Is there a “right” number of daily encounters?
May 16th, 2009
In this lively panel discussion of what is the “right” number of daily encounters, the short answer is “14″ (at least as close to consensus as the panel could muster), but the long answer, as we can all guess is “it depends”. Variable factors include patient illness severity, number of admits/discharges, and the efficiency of the system in which you work. As time-motion studies have shown, MOST of our time is NOT spent in direct patient care (only about 20%), so maybe the better question is: what is the “right” ratio (patient care-to-non patient care ratio), and what can we do to manage that ratio??
The “right” number of patients to carry is something we talk about frequently in our small group of four hospitalists. Ours is a closed 47 bed hospital, so all non-surgical (and lots of the surgical as well) patients are on our service. We also run the ICU, and there have been days when a single hospitalist has managed up to twenty patients easily, but there have also been days when we’ve had just one ICU patient that has monopolized our entire day. So, “it depends” seems like the only real answer that’s likely to work.
As discussed today, with the new ACGME requirements, hiring new graduates into existing staffing models will become more of a challenge while in training they are getting naps and caps.