Consult for an HMG
Question: We are an established hospitalist group going on two years. We started with two full-time physicians and now have five. We obviously have room for improvement and growth. Are there any hospitalist physician consultants who would be able to spend a couple of days with us to evaluate our program and review our systems?
Business Development Specialist,
Marietta Memorial Hospital,
Dr. Hospitalist responds: Since the term hospitalist was coined in 1996, the field has grown rapidly. The majority of hospitalist programs are less than five years old. Many hospitalist programs, having grown rapidly over the past few years, are planning to evaluate and improve their performance.
There are a number of options available to help programs benchmark themselves to industry standards. Hiring a consultant is certainly a reasonable choice. SHM has been a particularly valuable resource to help leaders understand how to evaluate their program.
On the Practice Resource section of its Web site (www.hospitalmedicine.org), SHM provides the names and descriptions of several practice management consultants. Also on the site is the downloadable dashboard white paper “Measuring Hospitalist Performance: Metrics, Reports, and Dashboards,” developed by the SHM Benchmarks Committee.
The white paper discusses “issues related to developing, reporting and interpreting performance data.” SHM has also developed the practice management course “Best Practices in Managing a Hospital Medicine Program” and published the book Hospitalists: A Guide to Building and Sustaining a Successful Career to assist those interested in evaluating and improving their hospitalist program.
Lastly, SHM surveys hospitalists every other year to gather productivity and compensation date. The results of the latest “Bi-Annual Survey on the State of the Hospital Medicine Movement” will be released at the SHM Annual Meeting in San Diego April 3-5. Survey information will be available on its Web site shortly thereafter.
Lend A Hand
Question: I am a certified diabetes educator with 20 years’ experience in diabetes. I’m about to graduate as an adult nurse practitioner (ANP). My goal is to work with management of inpatient diabetes. Are you aware of any models of ANPs working for or with hospitalists?
Potential Team Member, Ohio
Dr. Hospitalist responds: There are about 20,000 hospitalists in the country. SHM believes that number could grow to 40,000. I am not surprised by the size of that estimate. Just about every hospital I know wants to develop or expand its hospitalist program.
Hospital medicine has filled its ranks over the past decade largely at the expense of primary care. Many physicians have left primary care for hospital medicine. At the same time, many graduates of internal medicine and family medicine training programs have chosen employment in hospital medicine instead of outpatient medicine.
Despite this trend, we are still short of hospitalists. The long-term solution is to expand the numbers of trainees who choose hospital medicine as a career. We are unlikely to see that occur rapidly over the short term. Another potential solution is to increase hospitalist efficiency.
Many in the field are working to redesign systems in the hospital to increase hospitalist efficiency and productivity. Again, these efforts will take time. Adding non-physician providers as care extenders is another viable option many programs are exploring. The results of the latest SHM productivity and compensation survey “Bi-Annual Survey on the State of the Hospital Medicine Movement” being released in April will give a sense of how many midlevel providers (nurse practitioners and physicians’ assistants) are working in hospitalist programs. It will not, however, fully describe their roles and responsibilities. I suspect more hospitalist programs are employing midlevel providers, but the majority of programs do not have midlevel providers among their staff.