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Maternity Management
Editor's Note: Second in a two-part series
Lest anyone forget, it is essential to support workers having children for one reason—the continuation of the human species, says Rachel Lovins, MD, SFHM, who directs the hospitalist program at Waterbury Hospital in Waterbury, Conn. For HM program directors, that means following pregnancy labor laws. But it also should involve reasonably accommodating hospitalists who are balancing their new baby’s needs with the demands of their profession, says Dr. Lovins and other HM leaders.
"As there are more women in medicine, everybody needs to be more aware of this issue. We don’t want to make good talent feel uncomfortable with the process of taking maternity leave and reducing time," says Michelle Marks, DO, FAAP, SFHM, director of the Center for Pediatric Hospital Medicine at the Cleveland Clinic.
All HM program directors need to be aware of such federal laws as the Pregnancy Discrimination Act and the Family and Medical Leave Act (www.eeoc.gov/laws/types/pregnancy.cfm), as well as the corresponding laws of the state in which they work. Directors can contact their human resources (HR) department for assistance.
"Calling them upfront will save a lot of headaches later on," says Jasen Gundersen, MD, MBA, CPE, SFHM, chief medical officer of the hospital medicine division in Fort Lauderdale, Fla., for Knoxville, Tenn.-based TeamHealth.
Here are some other recommendations on how HM directors can best manage pregnancy issues affecting their team:
The "R" in Relationship
There are many reasons why the director of a hospitalist group should develop a good relationship with the providers in their group, but one of them is that a hospitalist is more likely to tell her director sooner rather than later that she is pregnant, Dr. Marks says.
"Knowing your staff well and knowing them personally helps a lot, too, because you can gauge where they are going personally, as far as marriage, children, that type of thing," she adds.
The earlier a group leader knows a staff member is pregnant, the more time they have to plan for maternity leave. And the better the plan, the easier the leave is on the entire group, says Dr. Gundersen.
Generally, finding out that a physician is pregnant within three to five months of conception provides enough time to make adequate arrangements for coverage, Drs. Marks and Lovins note.
The Conversation
Before scheduling a meeting to discuss maternity leave and plans for returning to work with the hospitalist, the group leader should call HR to see if such a conversation is permissible, says Dr. Marks. A better approach might be to wait until the hospitalist broaches the subject.
"So many times the hospitalist will ask for counseling as far as what are her options of coming back," Dr. Marks says. "That opens the door for an open discussion."
Once the conversation starts, the group leader should gauge the length of maternity leave, her plans for coming back full time or part time, and the anticipated scheduling limitations or childcare considerations, Dr. Gundersen says.
"That’s not to say the pregnant woman can really predict all the time what’s going to happen," says Kerry Weiner, MD, MPH, chief clinical officer for North Hollywood, Calif.-based IPC: The Hospitalist Company, Inc. "Obviously, it’s a medical condition that can change and everyone understands that. It’s getting a feel of what you can actually know at the time."
If it’s the HM director’s intent to call the physician while she is on leave to see how she and the baby are doing and how the maternity leave is going, that should be discussed during the conversation, Dr. Gundersen says.
"If you establish upfront that you are going to make that phone call, I think that’s fine to do," he explains. "If you’re calling constantly and pressuring the person, I don’t think that that’s kosher at all."
—Rachel Lovins, MD, SFHM, director, hospitalist program, Waterbury (Conn.) Hospital
The Coverage Plan
Most maternity leaves are from eight to 12 weeks, although the length varies by HM program and individual. It is essential to have your group’s coverage plan outlined well in advance of the maternity leave.
In a private-practice model in which hospitalists work weekdays and have a call-coverage schedule for nights and weekends, a group leader can spread the extra work among the other hospitalists in the group because there are more hospitalists working during the day when patient census is higher, Dr. Weiner says.
Shifting the workload in other schedule models isn’t always as easy. "In the seven-day-on, seven-day-off model, because of that maximum patient-to-doctor ratio, I don’t think there’s any way to do it without hiring help," Dr. Lovins says. "It’s important to recruit per diems all the time. When you’re in a bind is the worst time to do it."
To limit the disruption to patient care and operations quality, the goal when using outside hospitalists is to contract with physicians who have worked with the group before and who know the community, hospital, systems, and patients, Dr. Weiner says.
For HM groups that use a flexible schedule, maternity coverage plans aren’t really needed, says Reuben Tovar, MD, chairman of Hospital Internists of Austin, a physician-owned and -managed hospitalist practice in Texas.
"We’re not salary, so that changes the dynamic completely. People who work more make more, and people who work less make less," he explains. "We are much more liberal about time off, because if a person is taking off to do what is important to them, like taking care of a child, then the rest of us feel better about doing extra work."
—Michelle Marks, DO, FAAP, SFHM, director, Center for Pediatric Hospital Medicine, Cleveland Clinic
Things Change
Plans discussed at the outset with a pregnant hospitalist can change after the child is born, HM group directors caution.
"Particularly for the first child, people say, ‘I’ll come back full blast. Don’t worry about it.’ And they figure out how hard all that is in the first couple of weeks, and then I get a different answer," Dr. Tovar says. "I think the whole mom/wife/doctor thing is tough. I recognize how hard that is. Even though I am not in that role, I can see it."
Dr. Gundersen suggests group directors have a backup plan, in case the maternity leave lasts longer than expected or the transition back to work is delayed. "It really prevents you from putting pressure on the physician," he says.
If a hospitalist who had planned to come back full time decides that she wants to work less, a director should check with HR to see what the process would entail.
"Generally, we have to negotiate a time frame for when they can drop down" to part-time hours, Dr. Marks says. "It usually takes three to four months for me to be able to adjust staffing to make it work."
Back to Work
Physicians can return from maternity leave in a reduced role, but they very rarely drop out of medicine entirely, Dr. Marks says.
"[They] have put in a lot of time to get where they are," she says. "Plus, women in medicine are usually high achievers and very interested in their careers."
Yet hospitalist leaders should recognize that returning to work after having a baby is stressful. It will take some time for the returning hospitalist to develop a rhythm between her duties as a mother and a doctor.
Directors can review the hospitalist’s nonclinical roles, help with priorities, and perhaps reassign some of the responsibilities to colleagues, Dr. Marks says. With more women breastfeeding, it is important to provide a convenient space with a door that locks for women to breast-pump at work, she and the other directors say.
"The best thing in the world is to have colleagues that you trust and can rely on," Dr. Lovins says. "That way, people can help each other out in emergencies, like if someone has to take their kid to the doctor. That’s the kind of program I want to have and would want to be part of."
Lisa Ryan is a freelance writer based in New Jersey.
Editor's Note: Second in a two-part series
Lest anyone forget, it is essential to support workers having children for one reason—the continuation of the human species, says Rachel Lovins, MD, SFHM, who directs the hospitalist program at Waterbury Hospital in Waterbury, Conn. For HM program directors, that means following pregnancy labor laws. But it also should involve reasonably accommodating hospitalists who are balancing their new baby’s needs with the demands of their profession, says Dr. Lovins and other HM leaders.
"As there are more women in medicine, everybody needs to be more aware of this issue. We don’t want to make good talent feel uncomfortable with the process of taking maternity leave and reducing time," says Michelle Marks, DO, FAAP, SFHM, director of the Center for Pediatric Hospital Medicine at the Cleveland Clinic.
All HM program directors need to be aware of such federal laws as the Pregnancy Discrimination Act and the Family and Medical Leave Act (www.eeoc.gov/laws/types/pregnancy.cfm), as well as the corresponding laws of the state in which they work. Directors can contact their human resources (HR) department for assistance.
"Calling them upfront will save a lot of headaches later on," says Jasen Gundersen, MD, MBA, CPE, SFHM, chief medical officer of the hospital medicine division in Fort Lauderdale, Fla., for Knoxville, Tenn.-based TeamHealth.
Here are some other recommendations on how HM directors can best manage pregnancy issues affecting their team:
The "R" in Relationship
There are many reasons why the director of a hospitalist group should develop a good relationship with the providers in their group, but one of them is that a hospitalist is more likely to tell her director sooner rather than later that she is pregnant, Dr. Marks says.
"Knowing your staff well and knowing them personally helps a lot, too, because you can gauge where they are going personally, as far as marriage, children, that type of thing," she adds.
The earlier a group leader knows a staff member is pregnant, the more time they have to plan for maternity leave. And the better the plan, the easier the leave is on the entire group, says Dr. Gundersen.
Generally, finding out that a physician is pregnant within three to five months of conception provides enough time to make adequate arrangements for coverage, Drs. Marks and Lovins note.
The Conversation
Before scheduling a meeting to discuss maternity leave and plans for returning to work with the hospitalist, the group leader should call HR to see if such a conversation is permissible, says Dr. Marks. A better approach might be to wait until the hospitalist broaches the subject.
"So many times the hospitalist will ask for counseling as far as what are her options of coming back," Dr. Marks says. "That opens the door for an open discussion."
Once the conversation starts, the group leader should gauge the length of maternity leave, her plans for coming back full time or part time, and the anticipated scheduling limitations or childcare considerations, Dr. Gundersen says.
"That’s not to say the pregnant woman can really predict all the time what’s going to happen," says Kerry Weiner, MD, MPH, chief clinical officer for North Hollywood, Calif.-based IPC: The Hospitalist Company, Inc. "Obviously, it’s a medical condition that can change and everyone understands that. It’s getting a feel of what you can actually know at the time."
If it’s the HM director’s intent to call the physician while she is on leave to see how she and the baby are doing and how the maternity leave is going, that should be discussed during the conversation, Dr. Gundersen says.
"If you establish upfront that you are going to make that phone call, I think that’s fine to do," he explains. "If you’re calling constantly and pressuring the person, I don’t think that that’s kosher at all."
—Rachel Lovins, MD, SFHM, director, hospitalist program, Waterbury (Conn.) Hospital
The Coverage Plan
Most maternity leaves are from eight to 12 weeks, although the length varies by HM program and individual. It is essential to have your group’s coverage plan outlined well in advance of the maternity leave.
In a private-practice model in which hospitalists work weekdays and have a call-coverage schedule for nights and weekends, a group leader can spread the extra work among the other hospitalists in the group because there are more hospitalists working during the day when patient census is higher, Dr. Weiner says.
Shifting the workload in other schedule models isn’t always as easy. "In the seven-day-on, seven-day-off model, because of that maximum patient-to-doctor ratio, I don’t think there’s any way to do it without hiring help," Dr. Lovins says. "It’s important to recruit per diems all the time. When you’re in a bind is the worst time to do it."
To limit the disruption to patient care and operations quality, the goal when using outside hospitalists is to contract with physicians who have worked with the group before and who know the community, hospital, systems, and patients, Dr. Weiner says.
For HM groups that use a flexible schedule, maternity coverage plans aren’t really needed, says Reuben Tovar, MD, chairman of Hospital Internists of Austin, a physician-owned and -managed hospitalist practice in Texas.
"We’re not salary, so that changes the dynamic completely. People who work more make more, and people who work less make less," he explains. "We are much more liberal about time off, because if a person is taking off to do what is important to them, like taking care of a child, then the rest of us feel better about doing extra work."
—Michelle Marks, DO, FAAP, SFHM, director, Center for Pediatric Hospital Medicine, Cleveland Clinic
Things Change
Plans discussed at the outset with a pregnant hospitalist can change after the child is born, HM group directors caution.
"Particularly for the first child, people say, ‘I’ll come back full blast. Don’t worry about it.’ And they figure out how hard all that is in the first couple of weeks, and then I get a different answer," Dr. Tovar says. "I think the whole mom/wife/doctor thing is tough. I recognize how hard that is. Even though I am not in that role, I can see it."
Dr. Gundersen suggests group directors have a backup plan, in case the maternity leave lasts longer than expected or the transition back to work is delayed. "It really prevents you from putting pressure on the physician," he says.
If a hospitalist who had planned to come back full time decides that she wants to work less, a director should check with HR to see what the process would entail.
"Generally, we have to negotiate a time frame for when they can drop down" to part-time hours, Dr. Marks says. "It usually takes three to four months for me to be able to adjust staffing to make it work."
Back to Work
Physicians can return from maternity leave in a reduced role, but they very rarely drop out of medicine entirely, Dr. Marks says.
"[They] have put in a lot of time to get where they are," she says. "Plus, women in medicine are usually high achievers and very interested in their careers."
Yet hospitalist leaders should recognize that returning to work after having a baby is stressful. It will take some time for the returning hospitalist to develop a rhythm between her duties as a mother and a doctor.
Directors can review the hospitalist’s nonclinical roles, help with priorities, and perhaps reassign some of the responsibilities to colleagues, Dr. Marks says. With more women breastfeeding, it is important to provide a convenient space with a door that locks for women to breast-pump at work, she and the other directors say.
"The best thing in the world is to have colleagues that you trust and can rely on," Dr. Lovins says. "That way, people can help each other out in emergencies, like if someone has to take their kid to the doctor. That’s the kind of program I want to have and would want to be part of."
Lisa Ryan is a freelance writer based in New Jersey.
Editor's Note: Second in a two-part series
Lest anyone forget, it is essential to support workers having children for one reason—the continuation of the human species, says Rachel Lovins, MD, SFHM, who directs the hospitalist program at Waterbury Hospital in Waterbury, Conn. For HM program directors, that means following pregnancy labor laws. But it also should involve reasonably accommodating hospitalists who are balancing their new baby’s needs with the demands of their profession, says Dr. Lovins and other HM leaders.
"As there are more women in medicine, everybody needs to be more aware of this issue. We don’t want to make good talent feel uncomfortable with the process of taking maternity leave and reducing time," says Michelle Marks, DO, FAAP, SFHM, director of the Center for Pediatric Hospital Medicine at the Cleveland Clinic.
All HM program directors need to be aware of such federal laws as the Pregnancy Discrimination Act and the Family and Medical Leave Act (www.eeoc.gov/laws/types/pregnancy.cfm), as well as the corresponding laws of the state in which they work. Directors can contact their human resources (HR) department for assistance.
"Calling them upfront will save a lot of headaches later on," says Jasen Gundersen, MD, MBA, CPE, SFHM, chief medical officer of the hospital medicine division in Fort Lauderdale, Fla., for Knoxville, Tenn.-based TeamHealth.
Here are some other recommendations on how HM directors can best manage pregnancy issues affecting their team:
The "R" in Relationship
There are many reasons why the director of a hospitalist group should develop a good relationship with the providers in their group, but one of them is that a hospitalist is more likely to tell her director sooner rather than later that she is pregnant, Dr. Marks says.
"Knowing your staff well and knowing them personally helps a lot, too, because you can gauge where they are going personally, as far as marriage, children, that type of thing," she adds.
The earlier a group leader knows a staff member is pregnant, the more time they have to plan for maternity leave. And the better the plan, the easier the leave is on the entire group, says Dr. Gundersen.
Generally, finding out that a physician is pregnant within three to five months of conception provides enough time to make adequate arrangements for coverage, Drs. Marks and Lovins note.
The Conversation
Before scheduling a meeting to discuss maternity leave and plans for returning to work with the hospitalist, the group leader should call HR to see if such a conversation is permissible, says Dr. Marks. A better approach might be to wait until the hospitalist broaches the subject.
"So many times the hospitalist will ask for counseling as far as what are her options of coming back," Dr. Marks says. "That opens the door for an open discussion."
Once the conversation starts, the group leader should gauge the length of maternity leave, her plans for coming back full time or part time, and the anticipated scheduling limitations or childcare considerations, Dr. Gundersen says.
"That’s not to say the pregnant woman can really predict all the time what’s going to happen," says Kerry Weiner, MD, MPH, chief clinical officer for North Hollywood, Calif.-based IPC: The Hospitalist Company, Inc. "Obviously, it’s a medical condition that can change and everyone understands that. It’s getting a feel of what you can actually know at the time."
If it’s the HM director’s intent to call the physician while she is on leave to see how she and the baby are doing and how the maternity leave is going, that should be discussed during the conversation, Dr. Gundersen says.
"If you establish upfront that you are going to make that phone call, I think that’s fine to do," he explains. "If you’re calling constantly and pressuring the person, I don’t think that that’s kosher at all."
—Rachel Lovins, MD, SFHM, director, hospitalist program, Waterbury (Conn.) Hospital
The Coverage Plan
Most maternity leaves are from eight to 12 weeks, although the length varies by HM program and individual. It is essential to have your group’s coverage plan outlined well in advance of the maternity leave.
In a private-practice model in which hospitalists work weekdays and have a call-coverage schedule for nights and weekends, a group leader can spread the extra work among the other hospitalists in the group because there are more hospitalists working during the day when patient census is higher, Dr. Weiner says.
Shifting the workload in other schedule models isn’t always as easy. "In the seven-day-on, seven-day-off model, because of that maximum patient-to-doctor ratio, I don’t think there’s any way to do it without hiring help," Dr. Lovins says. "It’s important to recruit per diems all the time. When you’re in a bind is the worst time to do it."
To limit the disruption to patient care and operations quality, the goal when using outside hospitalists is to contract with physicians who have worked with the group before and who know the community, hospital, systems, and patients, Dr. Weiner says.
For HM groups that use a flexible schedule, maternity coverage plans aren’t really needed, says Reuben Tovar, MD, chairman of Hospital Internists of Austin, a physician-owned and -managed hospitalist practice in Texas.
"We’re not salary, so that changes the dynamic completely. People who work more make more, and people who work less make less," he explains. "We are much more liberal about time off, because if a person is taking off to do what is important to them, like taking care of a child, then the rest of us feel better about doing extra work."
—Michelle Marks, DO, FAAP, SFHM, director, Center for Pediatric Hospital Medicine, Cleveland Clinic
Things Change
Plans discussed at the outset with a pregnant hospitalist can change after the child is born, HM group directors caution.
"Particularly for the first child, people say, ‘I’ll come back full blast. Don’t worry about it.’ And they figure out how hard all that is in the first couple of weeks, and then I get a different answer," Dr. Tovar says. "I think the whole mom/wife/doctor thing is tough. I recognize how hard that is. Even though I am not in that role, I can see it."
Dr. Gundersen suggests group directors have a backup plan, in case the maternity leave lasts longer than expected or the transition back to work is delayed. "It really prevents you from putting pressure on the physician," he says.
If a hospitalist who had planned to come back full time decides that she wants to work less, a director should check with HR to see what the process would entail.
"Generally, we have to negotiate a time frame for when they can drop down" to part-time hours, Dr. Marks says. "It usually takes three to four months for me to be able to adjust staffing to make it work."
Back to Work
Physicians can return from maternity leave in a reduced role, but they very rarely drop out of medicine entirely, Dr. Marks says.
"[They] have put in a lot of time to get where they are," she says. "Plus, women in medicine are usually high achievers and very interested in their careers."
Yet hospitalist leaders should recognize that returning to work after having a baby is stressful. It will take some time for the returning hospitalist to develop a rhythm between her duties as a mother and a doctor.
Directors can review the hospitalist’s nonclinical roles, help with priorities, and perhaps reassign some of the responsibilities to colleagues, Dr. Marks says. With more women breastfeeding, it is important to provide a convenient space with a door that locks for women to breast-pump at work, she and the other directors say.
"The best thing in the world is to have colleagues that you trust and can rely on," Dr. Lovins says. "That way, people can help each other out in emergencies, like if someone has to take their kid to the doctor. That’s the kind of program I want to have and would want to be part of."
Lisa Ryan is a freelance writer based in New Jersey.
ONLINE EXCLUSIVE: Listen to program directors discuss managing a group when a hospitalist is out on maternity leave
Click here to listen to Dr. Weiner
Click here to listen to Dr. Marks
Click here to listen to Dr. Weiner
Click here to listen to Dr. Marks
Click here to listen to Dr. Weiner
Click here to listen to Dr. Marks
Nonclinical Skills Essential to Successful HM Career
Being a good hospitalist means more than being an adroit clinician. But when it comes to teaching nonclinical aptitude, traditional residency programs often come up short, says Russell Holman, MD, MHM, former SHM president and chief clinical officer of Brentwood, Tenn.-based Cogent Healthcare. He and other HM experts recommend that boots-on-the-ground hospitalists acquire the following nonclinical skills in a purposeful manner as part of their ongoing learning and long-term career goals.
Communication
Hospitalists are the liaison between hospital administrators, managed-care companies, case managers, patients, patients’ families, and primary-care physicians (PCPs), says Isela Sotolongo, executive director of the Southeast region for North Hollywood, Calif.-based IPC: The Hospitalist Company. “A lot of times, more time is spent communicating with all the individuals that are involved in the patient’s admission than is actually spent with the patient,” she says.
—Isela Sotolongo, executive director, Southeast region, IPC: The Hospitalist Company, North Hollywood, Calif.
Hospitalists must quickly establish a relationship with patients and their families; manage specialists and ancillary personnel; brief a PCP on a patient’s needs after discharge; update case managers on a course of hospitalization; and demonstrate effective, efficient patient care to hospital administrators. Being able to express such information in a concise manner that is understood by others will reduce errors and save time and effort, Dr. Holman and Sotolongo say.
Quality Improvement (QI)
An awareness and working knowledge of QI methodologies should be part of a hospitalist’s everyday professional life, Dr. Holman says. QI helps reduce unwanted variation in patient care and enhances the process and outcomes of such care.
“Hospitalists are almost always looked to as being a linchpin in the hospital to improving quality,” he says. Therefore, while QI might not be a hospitalist’s special interest, it is still good to know the basics and how to apply them to actual HM practice, Dr. Holman says.
Leadership
“Even if a hospitalist is not serving as medical director of their hospital medicine group, they are considered to be a leader in their own right,” Dr. Holman says.
A hospitalist takes charge of the admission process and is the person who manages all aspects of a patient’s care throughout the hospital stay to the point of discharge, Sotolongo says. (Click here to listen to Isela Sotolongo discuss hospitalist leadership and communication in detail.)
Also, a hospitalist might be leading and participating in QI activities at the hospital or leading the discussion for a multidisciplinary team, Dr. Holman notes. Having leadership skills helps a hospitalist appreciate the work their medical director must do, or the work that hospital administrators are trying to accomplish, he says.
Teamwork
Teamwork is an essential skill for hospitalists, yet traditional medical training often teaches doctors to be more of a rugged individualist, Dr. Holman says. Hospitalists should make it a point to adopt new behaviors that are teamwork-friendly:
- Value other members of the healthcare team;
- Direct people’s talents to their highest and best use; and
- Delegate tasks to those who are best suited to accomplish those particular needs.
“Teamwork tends to place much more emphasis on the patient being the center of care and others on the healthcare team going to support those patient-centered interests,” Dr. Holman say.
The Patient Perspective
How a patient moves through the healthcare system in theory is often different from reality. A hospitalist should physically follow some of their patients as they move from the hospital back to their caregivers at home or to a rehabilitation center, nursing home, or other facility in order to watch the transition, says Jasen Gundersen, MD, MBA, CPE, SFHM, chief medical officer of the hospital medicine division in Fort Lauderdale, Fla., for Knoxville, Tenn.-based TeamHealth. By doing this, a hospitalist can see where problems arise during handoffs and how to resolve them so that hospital readmissions are reduced.
Teaching
Teaching skills can be applicable in any hospital environment, Dr. Holman adds. Hospitalists who work in nonteaching hospitals often serve as teachers to nursing staff, case management, pharmacists, discharge planners, and other ancillary staff in their daily interaction or over lunchtime educational programs. HM also can provide the bulk of a hospital’s grand rounds or other departmental educational sessions, he says.
“Let's not forget about patients and caregivers,” Dr. Holman adds. “The ability to teach patients and caregivers the necessary information and skills that they need for self-care, for follow-up care, and for compliance to a medical plan is important.”
Professional Evaluation
A hospitalist has to know on which metrics and measurements their success will be based, Dr. Holman says. Will it be patient satisfaction, length of stay, readmission rates, mortality rates, or some other measure?
“We have to be aware of what the hospital’s needs are, what the hospital’s key points are that they look for,” Sotolongo says.
Once the metrics are clear, a hospitalist can set goals to accomplish individually, as a member of an HM group, and partner with the hospital, Dr. Holman says.
Lisa Ryan is a freelance writer based in New Jersey.
Being a good hospitalist means more than being an adroit clinician. But when it comes to teaching nonclinical aptitude, traditional residency programs often come up short, says Russell Holman, MD, MHM, former SHM president and chief clinical officer of Brentwood, Tenn.-based Cogent Healthcare. He and other HM experts recommend that boots-on-the-ground hospitalists acquire the following nonclinical skills in a purposeful manner as part of their ongoing learning and long-term career goals.
Communication
Hospitalists are the liaison between hospital administrators, managed-care companies, case managers, patients, patients’ families, and primary-care physicians (PCPs), says Isela Sotolongo, executive director of the Southeast region for North Hollywood, Calif.-based IPC: The Hospitalist Company. “A lot of times, more time is spent communicating with all the individuals that are involved in the patient’s admission than is actually spent with the patient,” she says.
—Isela Sotolongo, executive director, Southeast region, IPC: The Hospitalist Company, North Hollywood, Calif.
Hospitalists must quickly establish a relationship with patients and their families; manage specialists and ancillary personnel; brief a PCP on a patient’s needs after discharge; update case managers on a course of hospitalization; and demonstrate effective, efficient patient care to hospital administrators. Being able to express such information in a concise manner that is understood by others will reduce errors and save time and effort, Dr. Holman and Sotolongo say.
Quality Improvement (QI)
An awareness and working knowledge of QI methodologies should be part of a hospitalist’s everyday professional life, Dr. Holman says. QI helps reduce unwanted variation in patient care and enhances the process and outcomes of such care.
“Hospitalists are almost always looked to as being a linchpin in the hospital to improving quality,” he says. Therefore, while QI might not be a hospitalist’s special interest, it is still good to know the basics and how to apply them to actual HM practice, Dr. Holman says.
Leadership
“Even if a hospitalist is not serving as medical director of their hospital medicine group, they are considered to be a leader in their own right,” Dr. Holman says.
A hospitalist takes charge of the admission process and is the person who manages all aspects of a patient’s care throughout the hospital stay to the point of discharge, Sotolongo says. (Click here to listen to Isela Sotolongo discuss hospitalist leadership and communication in detail.)
Also, a hospitalist might be leading and participating in QI activities at the hospital or leading the discussion for a multidisciplinary team, Dr. Holman notes. Having leadership skills helps a hospitalist appreciate the work their medical director must do, or the work that hospital administrators are trying to accomplish, he says.
Teamwork
Teamwork is an essential skill for hospitalists, yet traditional medical training often teaches doctors to be more of a rugged individualist, Dr. Holman says. Hospitalists should make it a point to adopt new behaviors that are teamwork-friendly:
- Value other members of the healthcare team;
- Direct people’s talents to their highest and best use; and
- Delegate tasks to those who are best suited to accomplish those particular needs.
“Teamwork tends to place much more emphasis on the patient being the center of care and others on the healthcare team going to support those patient-centered interests,” Dr. Holman say.
The Patient Perspective
How a patient moves through the healthcare system in theory is often different from reality. A hospitalist should physically follow some of their patients as they move from the hospital back to their caregivers at home or to a rehabilitation center, nursing home, or other facility in order to watch the transition, says Jasen Gundersen, MD, MBA, CPE, SFHM, chief medical officer of the hospital medicine division in Fort Lauderdale, Fla., for Knoxville, Tenn.-based TeamHealth. By doing this, a hospitalist can see where problems arise during handoffs and how to resolve them so that hospital readmissions are reduced.
Teaching
Teaching skills can be applicable in any hospital environment, Dr. Holman adds. Hospitalists who work in nonteaching hospitals often serve as teachers to nursing staff, case management, pharmacists, discharge planners, and other ancillary staff in their daily interaction or over lunchtime educational programs. HM also can provide the bulk of a hospital’s grand rounds or other departmental educational sessions, he says.
“Let's not forget about patients and caregivers,” Dr. Holman adds. “The ability to teach patients and caregivers the necessary information and skills that they need for self-care, for follow-up care, and for compliance to a medical plan is important.”
Professional Evaluation
A hospitalist has to know on which metrics and measurements their success will be based, Dr. Holman says. Will it be patient satisfaction, length of stay, readmission rates, mortality rates, or some other measure?
“We have to be aware of what the hospital’s needs are, what the hospital’s key points are that they look for,” Sotolongo says.
Once the metrics are clear, a hospitalist can set goals to accomplish individually, as a member of an HM group, and partner with the hospital, Dr. Holman says.
Lisa Ryan is a freelance writer based in New Jersey.
Being a good hospitalist means more than being an adroit clinician. But when it comes to teaching nonclinical aptitude, traditional residency programs often come up short, says Russell Holman, MD, MHM, former SHM president and chief clinical officer of Brentwood, Tenn.-based Cogent Healthcare. He and other HM experts recommend that boots-on-the-ground hospitalists acquire the following nonclinical skills in a purposeful manner as part of their ongoing learning and long-term career goals.
Communication
Hospitalists are the liaison between hospital administrators, managed-care companies, case managers, patients, patients’ families, and primary-care physicians (PCPs), says Isela Sotolongo, executive director of the Southeast region for North Hollywood, Calif.-based IPC: The Hospitalist Company. “A lot of times, more time is spent communicating with all the individuals that are involved in the patient’s admission than is actually spent with the patient,” she says.
—Isela Sotolongo, executive director, Southeast region, IPC: The Hospitalist Company, North Hollywood, Calif.
Hospitalists must quickly establish a relationship with patients and their families; manage specialists and ancillary personnel; brief a PCP on a patient’s needs after discharge; update case managers on a course of hospitalization; and demonstrate effective, efficient patient care to hospital administrators. Being able to express such information in a concise manner that is understood by others will reduce errors and save time and effort, Dr. Holman and Sotolongo say.
Quality Improvement (QI)
An awareness and working knowledge of QI methodologies should be part of a hospitalist’s everyday professional life, Dr. Holman says. QI helps reduce unwanted variation in patient care and enhances the process and outcomes of such care.
“Hospitalists are almost always looked to as being a linchpin in the hospital to improving quality,” he says. Therefore, while QI might not be a hospitalist’s special interest, it is still good to know the basics and how to apply them to actual HM practice, Dr. Holman says.
Leadership
“Even if a hospitalist is not serving as medical director of their hospital medicine group, they are considered to be a leader in their own right,” Dr. Holman says.
A hospitalist takes charge of the admission process and is the person who manages all aspects of a patient’s care throughout the hospital stay to the point of discharge, Sotolongo says. (Click here to listen to Isela Sotolongo discuss hospitalist leadership and communication in detail.)
Also, a hospitalist might be leading and participating in QI activities at the hospital or leading the discussion for a multidisciplinary team, Dr. Holman notes. Having leadership skills helps a hospitalist appreciate the work their medical director must do, or the work that hospital administrators are trying to accomplish, he says.
Teamwork
Teamwork is an essential skill for hospitalists, yet traditional medical training often teaches doctors to be more of a rugged individualist, Dr. Holman says. Hospitalists should make it a point to adopt new behaviors that are teamwork-friendly:
- Value other members of the healthcare team;
- Direct people’s talents to their highest and best use; and
- Delegate tasks to those who are best suited to accomplish those particular needs.
“Teamwork tends to place much more emphasis on the patient being the center of care and others on the healthcare team going to support those patient-centered interests,” Dr. Holman say.
The Patient Perspective
How a patient moves through the healthcare system in theory is often different from reality. A hospitalist should physically follow some of their patients as they move from the hospital back to their caregivers at home or to a rehabilitation center, nursing home, or other facility in order to watch the transition, says Jasen Gundersen, MD, MBA, CPE, SFHM, chief medical officer of the hospital medicine division in Fort Lauderdale, Fla., for Knoxville, Tenn.-based TeamHealth. By doing this, a hospitalist can see where problems arise during handoffs and how to resolve them so that hospital readmissions are reduced.
Teaching
Teaching skills can be applicable in any hospital environment, Dr. Holman adds. Hospitalists who work in nonteaching hospitals often serve as teachers to nursing staff, case management, pharmacists, discharge planners, and other ancillary staff in their daily interaction or over lunchtime educational programs. HM also can provide the bulk of a hospital’s grand rounds or other departmental educational sessions, he says.
“Let's not forget about patients and caregivers,” Dr. Holman adds. “The ability to teach patients and caregivers the necessary information and skills that they need for self-care, for follow-up care, and for compliance to a medical plan is important.”
Professional Evaluation
A hospitalist has to know on which metrics and measurements their success will be based, Dr. Holman says. Will it be patient satisfaction, length of stay, readmission rates, mortality rates, or some other measure?
“We have to be aware of what the hospital’s needs are, what the hospital’s key points are that they look for,” Sotolongo says.
Once the metrics are clear, a hospitalist can set goals to accomplish individually, as a member of an HM group, and partner with the hospital, Dr. Holman says.
Lisa Ryan is a freelance writer based in New Jersey.
Maternity, Motherhood, and Medicine
Anna Gilley, MD, often worries about what would happen if her toddler got seriously sick while she was at work and the nanny didn’t know what to do. Working mothers in other professions might be able to leave their job at a moment’s notice, but Dr. Gilley says she doesn’t have that ability as a pediatric hospitalist at Hendricks Regional Health in Danville, Ind.
“Being a hospitalist, when I’m at work, I’m definitely at work. I cannot leave,” she says. “I have patients to look after who depend on me.”
So far, her daughter, who turned 1 last month, has been healthy. But the possibility of not being home if her little girl gets sick or injured weighs on Dr. Gilley’s mind.
With HM still a young medical profession and hospitalists with small children common, Dr. Gilley is not alone in her concerns. They range from the issues working mothers across professions experience (fatigue, time constraints, work-motherhood balance, breast-pumping) to such challenges as nontraditional work schedules and patient obligations that are unique to physicians.
“Sometimes you feel like you are the only person in the world who is going through this, but obviously you’re not,” Dr. Gilley says. “There is always a benefit to having people who have gone through the same thing you are going through.”
Pregnancy and Maternity Leave
When Jane Yeh, MD, a hospitalist at Overlake Hospital in Bellevue, Wash., was pregnant with the first of her two children, she often would seek advice from a colleague who had given birth two years before. The guidance she received then is something Dr. Yeh, who has sons ages 2 and 4, now passes along to hospitalists who are expecting.
“Keep an open mind and don’t put yourself into a corner that you can’t back out of,” she says.
Having a baby completely changes a person’s life, so when hospitalists speak with their group directors about work after maternity leave, they should avoid committing to a full-time contract and fixed start date, and instead talk about opportunities for flexibility, Dr. Yeh says.
Upon giving birth to her first son, Dr. Yeh’s initial thought was to take three months’ maternity leave and go back to work on a 0.6 FTE basis. Eventually, she returned to the job after four months and gradually added shifts over the next four to eight weeks to reach 60% working time. “It was the whole first-time mother thing,” she says, adding hospitalists on maternity leave should openly and honestly communicate their work intentions with their director.
Plan on taking as much maternity leave as possible under the law and workplace policy, counsels Roberta Chinsky Matuson, who has advised scores of pregnant women across professions about work-related topics as president of Northampton, Mass.-based Human Resources Solutions. “You can always come back early,” Matuson says.
While Hendricks Regional Health allows a maximum of 12 weeks of maternity leave, Dr. Gilley took 10 weeks. Under her seven-on/seven-off schedule, she works one week of day shift followed by one week off, and one week of night shift followed by one week off. “I think if I were working every day, I would have taken advantage of the full 12 weeks off, but 10 weeks was good enough for me,” she says.
Full Time Vs. Part Time
Carolyn McHugh, MD, MPH, who was hired by Overlake Hospital when she was pregnant and finishing her residency, always planned to go back to work after giving birth to her daughter, but on a part-time basis. “I had to work pretty hard to find part-time work,” she says.
Aside from a few months of working full time while she was pregnant with her second child and her husband was out of work, Dr. McHugh continues to work part-time. She gets paid a little more per shift but doesn’t have benefits. When she was out on maternity leave, it was unpaid leave.
Her boss will frequently ask if she wants to switch to full time, but Dr. McHugh, who has a 3 1/2-year-old daughter and a 16-month-old son, is content to decline. There are days now when she doesn’t see her children at all due to work, and her daughter’s cooperative preschool requires considerable hands-on involvement from parents.
“Maybe when my kids are in school, I’ll do it, but really, I don’t know,” she says. “I feel like I’m really lucky where I’m at. I have an employer who is concerned about my well-being, and the opportunity exists to move to full time.”
The decision about whether to work full time or part time must start with finances, explains Jennifer Owens, director of the Working Mother Research Institute in New York City. If a working mom can afford to work fewer hours, there are a number of factors that should go into the decision, including:
- Level of involvement with children;
- Impact on earning potential;
- Prospects for promotions and other career opportunities;
- Effect on relationship with spouse;
- Ability to switch to full-time work down the road;
- Level of support from family and spouse; and
- Impact on health benefits.
“It’s just a cost-benefit analysis where the costs and the benefits involve your baby,” Owens says. “You know the work environment that you’re in; you know the family environment. … Only you know all the factors.”
From the start of her pregnancy, Dr. Gilley knew she would be returning to work full time. “My husband is still a resident and that made a big impact on my decision. I work two weeks out of the month and that makes a big difference, too,” she says. “If my husband was out of residency and if we were a little more stable, I think I could have chosen part time.”
A self-described Type A personality, Dr. Gilley said she also chose full time because she needs to be doing something at all times.
“On my weeks off, I love it and I enjoy being with my daughter, but sometimes I’m ready to go back to work,” she says.
Back to Work
Dr. Gilley didn’t ease back into work. She jumped right in.
“I was ready to see patients and get back to work to do what I was actually trained to do,” she says. “It was hard mentally and emotionally, but once I was there, I was like, ‘I like this and I can keep doing this.’ ”
It helps that she has a nanny she loves and trusts with watching her child. “I called several times the first couple of days, but after I knew my daughter was fine, I didn’t call as much,” she says.
Nevertheless, Dr. Gilley often asks herself if she is spending too much time at work and not enough time at home.
Hospitalists with babies face many of the same challenges as other working parents returning to the job after maternity leave, Owens says. They have to contend with competing responsibilities, lack of personal time, and separation guilt and anxiety, to name just a few issues.
“The first thing is take it easy,” she says. “Returning from maternity leave and back into your work life can sometimes feel like you’re diving into the deep end of a pool.”
Matuson says hospitalist moms have to be realistic and accept that balancing motherhood and medicine is going to be difficult. “They are going to be totally exhausted, so they have to learn to not take on more projects,” she says. “They have to learn to say no.”
Also, be prepared to feel guilty about being at the hospital and understand there is going to be a lot of making the best of a less-than-ideal situation, Dr. Yeh says. She breastfed her sons and can remember feelings of frustration with the breast-pumping, even though she used a hands-free pump that allowed her to read labs and answer pages. On one hand, she was providing her baby with breast milk but spending less time at home. On the other hand, if she skipped the breast-pumping to get home earlier, her baby didn’t get breast milk.
“There are a lot of different things that make up who we are. We are not just a physician and we are not just a mother,” Dr. Yeh says. “It’s really important to figure out your own balance.” TH
Lisa Ryan is a freelance writer based in New Jersey.
Anna Gilley, MD, often worries about what would happen if her toddler got seriously sick while she was at work and the nanny didn’t know what to do. Working mothers in other professions might be able to leave their job at a moment’s notice, but Dr. Gilley says she doesn’t have that ability as a pediatric hospitalist at Hendricks Regional Health in Danville, Ind.
“Being a hospitalist, when I’m at work, I’m definitely at work. I cannot leave,” she says. “I have patients to look after who depend on me.”
So far, her daughter, who turned 1 last month, has been healthy. But the possibility of not being home if her little girl gets sick or injured weighs on Dr. Gilley’s mind.
With HM still a young medical profession and hospitalists with small children common, Dr. Gilley is not alone in her concerns. They range from the issues working mothers across professions experience (fatigue, time constraints, work-motherhood balance, breast-pumping) to such challenges as nontraditional work schedules and patient obligations that are unique to physicians.
“Sometimes you feel like you are the only person in the world who is going through this, but obviously you’re not,” Dr. Gilley says. “There is always a benefit to having people who have gone through the same thing you are going through.”
Pregnancy and Maternity Leave
When Jane Yeh, MD, a hospitalist at Overlake Hospital in Bellevue, Wash., was pregnant with the first of her two children, she often would seek advice from a colleague who had given birth two years before. The guidance she received then is something Dr. Yeh, who has sons ages 2 and 4, now passes along to hospitalists who are expecting.
“Keep an open mind and don’t put yourself into a corner that you can’t back out of,” she says.
Having a baby completely changes a person’s life, so when hospitalists speak with their group directors about work after maternity leave, they should avoid committing to a full-time contract and fixed start date, and instead talk about opportunities for flexibility, Dr. Yeh says.
Upon giving birth to her first son, Dr. Yeh’s initial thought was to take three months’ maternity leave and go back to work on a 0.6 FTE basis. Eventually, she returned to the job after four months and gradually added shifts over the next four to eight weeks to reach 60% working time. “It was the whole first-time mother thing,” she says, adding hospitalists on maternity leave should openly and honestly communicate their work intentions with their director.
Plan on taking as much maternity leave as possible under the law and workplace policy, counsels Roberta Chinsky Matuson, who has advised scores of pregnant women across professions about work-related topics as president of Northampton, Mass.-based Human Resources Solutions. “You can always come back early,” Matuson says.
While Hendricks Regional Health allows a maximum of 12 weeks of maternity leave, Dr. Gilley took 10 weeks. Under her seven-on/seven-off schedule, she works one week of day shift followed by one week off, and one week of night shift followed by one week off. “I think if I were working every day, I would have taken advantage of the full 12 weeks off, but 10 weeks was good enough for me,” she says.
Full Time Vs. Part Time
Carolyn McHugh, MD, MPH, who was hired by Overlake Hospital when she was pregnant and finishing her residency, always planned to go back to work after giving birth to her daughter, but on a part-time basis. “I had to work pretty hard to find part-time work,” she says.
Aside from a few months of working full time while she was pregnant with her second child and her husband was out of work, Dr. McHugh continues to work part-time. She gets paid a little more per shift but doesn’t have benefits. When she was out on maternity leave, it was unpaid leave.
Her boss will frequently ask if she wants to switch to full time, but Dr. McHugh, who has a 3 1/2-year-old daughter and a 16-month-old son, is content to decline. There are days now when she doesn’t see her children at all due to work, and her daughter’s cooperative preschool requires considerable hands-on involvement from parents.
“Maybe when my kids are in school, I’ll do it, but really, I don’t know,” she says. “I feel like I’m really lucky where I’m at. I have an employer who is concerned about my well-being, and the opportunity exists to move to full time.”
The decision about whether to work full time or part time must start with finances, explains Jennifer Owens, director of the Working Mother Research Institute in New York City. If a working mom can afford to work fewer hours, there are a number of factors that should go into the decision, including:
- Level of involvement with children;
- Impact on earning potential;
- Prospects for promotions and other career opportunities;
- Effect on relationship with spouse;
- Ability to switch to full-time work down the road;
- Level of support from family and spouse; and
- Impact on health benefits.
“It’s just a cost-benefit analysis where the costs and the benefits involve your baby,” Owens says. “You know the work environment that you’re in; you know the family environment. … Only you know all the factors.”
From the start of her pregnancy, Dr. Gilley knew she would be returning to work full time. “My husband is still a resident and that made a big impact on my decision. I work two weeks out of the month and that makes a big difference, too,” she says. “If my husband was out of residency and if we were a little more stable, I think I could have chosen part time.”
A self-described Type A personality, Dr. Gilley said she also chose full time because she needs to be doing something at all times.
“On my weeks off, I love it and I enjoy being with my daughter, but sometimes I’m ready to go back to work,” she says.
Back to Work
Dr. Gilley didn’t ease back into work. She jumped right in.
“I was ready to see patients and get back to work to do what I was actually trained to do,” she says. “It was hard mentally and emotionally, but once I was there, I was like, ‘I like this and I can keep doing this.’ ”
It helps that she has a nanny she loves and trusts with watching her child. “I called several times the first couple of days, but after I knew my daughter was fine, I didn’t call as much,” she says.
Nevertheless, Dr. Gilley often asks herself if she is spending too much time at work and not enough time at home.
Hospitalists with babies face many of the same challenges as other working parents returning to the job after maternity leave, Owens says. They have to contend with competing responsibilities, lack of personal time, and separation guilt and anxiety, to name just a few issues.
“The first thing is take it easy,” she says. “Returning from maternity leave and back into your work life can sometimes feel like you’re diving into the deep end of a pool.”
Matuson says hospitalist moms have to be realistic and accept that balancing motherhood and medicine is going to be difficult. “They are going to be totally exhausted, so they have to learn to not take on more projects,” she says. “They have to learn to say no.”
Also, be prepared to feel guilty about being at the hospital and understand there is going to be a lot of making the best of a less-than-ideal situation, Dr. Yeh says. She breastfed her sons and can remember feelings of frustration with the breast-pumping, even though she used a hands-free pump that allowed her to read labs and answer pages. On one hand, she was providing her baby with breast milk but spending less time at home. On the other hand, if she skipped the breast-pumping to get home earlier, her baby didn’t get breast milk.
“There are a lot of different things that make up who we are. We are not just a physician and we are not just a mother,” Dr. Yeh says. “It’s really important to figure out your own balance.” TH
Lisa Ryan is a freelance writer based in New Jersey.
Anna Gilley, MD, often worries about what would happen if her toddler got seriously sick while she was at work and the nanny didn’t know what to do. Working mothers in other professions might be able to leave their job at a moment’s notice, but Dr. Gilley says she doesn’t have that ability as a pediatric hospitalist at Hendricks Regional Health in Danville, Ind.
“Being a hospitalist, when I’m at work, I’m definitely at work. I cannot leave,” she says. “I have patients to look after who depend on me.”
So far, her daughter, who turned 1 last month, has been healthy. But the possibility of not being home if her little girl gets sick or injured weighs on Dr. Gilley’s mind.
With HM still a young medical profession and hospitalists with small children common, Dr. Gilley is not alone in her concerns. They range from the issues working mothers across professions experience (fatigue, time constraints, work-motherhood balance, breast-pumping) to such challenges as nontraditional work schedules and patient obligations that are unique to physicians.
“Sometimes you feel like you are the only person in the world who is going through this, but obviously you’re not,” Dr. Gilley says. “There is always a benefit to having people who have gone through the same thing you are going through.”
Pregnancy and Maternity Leave
When Jane Yeh, MD, a hospitalist at Overlake Hospital in Bellevue, Wash., was pregnant with the first of her two children, she often would seek advice from a colleague who had given birth two years before. The guidance she received then is something Dr. Yeh, who has sons ages 2 and 4, now passes along to hospitalists who are expecting.
“Keep an open mind and don’t put yourself into a corner that you can’t back out of,” she says.
Having a baby completely changes a person’s life, so when hospitalists speak with their group directors about work after maternity leave, they should avoid committing to a full-time contract and fixed start date, and instead talk about opportunities for flexibility, Dr. Yeh says.
Upon giving birth to her first son, Dr. Yeh’s initial thought was to take three months’ maternity leave and go back to work on a 0.6 FTE basis. Eventually, she returned to the job after four months and gradually added shifts over the next four to eight weeks to reach 60% working time. “It was the whole first-time mother thing,” she says, adding hospitalists on maternity leave should openly and honestly communicate their work intentions with their director.
Plan on taking as much maternity leave as possible under the law and workplace policy, counsels Roberta Chinsky Matuson, who has advised scores of pregnant women across professions about work-related topics as president of Northampton, Mass.-based Human Resources Solutions. “You can always come back early,” Matuson says.
While Hendricks Regional Health allows a maximum of 12 weeks of maternity leave, Dr. Gilley took 10 weeks. Under her seven-on/seven-off schedule, she works one week of day shift followed by one week off, and one week of night shift followed by one week off. “I think if I were working every day, I would have taken advantage of the full 12 weeks off, but 10 weeks was good enough for me,” she says.
Full Time Vs. Part Time
Carolyn McHugh, MD, MPH, who was hired by Overlake Hospital when she was pregnant and finishing her residency, always planned to go back to work after giving birth to her daughter, but on a part-time basis. “I had to work pretty hard to find part-time work,” she says.
Aside from a few months of working full time while she was pregnant with her second child and her husband was out of work, Dr. McHugh continues to work part-time. She gets paid a little more per shift but doesn’t have benefits. When she was out on maternity leave, it was unpaid leave.
Her boss will frequently ask if she wants to switch to full time, but Dr. McHugh, who has a 3 1/2-year-old daughter and a 16-month-old son, is content to decline. There are days now when she doesn’t see her children at all due to work, and her daughter’s cooperative preschool requires considerable hands-on involvement from parents.
“Maybe when my kids are in school, I’ll do it, but really, I don’t know,” she says. “I feel like I’m really lucky where I’m at. I have an employer who is concerned about my well-being, and the opportunity exists to move to full time.”
The decision about whether to work full time or part time must start with finances, explains Jennifer Owens, director of the Working Mother Research Institute in New York City. If a working mom can afford to work fewer hours, there are a number of factors that should go into the decision, including:
- Level of involvement with children;
- Impact on earning potential;
- Prospects for promotions and other career opportunities;
- Effect on relationship with spouse;
- Ability to switch to full-time work down the road;
- Level of support from family and spouse; and
- Impact on health benefits.
“It’s just a cost-benefit analysis where the costs and the benefits involve your baby,” Owens says. “You know the work environment that you’re in; you know the family environment. … Only you know all the factors.”
From the start of her pregnancy, Dr. Gilley knew she would be returning to work full time. “My husband is still a resident and that made a big impact on my decision. I work two weeks out of the month and that makes a big difference, too,” she says. “If my husband was out of residency and if we were a little more stable, I think I could have chosen part time.”
A self-described Type A personality, Dr. Gilley said she also chose full time because she needs to be doing something at all times.
“On my weeks off, I love it and I enjoy being with my daughter, but sometimes I’m ready to go back to work,” she says.
Back to Work
Dr. Gilley didn’t ease back into work. She jumped right in.
“I was ready to see patients and get back to work to do what I was actually trained to do,” she says. “It was hard mentally and emotionally, but once I was there, I was like, ‘I like this and I can keep doing this.’ ”
It helps that she has a nanny she loves and trusts with watching her child. “I called several times the first couple of days, but after I knew my daughter was fine, I didn’t call as much,” she says.
Nevertheless, Dr. Gilley often asks herself if she is spending too much time at work and not enough time at home.
Hospitalists with babies face many of the same challenges as other working parents returning to the job after maternity leave, Owens says. They have to contend with competing responsibilities, lack of personal time, and separation guilt and anxiety, to name just a few issues.
“The first thing is take it easy,” she says. “Returning from maternity leave and back into your work life can sometimes feel like you’re diving into the deep end of a pool.”
Matuson says hospitalist moms have to be realistic and accept that balancing motherhood and medicine is going to be difficult. “They are going to be totally exhausted, so they have to learn to not take on more projects,” she says. “They have to learn to say no.”
Also, be prepared to feel guilty about being at the hospital and understand there is going to be a lot of making the best of a less-than-ideal situation, Dr. Yeh says. She breastfed her sons and can remember feelings of frustration with the breast-pumping, even though she used a hands-free pump that allowed her to read labs and answer pages. On one hand, she was providing her baby with breast milk but spending less time at home. On the other hand, if she skipped the breast-pumping to get home earlier, her baby didn’t get breast milk.
“There are a lot of different things that make up who we are. We are not just a physician and we are not just a mother,” Dr. Yeh says. “It’s really important to figure out your own balance.” TH
Lisa Ryan is a freelance writer based in New Jersey.
Flexibility Is King
Michael Radzienda, MD, FHM, once worked in a hospitalist program in which physicians were scheduled 30 days straight on clinical duty and 30 days off clinical duty. Although it sounds harsh by today’s standards, that job was so satisfying, he says, the schedule never felt like a burden. Conversely, he’s seen hospitalists work five days on and five days off, and the job was treacherous.
His point: Work schedules are just one influential piece of the job satisfaction pie.
“Satisfaction has more to do with work relationships and opportunities for growth,” says Dr. Radzienda, chief of hospital medicine and director of hospital medicine service at Medical College of Wisconsin/Froedtert Memorial Lutheran General Hospital in Milwaukee.
Shift-based staffing has become the norm, as more than 70% of hospitalist groups use a shift-based staffing model, according to the State of Hospital Medicine: 2010 Report Based on 2009 Data.1 That figure is up 40% from SHM’s 2005-2006 survey. Conversely, the number of HM groups employing call-based and hybrid (some shift, some call) coverage is declining—2.8% of groups employ call-based schedules, and 26.9% use a hybrid schedule. Those figures have dropped significantly from the 2005-2006 report, from 25% and 35%, respectively.
If you are going to make HM a career, you’ll need time to be with your family and pursue other interests, Dr. Radzienda says. As HM groups turn to more shift-based models, in which hospitalists work a set number of predetermined shifts and have no call responsibility, the challenge is setting a schedule that balances productivity and quality time off.
Fixed = Inflexible
The most popular way to schedule is through blocks of five days on/five days off (5/5) or seven days on/seven days off (7/7), in which hospitalists work 12 or 14 hours at a time, says Troy Ahlstrom, MD, FHM, a member of SHM’s Practice Analysis Committee and CFO of Hospitalists of Northern Michigan, a hospitalist-owned and -managed group based in Traverse City, Mich. Many HM groups employ this model because it’s easy to schedule and is attractive to residents who want a fixed schedule. But from a career satisfaction standpoint, the 5/5 and 7/7 schedule models present their own issues.
Fairness is the first potential pitfall. If all of the physicians in a group work the same schedule, they all have to log the same number of shifts and receive the same compensation. This leaves little to no wiggle room for hospitalists who want to make more money by picking up more shifts or those who want to work fewer shifts, Dr. Ahlstrom says. “People have different income goals,” he adds.
Second, physicians have to see the same number of patients throughout the day. This doesn’t take into consideration the reality that some hospitalists naturally work faster than others, thereby forcing the slower-paced doctors to keep up with an imposed patient load. “Invariably, no matter what you do, people are different,” Dr. Ahlstrom says.
Another consideration is that when physicians are working 12 to 14 hours a day, essentially they have no time for activities other than work and sleep, which doesn’t match the realities of life. Inevitably, things in personal lives crop up, which leads to swapping shifts that the group scheduler doesn’t know about or overloading the scheduler with shift-change requests, Dr. Ahlstrom explains.
Additionally, 7/7 schedules and their ilk squeeze a year’s worth of work into a compressed time frame, which can lead to intense stress and burnout, says John Nelson, MD, FACP, MHM, director of the hospitalist practice at Overlake Hospital in Bellevue, Wash., SHM co-founder, and practice management columnist for The Hospitalist. “Maximizing the number of days off is not the holy grail,” he says. “If you choose to shut your life down on days that you work, that is going to be toxic.”
Flexibility Equates to Fairness
Dr. Nelson has long advocated a flexible shift schedule that accommodates individual preferences by giving physicians in the group autonomy in deciding how much or how little they want to work. While the group as a whole has to get all the work done, the flexibility comes from one physician taking more shifts as another takes less.
Dr. Radzienda tries to create teams within his group by pairing hospitalists with similar scheduling preferences. For example, he might have a pair working 5/5 and another working 14/14. “Up front, it takes a lot of work, but once you template it out, it becomes a good strategy,” he says.
He also strives to build robust backup plans and jeopardy models (see “Surge Protection,” September 2010, p. 43) into the schedule for short-notice callouts, as you never know when a hospitalist will need to miss a day or two because of illness or a family emergency. “Psychologically, it helps to know that you don’t have to be a hero if you’re ill or emotionally strained,” Dr. Radzienda says.
Dr. Ahlstrom agrees that a flex-schedule strategy has a positive impact on hospitalists’ career satisfaction and longevity. He suggests hospitalists be allowed to specify how many patients they want to see and be compensated according to their workload through built-in bonuses for physicians who work more. Dr. Nelson suggests paying hospitalists per relative value unit (RVU) of work. “I think hospitalists would like it and find it liberating to be paid on production,” he says.
An added bonus to flexible work hours and patient load, according to Dr. Ahlstrom, is that pay difference “will lead to a far more collegial atmosphere, because physicians know they are getting compensated fairly for the amount of work done.”
Another advantage of a flexible schedule is hospitalists knowing they have the option of ramping up or scaling back the number of shifts they work, Dr. Ahlstrom says—for example, a physician who wants to reduce shifts in order to coach his daughter’s softball team or have Friday nights off to watch her son play high school football.
“You prevent burnout by allowing people to change their work schedule depending on what’s going on in their life,” Dr. Ahlstrom says. TH
Lisa Ryan is a freelance writer based in New Jersey.
Michael Radzienda, MD, FHM, once worked in a hospitalist program in which physicians were scheduled 30 days straight on clinical duty and 30 days off clinical duty. Although it sounds harsh by today’s standards, that job was so satisfying, he says, the schedule never felt like a burden. Conversely, he’s seen hospitalists work five days on and five days off, and the job was treacherous.
His point: Work schedules are just one influential piece of the job satisfaction pie.
“Satisfaction has more to do with work relationships and opportunities for growth,” says Dr. Radzienda, chief of hospital medicine and director of hospital medicine service at Medical College of Wisconsin/Froedtert Memorial Lutheran General Hospital in Milwaukee.
Shift-based staffing has become the norm, as more than 70% of hospitalist groups use a shift-based staffing model, according to the State of Hospital Medicine: 2010 Report Based on 2009 Data.1 That figure is up 40% from SHM’s 2005-2006 survey. Conversely, the number of HM groups employing call-based and hybrid (some shift, some call) coverage is declining—2.8% of groups employ call-based schedules, and 26.9% use a hybrid schedule. Those figures have dropped significantly from the 2005-2006 report, from 25% and 35%, respectively.
If you are going to make HM a career, you’ll need time to be with your family and pursue other interests, Dr. Radzienda says. As HM groups turn to more shift-based models, in which hospitalists work a set number of predetermined shifts and have no call responsibility, the challenge is setting a schedule that balances productivity and quality time off.
Fixed = Inflexible
The most popular way to schedule is through blocks of five days on/five days off (5/5) or seven days on/seven days off (7/7), in which hospitalists work 12 or 14 hours at a time, says Troy Ahlstrom, MD, FHM, a member of SHM’s Practice Analysis Committee and CFO of Hospitalists of Northern Michigan, a hospitalist-owned and -managed group based in Traverse City, Mich. Many HM groups employ this model because it’s easy to schedule and is attractive to residents who want a fixed schedule. But from a career satisfaction standpoint, the 5/5 and 7/7 schedule models present their own issues.
Fairness is the first potential pitfall. If all of the physicians in a group work the same schedule, they all have to log the same number of shifts and receive the same compensation. This leaves little to no wiggle room for hospitalists who want to make more money by picking up more shifts or those who want to work fewer shifts, Dr. Ahlstrom says. “People have different income goals,” he adds.
Second, physicians have to see the same number of patients throughout the day. This doesn’t take into consideration the reality that some hospitalists naturally work faster than others, thereby forcing the slower-paced doctors to keep up with an imposed patient load. “Invariably, no matter what you do, people are different,” Dr. Ahlstrom says.
Another consideration is that when physicians are working 12 to 14 hours a day, essentially they have no time for activities other than work and sleep, which doesn’t match the realities of life. Inevitably, things in personal lives crop up, which leads to swapping shifts that the group scheduler doesn’t know about or overloading the scheduler with shift-change requests, Dr. Ahlstrom explains.
Additionally, 7/7 schedules and their ilk squeeze a year’s worth of work into a compressed time frame, which can lead to intense stress and burnout, says John Nelson, MD, FACP, MHM, director of the hospitalist practice at Overlake Hospital in Bellevue, Wash., SHM co-founder, and practice management columnist for The Hospitalist. “Maximizing the number of days off is not the holy grail,” he says. “If you choose to shut your life down on days that you work, that is going to be toxic.”
Flexibility Equates to Fairness
Dr. Nelson has long advocated a flexible shift schedule that accommodates individual preferences by giving physicians in the group autonomy in deciding how much or how little they want to work. While the group as a whole has to get all the work done, the flexibility comes from one physician taking more shifts as another takes less.
Dr. Radzienda tries to create teams within his group by pairing hospitalists with similar scheduling preferences. For example, he might have a pair working 5/5 and another working 14/14. “Up front, it takes a lot of work, but once you template it out, it becomes a good strategy,” he says.
He also strives to build robust backup plans and jeopardy models (see “Surge Protection,” September 2010, p. 43) into the schedule for short-notice callouts, as you never know when a hospitalist will need to miss a day or two because of illness or a family emergency. “Psychologically, it helps to know that you don’t have to be a hero if you’re ill or emotionally strained,” Dr. Radzienda says.
Dr. Ahlstrom agrees that a flex-schedule strategy has a positive impact on hospitalists’ career satisfaction and longevity. He suggests hospitalists be allowed to specify how many patients they want to see and be compensated according to their workload through built-in bonuses for physicians who work more. Dr. Nelson suggests paying hospitalists per relative value unit (RVU) of work. “I think hospitalists would like it and find it liberating to be paid on production,” he says.
An added bonus to flexible work hours and patient load, according to Dr. Ahlstrom, is that pay difference “will lead to a far more collegial atmosphere, because physicians know they are getting compensated fairly for the amount of work done.”
Another advantage of a flexible schedule is hospitalists knowing they have the option of ramping up or scaling back the number of shifts they work, Dr. Ahlstrom says—for example, a physician who wants to reduce shifts in order to coach his daughter’s softball team or have Friday nights off to watch her son play high school football.
“You prevent burnout by allowing people to change their work schedule depending on what’s going on in their life,” Dr. Ahlstrom says. TH
Lisa Ryan is a freelance writer based in New Jersey.
Michael Radzienda, MD, FHM, once worked in a hospitalist program in which physicians were scheduled 30 days straight on clinical duty and 30 days off clinical duty. Although it sounds harsh by today’s standards, that job was so satisfying, he says, the schedule never felt like a burden. Conversely, he’s seen hospitalists work five days on and five days off, and the job was treacherous.
His point: Work schedules are just one influential piece of the job satisfaction pie.
“Satisfaction has more to do with work relationships and opportunities for growth,” says Dr. Radzienda, chief of hospital medicine and director of hospital medicine service at Medical College of Wisconsin/Froedtert Memorial Lutheran General Hospital in Milwaukee.
Shift-based staffing has become the norm, as more than 70% of hospitalist groups use a shift-based staffing model, according to the State of Hospital Medicine: 2010 Report Based on 2009 Data.1 That figure is up 40% from SHM’s 2005-2006 survey. Conversely, the number of HM groups employing call-based and hybrid (some shift, some call) coverage is declining—2.8% of groups employ call-based schedules, and 26.9% use a hybrid schedule. Those figures have dropped significantly from the 2005-2006 report, from 25% and 35%, respectively.
If you are going to make HM a career, you’ll need time to be with your family and pursue other interests, Dr. Radzienda says. As HM groups turn to more shift-based models, in which hospitalists work a set number of predetermined shifts and have no call responsibility, the challenge is setting a schedule that balances productivity and quality time off.
Fixed = Inflexible
The most popular way to schedule is through blocks of five days on/five days off (5/5) or seven days on/seven days off (7/7), in which hospitalists work 12 or 14 hours at a time, says Troy Ahlstrom, MD, FHM, a member of SHM’s Practice Analysis Committee and CFO of Hospitalists of Northern Michigan, a hospitalist-owned and -managed group based in Traverse City, Mich. Many HM groups employ this model because it’s easy to schedule and is attractive to residents who want a fixed schedule. But from a career satisfaction standpoint, the 5/5 and 7/7 schedule models present their own issues.
Fairness is the first potential pitfall. If all of the physicians in a group work the same schedule, they all have to log the same number of shifts and receive the same compensation. This leaves little to no wiggle room for hospitalists who want to make more money by picking up more shifts or those who want to work fewer shifts, Dr. Ahlstrom says. “People have different income goals,” he adds.
Second, physicians have to see the same number of patients throughout the day. This doesn’t take into consideration the reality that some hospitalists naturally work faster than others, thereby forcing the slower-paced doctors to keep up with an imposed patient load. “Invariably, no matter what you do, people are different,” Dr. Ahlstrom says.
Another consideration is that when physicians are working 12 to 14 hours a day, essentially they have no time for activities other than work and sleep, which doesn’t match the realities of life. Inevitably, things in personal lives crop up, which leads to swapping shifts that the group scheduler doesn’t know about or overloading the scheduler with shift-change requests, Dr. Ahlstrom explains.
Additionally, 7/7 schedules and their ilk squeeze a year’s worth of work into a compressed time frame, which can lead to intense stress and burnout, says John Nelson, MD, FACP, MHM, director of the hospitalist practice at Overlake Hospital in Bellevue, Wash., SHM co-founder, and practice management columnist for The Hospitalist. “Maximizing the number of days off is not the holy grail,” he says. “If you choose to shut your life down on days that you work, that is going to be toxic.”
Flexibility Equates to Fairness
Dr. Nelson has long advocated a flexible shift schedule that accommodates individual preferences by giving physicians in the group autonomy in deciding how much or how little they want to work. While the group as a whole has to get all the work done, the flexibility comes from one physician taking more shifts as another takes less.
Dr. Radzienda tries to create teams within his group by pairing hospitalists with similar scheduling preferences. For example, he might have a pair working 5/5 and another working 14/14. “Up front, it takes a lot of work, but once you template it out, it becomes a good strategy,” he says.
He also strives to build robust backup plans and jeopardy models (see “Surge Protection,” September 2010, p. 43) into the schedule for short-notice callouts, as you never know when a hospitalist will need to miss a day or two because of illness or a family emergency. “Psychologically, it helps to know that you don’t have to be a hero if you’re ill or emotionally strained,” Dr. Radzienda says.
Dr. Ahlstrom agrees that a flex-schedule strategy has a positive impact on hospitalists’ career satisfaction and longevity. He suggests hospitalists be allowed to specify how many patients they want to see and be compensated according to their workload through built-in bonuses for physicians who work more. Dr. Nelson suggests paying hospitalists per relative value unit (RVU) of work. “I think hospitalists would like it and find it liberating to be paid on production,” he says.
An added bonus to flexible work hours and patient load, according to Dr. Ahlstrom, is that pay difference “will lead to a far more collegial atmosphere, because physicians know they are getting compensated fairly for the amount of work done.”
Another advantage of a flexible schedule is hospitalists knowing they have the option of ramping up or scaling back the number of shifts they work, Dr. Ahlstrom says—for example, a physician who wants to reduce shifts in order to coach his daughter’s softball team or have Friday nights off to watch her son play high school football.
“You prevent burnout by allowing people to change their work schedule depending on what’s going on in their life,” Dr. Ahlstrom says. TH
Lisa Ryan is a freelance writer based in New Jersey.
Communication Counts
Put yourself for a moment in your patient’s situation. You are sick enough to have been thrust out of your normal life and admitted to the hospital. You find yourself attached to unfamiliar objects and machines, listening to unfamiliar words, and watching a revolving door of unfamiliar faces stroll in and out of the room to take blood, ask personal questions, touch your body, and monitor equipment. It would be enough to bear if you were well, but you’re not. You are ill and that makes you feel particularly worried and desperate.
Whether the physician succeeds in this scenario largely depends on their communication skills.
“A hospitalist needs to develop an almost immediate relationship with their patients because they are at their most vulnerable,” says Mark Williams, MD, FACP, FHM, professor and chief of the Division of Hospital Medicine at Northwestern University’s Feinberg School of Medicine in Chicago. “It is proven that if a hospitalist can successfully communicate with their patients, the result is much more satisfied patients.”
CAT: The Doctor-Patient Relationship Exam
This is easier said than done, as new research by Dr. Williams and colleagues at Feinberg, Northwestern Memorial Hospital (NMH) in Chicago, and Saint Francis Hospital and Medical Center in Hartford, Conn., has found. As part of the study, which published in the December issue of the Journal of Hospital Medicine, patients who were admitted to NMH between September 2008 and August 2009 and cared for by a hospitalist or hospitalist-led teaching team were interviewed using the Communication Assessment Tool (CAT). The CAT is a 14-item survey designed to measure a patient’s perception of communication with their hospitalist.
The average excellent rating among the 35 hospitalists involved in the study was 59.1% on a scale of 0 to 100 percent. Collectively, the hospitalists scored highest on such items as paying attention to patients (64.1%), talking in terms patients could understand (64.2%), and showing care and concern for patients (63.8%). The hospitalists scored lowest in greeting patients in a way that made them feel comfortable (54.9%), encouraging patients to ask questions (53.2%), and involving patients in decisions as much as they wanted (52.9%).
“There are a lot of factors working against hospitalists. Hospitalists are first meeting their patients when they are at their weakest, they sometimes don’t know the patient’s history, and, of course, there are all the demands on hospitalists’ time,” says Darlene Ferranti, research coordinator at the Feinberg School of Medicine.
What is particularly fascinating about the research is 13% of the patients eligible for the study could not participate because they weren’t able to identify their hospitalist by name or photo, Ferranti says. “If your patient doesn’t know who you are, how can they recall the information you are sharing with them?” she asks.
The study wasn’t designed to test patient communication techniques and their effectiveness, Dr. Williams explains. “We think future research needs to focus on interventions to improve doctor-patient communication,” he says.
However, the study did demonstrate that the CAT survey can be a valuable tool for HM groups interested in learning how their physicians are doing from the patient’s perspective, Dr. Williams notes. Perhaps more importantly, it can also help hospitalists target those communication areas in need of improvement, Ferranti says. For example, each hospitalist in the study was given a report of their individual scores and where they fell in the chart compared to the group as a whole.
“If you want to improve your career, you need to improve your communication with patients,” says Dr. Williams, who notes that hospitalists often don’t know the areas in which they are weak and strong. “It’s a career killer if you have multiple patient complaints against you.”
Risk Reduction
Being an effective communicator can also reduce one’s risk of being sued for malpractice, says Mitchell Wilson, MD, FHM, chief medical officer of Atlanta-based Eagle Hospital Physicians, which manages hospitalist practices for clients in the Southeast and Mid-Atlantic regions of the U.S. Dr. Wilson’s company believes communication is so important that starting with the very first interview of a hospitalist candidate, it considers the candidate’s ability to communicate by taking note of such things as accents, how they present information, and body language, Dr. Wilson says.
“Communication is one of the top three competencies that are essential to hospitalists,” he says.
Certain aspects of hospitalist work make communication exceedingly important, Dr. Wilson says. Hospitalists are coordinators of a patient’s care; they are caring for patients who are out of their comfort zone; many times the patient is in an extreme health situation; and hospitalized patients are of all different ages and backgrounds.
“If a hospitalist is a poor communicator, I would encourage them to seek additional training,” Dr. Wilson says. TH
Lisa Ryan is a freelance writer based in New Jersey.
Put yourself for a moment in your patient’s situation. You are sick enough to have been thrust out of your normal life and admitted to the hospital. You find yourself attached to unfamiliar objects and machines, listening to unfamiliar words, and watching a revolving door of unfamiliar faces stroll in and out of the room to take blood, ask personal questions, touch your body, and monitor equipment. It would be enough to bear if you were well, but you’re not. You are ill and that makes you feel particularly worried and desperate.
Whether the physician succeeds in this scenario largely depends on their communication skills.
“A hospitalist needs to develop an almost immediate relationship with their patients because they are at their most vulnerable,” says Mark Williams, MD, FACP, FHM, professor and chief of the Division of Hospital Medicine at Northwestern University’s Feinberg School of Medicine in Chicago. “It is proven that if a hospitalist can successfully communicate with their patients, the result is much more satisfied patients.”
CAT: The Doctor-Patient Relationship Exam
This is easier said than done, as new research by Dr. Williams and colleagues at Feinberg, Northwestern Memorial Hospital (NMH) in Chicago, and Saint Francis Hospital and Medical Center in Hartford, Conn., has found. As part of the study, which published in the December issue of the Journal of Hospital Medicine, patients who were admitted to NMH between September 2008 and August 2009 and cared for by a hospitalist or hospitalist-led teaching team were interviewed using the Communication Assessment Tool (CAT). The CAT is a 14-item survey designed to measure a patient’s perception of communication with their hospitalist.
The average excellent rating among the 35 hospitalists involved in the study was 59.1% on a scale of 0 to 100 percent. Collectively, the hospitalists scored highest on such items as paying attention to patients (64.1%), talking in terms patients could understand (64.2%), and showing care and concern for patients (63.8%). The hospitalists scored lowest in greeting patients in a way that made them feel comfortable (54.9%), encouraging patients to ask questions (53.2%), and involving patients in decisions as much as they wanted (52.9%).
“There are a lot of factors working against hospitalists. Hospitalists are first meeting their patients when they are at their weakest, they sometimes don’t know the patient’s history, and, of course, there are all the demands on hospitalists’ time,” says Darlene Ferranti, research coordinator at the Feinberg School of Medicine.
What is particularly fascinating about the research is 13% of the patients eligible for the study could not participate because they weren’t able to identify their hospitalist by name or photo, Ferranti says. “If your patient doesn’t know who you are, how can they recall the information you are sharing with them?” she asks.
The study wasn’t designed to test patient communication techniques and their effectiveness, Dr. Williams explains. “We think future research needs to focus on interventions to improve doctor-patient communication,” he says.
However, the study did demonstrate that the CAT survey can be a valuable tool for HM groups interested in learning how their physicians are doing from the patient’s perspective, Dr. Williams notes. Perhaps more importantly, it can also help hospitalists target those communication areas in need of improvement, Ferranti says. For example, each hospitalist in the study was given a report of their individual scores and where they fell in the chart compared to the group as a whole.
“If you want to improve your career, you need to improve your communication with patients,” says Dr. Williams, who notes that hospitalists often don’t know the areas in which they are weak and strong. “It’s a career killer if you have multiple patient complaints against you.”
Risk Reduction
Being an effective communicator can also reduce one’s risk of being sued for malpractice, says Mitchell Wilson, MD, FHM, chief medical officer of Atlanta-based Eagle Hospital Physicians, which manages hospitalist practices for clients in the Southeast and Mid-Atlantic regions of the U.S. Dr. Wilson’s company believes communication is so important that starting with the very first interview of a hospitalist candidate, it considers the candidate’s ability to communicate by taking note of such things as accents, how they present information, and body language, Dr. Wilson says.
“Communication is one of the top three competencies that are essential to hospitalists,” he says.
Certain aspects of hospitalist work make communication exceedingly important, Dr. Wilson says. Hospitalists are coordinators of a patient’s care; they are caring for patients who are out of their comfort zone; many times the patient is in an extreme health situation; and hospitalized patients are of all different ages and backgrounds.
“If a hospitalist is a poor communicator, I would encourage them to seek additional training,” Dr. Wilson says. TH
Lisa Ryan is a freelance writer based in New Jersey.
Put yourself for a moment in your patient’s situation. You are sick enough to have been thrust out of your normal life and admitted to the hospital. You find yourself attached to unfamiliar objects and machines, listening to unfamiliar words, and watching a revolving door of unfamiliar faces stroll in and out of the room to take blood, ask personal questions, touch your body, and monitor equipment. It would be enough to bear if you were well, but you’re not. You are ill and that makes you feel particularly worried and desperate.
Whether the physician succeeds in this scenario largely depends on their communication skills.
“A hospitalist needs to develop an almost immediate relationship with their patients because they are at their most vulnerable,” says Mark Williams, MD, FACP, FHM, professor and chief of the Division of Hospital Medicine at Northwestern University’s Feinberg School of Medicine in Chicago. “It is proven that if a hospitalist can successfully communicate with their patients, the result is much more satisfied patients.”
CAT: The Doctor-Patient Relationship Exam
This is easier said than done, as new research by Dr. Williams and colleagues at Feinberg, Northwestern Memorial Hospital (NMH) in Chicago, and Saint Francis Hospital and Medical Center in Hartford, Conn., has found. As part of the study, which published in the December issue of the Journal of Hospital Medicine, patients who were admitted to NMH between September 2008 and August 2009 and cared for by a hospitalist or hospitalist-led teaching team were interviewed using the Communication Assessment Tool (CAT). The CAT is a 14-item survey designed to measure a patient’s perception of communication with their hospitalist.
The average excellent rating among the 35 hospitalists involved in the study was 59.1% on a scale of 0 to 100 percent. Collectively, the hospitalists scored highest on such items as paying attention to patients (64.1%), talking in terms patients could understand (64.2%), and showing care and concern for patients (63.8%). The hospitalists scored lowest in greeting patients in a way that made them feel comfortable (54.9%), encouraging patients to ask questions (53.2%), and involving patients in decisions as much as they wanted (52.9%).
“There are a lot of factors working against hospitalists. Hospitalists are first meeting their patients when they are at their weakest, they sometimes don’t know the patient’s history, and, of course, there are all the demands on hospitalists’ time,” says Darlene Ferranti, research coordinator at the Feinberg School of Medicine.
What is particularly fascinating about the research is 13% of the patients eligible for the study could not participate because they weren’t able to identify their hospitalist by name or photo, Ferranti says. “If your patient doesn’t know who you are, how can they recall the information you are sharing with them?” she asks.
The study wasn’t designed to test patient communication techniques and their effectiveness, Dr. Williams explains. “We think future research needs to focus on interventions to improve doctor-patient communication,” he says.
However, the study did demonstrate that the CAT survey can be a valuable tool for HM groups interested in learning how their physicians are doing from the patient’s perspective, Dr. Williams notes. Perhaps more importantly, it can also help hospitalists target those communication areas in need of improvement, Ferranti says. For example, each hospitalist in the study was given a report of their individual scores and where they fell in the chart compared to the group as a whole.
“If you want to improve your career, you need to improve your communication with patients,” says Dr. Williams, who notes that hospitalists often don’t know the areas in which they are weak and strong. “It’s a career killer if you have multiple patient complaints against you.”
Risk Reduction
Being an effective communicator can also reduce one’s risk of being sued for malpractice, says Mitchell Wilson, MD, FHM, chief medical officer of Atlanta-based Eagle Hospital Physicians, which manages hospitalist practices for clients in the Southeast and Mid-Atlantic regions of the U.S. Dr. Wilson’s company believes communication is so important that starting with the very first interview of a hospitalist candidate, it considers the candidate’s ability to communicate by taking note of such things as accents, how they present information, and body language, Dr. Wilson says.
“Communication is one of the top three competencies that are essential to hospitalists,” he says.
Certain aspects of hospitalist work make communication exceedingly important, Dr. Wilson says. Hospitalists are coordinators of a patient’s care; they are caring for patients who are out of their comfort zone; many times the patient is in an extreme health situation; and hospitalized patients are of all different ages and backgrounds.
“If a hospitalist is a poor communicator, I would encourage them to seek additional training,” Dr. Wilson says. TH
Lisa Ryan is a freelance writer based in New Jersey.
Background Checks
If the hospitalist recruitment process is a puzzle, then the background check is the vacuum cleaner, sweeping the area for any missing puzzle pieces.
“You are trying to get the whole picture,” Tim Lary, vice president of physician staffing at North Hollywood, Calif.-based IPC: The Hospitalist Company, says. “You are trying to see if something doesn’t fit right.”
Any competent healthcare organization will conduct a background check on hospitalist job candidates, first and foremost to ensure patient safety and a safe practice environment for other healthcare providers, Lary says. There also is the issue of liability.
Financial liability for the negative acts of employees, whether accidental or intentional, is an area of exposure for businesses, says Les Rosen, president and CEO of Employment Screening Resources, a consumer reporting agency and human resources consulting firm in Novato, Calif. Businesses can be held liable for injuries resulting from the failure to adequately screen the people it hires. Background checks demonstrate the organization has done its due diligence in assessing the safety and competence of job candidates.
“It enables an organization to hire based upon facts, not just instincts,” Rosen says.
Background Basics
Hospitalists must be prepared to effectively deal with background checks throughout their professional careers. Employment checks often involve three areas: credentials verification, reference checking, and an additional background investigation.
Credentialing includes a review of the hospitalist’s completed education, training, residency, licenses, and any certifications, and often encompasses the candidate’s hospital privileges history, malpractice claims history, and peer reviews.
Reference checking involves verifying dates of employment and title at the hospitalist’s previous jobs, and contacting references to speak with them about the candidate’s qualifications.
Background investigations often are done by a third-party agency. The investigation will vary depending on the policies of the healthcare organization contracting the review, but, generally speaking, it includes a check of the following:
- Criminal and civil court records for criminal convictions, arrests, and lawsuits;
- Motor vehicle records and driver record status;
- The National Practitioner Data Bank for malpractice cases and medical board sanctions;
- Medicare sanction list of the Office of Inspector General in the U.S. Department of Health and Human Services;
- Social Security number; and
- Sex offender and terrorist databases.
Some investigations will include credit checks, which can cover credit payment history, bankruptcies, tax liens, and accounts placed into collections.
It is illegal during a background check to search for information related to a job candidate’s race, age, religion, sexual orientation, or any other protected category under the federal Civil Rights Act, says Cheryl Slack, vice president of human resources at Brentwood, Tenn.-based Cogent Healthcare.
Under the federal Fair Credit Reporting Act (www.ftc.gov/os/statutes/031224fcra.pdf), it also is illegal for a third-party consumer-reporting agency to perform an employment background check in secret, Rosen says. The applicant must authorize the check by signing a standalone disclosure form, he says. For the rare healthcare organizations that do their background checks in-house, most will seek consent.
Disclosure Is Crucial
Hospitalist job candidates should do whatever they can to make sure the people in charge of hiring aren’t surprised by what turns up in a background check, the experts say. “Nothing is more frustrating than finding out there is a problem late in the application process,” Lary says.
Hospitalists should inform the references they list on their resumes that they could be contacted. Such a “heads up” often gives a reference time to organize their thoughts about the job applicant and provide the best possible recommendation.
“You would be shocked at how many references are surprised to learn the hospitalist is looking for a job or how many applicants give as references people who don’t like them personally or professionally,” Lary says. “There are even times when physicians will take a pass on a reference. That speaks volumes.”
The most important thing a candidate should know is if there is something negative in their background that could be professionally damaging if discovered. It is best to make the people hiring aware of the information, Rosen says.
“Disclosure is best 100% of the time,” says Reuben Tovar, MD, chairman of Hospital Internists of Austin, a physician-owned and -managed hospitalist practice in Texas. “To deny or not include something on a resume or in an interview makes it look like you are a liar, or haven’t come to terms with what happened.”
The main impediment to disclosure is embarrassment and shame, says Dr. Tovar, who has encountered a number of physician candidates who have had problems. Those who disclose past issues are in a much better position to explain the situation and show how they have cleaned up a messy situation.
“Physicians are generally willing to at least consider giving their colleagues a second chance in employment and [hospital] credentialing if they are forthright,” Dr. Tovar says. “Not being forthright is an automatic exclusion.” TH
Lisa Ryan is a freelance writer based in New Jersey.
If the hospitalist recruitment process is a puzzle, then the background check is the vacuum cleaner, sweeping the area for any missing puzzle pieces.
“You are trying to get the whole picture,” Tim Lary, vice president of physician staffing at North Hollywood, Calif.-based IPC: The Hospitalist Company, says. “You are trying to see if something doesn’t fit right.”
Any competent healthcare organization will conduct a background check on hospitalist job candidates, first and foremost to ensure patient safety and a safe practice environment for other healthcare providers, Lary says. There also is the issue of liability.
Financial liability for the negative acts of employees, whether accidental or intentional, is an area of exposure for businesses, says Les Rosen, president and CEO of Employment Screening Resources, a consumer reporting agency and human resources consulting firm in Novato, Calif. Businesses can be held liable for injuries resulting from the failure to adequately screen the people it hires. Background checks demonstrate the organization has done its due diligence in assessing the safety and competence of job candidates.
“It enables an organization to hire based upon facts, not just instincts,” Rosen says.
Background Basics
Hospitalists must be prepared to effectively deal with background checks throughout their professional careers. Employment checks often involve three areas: credentials verification, reference checking, and an additional background investigation.
Credentialing includes a review of the hospitalist’s completed education, training, residency, licenses, and any certifications, and often encompasses the candidate’s hospital privileges history, malpractice claims history, and peer reviews.
Reference checking involves verifying dates of employment and title at the hospitalist’s previous jobs, and contacting references to speak with them about the candidate’s qualifications.
Background investigations often are done by a third-party agency. The investigation will vary depending on the policies of the healthcare organization contracting the review, but, generally speaking, it includes a check of the following:
- Criminal and civil court records for criminal convictions, arrests, and lawsuits;
- Motor vehicle records and driver record status;
- The National Practitioner Data Bank for malpractice cases and medical board sanctions;
- Medicare sanction list of the Office of Inspector General in the U.S. Department of Health and Human Services;
- Social Security number; and
- Sex offender and terrorist databases.
Some investigations will include credit checks, which can cover credit payment history, bankruptcies, tax liens, and accounts placed into collections.
It is illegal during a background check to search for information related to a job candidate’s race, age, religion, sexual orientation, or any other protected category under the federal Civil Rights Act, says Cheryl Slack, vice president of human resources at Brentwood, Tenn.-based Cogent Healthcare.
Under the federal Fair Credit Reporting Act (www.ftc.gov/os/statutes/031224fcra.pdf), it also is illegal for a third-party consumer-reporting agency to perform an employment background check in secret, Rosen says. The applicant must authorize the check by signing a standalone disclosure form, he says. For the rare healthcare organizations that do their background checks in-house, most will seek consent.
Disclosure Is Crucial
Hospitalist job candidates should do whatever they can to make sure the people in charge of hiring aren’t surprised by what turns up in a background check, the experts say. “Nothing is more frustrating than finding out there is a problem late in the application process,” Lary says.
Hospitalists should inform the references they list on their resumes that they could be contacted. Such a “heads up” often gives a reference time to organize their thoughts about the job applicant and provide the best possible recommendation.
“You would be shocked at how many references are surprised to learn the hospitalist is looking for a job or how many applicants give as references people who don’t like them personally or professionally,” Lary says. “There are even times when physicians will take a pass on a reference. That speaks volumes.”
The most important thing a candidate should know is if there is something negative in their background that could be professionally damaging if discovered. It is best to make the people hiring aware of the information, Rosen says.
“Disclosure is best 100% of the time,” says Reuben Tovar, MD, chairman of Hospital Internists of Austin, a physician-owned and -managed hospitalist practice in Texas. “To deny or not include something on a resume or in an interview makes it look like you are a liar, or haven’t come to terms with what happened.”
The main impediment to disclosure is embarrassment and shame, says Dr. Tovar, who has encountered a number of physician candidates who have had problems. Those who disclose past issues are in a much better position to explain the situation and show how they have cleaned up a messy situation.
“Physicians are generally willing to at least consider giving their colleagues a second chance in employment and [hospital] credentialing if they are forthright,” Dr. Tovar says. “Not being forthright is an automatic exclusion.” TH
Lisa Ryan is a freelance writer based in New Jersey.
If the hospitalist recruitment process is a puzzle, then the background check is the vacuum cleaner, sweeping the area for any missing puzzle pieces.
“You are trying to get the whole picture,” Tim Lary, vice president of physician staffing at North Hollywood, Calif.-based IPC: The Hospitalist Company, says. “You are trying to see if something doesn’t fit right.”
Any competent healthcare organization will conduct a background check on hospitalist job candidates, first and foremost to ensure patient safety and a safe practice environment for other healthcare providers, Lary says. There also is the issue of liability.
Financial liability for the negative acts of employees, whether accidental or intentional, is an area of exposure for businesses, says Les Rosen, president and CEO of Employment Screening Resources, a consumer reporting agency and human resources consulting firm in Novato, Calif. Businesses can be held liable for injuries resulting from the failure to adequately screen the people it hires. Background checks demonstrate the organization has done its due diligence in assessing the safety and competence of job candidates.
“It enables an organization to hire based upon facts, not just instincts,” Rosen says.
Background Basics
Hospitalists must be prepared to effectively deal with background checks throughout their professional careers. Employment checks often involve three areas: credentials verification, reference checking, and an additional background investigation.
Credentialing includes a review of the hospitalist’s completed education, training, residency, licenses, and any certifications, and often encompasses the candidate’s hospital privileges history, malpractice claims history, and peer reviews.
Reference checking involves verifying dates of employment and title at the hospitalist’s previous jobs, and contacting references to speak with them about the candidate’s qualifications.
Background investigations often are done by a third-party agency. The investigation will vary depending on the policies of the healthcare organization contracting the review, but, generally speaking, it includes a check of the following:
- Criminal and civil court records for criminal convictions, arrests, and lawsuits;
- Motor vehicle records and driver record status;
- The National Practitioner Data Bank for malpractice cases and medical board sanctions;
- Medicare sanction list of the Office of Inspector General in the U.S. Department of Health and Human Services;
- Social Security number; and
- Sex offender and terrorist databases.
Some investigations will include credit checks, which can cover credit payment history, bankruptcies, tax liens, and accounts placed into collections.
It is illegal during a background check to search for information related to a job candidate’s race, age, religion, sexual orientation, or any other protected category under the federal Civil Rights Act, says Cheryl Slack, vice president of human resources at Brentwood, Tenn.-based Cogent Healthcare.
Under the federal Fair Credit Reporting Act (www.ftc.gov/os/statutes/031224fcra.pdf), it also is illegal for a third-party consumer-reporting agency to perform an employment background check in secret, Rosen says. The applicant must authorize the check by signing a standalone disclosure form, he says. For the rare healthcare organizations that do their background checks in-house, most will seek consent.
Disclosure Is Crucial
Hospitalist job candidates should do whatever they can to make sure the people in charge of hiring aren’t surprised by what turns up in a background check, the experts say. “Nothing is more frustrating than finding out there is a problem late in the application process,” Lary says.
Hospitalists should inform the references they list on their resumes that they could be contacted. Such a “heads up” often gives a reference time to organize their thoughts about the job applicant and provide the best possible recommendation.
“You would be shocked at how many references are surprised to learn the hospitalist is looking for a job or how many applicants give as references people who don’t like them personally or professionally,” Lary says. “There are even times when physicians will take a pass on a reference. That speaks volumes.”
The most important thing a candidate should know is if there is something negative in their background that could be professionally damaging if discovered. It is best to make the people hiring aware of the information, Rosen says.
“Disclosure is best 100% of the time,” says Reuben Tovar, MD, chairman of Hospital Internists of Austin, a physician-owned and -managed hospitalist practice in Texas. “To deny or not include something on a resume or in an interview makes it look like you are a liar, or haven’t come to terms with what happened.”
The main impediment to disclosure is embarrassment and shame, says Dr. Tovar, who has encountered a number of physician candidates who have had problems. Those who disclose past issues are in a much better position to explain the situation and show how they have cleaned up a messy situation.
“Physicians are generally willing to at least consider giving their colleagues a second chance in employment and [hospital] credentialing if they are forthright,” Dr. Tovar says. “Not being forthright is an automatic exclusion.” TH
Lisa Ryan is a freelance writer based in New Jersey.
Operation Critical
There is going to be a healthcare crisis in Haiti in the next few years if things don’t markedly improve, says Jocelyn David, MD, chief hospitalist at the Miami VA Healthcare System in Miami, who has traveled to the island nation four times since the Jan. 12 earthquake.
Dr. David returned on Aug. 15 from a four-day trip she took with the Haitian Resource Development Foundation to assess the needs of smaller hospitals outside the capital of Port-au-Prince.
"People are traveling from the capital to these hospitals because the hospitals in the city are overwhelmed and struggling due to a lack of funds," Dr. David says.
Some city hospitals, such as CDTI du Sacre Coeur Hospital, one of the country’s more modern medical facilities, have outright closed, she says.
“I was surprised that I didn’t see any improvement,” says Mario A. Reyes, MD, FAAP, FHM, director of Pediatric Hospital Medicine at Miami Children’s Hospital, who volunteered in Haiti in January and went back in August to visit the Children’s Hospital of the Hopital de l’Universite d’Etat d’Haiti (HUEH), the largest academic public pediatric hospital in the capital.
The Children's Hospital is uninhabitable; medical staff are treating patients in makeshift wood houses provided by the United Nations, he says. Children sleep in hospital beds without mattresses, and oxygen tanks are shared by four or five children. There are no ultrasounds, and ventilators, IV lines, and antibiotics are in short supply, he says.
"There is a frustration among Haitian physicians that things aren't being done as quickly as they should," Dr. Reyes says. "The needs are immense."
Dr. David plans another trip to Haiti in October to train healthcare providers in BLS, ALS, and intubations in order to expand the limited emergency care. Meanwhile, Dr. Reyes and a group of physicians who work at Miami Children's Hospital are organizing professional and academic trips to HUEH so physicians can lend their expertise.
"That's what the Haitian providers want," he says. "They want us to teach and work with them."
The first trip is planned for December, and the group hopes the American Academy of Pediatrics will endorse their effort, which likely will include donating medical equipment and developing a telemedicine program.
Pediatric hospitalists who are interested in joining one of the trips to the Children’s Hospital of the Hopital de l’Universite d’Etat d’Haiti can contact Dr. Reyes at 305-668-5500 or at [email protected].
There is going to be a healthcare crisis in Haiti in the next few years if things don’t markedly improve, says Jocelyn David, MD, chief hospitalist at the Miami VA Healthcare System in Miami, who has traveled to the island nation four times since the Jan. 12 earthquake.
Dr. David returned on Aug. 15 from a four-day trip she took with the Haitian Resource Development Foundation to assess the needs of smaller hospitals outside the capital of Port-au-Prince.
"People are traveling from the capital to these hospitals because the hospitals in the city are overwhelmed and struggling due to a lack of funds," Dr. David says.
Some city hospitals, such as CDTI du Sacre Coeur Hospital, one of the country’s more modern medical facilities, have outright closed, she says.
“I was surprised that I didn’t see any improvement,” says Mario A. Reyes, MD, FAAP, FHM, director of Pediatric Hospital Medicine at Miami Children’s Hospital, who volunteered in Haiti in January and went back in August to visit the Children’s Hospital of the Hopital de l’Universite d’Etat d’Haiti (HUEH), the largest academic public pediatric hospital in the capital.
The Children's Hospital is uninhabitable; medical staff are treating patients in makeshift wood houses provided by the United Nations, he says. Children sleep in hospital beds without mattresses, and oxygen tanks are shared by four or five children. There are no ultrasounds, and ventilators, IV lines, and antibiotics are in short supply, he says.
"There is a frustration among Haitian physicians that things aren't being done as quickly as they should," Dr. Reyes says. "The needs are immense."
Dr. David plans another trip to Haiti in October to train healthcare providers in BLS, ALS, and intubations in order to expand the limited emergency care. Meanwhile, Dr. Reyes and a group of physicians who work at Miami Children's Hospital are organizing professional and academic trips to HUEH so physicians can lend their expertise.
"That's what the Haitian providers want," he says. "They want us to teach and work with them."
The first trip is planned for December, and the group hopes the American Academy of Pediatrics will endorse their effort, which likely will include donating medical equipment and developing a telemedicine program.
Pediatric hospitalists who are interested in joining one of the trips to the Children’s Hospital of the Hopital de l’Universite d’Etat d’Haiti can contact Dr. Reyes at 305-668-5500 or at [email protected].
There is going to be a healthcare crisis in Haiti in the next few years if things don’t markedly improve, says Jocelyn David, MD, chief hospitalist at the Miami VA Healthcare System in Miami, who has traveled to the island nation four times since the Jan. 12 earthquake.
Dr. David returned on Aug. 15 from a four-day trip she took with the Haitian Resource Development Foundation to assess the needs of smaller hospitals outside the capital of Port-au-Prince.
"People are traveling from the capital to these hospitals because the hospitals in the city are overwhelmed and struggling due to a lack of funds," Dr. David says.
Some city hospitals, such as CDTI du Sacre Coeur Hospital, one of the country’s more modern medical facilities, have outright closed, she says.
“I was surprised that I didn’t see any improvement,” says Mario A. Reyes, MD, FAAP, FHM, director of Pediatric Hospital Medicine at Miami Children’s Hospital, who volunteered in Haiti in January and went back in August to visit the Children’s Hospital of the Hopital de l’Universite d’Etat d’Haiti (HUEH), the largest academic public pediatric hospital in the capital.
The Children's Hospital is uninhabitable; medical staff are treating patients in makeshift wood houses provided by the United Nations, he says. Children sleep in hospital beds without mattresses, and oxygen tanks are shared by four or five children. There are no ultrasounds, and ventilators, IV lines, and antibiotics are in short supply, he says.
"There is a frustration among Haitian physicians that things aren't being done as quickly as they should," Dr. Reyes says. "The needs are immense."
Dr. David plans another trip to Haiti in October to train healthcare providers in BLS, ALS, and intubations in order to expand the limited emergency care. Meanwhile, Dr. Reyes and a group of physicians who work at Miami Children's Hospital are organizing professional and academic trips to HUEH so physicians can lend their expertise.
"That's what the Haitian providers want," he says. "They want us to teach and work with them."
The first trip is planned for December, and the group hopes the American Academy of Pediatrics will endorse their effort, which likely will include donating medical equipment and developing a telemedicine program.
Pediatric hospitalists who are interested in joining one of the trips to the Children’s Hospital of the Hopital de l’Universite d’Etat d’Haiti can contact Dr. Reyes at 305-668-5500 or at [email protected].
Two-Way Street
Brad Schmidt, MD, can remember recruiting hospitalists to the HM program at Dean Clinic at St. Mary’s Hospital in Madison, Wis., seven years ago. He was a young doctor, just a couple of years removed from residency.
Back then, having Dr. Schmidt recruit hospitalists was a matter of necessity. He was the only hospitalist practicing at St. Mary’s. Today, hospitalists continue to be in charge of recruiting at Dean’s 18-physician HM department, but now it’s by design.
“It’s critical for hospitalists to get involved, because doctors being recruited want to be part of a team. They want to know how they would be contributing,” says Dr. Schmidt, who is the medical director of eight departments, including the HM department. “I also think it’s important for people to know who they are going to be working with.”
For hospitalists looking to advance their careers, being recruited by a group that heavily involves its own hospitalists in the process can provide an opportunity to get an in-depth look at the prospective job and community, observes Kenneth G. Simone, DO, FHM, founder and president of Hospitalist and Practice Solutions, a practice-management consultancy based in Veazie, Maine. At the same time, hospitalists who are active in recruitment efforts are helping their own pursuits, says Dr. Simone, a member of Team Hospitalist and author of several HM-centered books, including “Hospitalist Recruit-ment and Retention.”
It gives new meaning to the saying recruiting is a two-way street. In this case, it’s a two-way street to success if hospitalists at both ends of the recruitment process use the situation to their advantage.
Candidate Advantage
If given the chance to interact with hospitalists at a potential job, a candidate should really pay attention to what the workday is like, Dr. Simone says. How is the workload? What kind of specialist support are the hospitalists getting? Are primary-care physicians (PCPs) referring patients to the group? Is there a good rapport with nursing staff?
“As a candidate, I should be asking why they are looking for a provider,” Dr. Simone says. “Is it growth? Is it turnover due to burnout?”
Having hospitalists engaged in the recruitment effort gives a candidate a great opportunity to ask questions he or she might not be comfortable asking of a director or hospital human resources personnel, Dr. Simone says. A candidate also gets a chance to observe the level of collegiality among prospective coworkers and gauge if the hospitalists are happy in the workplace and with the community.
—Kenneth G. Simone, DO, FHM, president, Hospitalist and Practice Solutions, Veazie, Maine, Team Hospitalist member
“They want to know that they are not just a cog in the wheel, not just a person filling a shift,” Dr. Schmidt explains. “By and large, they want to be part of a team.”
According to Drs. Simone and Schmidt, hospitalist job candidates should make an effort to:
- Ask potential colleagues to show them the local neighborhoods, services, and cultural and entertainment amenities;
- Get the e-mail addresses and phone numbers of the hospitalists to contact them with any follow-up questions after the interview and site visit; and
- Meet the group’s newest hospitalists, as they are the people who are in the best position to talk about the job transition.
A candidate’s goal is to gather enough information to determine if the job opportunity is the best fit for them and their family, Dr. Schmidt says. But candidates must remember that the time they spend and the conversations they share with the group’s hospitalists are still part of the interview process, Dr. Simone emphasizes. “If the person interviewing for a job has a lot of questions about vacation time and workload, that could send a signal that he or she doesn’t have a good work ethic,” he says.
Conversely, candidates should be wary of any program that doesn’t in some degree include their hospitalists in the recruitment process. It could mean that the group is trying to hide something, or that morale is so low that the hospitalists don’t want to promote the program. “I personally would be very uncomfortable not knowing who my partners would be,” Dr. Schmidt says.
Other red flags to look out for are constant references to the job’s competitive salary, which could indicate problems in other areas that the hospitalist practice is trying to mask, and no references to challenging issues the group is facing. If the group appears too good to be true, it probably is, Dr. Simone says.
Recruitment = Leadership
Hospitalists who get involved in their group’s recruitment efforts show their employer and supervisor that they are team players and care about the group and its future. It shows they are willing to help the program beyond providing patient care, and it demonstrates to both current and future employers that they have valuable professional characteristics and skills.
“Hospitalists who are good at recruiting show that they are a leader, a good communicator, and a positive person,” Dr. Simone says. “They can put this on a resume and give examples of what they did to help bring a quality provider to the team.”
When recruiting, be honest about the program’s strengths and weaknesses. “You want to avoid telling a candidate something a program is not,” Dr. Schmidt says. “You should be open about the program’s goals, workload, and expectations.”
Hospitalists who help in recruiting can frame the challenges a program is facing in a positive light. If an HM program is having trouble with, for example, a pulmonology group that is understaffed, the hospitalist recruiting candidates could explain the program is temporarily cross-covering patients at night until a new specialist can be found, Dr. Simone explains. He also notes it’s always best to place negatives into a context that shows the hospitalist group is working on a solution.
Getting engaged in recruiting also helps a hospitalist improve their current job by strengthening their team with good doctors who care about doing quality work, Drs. Schmidt and Simone say.
And that is more important than building a resume. TH
Lisa Ryan is a freelance writer based in New Jersey.
Brad Schmidt, MD, can remember recruiting hospitalists to the HM program at Dean Clinic at St. Mary’s Hospital in Madison, Wis., seven years ago. He was a young doctor, just a couple of years removed from residency.
Back then, having Dr. Schmidt recruit hospitalists was a matter of necessity. He was the only hospitalist practicing at St. Mary’s. Today, hospitalists continue to be in charge of recruiting at Dean’s 18-physician HM department, but now it’s by design.
“It’s critical for hospitalists to get involved, because doctors being recruited want to be part of a team. They want to know how they would be contributing,” says Dr. Schmidt, who is the medical director of eight departments, including the HM department. “I also think it’s important for people to know who they are going to be working with.”
For hospitalists looking to advance their careers, being recruited by a group that heavily involves its own hospitalists in the process can provide an opportunity to get an in-depth look at the prospective job and community, observes Kenneth G. Simone, DO, FHM, founder and president of Hospitalist and Practice Solutions, a practice-management consultancy based in Veazie, Maine. At the same time, hospitalists who are active in recruitment efforts are helping their own pursuits, says Dr. Simone, a member of Team Hospitalist and author of several HM-centered books, including “Hospitalist Recruit-ment and Retention.”
It gives new meaning to the saying recruiting is a two-way street. In this case, it’s a two-way street to success if hospitalists at both ends of the recruitment process use the situation to their advantage.
Candidate Advantage
If given the chance to interact with hospitalists at a potential job, a candidate should really pay attention to what the workday is like, Dr. Simone says. How is the workload? What kind of specialist support are the hospitalists getting? Are primary-care physicians (PCPs) referring patients to the group? Is there a good rapport with nursing staff?
“As a candidate, I should be asking why they are looking for a provider,” Dr. Simone says. “Is it growth? Is it turnover due to burnout?”
Having hospitalists engaged in the recruitment effort gives a candidate a great opportunity to ask questions he or she might not be comfortable asking of a director or hospital human resources personnel, Dr. Simone says. A candidate also gets a chance to observe the level of collegiality among prospective coworkers and gauge if the hospitalists are happy in the workplace and with the community.
—Kenneth G. Simone, DO, FHM, president, Hospitalist and Practice Solutions, Veazie, Maine, Team Hospitalist member
“They want to know that they are not just a cog in the wheel, not just a person filling a shift,” Dr. Schmidt explains. “By and large, they want to be part of a team.”
According to Drs. Simone and Schmidt, hospitalist job candidates should make an effort to:
- Ask potential colleagues to show them the local neighborhoods, services, and cultural and entertainment amenities;
- Get the e-mail addresses and phone numbers of the hospitalists to contact them with any follow-up questions after the interview and site visit; and
- Meet the group’s newest hospitalists, as they are the people who are in the best position to talk about the job transition.
A candidate’s goal is to gather enough information to determine if the job opportunity is the best fit for them and their family, Dr. Schmidt says. But candidates must remember that the time they spend and the conversations they share with the group’s hospitalists are still part of the interview process, Dr. Simone emphasizes. “If the person interviewing for a job has a lot of questions about vacation time and workload, that could send a signal that he or she doesn’t have a good work ethic,” he says.
Conversely, candidates should be wary of any program that doesn’t in some degree include their hospitalists in the recruitment process. It could mean that the group is trying to hide something, or that morale is so low that the hospitalists don’t want to promote the program. “I personally would be very uncomfortable not knowing who my partners would be,” Dr. Schmidt says.
Other red flags to look out for are constant references to the job’s competitive salary, which could indicate problems in other areas that the hospitalist practice is trying to mask, and no references to challenging issues the group is facing. If the group appears too good to be true, it probably is, Dr. Simone says.
Recruitment = Leadership
Hospitalists who get involved in their group’s recruitment efforts show their employer and supervisor that they are team players and care about the group and its future. It shows they are willing to help the program beyond providing patient care, and it demonstrates to both current and future employers that they have valuable professional characteristics and skills.
“Hospitalists who are good at recruiting show that they are a leader, a good communicator, and a positive person,” Dr. Simone says. “They can put this on a resume and give examples of what they did to help bring a quality provider to the team.”
When recruiting, be honest about the program’s strengths and weaknesses. “You want to avoid telling a candidate something a program is not,” Dr. Schmidt says. “You should be open about the program’s goals, workload, and expectations.”
Hospitalists who help in recruiting can frame the challenges a program is facing in a positive light. If an HM program is having trouble with, for example, a pulmonology group that is understaffed, the hospitalist recruiting candidates could explain the program is temporarily cross-covering patients at night until a new specialist can be found, Dr. Simone explains. He also notes it’s always best to place negatives into a context that shows the hospitalist group is working on a solution.
Getting engaged in recruiting also helps a hospitalist improve their current job by strengthening their team with good doctors who care about doing quality work, Drs. Schmidt and Simone say.
And that is more important than building a resume. TH
Lisa Ryan is a freelance writer based in New Jersey.
Brad Schmidt, MD, can remember recruiting hospitalists to the HM program at Dean Clinic at St. Mary’s Hospital in Madison, Wis., seven years ago. He was a young doctor, just a couple of years removed from residency.
Back then, having Dr. Schmidt recruit hospitalists was a matter of necessity. He was the only hospitalist practicing at St. Mary’s. Today, hospitalists continue to be in charge of recruiting at Dean’s 18-physician HM department, but now it’s by design.
“It’s critical for hospitalists to get involved, because doctors being recruited want to be part of a team. They want to know how they would be contributing,” says Dr. Schmidt, who is the medical director of eight departments, including the HM department. “I also think it’s important for people to know who they are going to be working with.”
For hospitalists looking to advance their careers, being recruited by a group that heavily involves its own hospitalists in the process can provide an opportunity to get an in-depth look at the prospective job and community, observes Kenneth G. Simone, DO, FHM, founder and president of Hospitalist and Practice Solutions, a practice-management consultancy based in Veazie, Maine. At the same time, hospitalists who are active in recruitment efforts are helping their own pursuits, says Dr. Simone, a member of Team Hospitalist and author of several HM-centered books, including “Hospitalist Recruit-ment and Retention.”
It gives new meaning to the saying recruiting is a two-way street. In this case, it’s a two-way street to success if hospitalists at both ends of the recruitment process use the situation to their advantage.
Candidate Advantage
If given the chance to interact with hospitalists at a potential job, a candidate should really pay attention to what the workday is like, Dr. Simone says. How is the workload? What kind of specialist support are the hospitalists getting? Are primary-care physicians (PCPs) referring patients to the group? Is there a good rapport with nursing staff?
“As a candidate, I should be asking why they are looking for a provider,” Dr. Simone says. “Is it growth? Is it turnover due to burnout?”
Having hospitalists engaged in the recruitment effort gives a candidate a great opportunity to ask questions he or she might not be comfortable asking of a director or hospital human resources personnel, Dr. Simone says. A candidate also gets a chance to observe the level of collegiality among prospective coworkers and gauge if the hospitalists are happy in the workplace and with the community.
—Kenneth G. Simone, DO, FHM, president, Hospitalist and Practice Solutions, Veazie, Maine, Team Hospitalist member
“They want to know that they are not just a cog in the wheel, not just a person filling a shift,” Dr. Schmidt explains. “By and large, they want to be part of a team.”
According to Drs. Simone and Schmidt, hospitalist job candidates should make an effort to:
- Ask potential colleagues to show them the local neighborhoods, services, and cultural and entertainment amenities;
- Get the e-mail addresses and phone numbers of the hospitalists to contact them with any follow-up questions after the interview and site visit; and
- Meet the group’s newest hospitalists, as they are the people who are in the best position to talk about the job transition.
A candidate’s goal is to gather enough information to determine if the job opportunity is the best fit for them and their family, Dr. Schmidt says. But candidates must remember that the time they spend and the conversations they share with the group’s hospitalists are still part of the interview process, Dr. Simone emphasizes. “If the person interviewing for a job has a lot of questions about vacation time and workload, that could send a signal that he or she doesn’t have a good work ethic,” he says.
Conversely, candidates should be wary of any program that doesn’t in some degree include their hospitalists in the recruitment process. It could mean that the group is trying to hide something, or that morale is so low that the hospitalists don’t want to promote the program. “I personally would be very uncomfortable not knowing who my partners would be,” Dr. Schmidt says.
Other red flags to look out for are constant references to the job’s competitive salary, which could indicate problems in other areas that the hospitalist practice is trying to mask, and no references to challenging issues the group is facing. If the group appears too good to be true, it probably is, Dr. Simone says.
Recruitment = Leadership
Hospitalists who get involved in their group’s recruitment efforts show their employer and supervisor that they are team players and care about the group and its future. It shows they are willing to help the program beyond providing patient care, and it demonstrates to both current and future employers that they have valuable professional characteristics and skills.
“Hospitalists who are good at recruiting show that they are a leader, a good communicator, and a positive person,” Dr. Simone says. “They can put this on a resume and give examples of what they did to help bring a quality provider to the team.”
When recruiting, be honest about the program’s strengths and weaknesses. “You want to avoid telling a candidate something a program is not,” Dr. Schmidt says. “You should be open about the program’s goals, workload, and expectations.”
Hospitalists who help in recruiting can frame the challenges a program is facing in a positive light. If an HM program is having trouble with, for example, a pulmonology group that is understaffed, the hospitalist recruiting candidates could explain the program is temporarily cross-covering patients at night until a new specialist can be found, Dr. Simone explains. He also notes it’s always best to place negatives into a context that shows the hospitalist group is working on a solution.
Getting engaged in recruiting also helps a hospitalist improve their current job by strengthening their team with good doctors who care about doing quality work, Drs. Schmidt and Simone say.
And that is more important than building a resume. TH
Lisa Ryan is a freelance writer based in New Jersey.
Spousal Consent
When recruiting a hospitalist for his company, Jason Stuckey makes it a point to call the candidate’s home. His goal isn’t to speak with the hospitalist the company is interested in hiring—it’s to talk with the candidate’s spouse.
“One of the top five mistakes recruiters make is to not involve the spouse in the [recruitment] process,” says Stuckey, who directs HM recruiting for TeamHealth, a Knoxville, Tenn.-based company that provides healthcare staffing and administrative services to hospitals in 14 states.
Hospitalists are generally so busy with work that the spouse is often the person in the family who takes the lead in the job search, says Tim Lary, vice president of profession staffing for IPC: The Hospitalist Co., a national physician group practice based in North Hollywood, Calif.
The spouse often gives final approval on a decision to accept a job offer, adds Peggy Fricke, director of physician staffing for Eagle Hospital Physicians, an Atlanta-based company that manages hospitalist practices for hospitals in the Southeast and Mid-Atlantic regions.
“The physician could be making the most money, but if their spouse and family are not happy, then they won’t stay in the position long,” Stuckey explains. “I’ve also found that if the spouse is not on board with moving and uprooting the family to a new location, then it’s not going to happen.”
As a result, recruiters and prospective employers often spend just as much time engaging the spouse as they do the actual job candidate, the recruiters say. For this reason, hospitalists who are searching for a new job would be wise to include their husband or wife as early as possible in the job hunt in order to get the most out of the recruiting process.
For example, while the hospitalist focuses on determining if the work is the right fit professionally and financially, the spouse can appraise the community to see if it meets the family’s needs in such areas as schools, neighborhoods, religious services, community groups, and entertainment/cultural outlets. If the hospitalist is invited for an on-site interview, it’s important that their spouse makes the trip as well.
“We always do a community tour, and we will do school tours when asked,” Fricke says of Eagle’s recruiting efforts. “We can introduce the families of the other hospitalists in the practice so a spouse can meet and get to know them.”
—Jason Stuckey, director, HM recruitment, TeamHealth, Knoxville, Tenn.
Upfront Inclusion
When the spouse is involved in the process, they usually are more receptive to receiving information about what opportunities exist in other communities and more open to the idea of moving to a new place, Stuckey says.
For instances in which children are involved, the spouse is most often interested in learning about the location’s school districts and private schools, and determining if the community has a good quality of life for families, Fricke says. For situations in which there are no children or the children are grown, the spouse often focuses on job prospects in their own profession.
Hospitalists with a husband or wife who works and whose career is important to them should see if the HM recruiter can help put their spouse in touch with potential employers in the community, because many times they will, says Fricke, who has connected spouses in IT and engineering fields with people who could assist them in their job search.
“It goes back to making sure everyone is happy. If the spouse can’t find work, that is going to affect their happiness,” says Darren Swenson, MD, medical affairs director for IPC of Nevada and regional chair of IPC’s national advisory board.
Aside from schools, quality of life, and their own job opportunities, spouses also ask about what their hospitalist husband or wife’s work schedule would be and how much vacation and holiday time they would have in the prospective job, Dr. Swenson says.
“It’s extremely important that we look at our hospitalists and their spouses being happy in their home life, because if they’re not, that is going to spill over into in their work life,” IPC’s Lary says.
Good Partnership, Bad Partnership
Times arise when the spouse takes a proactive role in evaluating the actual HM job offer, the recruiters say. “In all couples, there is someone who is dominant and someone who is not,” says Fricke, who has seen spouses participate in job interviews with hospital administrators. “If the spouse is dominant, we try to understand them and listen to what is important to them.”
Sometimes the spouse is an attorney or other type of professional who wants to review the hospitalist contract and has the most questions about it, Dr. Swenson says. When that happens, recruiters will often have group members sit in to answer their questions, he says.
“Absolutely, without question, the spouse has to be involved. But if the spouse is too demanding and everything has to be run through them, to an employer, that can be a big turnoff,” Stuckey says.
When it comes to business matters, the physician—not the spouse—has to take the lead, he says. If the physician doesn’t, it could make the prospective employer wonder what challenges could be ahead should the candidate be hired, Stuckey says.
Two-Physician Families
One time when it is acceptable for a spouse to get intimately involved in the contract and negotiations is when he or she is a hospitalist who also is being recruited by the same prospective employer.
“It’s a unique situation. It’s great to have two for the price of one, so to speak,” Stuckey says. “But there are challenges from the employer’s perspective—for example, scheduling—that have to be resolved on the front end rather than when they get there.”
While still relatively rare, husband-wife hospitalist couples are becoming more prevalent because there are more hospitalists, Fricke says. They tend to meet each other in medical school or residency, she says.
“Even though they are a couple, we treat them as individuals during the recruiting process,” Fricke says. “I think the most important thing is we try to do anything we can—within reason, of course—to help the hospitalist and their spouse make the best decision for themselves and their family.” TH
Lisa Ryan is a freelance writer based in New Jersey.
When recruiting a hospitalist for his company, Jason Stuckey makes it a point to call the candidate’s home. His goal isn’t to speak with the hospitalist the company is interested in hiring—it’s to talk with the candidate’s spouse.
“One of the top five mistakes recruiters make is to not involve the spouse in the [recruitment] process,” says Stuckey, who directs HM recruiting for TeamHealth, a Knoxville, Tenn.-based company that provides healthcare staffing and administrative services to hospitals in 14 states.
Hospitalists are generally so busy with work that the spouse is often the person in the family who takes the lead in the job search, says Tim Lary, vice president of profession staffing for IPC: The Hospitalist Co., a national physician group practice based in North Hollywood, Calif.
The spouse often gives final approval on a decision to accept a job offer, adds Peggy Fricke, director of physician staffing for Eagle Hospital Physicians, an Atlanta-based company that manages hospitalist practices for hospitals in the Southeast and Mid-Atlantic regions.
“The physician could be making the most money, but if their spouse and family are not happy, then they won’t stay in the position long,” Stuckey explains. “I’ve also found that if the spouse is not on board with moving and uprooting the family to a new location, then it’s not going to happen.”
As a result, recruiters and prospective employers often spend just as much time engaging the spouse as they do the actual job candidate, the recruiters say. For this reason, hospitalists who are searching for a new job would be wise to include their husband or wife as early as possible in the job hunt in order to get the most out of the recruiting process.
For example, while the hospitalist focuses on determining if the work is the right fit professionally and financially, the spouse can appraise the community to see if it meets the family’s needs in such areas as schools, neighborhoods, religious services, community groups, and entertainment/cultural outlets. If the hospitalist is invited for an on-site interview, it’s important that their spouse makes the trip as well.
“We always do a community tour, and we will do school tours when asked,” Fricke says of Eagle’s recruiting efforts. “We can introduce the families of the other hospitalists in the practice so a spouse can meet and get to know them.”
—Jason Stuckey, director, HM recruitment, TeamHealth, Knoxville, Tenn.
Upfront Inclusion
When the spouse is involved in the process, they usually are more receptive to receiving information about what opportunities exist in other communities and more open to the idea of moving to a new place, Stuckey says.
For instances in which children are involved, the spouse is most often interested in learning about the location’s school districts and private schools, and determining if the community has a good quality of life for families, Fricke says. For situations in which there are no children or the children are grown, the spouse often focuses on job prospects in their own profession.
Hospitalists with a husband or wife who works and whose career is important to them should see if the HM recruiter can help put their spouse in touch with potential employers in the community, because many times they will, says Fricke, who has connected spouses in IT and engineering fields with people who could assist them in their job search.
“It goes back to making sure everyone is happy. If the spouse can’t find work, that is going to affect their happiness,” says Darren Swenson, MD, medical affairs director for IPC of Nevada and regional chair of IPC’s national advisory board.
Aside from schools, quality of life, and their own job opportunities, spouses also ask about what their hospitalist husband or wife’s work schedule would be and how much vacation and holiday time they would have in the prospective job, Dr. Swenson says.
“It’s extremely important that we look at our hospitalists and their spouses being happy in their home life, because if they’re not, that is going to spill over into in their work life,” IPC’s Lary says.
Good Partnership, Bad Partnership
Times arise when the spouse takes a proactive role in evaluating the actual HM job offer, the recruiters say. “In all couples, there is someone who is dominant and someone who is not,” says Fricke, who has seen spouses participate in job interviews with hospital administrators. “If the spouse is dominant, we try to understand them and listen to what is important to them.”
Sometimes the spouse is an attorney or other type of professional who wants to review the hospitalist contract and has the most questions about it, Dr. Swenson says. When that happens, recruiters will often have group members sit in to answer their questions, he says.
“Absolutely, without question, the spouse has to be involved. But if the spouse is too demanding and everything has to be run through them, to an employer, that can be a big turnoff,” Stuckey says.
When it comes to business matters, the physician—not the spouse—has to take the lead, he says. If the physician doesn’t, it could make the prospective employer wonder what challenges could be ahead should the candidate be hired, Stuckey says.
Two-Physician Families
One time when it is acceptable for a spouse to get intimately involved in the contract and negotiations is when he or she is a hospitalist who also is being recruited by the same prospective employer.
“It’s a unique situation. It’s great to have two for the price of one, so to speak,” Stuckey says. “But there are challenges from the employer’s perspective—for example, scheduling—that have to be resolved on the front end rather than when they get there.”
While still relatively rare, husband-wife hospitalist couples are becoming more prevalent because there are more hospitalists, Fricke says. They tend to meet each other in medical school or residency, she says.
“Even though they are a couple, we treat them as individuals during the recruiting process,” Fricke says. “I think the most important thing is we try to do anything we can—within reason, of course—to help the hospitalist and their spouse make the best decision for themselves and their family.” TH
Lisa Ryan is a freelance writer based in New Jersey.
When recruiting a hospitalist for his company, Jason Stuckey makes it a point to call the candidate’s home. His goal isn’t to speak with the hospitalist the company is interested in hiring—it’s to talk with the candidate’s spouse.
“One of the top five mistakes recruiters make is to not involve the spouse in the [recruitment] process,” says Stuckey, who directs HM recruiting for TeamHealth, a Knoxville, Tenn.-based company that provides healthcare staffing and administrative services to hospitals in 14 states.
Hospitalists are generally so busy with work that the spouse is often the person in the family who takes the lead in the job search, says Tim Lary, vice president of profession staffing for IPC: The Hospitalist Co., a national physician group practice based in North Hollywood, Calif.
The spouse often gives final approval on a decision to accept a job offer, adds Peggy Fricke, director of physician staffing for Eagle Hospital Physicians, an Atlanta-based company that manages hospitalist practices for hospitals in the Southeast and Mid-Atlantic regions.
“The physician could be making the most money, but if their spouse and family are not happy, then they won’t stay in the position long,” Stuckey explains. “I’ve also found that if the spouse is not on board with moving and uprooting the family to a new location, then it’s not going to happen.”
As a result, recruiters and prospective employers often spend just as much time engaging the spouse as they do the actual job candidate, the recruiters say. For this reason, hospitalists who are searching for a new job would be wise to include their husband or wife as early as possible in the job hunt in order to get the most out of the recruiting process.
For example, while the hospitalist focuses on determining if the work is the right fit professionally and financially, the spouse can appraise the community to see if it meets the family’s needs in such areas as schools, neighborhoods, religious services, community groups, and entertainment/cultural outlets. If the hospitalist is invited for an on-site interview, it’s important that their spouse makes the trip as well.
“We always do a community tour, and we will do school tours when asked,” Fricke says of Eagle’s recruiting efforts. “We can introduce the families of the other hospitalists in the practice so a spouse can meet and get to know them.”
—Jason Stuckey, director, HM recruitment, TeamHealth, Knoxville, Tenn.
Upfront Inclusion
When the spouse is involved in the process, they usually are more receptive to receiving information about what opportunities exist in other communities and more open to the idea of moving to a new place, Stuckey says.
For instances in which children are involved, the spouse is most often interested in learning about the location’s school districts and private schools, and determining if the community has a good quality of life for families, Fricke says. For situations in which there are no children or the children are grown, the spouse often focuses on job prospects in their own profession.
Hospitalists with a husband or wife who works and whose career is important to them should see if the HM recruiter can help put their spouse in touch with potential employers in the community, because many times they will, says Fricke, who has connected spouses in IT and engineering fields with people who could assist them in their job search.
“It goes back to making sure everyone is happy. If the spouse can’t find work, that is going to affect their happiness,” says Darren Swenson, MD, medical affairs director for IPC of Nevada and regional chair of IPC’s national advisory board.
Aside from schools, quality of life, and their own job opportunities, spouses also ask about what their hospitalist husband or wife’s work schedule would be and how much vacation and holiday time they would have in the prospective job, Dr. Swenson says.
“It’s extremely important that we look at our hospitalists and their spouses being happy in their home life, because if they’re not, that is going to spill over into in their work life,” IPC’s Lary says.
Good Partnership, Bad Partnership
Times arise when the spouse takes a proactive role in evaluating the actual HM job offer, the recruiters say. “In all couples, there is someone who is dominant and someone who is not,” says Fricke, who has seen spouses participate in job interviews with hospital administrators. “If the spouse is dominant, we try to understand them and listen to what is important to them.”
Sometimes the spouse is an attorney or other type of professional who wants to review the hospitalist contract and has the most questions about it, Dr. Swenson says. When that happens, recruiters will often have group members sit in to answer their questions, he says.
“Absolutely, without question, the spouse has to be involved. But if the spouse is too demanding and everything has to be run through them, to an employer, that can be a big turnoff,” Stuckey says.
When it comes to business matters, the physician—not the spouse—has to take the lead, he says. If the physician doesn’t, it could make the prospective employer wonder what challenges could be ahead should the candidate be hired, Stuckey says.
Two-Physician Families
One time when it is acceptable for a spouse to get intimately involved in the contract and negotiations is when he or she is a hospitalist who also is being recruited by the same prospective employer.
“It’s a unique situation. It’s great to have two for the price of one, so to speak,” Stuckey says. “But there are challenges from the employer’s perspective—for example, scheduling—that have to be resolved on the front end rather than when they get there.”
While still relatively rare, husband-wife hospitalist couples are becoming more prevalent because there are more hospitalists, Fricke says. They tend to meet each other in medical school or residency, she says.
“Even though they are a couple, we treat them as individuals during the recruiting process,” Fricke says. “I think the most important thing is we try to do anything we can—within reason, of course—to help the hospitalist and their spouse make the best decision for themselves and their family.” TH
Lisa Ryan is a freelance writer based in New Jersey.