95. William Cheng, Hospitalist and Singer

William Cheng has been working in the Silicon Valley area since 2000. He graduated from Harvard as a bio concentrator and later attended UCLA's David Geffen School of Medicine. He completed residency training in internal medicine at Santa Clara Valley Medical Center, a county hospital affiliated with Stanford Hospital System. He then joined the Palo Alto Medical Foundation as a hospitalist, focusing on acutely ill patients.

Working as a Hospitalist

William's understanding of the world has changed over the two decades as a hospitalist. He now understands the importance of non-hard science aspects, such as interactions, communication skills, and bedside manners. He also learned logistical skills, such as navigating the healthcare system and getting patients in and out of the hospital efficiently. William talks about the need for continuous learning in his field, including navigating insurance and bureaucracy. He shares how the recent pandemic had a significant impact on the Bay Area, and how the hospital environment has evolved over time, with new challenges and opportunities for growth. William shares tips for being a smart patient in the hospital, such as asking questions, double-checking medication, and understanding the importance of being a smart consumer of hospital care. He emphasizes the importance of clear communication and respecting the intelligence of patients and families. William explains what makes a good doctor, and the various demands that come with the job, including intellectual demands, emotional demands, physical demands, and long hours on the feet. 

Challenges Faced by Hospitalists

Hospitalists interact with patients and families more frequently during the day, especially in difficult situations such as difficult medical diagnoses, potentially life-threatening diagnoses, and end of life care. These discussions can be gratifying and stressful, but they also involve complex social interactions and relationships. He talks about the challenges of discussing severe conditions with patients, determining the appropriate treatment options, and navigating complex social discussions. Another challenge is reviewing charts quickly, understanding the patient's condition, and formulating a plan of action. In the initial admission orders, physical therapy and occupational therapy are often put in, but if the patient is too weak, additional help may be needed. Social workers or nursing case managers can then discuss these recommendations with the patient or family early on. They can teach the patient or family about the process of getting them home and ensuring they understand the process. William talks about the admission process and mentions that there are different types of patients, such as good teaching patients and non-teaching patients. 

A Professional Point of Pride

From a professional standpoint, William is most proud of his early involvement in scheduling for his group. Scheduling is one of the main pain points or stress factors for hospitalists, as they have to be on call for certain periods of time. The traditional seven-on-seven off schedule is not ideal for patients, as it can lead to stress and dread of work. William developed a good system that has led to very little turnover in his group and accommodates everyone's time off requests. His scheduling is essentially a giant logic puzzle, and he does it all by hand within a spreadsheet for over 20 years. He continues to do this to this day to ensure that everyone is happy with their work.

Influential Professors and Courses at Harvard

William mentions his love for the Glee Club Harvard Glee Club, where he sang in junior and senior year. William found that there was no experience after college that matched the quality of his time at Harvard. He has been involved in an alumni chorus, which he started in the late 2000s, which has been performing in Japan and the US. They have performed three times so far and are planning to perform at SEMA this year, focusing on peace and harmony among the world.

Timestamps:

02:56 Medical education, hospital care, and COVID-19 experiences

08:25 Hospital care and communication between doctors and patients

13:35 Medical work-life balance and emotional stress

18:27 Challenges and skills of a hospitalist

25:01 Streamlining hospital discharge process for elderly patients

27:35 Medical education and patient care

31:50 End-of-life care and scheduling for hospitalists

37:13 Work-life balance, scheduling, and singing experiences

43:46 Singing, harmony, and endorphins with a Harvard Glee Club alumnus