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By David Pierpont
Weatherby Health Care
In the face of increased managed care penetration and the privatization of medically assisted payer groups, some of the most attractive points of any hospital position are the financial and professional security it provides.
A physician who enjoys receiving a regular paycheck will appreciate the financial security associated with a hospital setting, as opposed to increased pressures to meet financial incentives to seeing more patients in a shorter span of time that are often associated with private practice.
Physicians also are interested in the team environment a hospital setting offers as well as the challenge of a higher acuity of patient care. However, in today’s market of single- and multi-specialty group practices, which typically offer greater financial incentives and lower acuity of care, these benefits are no longer enough to recruit and retain physicians.
While the degree of difficulty associated with recruiting hospital physicians differs from specialty to specialty, one point holds true it’s a daunting task. But it is not impossible.
There are solutions to staffing needs available in the marketplace. It is a matter of identifying the right solution for your particular need and employing the most effective recruitment technique, which protects your bottom line and entices physicians to view your opportunity as a wise career choice.
Recent demographic trends and the emergence of sub-specialties are playing a role in hospital physician staffing solutions, and they will assume a greater position in the future as the population ages. For example, geriatics is an emerging specialty. The nature of geriatrics as a subspecialty suggests that a large majority of the caseload will inherently be inpatient in hospitals, hospices, and long-term care facilities.
Another trend occurring in the marketplace involves hospital management supporting private practices of single-specialty and multi-specialty physicians who contract with the hospital.
These arrangements are hospital-based networks. Typically established as profit centers and taking the form of traditional outpatient private practices, these "arms" of the facility increase drawing power and more prominently position the hospital in the community and offer a staffing solution for many physicians who are willing to balance their practice between inpatient and outpatient settings.
Essentially, the practice is owned by the hospital. Physicians practicing in a setting like this are allowed the freedom, flexibility, and entrepreneurial environment present in a private practice. They retain a daily patient load incorporating half of their time in the office and the other half in the hospital caring for patients. This scenario has proven to continually generate additional revenue for the hospitals.
Another increasingly popular and lucrative trend for staffing in-house positions involves contracting the services of hospitalists. A newly emerging specialty, hospitalists act as independent private groups who service hospitals as the in-house physicians on a contractual basis. This scenario also provides a revenue building alternative for both physicians and hospitals.
The primary responsibility of a hospitalist is to provide in-patient care, acting as a key member of the team of providers, while assuming call duty as well. This practice situation provides the acuity of care desired by the hospitalist. As a solution for hospitals, it provides the quality of patient care necessary, while sustaining cost efficient methods for providing care.
A heated debate is growing as this new specialty begins to evolve and emerge in today’s managed care setting. In some instances, critical care specialists and primary care physicians are concerned by the emergence of hospitalists, as it could be perceived that they are encroaching on the patient care base and revenue by providing inpatient treatment.
However, the presence of hospitalists allow primary care physicians the ability to replace time spent on hospital visits with office time; thus, they can see more patients. In addition, hospitalists argue that the role of the critical care specialist is still entirely necessary, to cover the intensive care units and to treat pulmonary and cardiac patients, which traditionally are not encompassed in the continuum of care provided by hospitalists.
Hospitalists usually relieve primary care physicians from the responsibility of a call schedule. Typically, there is little need for worry regarding patient attrition, as hospitalists do not provide continuing care after discharge. Patients will need to return to their primary care physician upon release from the hospital for follow-up visits and other health-related concerns.
In many cases, from a patient standpoint, a strong relationship is established immediately with the hospitalists as he or she is positioned as an expert in hospital setting and as the patient’s advocate during the stay. A hospitalist’s job is to provide quality and immediate care while the patient is being treated in the hospital.
Staffing in-house physicians may be one of the more difficult tasks associated with recruitment, but it is not impossible. The evolution of the health care industry has seen some alternatives emerge including hospitalists and hospital-owned group practices. Identifying the best solution for your organizations and remaining diligent in your search efforts will assist you in finding the right candidates for your staffing needs.