Hospitalist Locum Tenens Fight the Flu: Four Tips to Reduce Risk

With most of the US still reporting elevated influenza activity, we asked our Chief Medical Officer, Robert Harrington, MD, SFHM, to offer his view of this year’s flu season and his advice for locum tenens, many of whom will be working in facilities with increased patient volumes because of the flu.

“Hospitals are using more locum tenens during the winter to manage the increase in patients with respiratory concerns,” says Harrington, a practicing Hospitalist who also works periodically as a locum. “If you’re a physician who works in a hospital, you generally understand that you will be exposed to the flu—it’s an accepted occupational hazard.”

While doctors accept this risk, they can also take steps to mitigate their exposure, says Harrington.  His tips:

  1. Wash Your Hands:  A seeming no-brainer, but studies show compliance with hand washing policies among healthcare workers is low. If you’re new to a facility, Harrington says take time on day one to note the locations of hand-washing and hand sanitizing stations. In addition to washing your hands both before and after you enter a room, carry around some germ-fighting lotion for extra protection.
  2. Find a mask:  This flu season, hospitals are increasing their vigilance on mask policies and adding mask stations for staff and patients. Know where to find masks in your facility and familiarize yourself with the hospital’s policies on mask-wearing.
  3. Get a Flu Shot:  Locum physicians must adhere to the employee health policies of the hospital they’re working at, and most hospitals now require the flu shot.  Vaccination records, of course, are standard for credentialing. While some healthcare workers refuse the shot annually (and face disciplinary action as a result), Harrington says most doctors comply unless they have a known contraindication, such as an allergy to the vaccine.
  4. Keep Yourself Informed:  Use the CDC website, to follow flu outbreaks and severity throughout the United States. As a locum tenens, it’s helpful to know the current status of the flu in an area where you’ll be working.

National Survey: More Hospitalists Working As Locum Tenens

Download a copy of the complete survey results.

A new national survey of Hospitalists shows more are working as locum tenens and an even larger percentage are pursuing locum tenens as a full-time career.

The findings come from a new survey of Hospitalists regarding their locum tenens work patterns. For the second consecutive year, the survey was conducted for Locum Leaders, a national locum tenens company specializing in Hospital Medicine, in conjunction with Today’s Hospitalist magazine.

11.6% of this year’s respondents said they had worked as locum tenens (a Latin term describing temporary, contracted health care providers) within the past 12 months. Of the locum tenens respondents, 14.5% said they were working full-time as a locum tenens provider.

These are increases from 2011 when 10% of all hospitalists reported working as locum tenens, and 10.8% of locum tenens Hospitalists said they were full-time locums.

Growing client demand for temporary hospitalists means there are more opportunities to work as a locum tenens. And those opportunities are also more lucrative, according to Robert Harrington, MD, SFHM, a practicing Hospitalist and the Chief Medical Officer of Locum Leaders.

“Industry data show that hourly pay rates for locum tenens Hospitalists have increased almost 20% over the past two years. I think that’s a big reason why there are more locum tenens in the specialty and more doctors who are willing to self-employ and work full-time in locum roles,” said Harrington.

This year’s survey, for the first time, asked Hospitalists about social media usage. 60% of respondents said they used Facebook, 23% reported using LinkedIN, and 7% had used Twitter. The results, which mirror consumer adoption of these sites, aren’t surprising to Dr. Harrington.

“Hospital Medicine is a newer specialty that skews toward younger physicians who are open to the use of social media.” he said.

Another sign of growing social media adoption: 8% of Hospitalists in the survey said they had used social media in a job search to browse job ads, reply to a recruiter or to network with others about employment opportunities. Hospital Medicine is the nation’s fastest growing medical specialty and Hospitalists are the number one locum tenens hiring need at U.S. hospitals.

Critical Care Training Course for Hospitalists

Locum Leaders offers a two-day critical care training course for locum tenens hospitalists. Physicians earn CME credit and improve and learn new skills allowing them to provide better patient care.

Hospitalist Recruitment Through Video

New hospitalist locum tenens jobs.

Survey: 10% of Hospitalists Work as Locum Tenens

A new national survey of Hospitalists shows one in ten working as locum tenens and doing so, for the most part, in addition to full-time employment.

The findings come from a first-ever survey of Hospitalists regarding their locum tenens work patterns. The survey was conducted for Locum Leaders, a national locum tenens company specializing in hospitalist jobs, in conjunction with Today’s Hospitalist magazine.

The survey found that 10% of respondents worked as locum tenens in the past 12 months. Of those Hospitalist locum tenens, 82% said they were employed full-time and also working as a locum. 11% said they were self-employed?working exclusively as a locum tenens hospitalist, while 7% said they were employed part-time and also working locum tenens assignments.

It is common for locum tenens physicians to be drawn from the ranks of salaried doctors. But employed hospitalists, even more than other specialists, may be more inclined to take on locum work, according to Robert Harrington, MD, SFHM, Chief Medical Officer of Locum Leaders.

“Hospital Medicine shift patterns are the biggest reason,” said Dr. Harrington. “Since most hospitalist programs rely on a 7-on, 7-off schedule, you end up with a large population of doctors who have a lot of time-off. They want to use that time productively and so they come to agencies, like Locum Leaders, for additional work.”

Age and financial goals may also play a role, according to Dr. Harrington. As a relatively new specialty, Hospital Medicine skews toward younger practitioners. Because younger doctors have a larger student debt burden, they are more likely to seek supplemental income sources.

The survey supports Dr. Harrington’s contention. Of the Hospitalists who had worked as a locum within the past year, 77% cited “compensation” as a primary motivation.

Hospital Medicine is the nation’s fastest growing medical specialty, and Hospitalists are the number one locum tenens hiring need at U.S. hospitals. A total of 750 Hospitalists responded to the survey.

Click here to download complete survey results.

Do Hospitalists Reduce Costs or Merely Shift Them?

A new study in the Annals of Internal Medicine suggests that cost-savings associated with Hospital Medicine care may be offset by increased costs associated with readmissions and ER visits. The analysis from researchers at the Sealy Center on Aging at the University of Texas Medical Branch, Galveston looked at five years of Medicare admissions from 2001 to 2006.

As reported in  Modern Healthcare:  The study found that “patients cared for by hospitalists had 0.64 of a day shorter average length of stay (5.17 days compared to 5.82) and their charges were $282 lower ($15,019 vs. $15,301). But the researchers said Medicare costs for these patients were $332 higher 30 days after discharge ($3,279 vs. $2,947).

Also, the hospitalist-seen patients were less likely to be discharged to home or have an appointment with a primary-care physician and more likely to have an emergency department visit.

“Hospitalists, who typically are employed or subsidized by hospitals, may be more susceptible to behaviors that promote cost shifting,” concluded the study authors.

The increased costs associated with readmissions and ER visits total $1.1B in added costs to Medicare annually. That figure is creating a slew of negative headlines for Hospitalists, like this one from Fox News:  Hospital-based Doctors Behind Surge In Medicare Spending, Study Finds.  

Non-clinical Skills Important for Hospitalists

Being a great hospitalist goes beyond being just an excellent clinician. While clinical skills remain the most important, there are many non-clinical skills that are essential for every hospitalist.

Leadership: Though not every hospitalist is or will be a medical director, leadership skills are still important. Hospitalists are responsible for their patients from admission to discharge, so effectively managing the care they receive, along with those who administer it, is crucial. The Society of Hospital Medicine (SHM) offers a specialized Leadership Academy just for hospitalists, focusing on the unique challenges they face in their field. Three levels of this course allow participants at all levels to develop their skills and bring them back to their institution.

Communication: This is a critically important skill for every hospitalist. There’s only a short period of time to establish a relationship with a patient and their family. Being able to effectively communicate with them about the patient’s condition, procedures and expectations, is essential in building rapport quickly and establishing trust. Additionally, the hospitalist is in constant communication with internal team members, as well as the patient’s primary care physician. Effective communication regarding a patient’s condition helps to reduce both error and confusion.

Teamwork: This goes hand-in-hand with effective communication. Because hospitalists work with such a variety of people on the patient care team, effective teamwork is crucial. This isn’t necessarily something that’s taught in medical school, but members of the team should always work together with the patient in mind. Everyone is working towards the same goal and everyone’s strengths should be recognized and put to good use.

Quality Improvement: Hospitalists tend to be leaders in the area of healthcare quality improvement. Health care is in a constant state of change and always in need of improvement, and hospitalists are uniquely positioned to lead a number of QI efforts for inpatients. SHM also offers numerous ways for hospitalists to get involved in QI projects.

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