Recent Articles
OB hospitalist programs: What the field has to say
I did an interview with Rob Olson, MD, an OB hospitalist practicing in Spokane, WA, to follow up on “Four tips for an effective OB hospitalist program” in the November issue of Hospitalist Leadership Advisor, a supplement to Medical Staff Briefing. Olson is the administrator and moderator of http://obgynhospitalist.com.
Susan Rutherford, medical director or Women’s and Children’s Services at Evergreen Healthcare in Kirkland, WA, also chimed in with her thoughts. I’d love to hear yours, too!
LJ: How is operating an OB hospitalist program different than a traditional internal medicine hospitalist program? Are there any special considerations?
RO: There are many similarities in all hospitalist programs. The differences between internal medicine (and for that matter, pediatric) hospitalists and OB hospitalists are that OB hospitalists perform surgery, have more urgent and emergency patients, have more consultations from family practitioners and midwives, and overall request fewer consultations from other specialists.
Hospitalist with a capital “H”
By Richard Rohr, MD, MMM, FACP, FHM
I worry a bit about the self confidence of recently trained hospitalists. When I started my first program, it was in a small hospital that had a good range of consultants, but most of them were located primarily at larger hospitals and were not always available for immediate consultation. Under those circumstances, we stretched ourselves a bit and handled a wide variety of problems, including critical care, on our own.
I consider myself an Internist with a capital I, because I am willing to manage all types of adult medical problems, with judicious use of consultants and liberal use of references such as UpToDate. Some physicians enjoy practicing in rural areas because it gives them the opportunity to use skills and perform procedures that are reserved for subspecialists in urban areas. I spent a year in a rural hospital with hardly any consultants but still managed to care for a lot of problems on my own.
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Cartoon: October 2009
"...And spellers!" (Illustration / HCPro, Inc.)
If you’d like more, click on the tag, “Cartoons” for our illustration archives.
Recruitment tip: Engage in the wrap-up discussion
The goal of each interview is for the candidate to leave wanting the job. That puts the power of the recruiting process in your practice’s hands.
Remember to allow time at the end of the interview to ask the candidate about his or her impressions of your practice. Establish a timeline for follow-up procedures, including the final decision date. Your practice might want to reach a decision on the candidate within 24 hours of the interview, but if the decision can be reached before the candidate leaves, that is even better.
Also, use this wrap-up discussion time to correct any false impressions the candidate might have received during the interview. It is good to ask some closing questions during this time, such as the following:
- Can you see yourself living and working here?
- Are you concerned about anything you saw or heard?
- Did this interview accomplish your goals?
- How do we stack up in your mind?
The above excerpt is adapted from Practical Guide to Hospitalist Recruitment and Retention by Kirk Mathews, MBA, foreword by John Nelson, MD, FACP, FHM, published by HCPro, Inc, in Marblehead, MA.
Tool: Sample surgical hospitalist clinical responsibilities
We've heard from readers that you would like to see more forms, policies, and tools. You asked, and here it is!
Because the clinical role of a surgical hospitalist, or “surgicalist,” vary from one setting to the next, we are including a sample job description. Remember, the duties are typically listed in employment contracts and maintained in the practice policy and procedure manual, which the hospital updates periodically.
News round-up: ABFM and ABIM pilot certification for hospitalists
The American Board of Family Medicine (ABFM) and the American Board of Internal Medicine (ABIM) this month jointly announced the pilot program, Recognition of Focused Practice (RFP) in Hospital Medicine.
After years of speculation on the details, the RFP in Hospital Medicine is the “first customized maintenance of certification pathway,” according to an October 10 ABFM press release. The RFP criteria will include ABFM- and ABIM-developed tools targeted at hospitalist practice-based learning.
The RFP in Hospital Medicine pilot program is expected to start in the fall of 2010 and continue for three years, according to the press release.
Find a list of news stories from around the Web below:
- Wachter’s World: Board certification for hospitalists: It’s Heeeere!
- The Hospitalist: HM’s watershed moment
- Hospitalist Leadership Connection: All board certification equal, study says
- HospitalistLeadership.com: Blog discussion
And don’t forget to check out the December issue of Hospitalist Leadership Advisor, supplement to Medical Staff Briefing, where we will be covering RFP certification in detail.
Recent physician recruitment survey
Merritt Hawkins & Associates recently released their 2009 Review of Physician and CRNA Recruiting Incentives report and revealed some interesting, but not particularly surprising, trends. This review is based on the physician and CRNA search assignments that Merritt Hawkins & Associates conducted during the 12-month period from April 1, 2008 to March 31, 2009. I look at some of the numbers with a bit of skepticism since this is totally a report of its own internal data. However, it does seem to affirm some trends that are evident in the marketplace. Here are some highlights of interest to hospitalists:
Great demand for hospitalists!
Hospitalists are third on its list of most sought after physicians, right behind family practice, which is number one by a long shot, and number two, internal medicine. The report correctly points out that since many internal medicine physicians are pursuing hospitalist positions, the demand for traditional internists is on the rise. Personally, I am of the opinion that the practice of traditional (outpatient and inpatient) internal medicine faces possible extinction over the next 10 years or so.
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Physician executives earn more money with business degrees
Cejka Search, a healthcare executive and physician search organization, recently released its annual Physician Executive Compensation Survey for 2009. Based on a survey of members of the American College of Physician Executives, this group is seeking business degrees; one-third of physician executives (33%) possess an MBA, MMM, MPH, or MHA.
Physician executives are also earning more based on their degrees. For example, they earned more compared to those who didn’t have a post-graduate degree:
- An average of 11% more with an MBA
- An average of 10% more with an MHA
- An average of 8% more with a MMM
"Healthcare organizations are now mandating advanced business degrees in conjunction with strong clinical expertise for their physicians in executive leadership positions," said Lois Dister, executive vice president and managing director with Cejka Search's Executive Search Division in a Cejka press release.
Compare the 2009 results to the 2008 results on blog posts on HospitalistLeadership.com from Cejka Search Manager of Industry Research and Publications Nancy Burns, MBA.
How to improve handoffs
Communication is key to hospitalist handoffs, according to a new study, “Hospitalist handoffs: A systematic review and task force recommendations,” published in the September issue of the Journal of Hospital Medicine.
Researchers from the University of Chicago made recommendations during the handoff period in which patient safety is sometimes at risk. They found that best way to communicate information during service changes is a verbal handoff with written documentation. The documentation should be in a structured format or through electronic means. Communication should be refreshed daily with the latest clinical information, according to the study.
Geriatrician-hospitalist model cut costs and LOS
A collaborative consultation model between geriatricians and hospitalists can help improve the care of older hospital patients with acute illness, according to a new study, “Development and Implementation of a Proactive Geriatrics Consultation model in Collaboration with Hospitalists,” published in the September issue of the Journal of the American Geriatrics Society.
Called the Proactive Geriatric Consultation Service, hospitalists, geriatricians, and nurse practitioners at Indiana University worked together to consult on cases early during the hospital stay. They focused these consultations on functional and psychosocial issues.
Researchers found that the geriatrician-hospitalist model reduced length of stay and cut hospital costs. In addition, most hospitalists (96%) rated this model as excellent and believed it to improve the care of the patients.
Plan for interdisciplinary morning rounds
During a patient's hospitalization, it's imperative that the hospitalist remain in continuous contact with the treatment team through interdisciplinary morning rounds. That involves appropriate nursing staff, social services, discharge planners, physical/speech/occupation therapists, and pharmacy staff, among others.
You can use the following best practices when establishing interdisciplinary morning rounds:
Leadership essential to preventing medical errors, says Joint Commission
We all know that good leadership can help the physicians that medical staff leaders work with everyday, but now, The Joint Commission says that effective leadership can prevent medical errors, in an Aug. 27 Sentinel Event Alert.
Healthcare leaders, including chief executives and senior managers, are the ones who should promote a culture of safety, according to the alert.
Inadequate leadership can cause 50% of medical errors, according to a 2006 Joint Commission alert.
The new alert includes a 14-step process to prevent medical errors and recommendations to follow accreditation standards.
“Leaders must recognize that all sentinel events involve a failure in the systems and processes which led to the event,” said Jeff Selberg, CEO of Exempla Healthcare, in the alert. “As leaders, we are accountable for those systems and processes which provide the framework for the clinical environment our staff works within.”
How has your organization's leaders shaped better patient care? Comment below.
