The Ralph H. Johnson VA Administrative Fellowship: Dan Bishop

<p>hello everyone this is Cole from the American Journal of healthc care strategy I'm joined this evening by a special guest from the VA Dan Bishop Dan please introduce yourself what's going on Cole my name is Dan Bishop I am currently administrator fellow at the Ralph h Johnson VA Medical Center here in Charleston [Music] we're so happy to have you on it's a unique administrative Fellowship I think people even in healthcare administration aren't always aware at the incredible work that the VA does and I think even fewer are aware about that administrative Fellowship opportunity so we're so excited to have you on to talk about that first I want to go all the way back to the University of South Carolina where you got your mha I want to ask what got you interested in getting that mha how early on did you know you wanted to go into that field and why did choose the University of South Carolina so a couple different things to touch on there with that so I knew that I wanted to be in healthcare from a very young age my uncle was a doctor my parents didn't go to school so I wanted to kind of change things up be a first generation college student and looking to you know my uncle there that's what got me into Healthcare first all um so looking into an mha specifically I originally wanted to do PA school or something maybe more clinical but in my few years that I spent in between undergrad and graduate school I realized that I like the business aspect of hospitals as well so that's where the mha came into play with that and in terms of the University of South Carolina I applied to a couple different programs I applied to some in Maryland University of Maryland Johns Hopkins West Virginia and then South Carolina as well looking at all of the different options the thing that really drew me to South Carolina was that paired their program with a graduate assistantship so essentially you would work part-time during that twoyear span that you were in the program and then you would do classes in the evening they were in person and it gave you that health care experience to give you a leg up over someone who may just be doing an online program or may be in a completely different profession that doesn't have Healthcare experience but would also be pursuing mha that sounds like a really big uh bonus to that program and how was that experience did you enjoy that assistantship absolutely loved it so I actually did my graduate assistantship at Lexington Medical Center so I spent my first year there working in their vaccine clinic so I got hands-on experience with a lot of different patients that would come in you sometimes get 500 to a thousand people that would come in a day there a lot of different faces you do get a little bit that clinical aspect and then my second year I was a data analytics graduate assistant with their emergency department so I got a little bit of insight into the leadership that sounds like a great array of experiences to have before even graduating with your mha program that's incredible I want to ask though you were talking about how during the years between your undergrad in grad school you found that you like that business side more right what are some of the experiences that you had in those years that made you want to go into the business aspect so I actually had a few different roles in between undergrad in grad school so I had about a three-year time span and I split it up essentially between two different roles when I came out from undergrad I knew that I eventually wanted to go back to school so I wanted to pursue something in the finance realm I got a position as a mortgage maker so I did that for about a year and a half gave me great insight into personal finances and you know business as a whole and then I actually worked for the US small business administration for a year and a half as well so I got some of that small business finance aspect of it so kind of healthc Care Plus finance and business was you know what Drew make the mha very cool and then when you of course you went into your program you were getting near the end you already had quite a bit of experience of course you had those three years in between so you had even more you know work experience in general than maybe the average you know person who'd go straight through would so I want to ask why did you decide to do a fellowship so I looked at doing and I guess I should preface this with when I was graduating I almost did not want to do a fellowship I thought I've worked three years already I want to get back to you know whatever salary figures I was at prior to that that was my main focus before I was coming out before I was in that second year then the more I was in healthcare I realized that a lot of times the progression and the opportunities come from you know either who you know or what Specialties you have done or what special you're in and I guess it shifted more from I got to get out and get this specific job or this golden goose egg job to actually I want to do a fellowship and then you are able to progress quicker throughout that Fellowship get more integrated within a healthare system or a hospital you get so many different aspects of that's system by doing a fellowship that you just come out with a broader knowledge overall so I thought to me it was worth it for that year to do the fellowship and it puts you way farther down along the line in comparison to just getting one job where you have one specific role that is not the the first time I've heard that many of the fellas who go on to be very successful share very similar sentiments how many fellowships did you end up applying to so when I was looking at fellowships I did three through the centralized application process and then I did two additional ones I had initially applied to luminous MedStar and WellSpan which were three that were in the DC Maryland Virginia Pennsylvania area then I also applied to the University of Kentucky and the Ral W Johnson via Medical Center here in Charleston how did the VA get on your radar because I'm familiar with those other organizations I've interviewed fellows from them but I haven't interviewed a fellow from the VA so how did the VA you know come up on your radar couple different ways so working for the small business administration prior to going back to school I had that thought in the back of my mind if I could potentially go back to working in the federal service really enjoyed it prior and then there were some individuals at the VA that were graduates of the South Carolina program and they had reached out to the program director and said hey we have this Fellowship opportunity if anybody would be interested in applying here's how you do so what did you like about it back at the small business administration for me I think it was the ability on a day-to-day basis I was working with uh the team doing dis the disaster loans for small businesses during the pandemic so essentially helping small businesses get the funding they needed while they weren't necessarily getting business in the door so for me it was very rewarding be able to call somebody hey we're gonna you know help get you approved for this alone and it was lifechanging for them because they could keep their doors open the government has a very broad reach and it's just very rewarding to help people and no I was say it sounds very rewarding for sure and so when you you know started doing the interviews what made you decide on going with the VA out of you know this the five different places that you applied for so the main thing that I felt with the VA was my connection with my preceptors so especially with this VA in particular Ralph h Johnson it's a very Hy feel if you will it's in Charleston South Carolina it's not that big of a city and I enjoyed a lot of the conversations that I had had with some of the other individuals at the other organizations however they were much larger organizations and I felt like I would get more attention from my preceptors to more guidance from them at the Ralph Johnson VI Medical Center in comparison how does that leadership work though because you're talking about larger organizations the VA as a concept in a lot of people's minds is massive right it's you know one of the hugest you know government programs but you know is because the leadership is localized in that that area yeah so there's a running joke in the VA that if you've been to one VA you've only been to one VA they're all very very different so although we all may operate under the same overarching you know veterans health administration every VA is very individualized and different so you know one VA in Charleston us may have six different community- based alation clinics and another may have 15 so it just depends it all varies wow that is very so yeah a lot of I mean I wouldn't have known that if you hadn't told me so that's that's very interesting and when you first started the fellowship what was that like you know where are the first things that you do is it rotation is it project what what are those first few you know weeks like the first few weeks to months were very rotational based so the VA is very very different from the private sector in that there are a lot of different programs that we utilize to help our nation's veterans there are a lot of different departments and different areas that you may not have in the private sector such as the office of Community Care um those kinds of things the first couple weeks was just doing rotation seeing how everything is integrated within the hospital and how everyone works together and what purposes each service provides what's the population like I you know of course of course people think veterans but what does that actually look like in terms of the patients that we see dayto day yeah it depends it just all depends to be quite honest with you is it you know does the VA care for all ages is it you know is it mostly older people what is it just a big variety what is it you know where you are as well what does that look like again I think it just depends on the day and what specialty it is and everything like that but obviously the does serve a very wide range of veterans in this area the Charleston area is consistently growing as well that also diversifies the patient population that you're getting but it all essentially depends upon your eligibility for the VA in terms of the care they provide so different individuals have different eligibility and then how about the staff and the people that you're working with are they from you know a bunch of different backgrounds are they from all across the country is it more people who are from the South Carolina area what does that look like I think it's a good mix I think that's just very representative of Charleston in general though you have some individuals that have been here their entire lives some people have been in the same VA for say 15 years for example and others are coming from you know maybe California Washington it all just depends and then what uh are some of your kind of standout projects or standout rotations that you've really enjoyed the most my favorite rotations so I really enjoyed the group practice management aspect of it because it is very different from what you would see in a group practice setting in a private realm if you will group practice sitting in some Health Systems is okay we've got one doctor's office that just does Dermatology you know just does OBGYN that sort of thing Within this particular VA you know the group practice management office oversees a lot of different departments um whether it be surgery or medicine or whatever it may be so they do have their hands in a lot of different things I find that extremely interesting looking at different you know utilization for patients or whatever it may be very interesting and so now that you're through it you know you've been there a year of course it's about a yearlong fellowship as you were explaining earlier right it's technically a year long yes technically a year long so we were discussing earlier there are a couple different paths one is the jiap program and that can go up to two years however our fellowship is more specific to our local hospital so that is you know hopefully a just a year long and with that year going through it do you feel more prepared now as a leader yes yes would do you think some of the key experiences that you you've had that have shaped you into being kind of the more prepared leader that you are I think the main part of it with this Fellowship has been being able to sit in some of those meetings see how some of the SE Suite individuals think and get their thoughts on different decisions you know what happens what occurs and how they go through that thought process just seeing how their wheels turn if you will getting their perspective on different things I think that has been the biggest change for me is just getting that Insight from higher up individuals that have been there done that if you will and what you know keeps them up or how they go about certain decisions what do you enjoy about the culture at the VA what draws you to to want to stay there after you know your fellowship is over because I know you mentioned earlier that you you know you really enjoyed it so what is it about it that you really draws you to it so for me both of my grandfathers were veterans so I really enjoy the idea of being able to on a daily basis help our nation's veterans and help provide the care that they need and provide quality care for them and then in terms of personally at work dayto day I really enjoy my preceptor she looks out for us she makes sure that we are getting a lot of different experiences and we're getting those opportunities to you know put our face in front of hospital leadership she also challenges us which I think is very very huge in a fellowship because that is one of the ways that you will learn the fastest is by doing so yourself so I think it's just the culture my preceptor and the individuals that I work with that's really nice to hear and it's it's I love hearing fellows who enjoy their experience and and want to continue on with the the same organization talking about the area that you're in in South Carolina you said that there's a big draw that people are are kind of coming there what is drawing people to the area and why do you like living there I would have to say it's the town it's a nice little Beach town I enjoy it because I always feel like I'm on vacation you know I leave work and I can go to the beach it's 15 minutes away or you know you can walk down King Street and you have all the palm trees all the shops I think it's just a very nice area it's a little bit more laidback than what I was used to in DC so a little bit less traffic too of course I know DC is is quite a wild area I have been to the Charleston area once or twice I'm from you know Raleigh originally up north a little ways so I agree very very nice town and the weather is I find sometimes the weather in South Carolina is even better than the weather in North Carolina even though technically it should be a bit hotter maybe it's the the way that the geography is shaped so these uh some of the fellows who are are interested in warmer weather are going to have to definitely take a look I want to ask on that note what should these fellows potential fellows look to do to gain that experience to prepare themselves for fellowship and you know to kind of level up to being the leader that you are now in terms of what they're looking for coming into a fellowship how they should prepare themselves for the fellowship or once they're in it all three uh you give you know feel free to give along the process what it looks like so my biggest tips when going into a fellowship I think the biggest thing is going to be one interview breath you're going to be doing you know some of these days have four five six hour long interview sessions not only that but you're going to want to try and network you know network with different Health Systems talk to different people that are at you know what does their health system have to offer and then do your research so you want to know going in what kind of Fellowship is this it might be just specifically for an Ambulatory Surgery Center it might be for you know peria outpatient what does it focus on and then also I'd want to know where did those fellows go after their Fellowship so you have a good idea of what your trajectory might be within the next couple years once you come in the fellowship my recommendation based on my experience would be just ask as many questions as you can do as many rotations as you can up front so you get that understanding of how different departments interact within your organization and then moving forwards try and get involved as many things as you can as well because rotating doesn't necessarily give you that indepth of a view of that certain Department doing a project in that area lets you dive a little bit deeper very very good advice and so what did that look like for you when you were coming in or when you were interviewing what did you notice about the previous fellows that you know attracted you they end up staying so all of the previous fellows that I know from the hospital little currently are with the hospital still I believe that's about four or five years back so and oddly enough I didn't actually get to interview with them prior so this program that we have is actually a new program that was started with my group of incoming fellows W that is very cool well nice that that sounds like a really a really great place for the you know people to look into when are the application deadlines when should people look into applying so last year what we did was we had a posting on the ACU website that just kind of gave you a broad overview of the program and then we post where every job goes essentially from the government is to USA jobs and then essentially you go through USA jobs and you apply through there and then we essentially go through our hiring process on our end so it's a little bit different in that you know we aren't able to fly people out or have two or three day long experiences with these individuals but I still think it's a great experience of course and it's it's Unique and that's why I wanted to kind of showcase it is because you know not everyone wants to work for the same type of organization in the same location and the VA offers kind of a different experience and of course the VA is everywhere and so I think uh you know I'm going to really link to the site and encourage people to apply I couldn't be more thankful for you coming on and sharing this experience it's very valuable and you know it's a an eye opener for me as well I really appreciate it of course thank you for having me</p>