UO > Sep/Oct 2008 > Young Chiefs of Staff

Hail to the Chief

Young physicians who lead their medical staffs sometimes fall into the role and others seek it. Regardless, they juggle clinical and administrative tasks and grow as they serve their colleagues and hospitals.

By karen edwards Unique Opportunities Sep/Oct 2008

Throughout his career Ramsey Hasan, MD, has often been told he looked too young to be a physician. While he’s no Doogie Howser, Hasan holds an early accomplishment that would probably get a professional nod from the child prodigy doctor. Lining the halls of Hawaii-based Castle Medical Center are photographs of all the chiefs of staff who have served the hospital. Standing out among the gray-haired former chiefs is a boyish Hasan, the current—and youngest—chief of staff in the history of the hospital.

The role of chief of staff is one many doctors aspire to later in their professional careers, but anecdotally it seems doctors are stepping into it before they reach the age of 40. For Hasan, who specializes in emergency medicine, becoming chief at the age of 37 was never really on the agenda. He sort of fell into it.

“No. Never thought about it,” says Hasan. “Somebody recommended me as a nominee, and I said yes. I had no plans to run.”

There were multiple people in the running for chief at Castle in 2004, and along the way some people dropped out. In the end it was down to Hasan and a surgeon in his 50s. Once elected, Hasan served the customary two years as vice chief of staff, during which time he “learned the ropes” and then began his two-year term as chief of staff in January 2007.

“It’s at times a popularity contest, but it’s also ability and experience,” says Hasan of the election process.

Job description

Castle Medical Center, a 160-bed facility located on the Hawaiian Island of Oahu, employs a medical staff of more than 256 physicians in a wide range of specialties and subspecialties. Castle is a full-service medical center that serves all of Oahu and is the primary health care facility for the East Shore of Oahu.

“My role specifically is that I’m the chairman of the medical executive committee, the decision-making body for all policy and procedure for the entire medical staff,” says Hasan. “I’m responsible for peer review of all the medical staff, and all medical direction of the hospital. I am also a voting member of the governing board of the hospital.”

In all, Hasan does about 40 hours a week of clinical practice and another 10 hours or so of administrative work, however the hours vary, and he sometimes works extra. “You’re always on,” he says.

Kremmling, Colorado-based family physician Lynnette Telck, MD, became chief of staff at the age of 33. She works at Kremmling Memorial Hospital District (KMHD), a community hospital about 100 miles from Denver and the only hospital in Grand County. A Level IV Trauma Center, KMHD provides inpatient and outpatient services in addition to 24-hour emergency care. Telck is well acquainted with the local community. In fact, she has the unique distinction of serving as chief at the hospital where she was born.

“It makes it that much more special,” says Telck, whose grandparents

homesteaded in Grand County. “Many of my patients grew up with my grandmother or father, so it is an honor to me to be able to treat them. I have a special bond with these patients that most physicians never experience.”

Her current role came about when it was her turn to fill the position. Unlike Hasan, all physicians at KMHD serve as chief on a rotational basis. Coming from such a rural area, the medical staff must fill all the roles with few physicians, Telck says. As a result, she and others are afforded opportunities that may not be available in a more urban setting.

According to Leslie Jones, the medical staff coordinator at KMHD, the chief of staff directs all med staff meetings and attends other meetings, oversees the schedule, attends to patients—both clinic and hospital—and does ER coverage once a week in addition to the administrative duties that consume many hours on any given week.

Jones says Telck works at least 48 hours a week in clinical practice, plus her administrative time. All qualified physician staff members will take a turn as chief and serve a one-year term.

As chief, Telck also represents physicians and mid-level providers and acts as a liaison between them and the administration. She manages all issues and concerns of providers or the administration that affect the group.

“I run the monthly provider meeting and medical staff meeting and help with scheduling when needed. I also am in charge of follow-up for tests on all patients that don’t have a PCP and the general medical paperwork that needs to be completed for the hospital,” says Telck.

Like Hasan, Telck never really gave much thought to becoming chief. Her true aspiration has always been to care for patients. “However, I have always been interested in trying to make programs work efficiently to benefit everyone,” she says.

Telck says she is grateful for having “a wonderful husband and son” who help with all the chores at home, which is especially important these days, because she is just back from maternity leave.

A natural role for leaders

Being a leader at the Rehabilitation Institute of Chicago (RIC) is something Colleen Fitzgerald, MD, always strived for, and although becoming chief of staff was not in her plans, she welcomed the opportunity. Fitzgerald, who specializes in physical medicine and rehabilitation, was nominated for the position by her chairman, elected by her peers in September 2007 at the age of 37, and will serve a two-year term. In her new role, she represents the hospital’s physiatrists.

“I serve as liaison for the medical staff to the chief medical officer, and also to our chairman, as the voice of the medical staff,” says Fitzgerald. “I’m also in charge of processes for the medical staff, determining processes that the staff need to follow, running the medical staff meetings, and I run the medical executive care committee meetings. Those are meetings where different committees of the hospital report at once,” she says.

Fitzgerald also serves as the medical director for the Women’s Health Rehabilitation program at RIC, which specializes in women’s health issues relating to musculoskeletal injuries and conditions caused by pregnancy and post-partum-related pain and dysfunction.

Fitzgerald spends a couple hours a week in her role as chief of staff and says 80 percent of her time is spent doing clinical work. She says her role as chief is different than at other hospitals because she is only representing one specialty, physical medicine and rehabilitation, which she says requires less time.

“I represent the people of my specialty, which is a great honor for me. It is a little bit less in terms of a time commitment,” she says. “I serve formally in meetings and in reporting to the chief medical officer about the direct experiences of the medical staff and how we can make things better for the medical staff. But I also serve as a sort of sounding board for the staff in a way that I can communicate the pulse of the staff.”

Becoming chief

Before becoming the chief of staff, Hasan says, physicians at his hospital typically are required to have some administrative experience such as being the director or chairman of a department or a committee. Hasan says the best training he received was as the chairman of the emergency department where he served for six years. He’s also currently enrolled in an executive MBA program, which has given him experience in leadership management.

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