All I need to know to be an Assistant Professor…I DIDN’T learn in Residency

1. All I need to know to be an Assistant Professor…I DIDN’T learn in Residency (or Medical school or Fellowship for that matter) Daniel S. Eiferman, MD, FACS Asst. Professor of Surgery New Faculty Orientation Sept. 16, 2014

2. An honor to be asked to give this talk However, some not convinced selection committee got it right!

3. Disclosures • NONE of the following is supported by level 1 evidence • (Or level 2 or 3 or 4 for that matter either) • “My advice has no basis more reliable than my own meandering experience” --BazLuhrmann

4. Because I have clinical competency, I must also be skilled at: • Communicating Effectively • Building a Team/Leadership • Process and Quality Improvement • Interacting with Patients & Colleagues • Doing research and writing scientifically • Health care finance

5. How I Learned How To Take Care of Patients • Wife and I struggling with infertility • Undergo IVF to try and start family • Our physician is pregnant herself and starts having severe 1st trimester complications • Physician gets placed on bed rest and partner assumes care for us • Partner reviews our labs and images and cancels our cycle

6. How I Learned How To Take Care of Patients • Our physician (while on bed rest and in the process of losing her own pregnancy) calls Ilissa and says I know your case and I think there is a drug that can salvage your cycle • One problem: Only one pharmacy in Chicago has it and its downtown and it closes it 5:00 • It’s 3:45, Ilissa is at work in Northern Suburbs and I am on call • Ilissa fights Chicago traffic and makes it on time

7. Result

8. My turn to pay it forward • Called by Resident to staff a consult of a women undergoing fertility treatments who clearly has appendicitis • Take patient to OR at 1:00 a.m. for laparoscopic appendectomy • Case takes no longer than 15 minutes to remove inflamed, non-ruptured appendix • Prior to completing operation, take an extra 10 minutes to assess her tubes, ovaries, and uterus to see if there is an anatomic cause to her infertility • Call husband and give results • Pt. discharged several hours later with no complications

9. Result • Patient writes a 3 page letter describing her awful hospital experience • Patient felt she was just a cog in a machine and that her needs weren’t met (specifically post-op pain medications) • Lesson no one ever taught me: 70% of patient satisfaction has nothing to do with their clinical outcome

10. Progress • 17 y.o. Cross-Country Athlete Involved in MVC and arrives in extremis • Have to amputate left lower extremity to stop hemorrhage. • Long hospital course—promise mother that I will attend high school graduation once he recovers

11. Priorities Patient has full recovery and will graduate on time in the spring Graduation Day is same day as Abby’s first Dance recital Gave my word that I would come to graduation

12. Compromise Went to Abby’s recital, took Julia to the Graduation Party 2 weeks later Always make sure your family is your #1 priority

13. The Rules of Eiferman • Be great (not just good) at what you do. If you have no street credibility, no one will listen to you. • Be a great team builder. Embrace conflict. Create an atmosphere where failure is expected and accepted so that there can be future success. Be willing to take risks. (Yerkes-Dodson curve below). • Be a great communicator. • Stay calm. Only 2 things are worth getting upset about and they both start with the letter “L” • Focus on the process, not the results