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With hospitalist demand outstripping supply, a fine-tuned group schedule can enhance productivity and job satisfaction. Two HM group leaders recently spoke with TH eWire about how they avoid a one-size-fits-all approach.

Stephen Houff, MD, president and CEO of Canton, Ohio-based Hospitalists Management Group, deploys 350 hospitalists to 41 hospitals in 11 states. Groups average eight hospitalists (range four to 20), and have an average daily census (ADC) of 50. Most work a seven-on/seven-off block shift. Dr. Houff says his HM groups create effective schedules in the following ways:

  • In an eight-person group, three hospitalists work 7 a.m. to 7 p.m., and one doctor staffs the ED from 11 a.m. to 11 p.m.;
  • Members must work four consecutive days;
  • After getting established in a location, HM groups find local office-based PCPs to moonlight, covering their malpractice insurance and billing; and
  • A dozen HMG hospitalists known as “firefighters” cover emergency or planned short-term leaves, receiving 15% higher pay plus per diems.

Haiwen Ma, MD, PhD, director of Hospitalist Services at South Nassau Communities Hospital in Oceanside, N.Y., has two nocturnists and five hospitalists in the group who work Monday through Friday from 7 a.m. to 7 p.m. The group has an ADC of 45-50 and a 15-patient cap per hospitalist. Here’s how she makes it work:

  • Four hospitalists cover admissions in three-hour blocks from 7 a.m. to 7 p.m. and do weekend calls every fourth week;
  • The fifth hospitalist performs pre-surgical/post-surgical consults; and
  • The group relies on per-diem moonlighters from other hospitals to pick up the slack.

For more scheduling tips, check out practice management articles on our Web site.

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