Carroll Hospital has announced its Physician of the Year and, for the first time, Advanced Practice Provider of the Year for 2018: Dr. Mark Goldstein, the interim chief of emergency medicine, and Kim Baker, a physician assistant and director of adult hospitalists and ICU services.
The two were surprised with the announcement of their twin honors at the recent Doctors Day celebration held at the hospital.
"Dr. Goldstein exemplifies compassionate care, making sure that patients' needs are first and foremost," Carroll Hospital President Leslie Simmons is quoted in a media release as having said, while Baker, she said, "Is the first advanced practice provider to be in charge of an entire service at the hospital and at the same time efficiently balances the care of multiple patients."
The task of surprising Goldstein and Baker fell to Dr. Mark Olszyk, vice president of medical affairs and chief medical officer, who also served on the executive committee that traditionally selects Physician of the Year from among the doctors who earn a Physician of the Month recognition in the past year.
"We look at the 12 providers of the month and then say, 'this one clearly stands out,' and not just for whatever they did to get recommended, but looking at their entire career. Maybe you got to be provider of the month because you birthed a baby in the parking lot," Olszyk said. But when it comes to provider of the year, "We make sure that person has good ethical character, is recognized by their peers. It's really someone to hold as role model."
Goldstein fit the bill.
"He was shocked," Olszyk said, of when he surprised his colleague with the news. "What's even more interesting is his father is still a physician on our active staff, so he was sitting right beside him. Both of them were humbled, surprised and obviously very pleased."
"I was completely surprised," Goldstein confirmed. "I am very touched by the recognition."
And perhaps even more shocked was Baker, as she realized she was becoming the first Advanced Practice Practitioner — a category that includes physician assistants, nurse practitioners, midwifes and nurse anesthetists.
"They started saying, 'we're going to see if you can guess who this is,' and then the more that they said, the more I thought, 'Oh my god, I think they're talking about me,'" Baker said. "Honestly, I was surprised. I did not expect it, I really didn't."
"She is the first one ever and she is the the inaugural APP of the Year," Olszyk said, noting that this honor will be awarded annually from here on out. "We have about 300 physicians on staff and a little over 100 advanced practice providers right now. It didn't make sense to exclude a quarter of our medical staff. I think they really appreciate it."
Baker also fit the description of a provider of the year that could serve as a real role model, Olszyk said.
"The first time I met her I found her very impressive and she continues to impress me," he said.
About 18 months ago, the previous director of the hospitalists — doctors and APPs that care exclusively for in-patients at the hospital — stepped down, and Baker stepped up.
"Traditionally, that would have been directed by a very senior physician. In fact the previous incumbent was a physician," Olszyk said. "When he left, all of her team members — physicians and APPs included — all pointed to her to be the natural leader."
"Twice I told them, no, I didn't want it, it should be physician. It was a director position and a group of physicians that I am in charge of," Baker said of her experience. But when her team told her she needed to do it because she was already filling the gap and doing great at it, Baker realized she had an affinity for the work.
"I like challenges. I like to do different things," she said. "I definitely think this fits that role — it's a very challenging job."
"She did it because she was asked and I think because she recognized that she was the most capable individual," Olszyk added. "She always remains calm and collected and formulates a good plan. And it's amazing to watch physicians defer to her."
Baker didn't start out thinking she would pursue a career in medicine, she just knew she liked science. After studying microbiology in college, she became interested in doing research and eventually enrolled in graduate school at Johns Hopkins University where she was able to pursue research into infectious disease.
"Then I realized I wanted to do something a little bit more healthcare related. The more you learn about disease states and things like that," Baker said. "So I actually became a paramedic."
And that only wet her appetite. It wasn't long before the role of a paramedic felt too cramped, and she decided to pursue certification as a physician assistant.
"Every PA program is set up on the medical model. It's basically an abbreviated version of medical school," Baker said. "It was intentionally done that way because the goal was to have people who were not physicians, but who had some kind of previous medical training. It started out with the military guys coming home from war who were medics, but didn't have a job afterward."
As a physician assistant, Baker has the same scope of practice in treating patients as her physician colleagues, "with the caveat that we have physician oversight in that if we have complicated cases or issues with patients or what have you."
She began practicing at Carroll Hospital in 2009, just as the hospitalist program was getting started, and was even involved in the hiring of many of the hospitalist physicians.
"I think sometimes it's more challenging for APPs, because they don't have the luxury of having had four years of kind of gradually increased responsibility in their training," Goldstein said. "The APPs that excel are super motivated and they learn quickly, and that definitely applies to Kim — She's a great leader and I think she's an incredibly capable clinician."
It has been challenging, but that's the way Baker likes it — she's happy that the hospital will now be recognizing advanced practice providers annually going forward.
"As far my profession is concerned, I think it's wonderful, she said. "I think it's nice to have some form of a recognition system that shows that it is a profession that you can do a lot of the things that were previously thought of as things that only a physician could do."
In many ways, Goldstein and Baker have similar jobs, as both deal with a wide variety of medical cases; Goldstein while they are acute emergencies, and Baker in follow-up care.
"I've been doing this for almost 17 years and honestly there is not a single day that goes by where I work clinically where I don't learn something new," Baker said.
It was a similar appetite for variety and knowledge that drew Goldstein to emergency medicine, kindled by a stint as an ER volunteer early in his medical training.
"I just remember thinking from the very beginning, 'wow, these guys get to do everything,'" he said. "They walk in one room and they are seeing a person with a GI bleed and trying to stabilize them, in another room they are managing a heart attack and in a third room they are seeing someone who is depressed."
Medicine trends towards specialization, with many professionals learning a whole lot within a narrow scope of practice, Goldstein said.
"I like that I can still learn about anything in the house of medicine and it will impact my job directly," he said.
And yet despite his current love of medicine and a physician father who had been associated with Carroll Hospital since the early 1980s, becoming a doctor was not Goldstein's first career choice.
"Even though I admire my dad and his profession, I never planned on being a physician growing up," he said. "I went to school and studied political science."
It was only at the end of his undergraduate education that Goldstein realized that while he liked political science as an academic discipline, he didn't like the practice of politics. That's when he heard the call of medicine, and entered a post-baccalaureate crash course program that compressed an entire pre-med curriculum into one year.
"It was a pretty harrowing experience," Goldstein said. "But I did it all in one year and then I went to med school at Tulane, in Louisiana, just because I thought it was time to get away from the Baltimore area and experience a new region."
But Carroll County was always on his mind, and after Goldstein completed his residency at Johns Hopkins in 2012, he started looking for work.
"Every place has its quirks but I think he always felt the Carroll community was home. It was an intimate atmosphere and people were like family there," he said. "When I was looking for ER jobs, I applied for a position with EMA, which services Carroll's ER. I've been there ever since I got out of training, so about six years."
Like Baker, Goldstein distinguished himself in stepping up to fill a role, in this case chief of emergency medicine when the former chief, Dr. Drew White, was elected president of the hospital medical staff.
Goldstein supervises a team of 20 emergency medicine providers seeing 100 patients per day in the only hospital department that runs 24 hours per day, seven days a week, according to Olszyk, making Goldstein both a clinician and administrator.
"What is really unique about him is he runs the the M and M, morbidity and mortality conference, for emergency medicine," Olszyk said of Goldstein. "A number of cases are selected to be reviewed in front of the entire department — the nurses, the scribes, physician assistants. He does all the academic research and he presents it in both a very intellectual and also a fun way."
In something like a Socratic dialogue, a format of medical education with a long history, according to Goldstein, where he reviews Carroll Hospital cases that were tough, or did not go as planned, mining them for information and lessons so that everyone can improve their practice.
"I think sometimes there is an instinct among doctors to bury the cases that go bad and not talk about them and feel ashamed," he said. "We are saying everybody makes mistakes. Every physician makes mistakes. The least we can do is learn from mistakes as a team so we can continuously improve care for our patients."
"I go to it — I am an emergency medicine doc, board certified — and I learn something every time I go to that," Olszyk added. "He has really become the educator for the entire department."
Goldstein has been expanding the M and M conferences as well, collaborating with other departments such as pediatrics and neurology, instigating some of the changes he said he feels lucky to have been a part of at Carroll Hospital.
"I have been able to really watch some rapid evolution in the way we provide care in the community," he said. "But I think the culture and the way that people relate to each other, all the positive parts of that experience at Carroll, have remained intact."