Andrew S. Parsons, MD, MPH, FACP
Hospitalist, UVA Health
Associate Dean for Clinical Competency, University of Virginia School of Medicine
Director for Research and Academic Advancement, UVA Division of Hospital Medicine
Charlottesville, VA
1. What is your current professional position?
I am a hospitalist at UVA Health, Associate Dean for Clinical Competency at the University of Virginia School of Medicine, and Director for Research and Academic Advancement for the UVA Division of Hospital Medicine.
2. Why did you choose internal medicine?
I enjoy critical thinking, seeing the big picture, and solving complex challenges to help people. I am fascinated by the clinical reasoning process and how physicians make decisions—not only for diagnosis but also management of conditions. How can we optimize this process to provide high-value care to our patients?
3. What trends are you seeing in your day-to-day practice (with patients, the health care system, or otherwise)?
Greater complexity. Hospitalized patients are sicker and more complex than ever before. This is a result of not only their illness and comorbidities but also the complex social milieu that defines our current health care system. Unfortunately, a broken social safety net and limited public health infrastructure promote inequities that are apparent in everyday patient care. Practicing medicine is hard but rewarding.
4. What do you want to accomplish professionally within the next five years?
I want to continue my work in the educational research space, specifically focused on clinical reasoning and high-value care. I am currently pursuing my PhD in Health Professions Education at Maastricht University in the Netherlands, and my research is focused on management reasoning. My aim is to explore how learners develop management reasoning in medical school and residency with the goal of informing educational initiatives, ultimately leading to improved patient care outcomes. I also look forward to mentoring others in my group to support their ongoing success as academic hospitalists.
5. Can you share a brief (and anonymous) patient encounter or professional situation that made you proud to be an Internal Medicine physician?
Absolutely. I recently cared for a patient with cirrhosis due to autoimmune hepatitis. She was admitted for worsening jaundice requiring procedural interventions and eventually transplant evaluation. It was an honor to discuss the risks and benefits of multiple treatment options with this patient and her loving partner. Sticking with the theme of complexity—due to a number of social and economic factors, including their unique living situation—the management plan was anything but straightforward. I enjoy, and take seriously, the responsibility to consider evidence-based management options in the context of patient preferences, navigating system barriers to provide high-value care. We also discussed a multifaceted plan for follow-up after discharge including contingency planning were she to become sicker. Thankfully, this patient and her partner have stayed in touch following discharge.