Message from Our Chief

Robert Wachter
Robert Wachter, MD
Division Chief of
Hospital Medicine

When we launched the nation's first academic hospitalist program in 1995, I had a vision of what we needed to do to succeed. In an environment like UCSF, one of the nation's premier academic medical centers, I knew this much — first, for our program to earn the respect of our faculty colleagues and our trainees, it would have to be every bit as academically successful as our cardiology or pulmonary divisions. Second, it was essential to give our faculty the mentoring and resources to reach their goals, whether they were in clinical care, research, education, or leadership. Third, our clinical operations would require financial support from our medical center, and that support would hinge on our ability to demonstrate that hospitalists improve value — quality divided by cost. Finally, we would never go wrong by trying to achieve excellence in all that we did... and, if that led to regional and national acclaim, so much the better.

As my kids will tell you without provocation, I am not always right. However, on this one, things worked out even better than I had hoped. It turns out that all of these goals boil down to something much simpler: hire the best people, give them the support they need to grow, and try to stay out of their way.

With this as our touchstone, we have managed to grow to a faculty of 50 exceptional physicians (supported by a superb staff), and those people have made the UCSF Division of Hospital Medicine into something unique and inspiring. I'm a big fan of culture, and I think our culture is our Secret Sauce. New faculty feel welcomed and supported by me and by their colleagues and trainees. They sense that while there is a high bar — we really want people to be great in all they do — help will be there to scale it. They know that we aren't religious about whether they make a difference by publishing articles in the New England Journal, setting up a hospital in Haiti, or providing empathic care to patients at the end of life. They feel that excellence in teaching medical students will be valued as highly as excellence in securing grants. And they have fun.

When our division has lunch together every Monday, I sometimes allow myself a moment to take stock — to look at this diverse and wonderful collection of people, all of whom are making a difference in the lives of their patients, trainees, and the healthcare system. That they do this in an environment of mutual respect and support, that they are as committed to each other's success as their own, that they are striving not only for professional accomplishments but work-life balance, that they are all good and humble folks who just happen to be extraordinarily talented — these are sources of great pride, and they make the job of leading our division a perpetual joy.