What had attracted you to Duke Med-Peds and/or Durham?
As I started my residency search, I looked at programs across the country. Due to reputation and location, Duke was on my list. During my interview days (it was 2 days then), I was impressed by the program but it was the Med-Peds dinner that convinced me this was the place to train. There were representatives of all classes. The sense of community and family was obvious. I wanted to be a part of the community I experienced during my interview and I was convinced that being part of the Duke Med-Peds program would prepare me to be the best physician I could be but more importantly would make me a better person. The residents I met were multidimensional with a diverse set of interests outside of medicine. Those interests were just part of who they are and did not appear to be forced into an interview weekend. The friendships appeared genuine and deep which reflects my experience from my time in Durham.
How did you get your start here?
When I started, we had a class of 6 with 2 of my class entering from Duke Medical school. Jane (Trinh) and Matt (Ellis) helped us meet people and get to know Durham. My first rotation was the VA wards and that is a great introduction to residency and new classmates. Our intern year was the last year before the 80 hour work week. We supported each other as a small class (our 6 became 4) but our medicine and pediatric classes kept us involved across all three programs.
We were lucky that our clinic experience allowed our class to have clinic together weekly across all four years - this kept us close and connected even when we were spread out across on different rotations throughout residency. Our other med-peds clinic session was shared with other classes; this allowed us to be mentored in the early years and ultimately mentor in the latter years.
Who were your mentors throughout training?
There were so many across my four years, some formal and many in an informal role. Sue (Woods) was the most influential mentor affecting my career. Sue was a meticulous physician with the ability to genuinely connect with patients. She has an ability to draw out critical details and put together the clinical story so effectively. I used to joke that I would spend a day with a patient and Sue would come in and say "so…" and the critical details would be revealed. The Infectious Disease faculty stands out to me for their overall skills and philosophy related to the approach to diagnosis and treatment. In my opinion, one of the greatest strengths of our program and our categorical programs in Internal Medicine and Pediatrics is that many of my mentors were classmates, some with more experience and some who matriculated after we started.
What are you doing now?
I am currently the Chief Medical Officer/System Vice President of Care Coordination and Hospitalist Medicine at Memorial Hermann Health System in Houston, Texas. My spheres of influence are Case and Care Management, System Utilization Review, Behavioral Health, our employed Hospitalist and Supportive Medicine programs, and I am the executive sponsor of our CMS BPCI-A (Bundled Payments for Continuous Improvement-Advanced) program.
How did you get to where you are now?
My first job out of residency was at the University of Michigan as a Med-Peds hospitalist. I spent a year in Ann Arbor and then transitioned back to Houston where I went to medical school. I returned to the University of Texas McGovern Medical School as a Med-Peds academic attending. I became an Associate Program Director for Internal Medicine and Internal Medicine and Pediatrics programs. A few years later I was asked to start a hospitalist program for our Texas Medical Center campus.
When the program started, I was the only hospitalist, and I was fortunate to attract a talented group of hospitalists and together we built a strong program. I transitioned the leadership program 9 years later to one of the original four docs to join our program. We were a 40 physician program at Memorial Hermann Texas Medical Center campus. As our program grew we integrated into multiple service lines. We are most proud of our support of the Level 1 trauma team and transplant teams.
During those 9 years, I became involved in quality and process improvement, case and care management, information technology which pulled me into system projects and roles which resulted in my transition to my current system role.
What are your other non-clinical activities and how did you get involved in these things?
My non-clinical activities are many. One of my early mentors at Memorial Hermann said, "I am going to take you to a lot of meetings. I don't want you to say anything but watch the people and how they get things done and influence the conversations." The advice exposed me to many aspects of operations of the hospital and a large integrated health system. My hospitalist medicine leadership role naturally had me focus on length of stay, readmissions, quality, efficiency and effectiveness. Being involved in so many aspects of health care delivery has been very valuable to me as I can better understand all of the pieces on the chess board.
How do you think the Duke Med-Peds Residency Program helped you prepare for your career?
The Duke Med-Peds Residency program has had a significant impact on my career. First and foremost, I graduated with an excellent clinical skill set. I believe the discipline and rigor of our program and our categorical programs provides each of us a clinical foundation that is recognized by other providers. The clinical reputation that we establish once in practice facilitates other opportunities as we are recognized by our peers and leaders. As I mentioned previously, the multidimensional nature of our classmates made me a better person with more empathy and exposure to topics and ideas I may not have experienced somewhere else.
What do you like to do in your free time?
Much of my free time is spent with my family and my children. We have 5 children between the ages of 17 to 10 year-old twins. We manage all of the day-to-day activities but we have been lucky enough for extensive travel experiences. So travel as often as we can overseas and bring back those experiences to our home.
Cooking is a release for me and with this many mouths to feed I have lots of opportunity. I am teaching each of them how to prep and cook and we try to explore the cultures where we have travelled.
Any words of wisdom to current trainees?
Spend your time enjoying your time and learning as much as you can clinically and otherwise from the environment and the people you are exposed to during these special years. You will take that with you into your career and will reflect back on what a unique time in your life it is.