sonora Regional Medical Center.
The transition was challenging. Moving from San Diego to a small town was a big adjustment. Almost immediately, I was charged with filling several full-time hospitalist positions in a rural healthcare shortage area. But thanks to the fellowship, I had a ton of new contacts in the CEP community — many of whom empathized and offered helpful advice.
At times, leadership can be lonely. But I knew I had a great network of colleagues and mentors rooting for my success — even when they were out of sight.

Becoming a Mentor

The Administrative Fellowship Program has continued to expand, and now I have the privilege of hosting the 2017 HM fellow at my hospital. This is a great opportunity for both of us, as I am able to further develop my leadership skills by giving hands-on training and advice. And he's also able to learn from me — someone who has experienced the program first hand.
Overall, I've been very satisfied with my administrative fellowship experience. I'd definitely recommend it to anyone interested in growing as a leader and learning the business of medicine. Whether you've been practicing for a few years or you're a new attending, it's a great way to kickstart a meaningful career.
Are you interested in a becoming a CEP America Hospitalist Fellow? Apply online here

This post was originally published on Jan. 30, 2017.

Jeffrey Frank
Nice job Ryan. CEP and Sonra is lucky to have you on our team.
2/24/2017 6:21:02 PM

Ben Frizner
Great Job Ryan! Having spent 10 years working in hospital-employed hospitalist groups, leadership mentorship is rare. CEP provides an extraordinary opportunity for young physicians to get leadership exposure/training early. Congratulations on your success!
2/9/2017 8:38:22 PM

Cyndy Flores
Great article and a great explanation!
2/1/2017 1:26:49 PM

Rick Newell
Great article Ryan. Your are absolutely correct, the CEP Administrative Fellowship is the best leadership/management fellowship available anywhere!
1/31/2017 8:36:55 AM