The Appropriate Patient Census

What’s the appropriate number of patients that an FTE hospitalist should see in one day? More than half of those surveyed on the-hospitalist.org believe they should see between 11 and 15 patients. According to two members of Team Hospitalist, 10 to 20 patients per day is a reasonable guideline.

"On average, 15 to 18 patients per day is a pretty easy-to-manage number," says Rachel George, MD, MBA, FHM, CPE, chief operating officer for Cogent HMG’s west and north-central regions. But daily patient census depends on several factors, such as the types of patients admitted, the length of the doctor’s shift, and the level of support from other staff on duty, she explains.

Readers were given one of five choices to respond with: "10 or fewer patients," "11-15," "16-20," "21-25," and "more than 25." Of the 421 responses, 51% felt that the average full-time hospitalist should see from 11 to 15 patients per day, followed by 35% who say they’d prefer to see 16 to 20 patients. Six percent voted for "10 or fewer." Only 4% of respondents said 20 or more patients a day was optimum.

"Honestly, I try not to get fixated on numbers," says Ken Simone, DO, SFHM, founder and president of Hospitalist and Practice Solutions in Veazie, Maine. As a consultant, he says that rather than trying to expect physicians to attend to a standard census, HM groups should focus on acuity of illness and quality of care, and let patient needs dictate the staff required. Dr. Simone also recalled working with some groups who have delegated one or more staff members to handle admitting and screening, so that hospitalists can concentrate on the patients already in beds.

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