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The end of the world as I know it

July 2013

Published in the July 2013 issue of Today’s Hospitalist

I ADMIT that until I just Googled the lyrics, this was the first time that I have come to know the words to more than 10% of R.E.M.’s “It’s The End Of The World As We Know It (And I Feel Fine).” Lyric ignorance never prevented me from mumbling in unison with the radio (look it up) a million times before, all those formative high school years ago. As a history lesson to freshly-minted hospitalists: Twenty-five years ago, the Internet was remarkably not part of our hourly existence, that song was being played on vinyl and Armageddon was the last thing on most of our minds. Admittedly, Armageddon still remains relatively low on the list of things I worry about.

Why can’t I get this song out of my head? For one, my tenure as a hospitalist is coming to an end. After 13 years of practice, this does have a bit of an “end of the world” feel to it. Have I joined the circus, put my MBA to lucrative use at a hedge fund or fulfilled my lifelong dream of announcing my eligibility for next year’s NBA draft?

Unfortunately, nothing so spectacular. Instead, I have taken the route I envision many hospitalist directors may already or soon be taking: I have become a hospital administrator.

My new roles
Effective the beginning of this year, I became the medical director for Virtua’s beautiful new hospital in Voorhees, N.J., and the program director for inpatient care services for the Virtua multihospital system.

They made me an offer that I could not refuse. Fortunately for me, think less Al Pacino in “The Godfather” and more the opportunity to step outside my comfort zone into a position that I believe will bring me tremendous professional growth and development. Most importantly, my new roles allow me to take 13 years of hospitalist experience and transition those skills to providing leadership for an entire hospital system across all medical disciplines.

I’ve spent most of my years in hospital medicine in leadership, dating back to 2000, when I started a group just outside Chicago with some friends. But I see this as a unique opportunity to further what hospital medicine has given me while I was busy giving it my heart, my soul and many of my weekends.

I should note that the ride has been a wonderful one, a racemic 50/50 mix of administrative and clinical responsibilities. I was made for hospital medicine and it was made for me. Like so many candidates I have interviewed and asked, “So why do you want to be a hospitalist?,” I knew I wasn’t made for the office and I needed the adrenaline fix of acute care medicine.

I have also enjoyed spending five years writing for this magazine. Now, however, some recent life changes, including the birth of our second child, have caused my creative juices to ebb, and moving away from inpatient care has resulted in less fodder to write about. That said, I do still believe that we are “The Real Hospitalists of New Jersey” and we should be part of hospital medicine’s first reality show when it debuts.

Today, I spend my days trying to ensure that we hit system-wide quality metrics, improve population health via our budding ACO, increase process standardization across all hospital campuses and, most importantly, work to guarantee patients an outstanding experience from the moment they hit the door to well beyond their departure.

A driver and catalyst
In my new role, I have a few early thoughts. First, I appreciate that the conflict resolution skills I honed as a hospitalist director will be more than a little useful. Two, I may appreciate a good hospitalist program more from the outside looking in than the other way around. We really drive “and I do still think of it as “we” “just about everything now in the hospital. And we will increasingly be the catalyst for making sure patients leave with the resources they need to prevent them from coming back.

So I end my career as a hospital medicine blogger, scale back my career as a clinical hospitalist and go full speed ahead into hospital administration. As I look forward to an exciting career in hospital administration for a fantastic hospital system, I remain very thankful for the time I spent in the trenches as a hospitalist. I would not trade those lucky 13 years for anything.

My new job is far from the end of the world as I know it, but I’ll be darned if I can’t get that song out of my head. At least I still do feel fine.

Erik DeLue, MD, MBA, is medical director of Virtua Voorhees and program director of acute care services for Virtua Health in south New Jersey.