Health Systems Initiative

Family Medicine Leaders During COVID

Nicole Bonk, MD

Describe what you/your faculty/department/program/clinic did that demonstrated that family physicians are leaders in health systems.
I am a hospitalist trained in family medicine. I work at a large academic institution. At our main academic hospital, I am the medical director for our inpatient teaching service and the unit that service primarily works on. During the pandemic, that unit became a covid unit and I assisted in that transition.

We also have a 55 bed satellite hospital approximately 10 miles from the main campus. At this hospital, I am the director of hospital medicine and inpatient services. In the spring, I helped coordinate the planning for turning this hospital into a major surge center, fortunately we did not need to use this. In the fall, we did have our surge and I was responsible for staffing the hospitalists. We were able to draw on our partners in internal medicine, but we also used many of our family medicine faculty, outpatient physicians, fellows, and residents to staff our surge services. Some of our hospitalists are part time outpatient family medicine physicians and part time hospitalists, they also played a big role in filling the gap. We were able to backfill the clinics with other outpatient providers in order to staff the inpatient services with people who were best able to provide inpatient care. I was responsible for this coordination of the inpatient surge services with family medicine.

How did you communicate with health systems leaders during the process?
We were fortunate to have a robust incident command center. Our incident command center was made up of our leaders who are regularly accessible. At our satellite hospital, the CMO, CNO, CFO, the medical director of the emergency department and myself met regularly. When things were busy, that meant daily huddles, communication via text message or email throughout the day.

In coordinating care of all of the hospital medicine patients throughout our system, our hospitalist division held a leadership meeting weekly. We met with incident command weekly. We met with our division members weekly. We also coordinated a weekly meeting between hospital medicine and critical care medicine.

What type of feedback have you received about your efforts?
Overall, I think people have been happy with how our efforts worked out. It's hard to be the one that is always asking for help, scheduling people for surge services, etc. But I think our team members feel good about the way we were able to coordinate orientation and scheduling. People who were not used to working at the satellite hospital or on non-teaching services at the main hospital were pleasantly surprised with how smooth we were able to make things work. I did receive an exemplary service award from our division this year.

What type of impact do you think this will have on your health systems leaders’ perception of family medicine?
Our leaders have been happy with the support family medicine physicians have provided to the inpatient services. We are lucky to have truly amazing colleagues who are willing to step up and help out. We saw this time and time again all year long. This has been a good opportunity to demonstrate our value to provide care throughout the system at a major academic hospital.

What type of advice would you give to other family physicians or family medicine faculty about helping health systems leaders see the value of family medicine?
We have so much to offer. Family medicine physicians are trained to be malleable, to respond to a huge variety of situations from delivering a baby to transitioning a patient to hospice, often all in the same day. I believe this training helps our resiliency in times of crisis. Because we have physicians working across the spectrum, our department was able to play a role in many aspects of the healthcare system. I'm proud of the work we have done this year, and continue to do.

Image Description

Submitted by: Nicole Bonk, MD, Hospitalist

Institution: University of Wisconsin

"Family medicine physicians are trained to be malleable, to respond to a huge variety of situations from delivering a baby to transitioning a patient to hospice, often all in the same day. I believe this training helps our resiliency in times of crisis."

 

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