On a clear spring morning in the Department of Medicine, Richard Rothstein, M.D, walks into morning report.
Nearly a dozen residents and Geisel medical students have gathered in a small library in the Department of Medicine to learn about a patient case and to discuss its outcome. An important daily teaching ritual, morning report encourages residents and other trainees to toss around ideas and ask questions about diagnosis and patient care—engaging everyone in the room. A self-directed learning experience, attending physicians chime in when needed.
Rothstein, the Joseph M. Huber Professor of Medicine and Chair of the Department of Medicine at Dartmouth’s Geisel School of Medicine, says that after 30 years, he’s still invigorated by morning report.
“I bring experience to the table, but I still learn new things from our young trainees and young doctors,” he enthusiastically says.
This interplay between students, residents, fellows and physicians is what drew Rothstein to Dartmouth-Hitchcock Medical Center and Geisel. While still in medical school, he knew he wanted to practice medicine in an academic medical environment—“I love taking care of patients, I’d never give that up, being a clinician is part of my identity, but I also love teaching and mentoring.”
Naturally curious, Rothstein enjoys asking questions, creating new knowledge—for example, he pioneered an innovative outpatient procedure to relieve heartburn in patients with gastroesophageal reflux using a modified endoscope—and passing that knowledge along to others, especially to a new generation of doctors.
Although attending physicians teach residents during rounds, residents are responsible for most of the teaching done in an academic medical center. Rothstein’s pleased that his department has the resources necessary to develop a teaching curriculum—a curriculum that parallels Geisel’s curriculum redesign initiative.
“As we make changes to the Geisel curriculum, we are going to be sure to not only train our residents, but also our faculty in the new methods of teaching,” he says. “It will make us better teachers.”
Rothstein is committed to Geisel’s culture and mission of excellence in learning, discovery and healing and setting the standard for educating physician-leaders of change in creating a healthier world—setting an example for Geisel students and residents alike to emulate.
Being in a leadership position isn’t easy, Rothstein acknowledges—it’s an enormous responsibility that requires dedication, a strong sense of self, an eye on the big picture and an ability to lead by example. It also requires honesty about goals and available resources.
During his 15 years as chief of gastroenterology and hepatology, he worked hard to create an open, honest, collegial atmosphere along with a culture of accountability within the section—an environment that also encouraged people to be healthy and happy. The result: one of the highest functioning units in the medical center.
“We built a team culture based on mutual respect and the knowledge that we were part of something bigger,” he notes.
Contented as a section chief, Rothstein never thought about becoming chair of medicine, but when the opportunity arose, he accepted.
With 16 sections in the department, and 575 faculty appointments, he now feels a greater sense of responsibility to help students, interns, residents, fellows and faculty build their careers, enhance their professional lives and maintain their wellbeing.
“Ultimately, you are the leader of your own sphere of influence and how you come across to others has a lot to do with how you feel about yourself,” he says. “I’m very interested in developing people, professionally and personally, and I understand the work/life balance that people need to attend to.
“If we don’t pay attention to our personal lives, we get caught in a cycle of work, unhappiness and frustration.”
An apt description of what existed in the department when Rothstein became chair last summer.
Increasing demands to achieve a particular work performance level, coupled with a new electronic medical records system that required more work, engendered poor morale. “One thing I decided to focus on when becoming chair, was improving morale,” Rothstein says. “I needed to figure out how to make our work more efficient and rewarding.”
By reaching out and bringing together section chiefs in his department to share information and ideas and encouraging them to allow others in their section to take ownership of what’s happening, he’s able to help people from different backgrounds achieve their goals. And reminding people why they chose to work in an academic medical center in the first place—patient care, teaching, research and intellectual challenges—goes a long way toward actualizing success.
Rothstein clearly enjoys creating teams of smart, motivated collaborators who together figure out problems and get things done.
“We did this as a team because we understood that it was important to all of us,” he says happily. “That has been one of the most fun things in this job as chair—learning what people need to achieve their dreams and working to identify and secure the resources for that to happen.”