So You Want to be a Chairwoman/man? David H. Song, MD, MBA, FACS Regional Chief, MedStar Health Plastic Surgery Professor and Chairman Department of Plastic Surgery Georgetown University School of Medicine

Disclosures Biomet Microfixation – developer of SternaLock® Elsevier – Plastic Surgery 3e, 4e Editor of Volume IV Healthengine – Chief Medical Officer

Bio – Education/Training UCLA Med School University of Chicago General Surgery Plastic Surgery Microsurgery Booth School of Business (Strategy/Marketing)

Bio - Employment University of Chicago Pritzker School of Medicine Assistant Professor 2001-2005 Section Chief of Plastic Surgery 2004-2016 Associate Professor 2005-2009 Professor 2009-2016 Vice-Chairman, Dept. of Surgery 2009-2016 Cynthia Chow Endowed Professor 2012-2016 Associate Dean for CME 2013-2016 MedStar Health Regional Chief 2017- Professor and Chairman, Department of Plastic Surgery, Georgetown University School of Medicine

Why Move? University of Chicago Medicine MedStar Health….. One Acute Care Hospital – 500 beds PRS: 1/10 Sections in the Dept. of Surgery Integrated PRS residency 2/year Zaccone Family Microsurgery Fellowship MedStar Health…..

Largest Health System in Mid-Atlantic

Largest Health System in Mid-Atlantic 10 Acute Care Hospitals

MedStar Health MedStar Institute of Plastic Surgery 3 Divisions: Podiatric Surgery Center for Wound Care/Limb Salvage/HBOT Plastic Surgery: Aesthetic, Breast, Pediatric, Micro, Hand Department: Georgetown University SOM Integrated PRS residency - 18 residents Podiatric Residency – 24 residents WoundCare/Limb Salvage fellowship

MedStar Health Future Goals MedStar Institute of Plastic Surgery Growth: Addition of faculty Addition of resident compliment Addition of microsurgery fellowship MedStar Health Research Institute Increase Extramural funding Systemwide integration of Health Services Research Outcomes Cost Effectiveness Clinical Innovation

Section/Division To Department Things to consider ”All Politics is local” – Tip O’Neill University of Chicago – Except Ortho/Optho, ALL service lines are Sections of the Department A Department of PRS would have to compete against the larger Department of Surgery Resource pool would be limited if PRS would have become a Department Growth is tethered…but slumps in business are backstopped Faculty and staff hiring decisions…multiple layers of checks MedStar Health – Very different structure Untethered growth across the system wide Department (without walls) with 3 distinct divisions Tax structure more favorable Autonomy for all decisions (but also full responsibility) Faculty and staff hiring decisions…Full autonomy

Section/Division To Department Things to consider ”Not All Departments are created equal” Checklist Governance and reporting structure Peer departments assessment Tax structure Infrastructure considerations (finances, IT, academic, research, HR) Compensation plan (centralized vs. within the purview of the Chair Climate survey Vision and strategy alignment with the Med Center and/or University Med Center owned by University vs. stand alone E.g. Growth of cosmetic surgery as a plus, minus or neutral ? Who leads negotiations with 3rd party payors Weighted value of the tri-partite mission?

Section/Division To Department Things to consider Due Diligence Call the previous Chair, other chairs in the institution, key faculty, residents, nurses, admin. Study the institutions 990 form and recent annual reports Background check of all admin. staff and C-suite Self Reflection Do you really want this? Family/Lifestyle considerations Goal Setting 100 day goal Vision and mission Strategic plan Create and define metrics…then share them

Section/Division To Department Things to consider Seek Advice and Help: -Colleagues -AAPS/ACAPS/ASPS etc. -Past Chairs -Current Chairs -Business Contacts outside of Medicine

Thank You and Best of Luck!