why I do what I do

On the inpatient pediatric unit, where I work as an occasional pediatric hospitalist, one can generally find all ages and sizes of infants, children and adolescents, with all sorts of medical and surgical problems. The role of the hospitalist is to be the general pediatrician for inpatients on our unit. We directly supervise a variety of students--medical, and physician assistant, plus interns and residents. We work side-by-side with our nursing and nurse practitioner colleagues, as well as respiratory, physical, occupational  and speech therapists, pharmacists, nutritionists, social workers, case managers, chaplains, child life specialists, and others that I may have neglected to mention. As the leader of this team, it is my job, when I am on service, to make sure this group of well-trained and well-meaning individuals work together. In addition, other colleagues, the subspecialists, are often needed to provide assistance in managing the patients. These might be pediatric gastroenterologists (take care of the GI system), pediatric pulmonologists (take care of the lungs and associated disorders like asthma), pediatric endocrine (take care of endocrine problems such as diabetes and thyroid problems), pediatric geneticists (take care of inherited disorders), pediatric neurologists (brain, spinal cord, movement problems), and so on. It is the role of the hospitalist to coordinate the care provided by, and the opinions offered by the subspecialists, and help it all to make sense to the family, as well as ensure that we don't just do a bunch of stuff to the patient that might not be absolutely necessary.

I say all this as background, so that you will understand the significance of what I am about to say.

Toward the middle of the afternoon on a busy Monday of a recent week "on service" as the pediatric hospitalist,  one of the senior nurses on the pediatric unit, someone I work with frequently, said to me:

"You clearly love what you do--you know, being here, working with the children, doing clinical doctoring work. I am wondering why you don't do it more often. I am sure you are very good at the administrative work you do, but you really love this."

She was trying to ask me why I would do administration for so much of my time, and only do the real "doctor work" for 15-20% of my time. I am glad that it shows how much I love being on the unit. How much I love teaching the students and interns and residents. How much I love all the little patients and their parents. But I thought that perhaps I should talk about why I have chosen to spend so much of my time as an "administrator"

I am not sure whether any of you out there actually CARE about the reason, but, as you can undoubtedly guess, I am going to tell you anyway.

Maybe I should first tell you some of the reasons that DO NOT drive my interest in administration. I did not choose to do less clinical work because I dislike clinical medicine, unlike some of the physicians I know who have followed this career path. Nor did I choose this path to avoid all the hassles of modern medicine, like fighting with insurance companies, providing care for families that suspect you are trying to do them harm, like being frustrated by the social problems that prevent us from having the impact we want to have in improving health for children.

I chose administration  BECAUSE I LOVE BEING A DOCTOR, SPECIFICALLY BEING A PEDIATRICIAN. I chose it so that I could have a better chance of making a difference, of impacting medical education, of working to change the insurance systems that make it hard for children to obtain optimal care.

In addition, being able to recruit physicians to work at the Carilion Clinic Children's Hospital, by being in a position to influence the way that pediatrics is taught at VTC school of medicine, by raising money to help get needed services to children who would otherwise have to go without, or travel great distances to see an appropriate physician. For all those reasons I chose administration. Not to mention that I actually ENJOY solving problems, facing challenges, and working within a limited budget (well, maybe not that).

For all those reasons, I have chosen to be here, in this community, serving the children of southwest Virginia, serving the physicians who serve those children, and hopefully helping those physicians to be better educated, to have more subspecialists available to help them help their small patients better. I can't think of a better place to be, or a better thing to do. I do clinical pediatrics because I love it. I do administration, because I love it even more. As always I would REALLY enjoy seeing your comments, questions, concerns, suggestions for future posts. Please let me know how we are doing. I am counting on you.

Comments

Kim,
Thanks for all the kind words. Many folks think that being in administration is all about power. Perhaps that is true for some. For me, it is an honor to work with the clinicians and to work FOR the patients. We still have much to do at CCCH. I feel blessed to have individuals like yourself on the leadership team. We will be busy for quite some time bringing the best possible health care to the children of SW Virginia. The work will continue even after we ourselves are done. Thanks for being a strong member of the leadership team.

Dr. Ackerman,

It is evident that you enjoy all aspects of being a doctor and you are a phenominal administrator. In these economic times, it is especially challenging to do what we know is necessary and right and stay within our means. It is difficult for many to see that along with our medical responsibility and our commitment to the community that we must also be fiscally responsible.
I enjoy the clinical part of nursing...and I do miss the one on one interactions with patients and families. But, as you said, there are other ways to impact and improve the care provided. That is the factor that keeps me going and looking toward a better future for our patients and families.
Thanks for all you do and for your leadership to improve the care of children in our community.

Kim

Dr. Ackerman,
This is an excellent description of why clinicians, whether it be doctors or nurses decide at some point to leave the bedside and “go to the other side” as some people call it. Like you and Kim I love being a bedside clinician but, I also love what I do now. As the quality facilitator for the Department of Pediatrics, I can put those years of experience to work for our patients and staff in a different way. I am so very proud of the work we do here at CCCH.I think we work extremely hard to deliver the highest level of healthcare to our patients, and work equally as hard to include our families in the care of their child. I have the opportunity to work with you and several other CCCH physicians that do both administrative and clinical work; I agree that by doing this. it allows you and the other physicians to continue to make CCCH the premiere hospital for children.
Nora

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