As a part of our “Meet Yale Internal Medicine” series, today’s feature is on Michelle Hughes, MD, assistant professor of medicine (digestive diseases).
Michelle Hughes, MD, assistant professor of medicine (digestive diseases), comes from a long line of doctors. This family legacy of patient care informs her work every day.
“My grandparents were both quintessential country doctors, like out of a Norman Rockwell painting. They were phenomenal diagnosticians, and patients loved them,” she said. “Even though my work looks very different from theirs, I share their philosophy of wanting to do as much good for my patients as I can.”
Hughes joined Yale five years ago after completing her gastroenterology fellowship at the University of Rochester Medical Center. She came to Yale to start a gastrointestinal (GI) hospitalist program at the Yale New Haven Health System.
Six months after she arrived, the COVID-19 pandemic hit.
“The pandemic ended up providing a kickstart to my work at Yale. It was such a unique position to be in,” she said. “Ultimately, it helped me build a network focused on change and helped solidify why a GI hospitalist can be so important to quality, safety, and patient care.”
As a GI hospitalist, Hughes provides inpatient care for people with acute GI conditions, like GI bleeding, inflammatory bowel disease, nutritional disorders, and GI malignancies. She says the dynamic and fast-paced nature of the role has been professionally satisfying.
“Endoscopically, you get to be very innovative. You're in very challenging situations. My patients are very ill, but I can often help them get immediate results,” she said.
GI hospitalist programs are a relatively new concept. Hughes has led the charge to increase collaboration and spearhead research about how GI hospitalists impact patient care, and she speaks about this around the country. She co-led the first national conference focused on inpatient gastroenterology and, alongside Melissa Latorre Debordeaux, MD, at NYU Langone, started a special interest group at the American Society for Gastrointestinal Endoscopy (ASGE) for GI hospitalists. In June 2024, she published a paper in iGIE with her colleagues showing that a GI hospitalist model increases inpatient and outpatient endoscopy procedures.
“I happened to find my way into a niche that didn’t exist a few years ago,” Hughes said. “I have enjoyed growing and defining this role along the way.”
Hughes also has helped build and maintain the quality and safety infrastructure for the medical side of the Digestive Health service line and currently leads several quality and safety initiatives at Yale New Haven Health System and the Yale School of Medicine. As co-chair of the Digestive Health Care Signature Council, she has also helped create several pathways through a combination of process improvement and care standardization to improve patient care.
“If I come across something broken, I can’t sit still and not try to fix it,” she said about her quality and safety work.
Education is a key element that exists regardless of whether she is working in her role as a GI hospitalist or in one of her roles in Quality and Safety. She co-leads both the Health Equity, Patient Safety and Quality Improvement (HEPSQI) Distinction Pathway through the Office of Graduate Medical Education and the Quality Improvement, Patient Safety, and Leadership (QIPSL) Distinction through the Department of Internal Medicine. She also has developed and runs the annual quality and safety curriculum for the Digestive Disease fellows and serves as a mentor for trainees at all levels of education.
If I come across something broken, I can’t sit still and not try to fix it
Michelle Hughes, MD
Hughes is especially proud of her work revamping the section’s Mortality and Morbidity Conference (M&M), another way she combines her clinical and quality work. After reviewing the literature and consulting with other specialties and hospitals nationwide, she developed a structured approach to help teach fellows and faculty how to constructively analyze cases and successfully utilize improvement concepts to drive change.
“Adverse events happen, but the last thing you should do is avoid talking about them,” she said. “I create a safe space to encourage conversation so that we learn from errors, make positive changes, and continue to improve.”
A few years ago, Hughes found herself on the other side of the medical system after being badly impacted by COVID-19. The experience, she said, changed her perspective on being both a patient and a provider.
“I feel for patients who are encountering the health care system,” she said. “The U.S. health system is hard to navigate, even if you are a well-informed patient with high health literacy and all the resources in the world. When you add in other barriers, it can be nearly impossible.”
Hughes said this experience has only fueled her desire to make systemic changes.
“There’s a lot of room to improve how we care for patients,” she said. “I spend my days caring for individual patients in life and death situations, and then use my quality and safety influence to fix a system that is not always perfect.”
Since forming one of the nation’s first sections of hepatology more than 75 years ago and then gastroenterology nearly 70 years ago, Yale School of Medicine’s Section of Digestive Diseases has had an enduring impact on research and clinical care in gastrointestinal and liver disorders. To learn more about their work, visit Internal Medicine: Digestive Diseases.