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CA faces AHP shortage

The average non-nursing allied health professionals (AHP) faces a vacancy rate of 4.4%, according to a February 9 California Hospital Association (CHA) report, “Critical Roles: California’s Allied Health Workforce.” Out of 111 survey respondents, the occupation that have the highest vacancy rates are physical therapists (7.8%), cardiovascular and interventional radiology technologists (6.8%), medical lab technicians (6.3%), and MRI technologists (6.2%).

The CHA Healthcare Workforce Coalition, created in 2007, conducted the study looking at AHPs and found that the five largest occupations are respiratory therapist, pharmacist, pharmacy technician, radiological technologist, and clinical lab scientist. Together, they make up more than three-quarters of the non-nursing AHP workforce.


Practice creep or value opportunity?

As hospital medicine continues to grow and demonstrate a positive impact on the nation’s healthcare delivery system, hospitalists are being asked to provide a greater variety of services. In some circles, this is known as the dreaded “practice creep,” but, in others, some of these services are viewed as an opportunity to add value to the hospital and local healthcare system, which, in turn, can lead to increased compensation. At my company, we have experienced both the good and the bad of this multi-faceted topic.
Here are some things to consider when administration comes knocking with a request for expanded services:

  • Is the current program staffed appropriately?
    If the current program is understaffed for the current workload and acuity, be prepared to articulate and defend the current staffing needs, explaining why more staff are needed to cover the current load. When administrators request expanded services, it’s a good time to revisit the current staffing model.


Policy: Determining the need for on-call backup

Readers have been sending in requests for more free policies and tools. We've listened. Here is one sample policy from our books.

Policy: The [name of hospitalist service] will use staffing patterns aimed at maximum use of provider resources adjusted to patient census and/or acuity of illness. If a decrease in on-site provider resources is needed, the following will be used to make said adjustments.

Purpose: To facilitate access to the [name of hospitalist service] by assuring the availability of adequate resources to meet patients’, families’, and referring providers’ needs while providing safe, efficient quality care.


Economic downturn not over yet

St. Vincent’s Hospital Manhattan recently laid off 300 employees, including 32 residents, managers at all levels, dietary workers, transporters, and housekeeping staff, according to The New York Times. Although hospitalists are in high demand across the country, stories like this make you ponder your job security and just how far you would go to keep your hospital afloat. As a hospitalist or hospitalist program director, would you take a 25% pay decrease, as many St. Vincent employees have been asked to do?

In an April 2009 PBS report, Paul Levy, CEO of Beth Israel Deaconess Medical Center, described how, when his hospital was facing layoffs, he asked everyone to share the pain. To his surprise, hospital and medical staffs embraced the idea. “I said to the staff, ‘I’d really like to avoid layoffs to the extent possible because it’s a hard time for people to get jobs, and many people’s spouses have already lost their jobs, and we don’t want to put folks through that…In addition, I said to them, ‘I’d like to do what we can to protect the low-wage earners in the hospital, the housekeepers, the transporters, the food service workers, who face a particularly hard time just because of their income level,’ and the response from people was overwhelmingly positive,” Levy said.

How to figure out the right number of hospitalists

calculator-13Initially, many primary care physicians (PCPs) resisted having a hospital-based physician care for their patients because of concerns about discontinuity in patient care and lower patient and family satisfaction. However, since then, proponents of the hospitalist model cite two major benefits: increased quality of care and greater efficiency.

Many hospitals now want to know how many hospitalists they need. One approach is to calculate hospitalist need as a percentage of adult primary care need. Many hospitals determine the need for PCPs by geographic subarea by dividing their primary or primary and secondary service area into directional subsets (e.g., southeast, northeast, central, or west). Other hospitals define a smaller core service area in the immediate vicinity and a set of surrounding subareas that complete its primary or primary and secondary service area. However it is defined, the hospital’s effective service population for primary care in each geographic subarea is determined solely by its market share in the subarea.