John Nelson writes…

Daily encounters are a good metric for financial analyses, but I think they’re not so good when thinking about quality of care or hospitalist career longevity.

Most groups track the average number of encounters per hospitalist each day (or rounding) shift.  And everyone wants to know what it the right or SHM recommended average number of daily encounters.  When does an increasing average encounter volume begin to impair quality of care?  (more…)

Robert Chang writes…

In the academic hospitalist world, we’re still in the midst of what is essentially a cultural revolution with significant practical implications.  The continued changes to healthcare and the increasing fraction of work falling to the hospitalist workforce are accompanied by tensions along the multiple interfaces with nursing staff, our colleagues, residents and administration.  After writing my last post, I realized that it may be helpful to give a window into the academic world and the particulars of how I have chosen to prioritize relationships over problems (or failed to do so).  I trust that my experience will not be universally true – hopefully fragments of the story are familiar and help define the issue more clearly whereas other fragments are illuminating due to their contrast with the reality at your institution.
This post will primarily serve as an outline for things to come. (more…)

John Nelson writes…

At the 2008 SHM Annual Meeting in San Diego I got some ribbing for raising the issue of whether the supply of hospitalists might catch up with or exceed demand within the next 5 or 10 years.  I posed the question while moderating a panel discussion, and all three panelists were convinced that there would be a shortage of hospitalists for the rest of our careers.  One panelist, Ron Greeno, even teased that I just worry too much to even think of asking such a question. (more…)