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In This Issue:
Stan Ashley, MD, during a recent meeting with Dr. Thomas Sequist, MD, MPH.
Stan Ashley, MD, sat down with BWH Bulletin to discuss his first month as chief medical officer and the opportunities and challenges ahead. Ashley, who was previously the vice chair of the Department of Surgery and program director of the general surgery residency program, is excited to work with BWHers in departments across the hospital to develop new ways to improve the delivery of care. This summer, he looks forward to delving into his many new responsibilities—and taking a few days off to visit colleges with his daughter, a junior in high school.
Q. Tell us about your first month as chief medical officer.
A. It’s been a very fast-paced first month getting to know this role; no two days have been the same. I appreciate that Dr. Whittemore [BWH’s former CMO who stepped down June 1] spent a lot of time with me to help bring me up to speed on the many responsibilities of the chief medical officer. In this position, I will oversee the Center for Professionalism & Peer Support, the Center for Bioethics, Physician Assistant Services, the Medical Library, Pharmacy and many other areas that I’m learning about.
Q. What are you most excited about working on?
A. With the hospital-wide and Partners-wide strategic planning initiatives, I’ve had exposure to the task force on research and education and the Partners care redesign work around colon cancer. I want to learn about all aspects of the strategic planning initiatives and help shepherd many parts of it.
Q.Describe the importance of research and innovation at the Brigham.
A. Research has been one of our defining qualities from the very beginning. The first chairs of our departments in 1913 were recruited because they were pioneers. That tradition has continued, and we have been innovative in many areas. The Brigham has multiple investigators doing groundbreaking research every day. And that needs to continue to be one of our major areas of emphasis.
Q. What aspects of the chief medical officer role drew your interest?
A. First, I love being at the Brigham, and the fact that I have this opportunity at this hospital is very special to me. Right now, we face a lot of change in the health care environment, and I think I will have an opportunity to help lead some of the work that will position the hospital to succeed.
One of the major themes involves creating truly multidisciplinary, patient- and family-centered care. We have traditionally done a superb job at delivering patient care, but it’s partly been in silos, or in our specific departments. I think the Brigham is poised to be a leader in providing true multidisciplinary care, and it’s something I’m very committed to working on as chief medical officer.
Q. How will that be challenging?
A. There are several challenges, the largest of which is that staff are already extremely busy. Helping people find the time to think about how we can provide care differently is important to our success going forward, and I don’t think there are any easy answers. We also have to continue to better coordinate care and put our patients at the right place at the right time for that care, taking into account where they go after they leave the hospital and how we work with referring doctors. All of those things are part of this charge.
Q. What were some of the major initiatives you worked on in your previous roles in the Department of Surgery?
A. As vice chair, I worked on a wide range of initiatives in many areas, including space allocation, research administration and others. One of the things I am most proud of was how we handled the work hour regulations set by the ACGME for residents. It’s been one of the hardest things – particularly for Surgery – and we all struggled to determine the right balance between the number of work hours and continuity, that is, how to learn by completely following a patient through their course of illness.
Two years before the regulations went into place, we formed a task force to develop a solution that has worked well for the most part. I’m proud that we had the foresight to bring a talented group of people together to solve a very tough problem.
Q. How is the Center for Professionalism and Peer Support changing the way physicians practice?
A. Traditionally, we as medical professionals have not done the best job supporting each other. There is an incredible amount of stress that comes with being a physician, a nurse or a caregiver of any kind. If you had a problem – an error, a lawsuit or an issue at home – you had to just deal with it by yourself.
Dr. Whittemore and Dr. Jo Shapiro (director of the Center for Professionalism and Peer Support) have done remarkable things to change this culture at the Brigham and to ensure there is support for all of our care providers when they need it. The Brigham is a leader in that area, and I hope we continue to be. Our model is receiving a lot of national attention as other academic medical centers begin to think about this.
Q. You joined BWH from UCLA in 1996. How has the hospital changed since you started?
A. At that time, we were facing a profound transformation as a result of managed care, and there was concern that hospitals were going to be downsizing. Some of the same pressures people said we faced then are now ahead of us once more with the health care reform initiative. It’s no longer about the insurance companies’ bottom line, though. It’s about doing the right things to make sure we can provide the highest quality of care at a price patients can afford.
In terms of change, the Brigham has seen exponential growth since I began, adding our ambulatory care centers in Foxborough and at 850 Bolyston St., as well as the Shapiro Cardiovascular Center. We’ve also become increasingly sub-specialized. In Surgery, for example, we no longer have truly general surgeons, and this has improved care for complex problems. And our institution is becoming increasingly diverse.
Q. You said before that you love working at the Brigham. What makes it special?
A. There is a sense of excellence with everything we do here – patient care, research, teaching and community work. The leadership at the top is also very forward-thinking and innovative. And even though we are a huge institution, it still feels like a small place. You walk down the Pike and you feel like you know everybody. It’s a wonderful and unique characteristic about the Brigham environment.
From: Cooperstown, New York
Family: wife, Vicki; son Thomas, a college senior majoring in geology; and daughter, Eliza, a junior in high school.
Outside of the hospital, you’ll most likely find Dr. Ashley: skiing, hiking and spending time with his family. This summer, he looks forward to embarking on a 10-day visit to colleges in Washington, Oregon and Wisconsin with Eliza.
Hobbies: “I like to bang on the guitar a little – mostly traditional folk music,” he says.
Book he’s currently reading: “Dr. Whittemore suggested I read ‘In the Care of Strangers,’ by Charles Rosenberg. It’s about the development of the hospital system in America. But I read a wide range of things, including a fair amount of popular best sellers.”
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