Troy Ahlstrom writes…

Our group has partnered with facilities that have need for Hospitalists capable of the fullest spectrum of hospital-based patient care.  The ICUs are busy.  Step-down and med-surg floors turn patients over quickly.  A steady stream of stress tests rolls through non-invasive cardiology.  But they’re not all busy at the same time… excepting the occasions when they really are all busy concurrently.  Meanwhile, everyone’s sicker.  It seems acuity doubles every two years matching Moore’s Law.  Yet, there’s no Intel, Apple, Microsoft, Oracle, or HP inventing increasingly capable providers to meet the pressing need.

Much to the contrary, I find myself wondering, “Are we actually training physicians to be less adaptable?” (more…)

John Nelson writes…

We now have access to the latest version of what in my opinion is clearly the best national source of data on hospitalist workload, compensation and other metrics:  MGMA’s Physician Compensation and Production Survey: 2010 Report Based on 2009 Data.  This September, SHM and MGMA will jointly release the State of Hospital Medicine: 2010 Report Based on 2009 Data.

In “The Hospitalist” I provided a brief commentary on the trend in compensation, including my view of what is a ‘benchmark.’  Here I want to have another go at what I see as the confusion around the term.  (more…)

Mike Radzienda writes…

Over the past ten years, hospitals have been bombarded with external regulatory mandates aimed at improving quality of care.  Amidst these challenges, payer mixes have dwindled and operating margins have narrowed.  This has left hospitals few resources for implementing thoughtful and robust quality improvement infrastructures.  As a result, hospital COOs struggle to develop meaningful partnerships with physicians who can effectively advance the local QI agenda.

Due to a dearth of availability and leadership in the traditional physician staff model, hospital administrators have taken on this QI agenda. This tactic has failed (more…)

Rob Chang writes…

It’s the end of the year and evaluation time has come around again.

It’s a laborious process.  Self-assessments, peer assessments, nursing assessments, patient assessments, director assessments….  Thick stapled sheets of papers coated with numbers and ratings lay stacked and scattered across the lined dark carpet and desk in my office, each pile somehow representing the culmination of a year’s worth of effort.  The sheer amount of paperwork could likely reconstitute a small forest. (more…)