{"id":2895,"date":"2021-09-01T12:05:52","date_gmt":"2021-09-01T16:05:52","guid":{"rendered":"https:\/\/coreclinicals.wpengine.com\/?p=2895"},"modified":"2022-11-17T10:30:04","modified_gmt":"2022-11-17T14:30:04","slug":"the-future-of-hospitalist-staffing-issue-5","status":"publish","type":"post","link":"https:\/\/www.coreclinicalpartners.com\/the-future-of-hospitalist-staffing-issue-5\/","title":{"rendered":"The Future of Hospitalist Staffing \u2014 Issue #5"},"content":{"rendered":"

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The Future of Hospitalist Staffing<\/h2>\n

The Standard Hospitalist Scheduling Can Be Improved\u2014Helping to Reduce Burnout and Improve Patient Care<\/em><\/strong><\/h3>\n

Greetings! This month, we announced a major new hospitalist partner in Oklahoma, Hillcrest HealthCare System<\/a>: eight new sites totaling 180,000 patients annually. As this means we are now in full on recruiting mode for 70 clinicians and a system medical director, a lot of what I\u2019ll write about in this issue relates to hospitalist staffing and scheduling models (no surprise there).<\/p>\n

But first: this is undoubtedly a huge win for our company, and a huge congratulations goes to our team at Core. Growing organically like this is validating on a number of levels. First, it shows you do\u00a0not<\/em>\u00a0have to scale into a gigantic national group in order to earn large partnerships with health systems.<\/p>\n

I\u2019ve been writing about this theme in one way or another since I started this newsletter (See\u00a0There is no one size fits all<\/a>\u00a0and\u00a0The promises and failures of consolidation<\/a>), but the overall point is that there is room in this environment for a nimble company like ours to combine the capability of a big EM & hospitalist group with the service and buy-in of a smaller physicians group.<\/p>\n

There are a couple reasons why that\u2019s the case. One is the rise of telemedicine, which allows hospitals, health systems, and groups to make more efficient use of their clinical workforce\u00a0no matter their size<\/em>.<\/p>\n

In other words, telemedicine helps solve a big staffing challenge that previously only gigantic national groups could solve. You don\u2019t need to have \u201cnational scope\u201d anymore to pull in physicians from other locations to come fill shifts at a difficult-to-staff site, because telemedicine technology can potentially give every company national scope.<\/p>\n

But telemedicine alone isn\u2019t a panacea. Most hospitalist groups know that the standard hospitalist schedules aren\u2019t perfect\u2014but change is hard, and figuring out how to improve the staffing models will require a combination of strategies. How will we approach this on the ground in Oklahoma? Read on!<\/p>\n

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Not that many groups do HM well<\/h2>\n

I\u2019m an ER physician by training, and I come from the ER world, so of course my view of hospitalist medicine is inherently shaped by my experience in the EM market. One thing I can say for sure is that most of the big emergency medicine companies tend to think of HM as an add-on to their core business. They might dispute that characterization, but if we\u2019re honest we have to acknowledge that there are a lot of EM groups out there who decided to\u00a0add on<\/em>\u00a0hospitalist medicine, rather than think about how to do HM well as its own stand-alone thing.<\/p>\n

One reason for this is that hospital medicine is still pretty new. It didn\u2019t even exist when I started my career. Now, there are hospitalists in just about every hospital in the country. If you\u2019re an internist or a family practitioner, becoming a hospitalist is very attractive because it\u2019s shift work, and you don\u2019t need to run your own office.<\/p>\n

Second, a good hospitalist group must thread the needle between what the hospital wants and needs and what the hospitalist physicians themselves want and need, and figure out how to make all of those things better at the same time. There is no silver bullet here, but there is an optimal way to do it where you get clinician satisfaction, hospital satisfaction, and all the stakeholders pointed in the direction of a better patient experience and patient satisfaction.<\/p>\n

There are a lot of moving parts and levers to pull in order to do this. But for now, I want to focus on what could be considered the elephant in the hospital: the standard hospital medicine schedule.<\/p>\n

The reasons for seven on, seven off, 12-hour shifts<\/h2>\n

The historic schedule is for hospitalists to work seven days on, 12 hours a day, and then get seven days off. That schedule is (at least initially) really appealing for a lot of physicians: it means they get half their days off! The schedule also makes sense for continuity of care, allowing hospitalists to both admit and see a majority of their patients through until discharge. The more continuity you have in scheduling, the easier it is to implement a successful\u00a0geographic rounding program<\/a>. All these things are a big part of why the 7 on, 7 off schedule has proven so resilient.<\/p>\n

Yet, despite the obvious benefits for physicians, the hospital, and patients, almost from the beginning, the seven on, seven off schedule has come in for criticism. Here\u2019s a\u00a0piece from 2013 debating the pros and cons<\/a>\u00a0of the schedule, published by SHM\u2019s The Hospitalist. Among the pros of the model:<\/p>\n