Indeed, in the following four scenarios young physicians found that stepping in, speaking up, and offering solutions can transform patient care and even fast-track one\u2019s career. Here\u2019s how they did it\u2026<\/p>\n
1. A Set of Notes Lead to a Treatment Breakthrough\u00a0<\/p>\n
Infectious disease physician Michael Scoma, MD<\/a>, spends his days managing complex multisystem patients, \u201cthe kind who rarely fall into textbook definitions, and never follow specific boundaries,\u201d he said. But recently he had a resident step up to change the trajectory of a complex patient\u2019s care \u2014 just weeks into her infectious disease rotation.<\/p>\n An ICU patient was an immunocompromised transplant recipient having daily fevers of unclear origin and declining multisystem function. \u201cMultiple teams were involved, the clinical picture had become muddled, and the plan of care was growing inert,\u201d Scoma said. His intern approached him with what he refers to as a \u201cpristinely typed one-page outline of the patient\u2019s cultures, antibiotics, inflammatory markers, and imaging, each section color-coded, and cross referenced.\u201d\u00a0<\/p>\n \u201cIt didn\u2019t just help \u2014 it shifted the momentum,\u201d said Scoma. \u201cThis intern\u2019s analysis gave us the clarity that had been missing, allowing us to step back and delineate a pattern that had been overlooked which led to adjusting the treatment plan.\u201d\u00a0<\/p>\n By aligning fevers, cultures, and antibiotic timing side by side, she exposed a subtle pattern the team had missed. That helped the doctors adjust their antibiotic plan, remove redundancies, and focus on the true source of infection. Within days, the patient\u2019s fever broke and organ function began to recover. The breakthrough, said Scoma, didn\u2019t come from new data, but from seeing familiar data with fresh eyes.<\/p>\n \u201cWhat struck me was this intern\u2019s intuition whereby she recognized the clinical chaos and, instead of waiting for direction, brought order and clarity,\u201d said Scoma. And that moment reminded Scoma that managing-up medicine isn\u2019t about navigating personalities \u2014 it\u2019s about elevating patient care. \u201cSometimes the most junior voice in the room is exactly what the case \u2014 and the team \u2014 needs to hear.\u201d<\/p>\n 2. Doctors Aren\u2019t the Only Ones to Impress<\/p>\n When Caitlin Hauser, MD, first started as an OB hospitalist with OB Hospitalist Group<\/a> (HG) in Richmond, Virginia, she quickly realized that gaining trust on the unit would be just as important as clinical skill. \u201cI wouldn\u2019t say it was one specific thing that I did that made people trust me, but I do think that it was a culmination of events that allowed me to gain the trust of the nurses and of the private practice providers,\u201d she said.<\/p>\n She recalls one early example in which she took the initiative to step up in a critical moment. One day, she was the only OBHG clinician at the hospital and there was a call overhead for help. A private practice clinician was having problems with a shoulder dystocia case and had been trying for some time to get the baby out. \u201cWe have overhead pages for emergencies, and we have one doctor \u2014 me \u2014 that was on the floor that day,\u201d she said. \u201cMe and my midwife came to the room, immediately assessed the situation and were able to get the baby out.\u201d<\/p>\n \u201cI do think being in training recently, we have exposure to a lot of these emergencies that the private practice docs just don\u2019t have the volume to handle,\u201d said Hauser. In residency, she saw scenarios like this every day. She assessed the situation and was able to reassure the doctor and get the baby out.<\/p>\n Beyond stepping up when needed, Hauser focused on building strong relationships with both nurses and the 80 private practice physicians who deliver at the hospital. She took time to include nurses in discussions before entering patient rooms, ensuring they were prepared and engaged. \u201cThe nurses want to feel involved,\u201d she said, thus she has made a point to always include them in conversations before they go into the room. \u201cWhen I went into the room, they were already on my side, already knowing what the plan was going to be,\u201d said Hauser.<\/p>\n She also found that being transparent about her status as a newer graduate was seen as an asset, not a shortcoming. Soon she found herself invited to a weekly conference to talk about the policies on the unit and even a part of helping to create a new postpartum hemorrhage algorithm at her hospital.<\/p>\n Hauser\u2019s efforts paid off and by January of her first year, she was promoted to site director for the hospital, overseeing OB hospitalists and midwives, coordinating schedules, liaising with hospital leadership, and participating in quality improvement initiatives.<\/p>\n 3. A Vision to Revitalize an Exhausted Department<\/p>\n When Valerie Weber, MD, first started as a division chief of Internal Medicine, she inherited a relatively small group of general internists who all did roughly the same thing \u2014 outpatient practice, hospital medicine, and inpatient consults.<\/p>\n \u201cMost of the docs were dissatisfied with the status quo but hadn\u2019t done anything about it \u2014 beyond a lot of grumbling,\u201d said Weber. Then, a junior faculty member approached her with an idea for how to shake things up. \u201cIt was a very detailed and data driven plan showing that if we got the hospital to invest in a hospitalist program, we could really grow our group, provide needed services to the hospital, and grow our outpatient practice as well \u2014 solving multiple problems at once.\u201d\u00a0<\/p>\n \u201cThe old, traditional model of physicians in internal medicine seeing hospitalized patients in the morning, then seeing office patients all day, and maybe heading back to the hospital \u2014 essentially being a \u2018jack of all trades\u2019 \u2014 was becoming less workable as patients in the hospital were becoming sicker\/having higher acuity, and changes in insurance reimbursement drove hospitals to want to reduce length of stay,\u201d said Weber. These newer realities required physicians to be available in the hospital all the time. Getting a hospitalist group started was a new trend that was emerging around the country that Weber said her team hadn\u2019t implemented yet. \u201cI encouraged him to develop a business plan, and we then presented it to hospital leadership to get the required support.\u201d<\/p>\n The way this staff member approached her as his chief, with data and a well-thought-out plan for growth, improving patient care, and increasing satisfaction of our docs, was the best example of successfully managing up that Weber has witnessed in her career.<\/p>\n \u201cHe came to me with solutions to problems that existed within our practice and the hospital,\u201d she said. \u201cThe hospitalist program was wildly successful \u2014 I ended up appointing him the lead of it \u2014 and it now extends over multiple hospitals.\u201d<\/p>\n 4. Building a Wellness Program That Transforms Surgical Outcomes<\/p>\n \u201cAt our integrated plastic surgery and wellness practice, we were initially offering a narrow set of wellness services \u2014 IVs [ intravenous], a few peptides, and basic weight optimization \u2014 primarily operating in parallel with our surgical care,\u201d said Diane Alexander, MD, FACS<\/a>, plastic surgeon and co-founder of Artisan Beaute in Atlanta.<\/p>\n![\"photo](\"https:\/\/www.newsbeep.com\/au\/wp-content\/uploads\/2025\/11\/ht-251124-cristina-del-toro-badessa-120x156.jpg\")
Cristina Del Toro Badessa, MD<\/p>\n
![\"photo](\"https:\/\/www.newsbeep.com\/au\/wp-content\/uploads\/2025\/11\/ht-251124-diane-alexander-120x156.jpg\")
Diane Alexander, MD, FACS<\/p>\n