All Entries Tagged With: "hospitalists"
The link between hospitalists and quality
A recently study shows that hospitalists improve the quality of care delivered in hospitals, but do they really improve the care? That’s the question being asked on The Wall Street Journal Health Blog. (Be sure to read the comments below the original post for perspectives from the field, too.)
The Archives of Internal Medicine published study finds that these practitioners “may contribute to improved quality of care for patients with common inpatient diagnoses.” But critics are quick to point out that hospitalists typically work at large, academic medical centers and there may be other reasons for the high quality delivery of care at those organizations.
Does your hospital employ hospitalists? If so, how well do they interact with the rest of the medical staff? Do you think they contribute more to quality care than medical staff members?
Check out our Hospitalist Leadership blog for more hospitalist news. http://blogs.hcpro.com/hospitalist
State hospitals layoff MD staff, could private hospitals do the same?
New Jersey state mental hospitals have laid off 16 doctors in order to fix budget gaps, according to the state Department of Human Services. Typically, hospitals do not have the authority to layoff members of the medical staff because most are not directly employed by the hospital. However, some practitioners, such as hospitalists and contracted physicians, are direct hospital employees.
Does this mean MD layoffs can become a common occurrence at private hospitals, as well?
Only time will how common the occurrence becomes, but some private hospitals have already made medical staff cutbacks. “It can happen anywhere and unfortunately there’s a perfect storm because you’ve got decreased Medicare/Medicaid reimbursement, you’ve got increasing bad debt, you’ve got the economic melt down of many hospital’s investments,” says Jonathan H. Burroughs, MD, MBA, FACPE, CMSL, Senior Consultant at The Greeley Company, a division of HCPro, Inc., based in Marblehead, MA. “Almost every hospital in the nation is facing budget shortfalls and budget cuts and one of the expenses on the ledger is physicians’ compensation.”
The growing number of hospitalists
Like many of you, I enjoyed the piece on NPR yesterday by Douglas Kamerow, MD, on the pros and cons associated with the increase in the number of hospitalists across the country. Kamerow cites one recent University of Texas study which found that the number of hospitalists in this country is growing at a rate of nearly 30 percent per year. I wonder if you’re seeing that kind of growth at your facility.
Kamerow, a family physician and former assistant former general, reports that the drive for efficiency is largely responsible:
Since hospitals generally get paid one fee for each hospitalization, they want to get patients home as soon as possible. They have found it’s more efficient to have doctors in the hospital all the time to make decisions and move things along, rather than waiting for your doctor to make rounds once a day. Also, since payments for primary care doctors have gone down, they need to see more and more patients in their offices in order to make a living. Going to the hospital every day cuts into that time and isn’t very cost-effective if they only have a few hospitalized patients.
But Kamerow also notes that there are downsides to this trend because of the communication challenges that can exist between the hospitalist and the patient’s own physician.
Click here to read the story or to hear a replay of the segment.
Todd Morrison
Managing Editor
Battle of the boards – are all created equal? (cont’d)
The American Board of Internal Medicine (ABIM) recently took a stance on what it views as “phony” certification boards, stating that it is concerned about the welfare of patients who may be misled by physicians who display their board certification as being equivalent to the American Board of Medical Specialty certification programs. Although the American Board of Hospital Medicine (ABHM) was not identified specifically, the ABIM mentioned “hospital medicine” as one of the certification groups that may be “fraudulent”.
New board for hospitalists
Today’s news release from the American Board of Physician Specialties revealed the new American Board of Hospital Medicine. This new board certifies physicians who practice in an inpatient setting and meet the criteria listed in the eligibility Requirements. Most MSPs are familiar with American Board of Medical Specialties and American Osteopathic Association Boards. However, it would be worth a discussion at your next Credentials Committee to discuss whether or not certification by the American Board of Physician Specialties would be recognized.
What seems to be an element of controversy is the requirement for completion of a residency program approved by the Accreditation Council of Graduate Medical Education or the American Osteopathic Association, or the College of Family Practice of Canada, or the Royal College of Physicians and Surgeons and deemed acceptable to the American Board of Hospital Medicine. Unlike the ABMS Board, there is less stringency with the type of residency required. For example, the American Board of Internal Medicine requires completed residency in Internal Medicine. I’ve heard comments from Board certified physicians that the American Board of Physician Specialties is not as discerning as the ABMS Boards.
It is interesting that another eligibility requirement could be current board certification in Family Practice, Internal Medicine, or Emergency Medicine by ABMS, ABPS, or AOA. (www.abpsga.org/certification/hospital_medicine/eligibility.html)
This topic may spark some interesting discussion among the physician leaders at the next Credentials Committee or Medical Executive Committee.
Carole La Pine, MSA, CPMSM, CPCS