Question: I am working too hard and getting paid too little. Is there any easy to figure out if I am getting paid what I am worth?
Show Me the Money, Austin, Texas
Dr. Hospitalist responds: I suspect you may have already asked hospitalists you know about how much they make and compared schedules. Although this may be sadistically fun (alas, misery loves company), there are problems with this approach.
Your perspective is limited to friends and colleagues willing to share this information. Some people are reluctant to talk money, others have a tendency to embellish their productivity. I am not saying folks would intentionally lie to you (wink, nod), but who would tell you they feel overpaid and do not work hard?
What you need are objective data. You and a couple of colleagues could develop a survey, send it to every hospitalist you know, and hope they respond. But even if you did, how often could you muster the energy to do this to keep your data up to date?
Remember, you are doing this survey to demonstrate you are compensated appropriately for how much work you produce. Lucky for you, several organizations collect physician productivity and compensation data, including SHM and the Medical Group Management Association (MGMA). But there are differences in the data.
Some believe the MGMA data set may include information from primary care groups with inpatient rounders in addition to full-time hospitalists. Meanwhile, SHM data were last collected in November 2005. SHM collects updated information from hospitalists around the country. They will make those findings available at the next SHM annual meeting in San Diego in April 2008.
This will also be the first survey done since Medicare moved to the new 2007 relative value unit (RVU) values. Hospitalists who contribute to the survey can access the data for free. I suppose critics could argue that the approach taken by these groups is subject to bias because individuals could submit false data. This is all the more reason I would encourage you to submit data to the SHM survey. The larger the sample size, the more difficult it will be for any one individual’s data to warp the survey.
Question: I know hospitalists should communicate with primary care physicians (PCPs) about their patients, but I find it takes a lot of time for me to call their offices. Is there an easier way to do this? I am also not completely sure of when I should communicate. Any suggestions?
No Time to Talk, Atlanta
Dr. Hospitalist responds: Let me guess. Your “communication” with the PCP goes something like this: You pick up the telephone to call a patient’s PCP. After sitting on hold for what seems like eternity (your pager rings repeatedly during this time), a voice on the other end of line tells you that the doctor is in an exam room. “Do you want me to interrupt him?”
Do you say yes and run the risk of sitting on hold another five minutes? Or do you decide whatever you had to say really isn’t that important? But don’t you need that outpatient medication list? Do you really have to tell the PCP about the ongoing end of life discussions with the patient? What’s a hospitalist to do?
This method of communication may have worked when you were a resident in training, when your workload was capped and your attending physician had to make time for your calls. But try this as a hospitalist and you’ll quickly discover you don’t have enough hours each day.