Survey: 10% of Hospitalists Work as Locum Tenens

October 11, 2011 Leave a Comment

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.

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Do Hospitalists Reduce Costs or Merely Shift Them?

August 3, 2011 Leave a Comment

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.  

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Specialty Hospitalists Gain Traction

May 3, 2011 Leave a Comment

The role of the specialty hospitalist has been gaining momentum in recent years. Just last month, The Hospitalist reported the addition of the first otolaryngology hospitalist to the faculty of the University of California at San Francisco’s staff. And these “hyphenated hospitalists,” as Robert Wachter, MD calls them, are springing up around the country.  

Here’s a quick guide to some of the more common specialists that also wear a hospitalist hat:

Neurohospitalist: Many hospitals, particularly those with dedicated stroke centers, are adding neurohospitalists to their staff. Not only are they able to handle complex cases quickly, but hospitals don’t have to pay the pricey fees to bring in a neurologist on call.

Surgical Hospitalist (a.k.a. Surgicalist): These hospitalists started out as a solution to overcrowded emergency departments. They were brought in to provide timely surgical consults and get patients into surgery quickly, increasing throughput. But the concept stuck, and many hospitals are adding this position as a part of their staff.

OB Hospitalists (a.k.a. Laborists): More hospitals are moving toward using laborists. They’re able to oversee a labor until the mother’s regular OBGYN can make it to the hospital. And because they can more effectively manage tough labors and deliveries, they can reduce a hospital’s C-section rate.

Dermatological Hospitalists: These specialists are integrating themselves back into the inpatient setting after long being a predominately office-based specialty. They can be called upon for a number of cases spanning from adverse drug reactions to stem cell transplant complications.

As inpatient cases become more complex, hospitals around the country are likely to add more  “hyphenated hospitalists” in the near future.

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Hospitalists May Boost Satisfaction Scores

March 31, 2011 Leave a Comment

Press Ganey, the company whose ubiquitous quality and satisfaction survey tools are used by over half of US hospitals, has reviewed its data to measure the impact of hospitalists on patient satisfaction. The findings, published in the March 1 American Journal of Medical Quality, suggest  “that facilities with hospitalists may have an advantage regarding satisfaction” in certain areas, such as nursing satisfaction and personal issues (eg, privacy, emotional needs, response to complaints).

The authors suggest that positive scores in these areas are more broadly related to succcessful communication.  “Exploring how specific hospitalist functions influence patient satisfaction may reap rewards,” they conclude.

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Hospitalist CMO Elected to SHM Board

March 31, 2011 Leave a Comment

Robert Harrington, Jr., MD, SFHM, Chief Medical Officer for Locum Leaders, has been elected to the Board of Directors for the Society of Hospital Medicine (SHM), the leading national medical society for more than 31,000 hospitalists. His three-year term on the board will commence at the SHM Annual Conference beginning May 10th in Dallas, TX.

Long active in hospital medicine and SHM leadership positions, Dr. Harrington serves as the Chair of the SHM Family Medicine Task Force and the board liaison to the IT Core Committee. A trained family physician and Senior Fellow in Hospital Medicine, he earned his medical degree from Temple University School of Medicine in Philadelphia, PA, and completed his residency at the Medical Center of Delaware in Wilmington, DE.

Locum Leaders is one of the fastest growing physician recruitment companies specializing in locum tenens hospitalist jobs and other specialists. As Chief Medical Officer, Dr. Harrington is in charge of risk management, which includes physician credentialing and other candidate quality programs.

“It is an honor to serve SHM as an elected member of the Board,” said Dr. Harrington. “I look forward to working with my peers to advance the practice of hospital medicine and enhance our role in the delivery of high-quality patient care.”

“SHM depends on the vision and talent of its leaders,” said SHM President, Jeffrey Wiese, MD, FACP, SFHM. “I welcome Dr. Harrington to the board and look forward to working with him toward SHM’s vision of transforming healthcare.”

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Hospitalists Offer Best Guess at Patient Costs

August 10, 2010 Leave a Comment

It’s often difficult for patients to know how much they’ll pay for procedures, tests and services in a hospital, but the same seems true for their doctors.  In a recent study in the Journal of Hospital Medicine, hospitalists fared poorly in a survey assessing their knowledge of patient costs.

As reported by Karen Cheung for HealthLeaders Media, researchers “asked hospitalists how much a hypothetical unadjusted self-paying patient would be billed for commonly used services, procedures, tests, and physician charges. Out of the 26 completed hospitalist surveys, researchers found that only a tenth of them were within a 10% accuracy rate.”

For example, when asked to price an overnight stay in an ICU bed, hospitalists guessed anywhere from $750 to $6,000. Researchers put the true cost for a night in the ICU at the hospitals in their study at $1,107.

“Their guesses were not very close, in general, to the so-called ‘true price’,” says Jeremy D. Graham, MA, DO, internal medicine residency Spokane faculty, clinical assistant professor of medicine at the University of Washington School of Medicine, and lead author of the study.

Physicians are not generally trained on price awareness and the authors point out that true patient costs are challenging to ascertain because of cost adjustments between hospitals and insurers.

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Hospitalist Salaries Continue to Climb

July 14, 2010 Leave a Comment

Hospitalist Salary ChartNew survey data from the Society of Hospital Medicine (SHM) and the Medical Group Management Association (MGMA) show that hospitalist salaries continue to climb.  The mean annual salary for a hospitalist, according to the report, is now $225,344.  The figure is inclusive of base pay plus benefits and incentive compensation, such as quality bonuses.

Writing about the data in the July issue of The Hospitalist, John Nelson, MD, cites several factors for the continued climb in compensation.  Increased productivity and inflation, says Nelson, are two factors.  But “the principal reason for the rising trend in our pay is ‘market forces,’ primarily demand for hospitalists that has exceeded the supply.”

The survey excludes pediatric hospitalists.  Academic hospitalists, who had been represented in previous SHM salary surveys, were also left out of the 2010 SHM-MGMA survey, according to Nelson.  SHM plans a separate survey on academic hospitalist compensation.

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Hospitalist Care Gains Support From OB-GYNs

June 22, 2010 Leave a Comment

The increasing role of hospitalists in delivering OB-GYN care is being acknowledged by the nation’s leading group of physicians for women.  In a new advisory opinion from the American College of Obstetricians and Gynecologists (ACOG), the group says “the rising number of ob-gyn hospitalists in the US holds promise for benefiting both patients and physicians while also maintaining safe and effective care.”

Writing for ACOG in the July issue of Obstetrics and Gynecology, Dr. Patrice Weiss notes two types of hospital-based practitioners for women.  ”Laborists” generally care for women in labor and manage obstetric emergencies, while a general ob-gyn hospitalist may provide in-house gynecologic services, perform inpatient consultations, and see emergency room patients.

One benefit of hospitalist care for patients, according to ACOG, is having an immediately available, well-rested physician which can enhance patient safety and improve outcomes.

ACOG also sees benefits for OB-GYNs who choose hospital-based employment.  Ob-gyn hospitalists, and laborists, who practice solely in the hospital setting, stand to benefit from more predictable schedules, assistance with medical liability insurance premiums, avoidance of work-related fatigue, and freedom from day-to-day practice worries such as overhead costs, billing, and collections.

“The most important thing when these programs are implemented is to establish and maintain clear, ongoing communication between physicians in practice and hospitalists,” said Dr. Weiss. “It’s vital that the hospitalist and the primary care provider consult with each other regarding the handoff of patients, progress updates, and follow-up care so patient injury is avoided.”

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Hospitalist Growth Highlighted in NYT

June 4, 2010 Leave a Comment

The New York Times Jane Gross puts the spotlight on Hospital Medicine with her recent article:  “New Breed of Specialists Signs in for Family Doctor. “

With patients still largely confused or even ignorant of the role of Hospitalists, Gross’ article explains, in lay terms, how hospitalists fit into new models of health care delivery:

“Because hospitalists are on top of everything that happens to a patient — from entry through treatment and discharge — they are largely credited with reducing the length of hospital stays by anywhere from 17 to 30 percent, and reducing costs by 13 to 20 percent, according to studies in The Journal of the American Medical Association. As their numbers have grown, from 800 in the 1990s to 30,000 today, medical experts have come to see hospitalists as potential leaders in the transition to the Obama administration’s health care reforms, to be phased in by 2014.

Under the new legislation, hospitals will be penalized for readmissions, medical errors and inefficient operating systems. Avoidable readmissions are the costliest mistakes for the government and the taxpayer, and they now occur for one in five patients, gobbling $17.4 billion of Medicare’s current $102.6 billion budget.”

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