Professor in Medicine-General Internal Medicine
MD: University of Chicago
Residency: University of Chicago Hospitals
How did you choose Internal Medicine?
My last year of residency was an internal medicine/oncology rotation, and I had an offer to work at the National Cancer Institute. I paid for school with a National Health Service scholarship. Since it would take a year for me to transfer from the NHSC to the NIH, I asked for an assignment at the Indian Health Service in the southwest. Instead, I was assigned to working an STD clinic in Detroit. As it happened, the federal government was trying to wind down the NHSC and offered a private practice option where you could work in an underserved area, which would count for your payback. I did a year of internal medicine and I realized I really liked it. So, I resigned at the NCI and stayed in Internal Medicine.
And how did you get into clinical administration?
I was working on my payback agreement working as an Internal Medicine physician for Anchor (HMO) at Rush. The medical staff at Anchor decided to organize because of conflicts with the administration. We had a meeting and elected a president and the administration promptly fired him. We had another meeting. We were going to strike. I guess I made a speech – I don’t know what I said at all – but I ended up being vice president of the medical staff organization. When we settled our issues, the agreement included putting the president and vice president on the board of the HMO. In the space of 18 months, I went from a Hem/Onc fellowship to being on the executive board of the biggest HMO in the Midwest.
What major changes have you implemented during your time at Northwestern?
Northwestern’s Department of Medicine has become one of the best in the country. I’d love to pretend that I caused it, but it was due to the work of a lot of people. I am proud that I could contribute some things. For example, when Dr. (Larry) Jameson hired me, we spoke about how the inpatient service worked here. It used to be that every patient came in with his own attending physician. Housestaff were randomly assigned. With so many attendings, there were no daily rounds with attendings and residents. Communication was not good. There was no electronic record. Such a system tended not to attract the top students from around the country to apply for residency match with us. Moreover, we were not compliant with ACGME regulations. So, we changed the system. Within 3-4 years, we started to attract top students from places that had never interviewed with us before.
How has Internal Medicine care changed during your career?
The changes in the inpatient service forced us to develop a system of hospital medicine because we found that we were only going to be able to cover half the patients with our residents. The Department created a Division of Hospital Medicine to meet a service need. There was substantial resistance to change initially. We created a policy, which we still have, that any attending who wants to manage his/her own patient can do that… but without interns. No one has asked to do that in more than 10 years. Also, we were able to recruit Mark Williams, who was very successful in recruiting excellent faculty hospitalists. When Mark left, Kevin O’Leary exceeded his standards of leadership in the division.
What are you reading?
I am currently reading a biography of (Alexander von) Humboldt. I have a number of books stacked. Next one is a story of one of the people in John Brown’s raid.
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