February 27, 2020
Daniel Giesler, MD, Assistant Professor in the Division of Hospital Medicine, is a hospitalist who provides care for patients in the hospital setting. In addition to his clinical work, Dr. Giesler also performs research, primarily focused on quality improvement, and is actively involved with teaching and passing on his knowledge and lessons learned to residents and medical students. Dr. Giesler also has a Doctor of Pharmacy (PharmD) degree, giving him a unique perspective and a well-rounded expertise in all areas of his work, whether he's treating patients, conducting research, or teaching students.
Behind the Scenes with Dr. Daniel Giesler
What is your research about?
My research is in the area of quality improvement. Specifically, we are studying the role of antibiotic stewardship at the time of hospital discharge as a means to reduce antibiotic overuse. Our intervention includes the use of educational tools for physicians, as well as pharmacist-led checklists, prior to discharge.
The current project I am working on, “Reducing Overuse of Antibiotics at Discharge (ROAD) Home”, is going very well. The intervention period has come to an end. Our preliminary data has found the pharmacist-led antibiotic timeout to be feasible, acceptable, and changed prescribing in 18% of patients. We also found that the intervention led to improved documentation of antibiotic choice in discharge summaries. Next steps include expanding the intervention to other services and evaluating the intervention’s effect on total antibiotic duration.
I will be presenting preliminary findings from this study and also a clinical vignette at this year’s Society of Hospital Medicine (SHM) Annual Conference that is taking place in San Diego, California.
Why are you interested in this area of research?
Given my prior career as a clinical pharmacist, I am interested in promoting antibiotic stewardship, as well as utilizing interdisciplinary means to optimize its role in the hospital setting.
Prior work I have done included systematically reviewing the appropriate use of antibiotics to treat hospitalized patients with community-acquired pneumonia, resulting in two peer-reviewed articles published in the Journal of the American Medical Association (JAMA):
- “Duration of Antibiotic Therapy for Community-Acquired Pneumonia in the Era of Personalized Medicine”
- “Antibiotic Therapy for Adults Hospitalized with Community-Acquired Pneumonia - A Systematic Review”
Why did you decide to switch from a career in clinical pharmacy to clinical medicine?
Completing a pharmacy residency in Syracuse, New York and then subsequently working as a pharmacist in the Neurological ICU at Brigham and Women’s Hospital in Boston introduced me to the world of clinical medicine. I loved being part of an interdisciplinary team of providers taking care of patients, though, in time I yearned for a more complete understanding of each patient’s care. I also grew increasingly interested in direct patient care and seemed to derive most satisfaction from patient encounters. Eventually, this led to my decision to pursue medical school followed by internal medicine training.
How do you spend your day at the hospital?
As an internal medicine provider in the Division of Hospital Medicine, I spend my clinical time divided between the Medical Short Stay Unit, the Michigan St. Joe's Service, and the teaching wards at the University Hospital. In each of these roles, I work to varying degrees in multidisciplinary settings which include advanced practice providers, nurses, case managers, social workers, residents, and medical students to collaborate with and care for hospitalized patients.
What accomplishment are you most proud of?
Professionally, I am most proud of being selected for the 2019-2020 Department of Internal Medicine Quality Improvement Award for the "ROAD Home" project we talked about earlier. This honor allowed me to refine my skills in quality improvement, learn from strong mentors within the department, utilize my prior training as a pharmacist, and engage in something I find impactful for patient care.
Is there a moment when you knew you had chosen the right career?
Shortly after joining the Hospital Medicine Division at the University of Michigan, I took care of a patient who had undergone a sequence of unfortunate events which ultimately left her fairly debilitated. Despite her misfortune, as well as being far from home and still needing extensive rehabilitation, she would actively tell herself to “get rid of that stinkin’ thinkin’”. Her optimism and wholehearted trust in the system was a reminder to me of the privilege we have in taking care of patients. I now find myself frequently evoking her simple motto.
How do you balance your work and personal life?
In order to have a thriving and sustainable work life, I have to be intentional with my personal life. My wife and I have dinner together every night without phones or computers to distract us. This gives us time to discuss our days and communicate with each other about things in our personal lives. We function as a team and without her wisdom and support we would not be where we are today. When I am not doing clinical or research-related work, I am dabbling in house projects, mountain biking, snowboarding, reading fantasy novels, listening to financial podcasts, or going on adventures with my wife and our French bulldog.
What five words best describe you?
Inquisitive, reliable, persistent, tolerant, and grounded.