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Mark J. Ault, MD, Receives Master Clinician Award

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Mark J. Ault, MD

Mark J. Ault, MD, recalls a day in 1990, while he was director of Cedars-Sinai's Ambulatory Care Center, when his chief of medicine asked him and a colleague if they could start putting PICC lines in patients.

Their reply: "OK. What’s a PICC line?"

PICC lines—long, thin tubes, or catheters, inserted into a vein in the arm to do such things as provide chemotherapy or antibiotics over extended periods—still were new then. But Ault and his colleague figured out what to do, and put four into patients that first year.

That marked the beginning of Cedars-Sinai's Procedure Center, which now handles thousands of cases a year, involving PICC lines as well as other diagnostic and therapeutic procedures for patients from all over the medical center.

It also marked an important professional turn for Ault, a 41-year Cedars-Sinai veteran who on Oct. 14 was presented with the institution's inaugural Master Clinician Award.

The new award was created to recognize a candidate who has made "a substantive contribution to patient care at Cedars-Sinai," as well as contributions "recognized at a national level by specialty societies or specialty boards." It also calls for candidates to have demonstrated "community activism and educational efforts that advanced healthcare and the wellbeing of the Cedars-Sinai community."

In her letter nominating Ault for the award, Teryl Nuckols, MD, MSHS, director of the Division of General Internal Medicine, said "physicians have come to count on the fact that they can order a procedure and have it performed within only a few hours in most cases. Truly, without Dr. Ault and the others on the team, the flow of patients through Cedars-Sinai would practically come to a halt."

Nuckols' letter mentioned that the center "started small as an approach to avoiding complications including injuries due to misplaced lines, infections, perforations of the bowel, bleeding, etc." The result of the Procedure Center's performance, Nuckols said in comments prepared for the award presentation, is that complications at Cedars-Sinai have been reduced "to only a tiny level" compared to rates documented elsewhere.

"Patients adore him, and as an educator he is revered," she wrote. Nuckols noted that Ault has won the Circle of Friends Recognition award seven times, a Standing Ovation for Quality Service eight times and the Golden Apple Teaching Award twice.

In the nomination letter, Ault also was cited for being "instrumental" in opening a pioneering AIDS unit at Cedars-Sinai in the early 1980s.

Ault, who grew up in small-town Sewickley, Pennsylvania, near Pittsburgh, came to Cedars-Sinai as an intern in 1978 and has remained with the institution ever since. Over the years he has held an array of leadership roles, including director of the Procedure Center and of General Internal Medicine, where he remains a staff physician and proceduralist.

These days, he is spending more time in direct patient care. In the most recent fiscal year, Ault performed 6,564 procedures—more than half of the Procedure Center's total of 11,745.

"The Procedure Center really is my pride and joy,"Ault said.

He said he was inspired in that direction while a student at the Mount Sinai School of Medicine in New York in the 1970s. He witnessed the deft way a physician performed a paracentesis, a removal of fluid from an abdominal cavity, on a patient badly suffering from liver disease.

"It just struck me at the time how an experienced doctor and a decisive procedure can make such a huge difference in a quick way. And that sort of stuck with me forever," Ault said.

From there, Ault said, he continued "to migrate toward things that allowed me to do procedures—for instance, the ICU and the emergency department. And then when the opportunity came to develop a procedure center, that was the icing on the cake."

And what's kept him at Cedars-Sinai for so long?

"Two things," Ault said. "One is the role models. Everything I've done—whether it's been critical care, emergency medicine, ambulatory care—I've had good role models to lead the way. The science of medicine, you can learn by reading, but the art of medicine, you've got to learn by watching your role models and adopting the nuggets that they can show you."

The second factor, he said, "was opportunity. I almost couldn't think of another place where I could do the things that I've done over time to get to my role at the Procedure Center. And so, somehow or another, I've lasted for 41 years."