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A passion for quality improvement, right from the start

From the December ACP Hospitalist, copyright © 2008 by the American College of Physicians

By Jessica Berthold

Mark R. Chassin, FACP

Occupation: President of The Joint Commission.

Age: 61.

Current residence: Greater Chicago area and Westchester, New York.

Hometown: New York City.

Family: Married with three children and two grandchildren.

Medical school: Harvard Medical School.

Residency: Los Angeles County-Harbor General Hospital, Torrance, Calif.

Something I wish I’d learned in medical school: Management. All of the art, and whatever little science there is, of how to manage teams, organizations, people and projects. It is a set of skills that physicians increasingly need in the different roles they play, particularly as they get into organizational and executive positions and into big medical groups.

First job: I did a health services research fellowship with the Robert Wood Johnson Foundation’s Clinical Scholars Program at UCLA. That’s where I started to get interested in, and focus on, quality of care. At the same time, I practiced emergency medicine as a moonlighter to keep my clinical skills active.

I chose internal medicine because: I come from a medical family. My grandfather was a general practitioner in Maspeth, Queens (New York) for 40 years; my father is a surgeon; my uncle is an internist. I saw how rewarding their lives were, both because of the helping nature of the profession and the intellectual stimulation of solving problems. I thought seriously about surgery, but I didn’t want to go through the excruciatingly long training. I chose to practice emergency medicine because there is a lot of immediate gratification in being able to relieve a patient’s suffering rapidly, and in the intellectual challenge of making the right diagnosis quickly.

Most meaningful professional accomplishment: One is the cardiac surgery reporting system that we created when I was the health commissioner of New York State. It was the first public program to collect really detailed clinical information, use it to risk-adjust mortality rates by hospital and surgeon, and make the data publicly available. We then used the data to confront hospitals with poor performance and work with them to improve. Within four years of the start of the program, New York achieved the lowest mortality following cardiac surgery of any state in the country and, according to published research, it maintained that position for at least the 10 years that have been studied.

The other, more general accomplishment that I find so meaningful is working with, mentoring and growing young people in their careers.

Career advice for hospitalists coming out of residency: Pick a place to work and a job you love to do every day. If you are picking something solely because you want to achieve some goal five years from now, then the everyday grind may be really frustrating. Do some introspection as a physician about what you really love to do on a daily basis, whether it is academics, teaching or clinical care, and do that.

Hardest medical lesson learned: Sick patients will die despite your best efforts.

Personal heroes: My father and my mother. I was very close to my father growing up, and spent a lot of time with him in the hospital as he treated patients. I saw him approach very critical situations with a confidence and calm that allowed everyone else to have that approach, too. My mother amplified his caring and compassionate side. She is a nurse, and together they created such a strong family bond among my brothers and sisters and me. That has been a critical part of who I am: a strong sense of family, professional dedication, and compassion and caring.

Favorite ways to spend free time: What free time? Reading, snow skiing, water skiing, and hiking in the mountains.

Pet peeve: Spelling errors. Mostly the ones I make myself.

Most recent book read: “The Big Oyster” by Mark Kurlansky. It is a history of how New York City, right through the early 20th century, was the oyster capital of the world, and how that disappeared with pollution.

Item I can’t live without: My exercise bike.

Most surprising thing about me: I was a water ski instructor in my younger days.

If I weren’t a physician, I would be: A history professor, but one who relates historical information to present-day public policy issues.

Future goals: We are really at a crossroads in health care delivery today. We have to figure out a way to do much better with respect to safety and quality. I think the field is poised for a major improvement, perhaps a fundamental transformation, and that is what I hope I can play a part in stimulating and leading at The Joint Commission.

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ACP Hospitalist provides news and information for internists about the practice of medicine and reports on the policies, products and activities of ACP. All published material, which is covered by copyright, represents the views of the contributor and does not reflect the opinion of the American College of Physicians or any other institution unless clearly stated