If such a thing exists, hospitalist Dwayne Gard, MD, of Memorial Health in Savannah, Ga., has a good practice management problem: In recent years, his HM group started collaborating with Memorial’s gastrointestinal team to admit their patients. Now, Dr. Gard and his colleagues are in similar discussions with neurosurgery. And ments provide steady revenue for the hospitalist group, too much growth, too fast, can be as dangerous as too little.
“There are a lot of demands, from an administrative standpoint, to cater to the needs of some of the subspecialists at a time where we really need to grow the number of hospitalists within our program before we even consider expanding our services,” says Dr. Gard, whose group has 10 FTE hospitalists and has an average patient census of 90-110 at the 500-bed hospital. “I let our administration know it’s a challenge we’re willing to take on as long as we have the support to get the staff in that we need to safely see those patients.”
Just how to let them know is the art of practice management, a topic that dominates much of SHM’s annual meeting. From a popular, daylong CME pre-course to a dedicated practice-management track, hospitalists looking for real-time advice on the business side of medicine came away from HM12 last month with brown bags full of tips.
“This is a huge pause, a huge opportunity to pause and remind ourselves what’s important,” says Steven Pestka, MD, chief of the hospitalist service at Newton-Wellesley Hospital in Newton, Mass. “And then recognizing that all those other things … need to be kept in context and need to be limited so that the core running of the group can be performed.”
For Dr. Gard, gaining management skills at this year’s annual meeting was a two-step process. First, they sent seven members of their HM groupthree hospitalists, two non-physician providers (NPPs), an administrator, and an office managerto San Diego. The annual-meeting team spread across as many sessions as they could, including pre-courses on value-based purchasing and practice management. Second, and perhaps more important, the team members didn’t decide ahead of time what advice they were going to glean; they came with agendas and schedules of what breakout sessions
they viewed as most valuable while remaining flexible.
“It always seems like while you’re here, you learn something you weren’t expecting,” Dr. Gard adds, “and something that’s actually maybe more pertinent than the reason you maybe thought about coming to the meeting to begin with. You can take that home as well.