At a hefty 291 pages, SHM’s 2005-2006 survey, “The Authoritative Source on the State of the Hospital Medicine Movement,” contains a wealth of detail about hospitalists and their working conditions. Most readers will probably first refer to the compensation and benefits package statistics. But take a closer look: The survey’s chapters and tables yield a depth of even more helpful information.
After reviewing the survey’s “Executive Summary” (available online at the SHM Web site, www.hospitalmedicine.org), Charlene Carroll Clark, MD, a hospitalist at Inpatient Care Service at Good Samaritan Regional Medical Center in Corvallis, Ore., says “I think knowledge is always a good thing. Just knowing what is going on in other locations helps us. We can see that we fit right in with the median compensation, and that we are competitive as we recruit.”
It is reassuring, other sources concurred, to see that their hospitalist groups compare favorably with national median salaries and benefits packages. However, some group leaders caution that hospitalists should not benchmark their groups’ professional viability using only compensation and benefits medians. The real worth of the survey’s statistics, they say, will be realized when hospitalists utilize the document as a tool for improving management and care processes at their own institutions.
Indeed, in conversations with SHM leaders and with hospitalists across the country, it becomes clear that the survey has multiple uses, depending on its readers’ specific characteristics. And that’s just what SHM intends, says Joe Miller, SHM senior vice president, who was in charge of the survey project. “Our role was to create more of an almanac and a reference, rather than furnish an interpretation,” says Miller. “I think the real value for people will be in finding the metrics that are descriptive of their particular program.”
Survey Participation Increases
Miller is gratified by the increase in participation since the 2003-2004 SHM survey. Two years ago approximately 300 hospital medicine group (HMG) leaders participated in the survey. This time 396 HMG leaders participated—a 32% increase. Individual hospitalists completing the survey increased by more than 500 over the previous survey to a total of 2,550 individual hospitalist respondents.
“Given the magnitude of this survey, I think we’ve got very impressive representation of the industry,” says Miller. For instance, the regional representation of respondents was almost equally divided: 24% from the East, 26% from the South, 27% from the Midwest, and 22% from the West.
Miller attributes the greater participation to a variety of factors: conducting a multifaceted communication campaign, targeting every SHM board member and committee member, and extending the survey deadline.
An Eclectic and Thriving Group
According to Miller, the survey reveals many characteristics about hospitalists and the profession in general. While some of the results may not be surprising, they serve to corroborate (with real numbers) what many have perceived anecdotally about the hospital medicine movement. For instance:
- The hospital medicine movement is diverse. The survey documents six different models for hospital medicine programs. Currently, 34% of hospitalists are employed by hospitals or hospital corporations, and 12% are employed by local hospitalist-only groups. Multistate hospitalist-only groups or management companies employ 19%, while multi-specialty groups employ 14% of hospitalists. Academic hospital medicine programs employ 20%, and another 2% are employed by emergency or critical care physician groups.
- Hospitalists provide documented value for their hospitals, including around-the-clock patient care (51% of HMGs have on-site providers at night, and 41% of programs provide hospitalists on call), and participation in quality improvement (86%), hospital committees (92%), and other value-added activities, such as implementing information technology (54%).
- Other trends emerge when comparing 2003-2004 survey results with the current survey, including an increase in HMGs that now use a hybrid coverage schedule (a combination of shift and call schedules; an increase to 35% from 27%); more groups being paid using a mixed compensation model (a combination of salary and productive/performance-based compensation; up to 67% from 47% in 2003-2004); and a slight increase in hospitalists employed by academic institutions—up to 20% from a prior 16%.