Hospitals are turning toward hospitalists to help them address physician shortages and ever-growing patient volumes in the inpatient setting. In fact, in 2012, hospitalists were found to be the second most-placed physician specialty, according to physician search company, The Medicus Firm.
There are a number of reasons for the growing popularity of hospitalists. According to the Society of Hospital Medicine, hospitalists are physician and non-physician providers who provide medical care for acutely ill patients in a hospital setting. They are generally trained in internal medicine, general pediatrics or family medicine.
Specialty hospitalists, however, are surgical specialists who work exclusively in the hospital setting, taking care of patients in need of emergent and urgent care, according to Gene Krumanocker, COO of Delphi of TeamHealth, a hospitalist physician staffing firm. Delphi of TeamHealth specializes in hospitalists providing orthopedics, general surgery, and obstetrics and gynecology services. Specialty hospitalists are typically on-call 24 hours a day and provide emergency department call coverage for their specialty. They also perform surgeries, provide postoperative follow up and provide inpatient consults.
For hospitals, Mr. Krumanocker says contracting specialty hospitalists has obvious advantages, the largest one being increasing the satisfaction of physicians who have privileges at the hospital and also have private practices. Another advantage is that the hospital can ensure a specialist is always accessible to ED patients. Contracting specialty hospitalists also acts as an effective tool for recruiting private practice physicians. Specialty hospitalists can help reduce the number of hours physicians with privileges have to be on-call at the ED, allowing the physicians to concentrate on their practices, says Kurt Ehlert, national medical director for orthopedic surgery at Delphi of TeamHealth.
While specialists in private practice sometimes resist the idea of bringing in specialty hospitalists, the resistance evaporates once they see the benefits, says Andrew Lin, national medical director for OB-GYN services at Delphi of TeamHealth. Some of them are afraid of facing competition, and some are wary of losing revenue from not being on-call in the ED, but these fears end up being largely unfounded, says Dr. Ehlert.
There are five key ways in which specialty hospitalists help private practice physicians, and this can help hospitals recruit and retain them:
1. Remove the burden of ED calls. "Specialty hospitalists help private physicians by relieving them of the burden of ED calls, which can be very unpredictable," says Mr. Krumanocker. They can focus on their own practices and scheduled surgeries without worrying about responding to an ED call, which usually allows them to grow their own practice. "Most private practices experience overall growth after being relieved of ED calls," adds Mr. Krumanocker.
2. Allow private practice physicians more time at home. Specialty hospitalists take on more ED call time, because of which hospitals do not need to depend on private practice physicians for ED call duties. This gives private practice physicians more free time, which they often elect to spend at home. Having enough time with their family is particularly important for younger physicians, says Dr. Lin, and having a specialty hospitalist program in place may, in fact, help hospitals recruit younger physicians. The fact that physicians do not have to be on-call in the ED due to the presence of specialty hospitalists could become an effective recruiting tool for the hospital, adds Mr. Krumanocker.
3. Help private practice physicians ensure better care for their patients. According to Dr. Lin, specialty hospitalists can enhance patient safety since they can step in and take care of a patient until the private practice physician arrives. This is particularly true in the case of labor and delivery, where patients sometimes need to deliver quickly, he says. Given the fact that most hospital EDs have to deal with high patient volumes and high-acuity cases, hospitalists can provide invaluable services in helping ensure the safety of patients.
4. Allow private practice physicians to focus on their primary interest. As the trend toward sub-specialization continues, private practice physicians sometimes lose interest in general procedures, says Mr. Krumanocker. Procedures involving fractures, for example, are the most common procedures performed by orthopedic hospitalists, he says. Many physicians are more comfortable performing procedures only within their own subspecialty, and specialty hospitalists can help them do so by taking over the fracture procedures, says Dr. Ehlert.
5. Help combat physician shortages. Only 4.8 percent of physicians practice in rural areas, according to a study by researchers at the George Washington University School of Public Health and Health Services. It is harder to retain or recruit physicians in smaller areas, says Dr. Lin, and in communities where physician shortages exist, specialty hospitalists can reduce the pressure local private practice physicians face to fill the void in the ED. A specialty hospitalist program can also keep an ED from going uncovered in specialties or services for which physician shortages exist, says Mr. Krumanocker.
The presence of specialty hospitalists proves to be advantageous for private practice physicians, resulting in a positive situation for both hospitals and their physicians. Having private practice physicians and specialty hospitalists work together at a hospital is an ideal model, and one that will hopefully become a standard of care in the future, says Dr. Lin.
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