Last week I had the good fortune to attend the meeting of the Association of Professors of Medicine (APM), sponsored by the Alliance for Academic Internal Medicine. As nice as it was to catch up briefly with Dr. Abel and—for those of you who have been here for a few years—with Dr. Rosenthal, the true benefit for me was meeting with and hearing from many other Chairs of Medicine from around the country. It should come as no surprise that the challenges their departments face mirror our own: recruitment and retention on all levels, equitable compensation, recovery from the pandemic and rebuilding with an eye toward sustainability amid the strain to our systems. The solidarity with the other Chairs was welcome, as was learning that our institution is not uniquely burdened. Also, many departments of Internal Medicine are building compensation models similar to the one that we are still constructing and readying to model. And while the seeming inevitability of our current moment could induce pessimism, I have instead been energized by possibility. Because, although we may have the same challenges as other academic medical centers, we have many things they do not, all of which will help us climb faster and into an even stronger position.
We have robust and diverse infrastructure and the creativity to recognize its potential for other uses. For years, the department has had a contract with the US Centers for Disease Control and Prevention to manage a digital forum for infectious disease specialists. Led by our ID division’s Dr. Phil Polgreen and Susan Beekman, RN, MPH, the Emerging Infections Network was conceived as a sentinel network, a means of swift communication about details of new pathogens and other infectious threats with thousands of members from around the country in regular contact. A recent publication reveals that our faculty saw the forum’s potential for other discoveries. A research team consisting of Beekman, Dr. Polgreen, Dr. Aaron Miller, and Dr. Manish Suneja administered a survey to the EIN members, not about emerging pathogens, but about factors leading to delays in diagnosing otherwise well-known infections. Their survey had a respectable 40% response rate. An invested population, it turns out, is a good one to engage. Their creative thinking and openness to possibility is one that is difficult to dictate from the top down, but it can be encouraged, replicated, and, when the results bear nationally recognized fruit, inspirational to those around them. Especially when practiced by those in leadership positions.
We have a track record at Iowa of soliciting ideas from everyone in the room and of respecting their input no matter where they may fall on a hierarchy. Respect for good ideas has a twofold impact: first, it ensures the best possible outcomes, whether in the classroom or lab or in a clinical setting; second, it empowers trainees and junior faculty to speak up and builds a sense of loyalty in them to those who trust them. Formalizing mentor-mentee relationships is important, but so are those informal day-to-day brainstorming sessions or lessons-learned conversations. This, I believe, is how you build a stable and enduring pipeline that promotes trainees and faculty from within and retains them over the long-term. Consider the recent example of Dr. Yousef Zakharia, an oncologist who excels at connecting with his patients. Upon learning that a high school English teacher in his office because of a melanoma diagnosis had already published four books of poetry, Dr. Zakharia encouraged him to write a book about his coming treatment. That 2019 collection, which still provides his family with comfort, will be published posthumously later this spring. No doubt Dr. Zakharia joined Iowa’s faculty already with some of those communication skills in his toolkit, but it took being surrounded and mentored both informally and formally by other Iowa oncologists, who have all made compassion an essential component of their care, to help hone his skills.
As I wrote in a previous “Views” a few weeks ago, as a department, we have done very well in mentoring and nurturing future leaders. And building mastery and purpose in your profession is a great way of combatting burnout. The Executive Leadership Academy has always attracted one or two of our members each year as an opportunity to develop and implement a process improvement project or some other innovation that benefits our institution with input from experienced educators. This year, the Department of Internal Medicine wants to make it easier for interested faculty members to take advantage of this training by subsidizing time and salary support for the effort. If you are interested in applying, let the department or your division leadership know. The deadline to apply is in late April. A separate email was sent out yesterday with more details. I am also very happy that several women faculty expressed an interest in attending the AAMC leadership seminars this year with the department’s support. More career development opportunities, aimed at our minority faculty, are coming soon. And, as always, keep the feedback coming, signed or unsigned; we are reading it and it is informing our conversations and our planning.