Physicians who join a hospitalist practice often have the opportunity to purchase an equity interest after some period of employment. The future possibility of the physician-employee becoming an owner of the practice is sometimes addressed in the physician’s employment agreement. The amount of detail in the employment agreement regarding potential ownership will vary depending on the practice and the negotiating power of the individual physician. Clearly, the more specificity found in the contract, the better the hospitalist is served.

Because the circumstances of the individual parties will govern the terms of the buy-in, there is no standard contract language universally used in physician employment agreements. Specific aspects exist in many buy-in provisions contained in physician employment agreements, however. Such issues include: (i) the opportunity to purchase an ownership interest; (ii) performance reviews; (iii) how the interest will be valued; and (iv) payment terms.

Ownership Interest

The employment agreement should specify whether and when the employee-physician will be eligible to acquire an interest in the practice. The idea of remaining an employee may be attractive to some physicians who prefer to have less involvement in the business and financial aspects of the hospitalist practice. Sometimes cost becomes a critical issue.

However, if the parties do intend for the physician to have the right to purchase an ownership interest, the timeframe and conditions for exercising that right should be specified in writing. The following is an example of a provision addressing the opportunity to purchase an equity interest:

“The parties agree that it is their intent that upon X years of continuous employment pursuant to the terms and conditions of this Agreement, Hospitalist shall be given the opportunity to purchase [a partnership interest or stock] in Practice.”

Performance Reviews

One condition precedent to the right to purchase an equity interest may be satisfactory performance reviews by senior physicians. Although these reviews frequently are based on subjective standards, the employee-physician should seek a contractual commitment describing the criteria to be evaluated in order to make the reviews as objective as possible. Standard criteria include statistical analysis (e.g. number of patients seen a day), the quality of patient care rendered, and contributions to the practice’s operations (e.g. marketing, community outreach).

In addition, the physician’s employment agreement should specify the frequency of performance reviews. Physician reviews commonly occur on an annual, and sometimes semi-annual, basis, especially during the initial years of employment. Regardless of how often the reviews are conducted, it is highly beneficial to both the practice and the physician-employee that the time periods for evaluations be strictly enforced. Consistent, formal performance reviews promote improvement and synergy between the physician and the practice.

Equity Interest

Typically, an employment agreement will either provide an exact purchase price or, more often, state the future method to be used for calculating the buy-in price. Ordinarily, the buy-in price will be a function of the valuation of the total equity of the practice and the percentage of that equity, which is represented by the interests to be acquired by the purchasing physician. While there are a few formulas for valuing the equity of a hospitalist practice, the most common method is discounted present value of net revenue stream.

The appropriate valuation method will depend on a number of factors unique to the individual practice. Therefore, the practice should seek the assistance of an accountant or practice valuation specialist when determining the value. Stating an agreed-upon valuation method in the employment agreement will limit surprises and “sticker shock” to the buy-in price when the ownership decision is made down the road.

 

Payment Terms

In the event that the physician-employee exercises the opportunity to buy in, the employment or purchase agreement should provide terms governing how the purchase price will be paid. Often, the practice will be flexible in negotiating payment terms that meet the physician’s individual financial needs; however, the parties frequently agree that the physician will either pay the owners in full up front or make installment payments over a specified number of years.

If the physician is required to pay the total purchase price up front, he or she will be personally responsible for obtaining the necessary funding through bank loans or other sources. If the purchasing physician is permitted to make installment payments, he or she will be required to sign a promissory note in which the payee is the practice and the note is secured by a security interest in the equity granted to the physician. There are important tax strategies that can be implemented when installment payments are agreed upon. In the event that the physician fails to make the installment payments, the practice may be able to recover the equity interest.

In Sum

Both parties should review and understand the terms and conditions of the buy-in so that all parties enter the employment relationship with the same expectations for future ownership.

---

Steven Harris is a nationally recognized healthcare attorney and a member of the law firm McDonald Hopkins LLC in Chicago. Write to him at [email protected].

Physicians who join a hospitalist practice often have the opportunity to purchase an equity interest after some period of employment. The future possibility of the physician-employee becoming an owner of the practice is sometimes addressed in the physician’s employment agreement. The amount of detail in the employment agreement regarding potential ownership will vary depending on the practice and the negotiating power of the individual physician. Clearly, the more specificity found in the contract, the better the hospitalist is served.

Because the circumstances of the individual parties will govern the terms of the buy-in, there is no standard contract language universally used in physician employment agreements. Specific aspects exist in many buy-in provisions contained in physician employment agreements, however. Such issues include: (i) the opportunity to purchase an ownership interest; (ii) performance reviews; (iii) how the interest will be valued; and (iv) payment terms.

Ownership Interest

The employment agreement should specify whether and when the employee-physician will be eligible to acquire an interest in the practice. The idea of remaining an employee may be attractive to some physicians who prefer to have less involvement in the business and financial aspects of the hospitalist practice. Sometimes cost becomes a critical issue.

However, if the parties do intend for the physician to have the right to purchase an ownership interest, the timeframe and conditions for exercising that right should be specified in writing. The following is an example of a provision addressing the opportunity to purchase an equity interest:

“The parties agree that it is their intent that upon X years of continuous employment pursuant to the terms and conditions of this Agreement, Hospitalist shall be given the opportunity to purchase [a partnership interest or stock] in Practice.”

Performance Reviews

One condition precedent to the right to purchase an equity interest may be satisfactory performance reviews by senior physicians. Although these reviews frequently are based on subjective standards, the employee-physician should seek a contractual commitment describing the criteria to be evaluated in order to make the reviews as objective as possible. Standard criteria include statistical analysis (e.g. number of patients seen a day), the quality of patient care rendered, and contributions to the practice’s operations (e.g. marketing, community outreach).

In addition, the physician’s employment agreement should specify the frequency of performance reviews. Physician reviews commonly occur on an annual, and sometimes semi-annual, basis, especially during the initial years of employment. Regardless of how often the reviews are conducted, it is highly beneficial to both the practice and the physician-employee that the time periods for evaluations be strictly enforced. Consistent, formal performance reviews promote improvement and synergy between the physician and the practice.

Equity Interest

Typically, an employment agreement will either provide an exact purchase price or, more often, state the future method to be used for calculating the buy-in price. Ordinarily, the buy-in price will be a function of the valuation of the total equity of the practice and the percentage of that equity, which is represented by the interests to be acquired by the purchasing physician. While there are a few formulas for valuing the equity of a hospitalist practice, the most common method is discounted present value of net revenue stream.

The appropriate valuation method will depend on a number of factors unique to the individual practice. Therefore, the practice should seek the assistance of an accountant or practice valuation specialist when determining the value. Stating an agreed-upon valuation method in the employment agreement will limit surprises and “sticker shock” to the buy-in price when the ownership decision is made down the road.

 

Payment Terms

In the event that the physician-employee exercises the opportunity to buy in, the employment or purchase agreement should provide terms governing how the purchase price will be paid. Often, the practice will be flexible in negotiating payment terms that meet the physician’s individual financial needs; however, the parties frequently agree that the physician will either pay the owners in full up front or make installment payments over a specified number of years.

If the physician is required to pay the total purchase price up front, he or she will be personally responsible for obtaining the necessary funding through bank loans or other sources. If the purchasing physician is permitted to make installment payments, he or she will be required to sign a promissory note in which the payee is the practice and the note is secured by a security interest in the equity granted to the physician. There are important tax strategies that can be implemented when installment payments are agreed upon. In the event that the physician fails to make the installment payments, the practice may be able to recover the equity interest.

In Sum

Both parties should review and understand the terms and conditions of the buy-in so that all parties enter the employment relationship with the same expectations for future ownership.

---

Steven Harris is a nationally recognized healthcare attorney and a member of the law firm McDonald Hopkins LLC in Chicago. Write to him at [email protected].

Physicians who join a hospitalist practice often have the opportunity to purchase an equity interest after some period of employment. The future possibility of the physician-employee becoming an owner of the practice is sometimes addressed in the physician’s employment agreement. The amount of detail in the employment agreement regarding potential ownership will vary depending on the practice and the negotiating power of the individual physician. Clearly, the more specificity found in the contract, the better the hospitalist is served.

Because the circumstances of the individual parties will govern the terms of the buy-in, there is no standard contract language universally used in physician employment agreements. Specific aspects exist in many buy-in provisions contained in physician employment agreements, however. Such issues include: (i) the opportunity to purchase an ownership interest; (ii) performance reviews; (iii) how the interest will be valued; and (iv) payment terms.

Ownership Interest

The employment agreement should specify whether and when the employee-physician will be eligible to acquire an interest in the practice. The idea of remaining an employee may be attractive to some physicians who prefer to have less involvement in the business and financial aspects of the hospitalist practice. Sometimes cost becomes a critical issue.

However, if the parties do intend for the physician to have the right to purchase an ownership interest, the timeframe and conditions for exercising that right should be specified in writing. The following is an example of a provision addressing the opportunity to purchase an equity interest:

“The parties agree that it is their intent that upon X years of continuous employment pursuant to the terms and conditions of this Agreement, Hospitalist shall be given the opportunity to purchase [a partnership interest or stock] in Practice.”

Performance Reviews

One condition precedent to the right to purchase an equity interest may be satisfactory performance reviews by senior physicians. Although these reviews frequently are based on subjective standards, the employee-physician should seek a contractual commitment describing the criteria to be evaluated in order to make the reviews as objective as possible. Standard criteria include statistical analysis (e.g. number of patients seen a day), the quality of patient care rendered, and contributions to the practice’s operations (e.g. marketing, community outreach).

In addition, the physician’s employment agreement should specify the frequency of performance reviews. Physician reviews commonly occur on an annual, and sometimes semi-annual, basis, especially during the initial years of employment. Regardless of how often the reviews are conducted, it is highly beneficial to both the practice and the physician-employee that the time periods for evaluations be strictly enforced. Consistent, formal performance reviews promote improvement and synergy between the physician and the practice.

Equity Interest

Typically, an employment agreement will either provide an exact purchase price or, more often, state the future method to be used for calculating the buy-in price. Ordinarily, the buy-in price will be a function of the valuation of the total equity of the practice and the percentage of that equity, which is represented by the interests to be acquired by the purchasing physician. While there are a few formulas for valuing the equity of a hospitalist practice, the most common method is discounted present value of net revenue stream.

The appropriate valuation method will depend on a number of factors unique to the individual practice. Therefore, the practice should seek the assistance of an accountant or practice valuation specialist when determining the value. Stating an agreed-upon valuation method in the employment agreement will limit surprises and “sticker shock” to the buy-in price when the ownership decision is made down the road.

 

Payment Terms

In the event that the physician-employee exercises the opportunity to buy in, the employment or purchase agreement should provide terms governing how the purchase price will be paid. Often, the practice will be flexible in negotiating payment terms that meet the physician’s individual financial needs; however, the parties frequently agree that the physician will either pay the owners in full up front or make installment payments over a specified number of years.

If the physician is required to pay the total purchase price up front, he or she will be personally responsible for obtaining the necessary funding through bank loans or other sources. If the purchasing physician is permitted to make installment payments, he or she will be required to sign a promissory note in which the payee is the practice and the note is secured by a security interest in the equity granted to the physician. There are important tax strategies that can be implemented when installment payments are agreed upon. In the event that the physician fails to make the installment payments, the practice may be able to recover the equity interest.

In Sum

Both parties should review and understand the terms and conditions of the buy-in so that all parties enter the employment relationship with the same expectations for future ownership.

---

Steven Harris is a nationally recognized healthcare attorney and a member of the law firm McDonald Hopkins LLC in Chicago. Write to him at [email protected].

Finding the right hospitalist position can help make the transition from resident to attending enjoyable as you adjust to a new level of responsibility. But the wrong job can leave you feeling overwhelmed and unsupported. So what is a busy senior resident to do? Here we offer selected pearls and pitfalls to help you find a great position.

Initial Steps and Things to Consider

Start applying in the fall of your PGY-3 year. The process of interviewing applicants, finalizing contracts, arranging for hospital privileges, and enrolling a new hire in insurance plans can take many months. Many employers start looking early.

Meet with your residency program director and your hospitalist group director to discuss your plans. They can help you clarify your goals, serving as coaches throughout the process, and they may know people at the places you are interested in. Recruiters can be helpful, but remember—many are incentivized to find you a position. Advertisements in the back of journals and professional society publications are useful resources.

Obtain your medical license as early as possible. Getting licensed in the state you will be working in can be much faster if you already have a license from another state. Applicants have lost positions because they didn’t have their medical license in time.

Don’t shop for a job based on schedule and salary alone. There are reasons some jobs pay better than most, and they aren’t always good (home call, for example). A seven-on, seven-off schedule affords a lot of free time, but while you are on service, family life often takes a back seat. Conversely, working every Monday to Friday offers less free time for travel or moonlighting.

Think about the care model you prefer. Do you want to work with residents, physician assistants, nurse practitioners, or in a “direct care” model where it’s just you and the nurses caring for patients? Salaries often are inversely related to the number of providers between you and the patients. Positions without resident support might require procedural competence. Demonstrating academic productivity, especially in the area of quality improvement or patient safety, can help you secure a position working with residents. Some programs first place new hires on the non-teaching service to earn the chance to work with residents and medical students.

Think about what type of career you want. Do you only want to see patients, or do you want a career that includes a non-clinical role for which you will be paid? Some hospitalists find that becoming a patient safety officer or residency program director, trying out a medical student clerkship, or growing into another administrative role is a great complement to their clinical time and prevents burnout.

How to Stand Out

Start off by getting the basics right. Make sure your e-mail address sounds professional. A well-formatted CV, with no spelling errors or unexplained time gaps, is a must. A cover letter that succinctly describes the type of position you are looking for, highlights your strengths, and does not wax on about why you wanted to become a doctor—that was your personal statement for med school—is helpful. Don’t correspond with employers using your smartphone if you’re prone to autocorrect or spelling errors, or if you tend to write too casually from a mobile device. Before you shoot off that immediate e-mail response, make sure you’re addressing people properly and not mixing up employers.

Join SHM (they have trainee rates!), and attend an SHM conference or local chapter meeting if you can (www.hospitalmedicine.org/events). SHM membership reflects your commitment to the specialty. Membership in other professional societies is a plus as well.

 

Quality improvement (QI), patient safety, and patient satisfaction are central to hospital medicine. Medication reconciliation, infection control, handoff, transitions of care, listening carefully to patients, and explaining things to them are likely things you’ve done throughout residency. Communicate to employers your experience in and appreciation of these areas. Completing a QI or patient safety project and participating on a hospital committee will help make you a competitive applicant.

Interview Do’s and Don’ts

The advice most were given when applying to residency still holds. Be on time, dress professionally, research the program, and be prepared to speak about why you want to work at a particular place. Speak to hospitalists in the group, and be very courteous to everyone.

Don’t start off by asking about salary—if you move along in the process, compensation will be discussed. Get a clear picture of the schedule and how time off/non-clinical time occurs, but don’t come off as inflexible or too needy.

Ask why hospitalists have left a group. Frequent turnover without good reason could be a red flag. If the hospitalist director and/or department chair are new or will be leaving, you should ask how that might affect the group. If the current leadership has been stable, ask what growth has occurred for the group overall and among individuals during their tenure.

Find out whether hospitalists have been promoted academically and if there are career growth opportunities in areas you are interested in. Try to determine if the group has a “voice” with administration by asking for examples of how hospitalist concerns have been positively addressed.

Having a clear picture of how much nursing, social work, case management, subspecialist, and intensivist support is available is critical. Whether billing is done electronically or on paper is important, as is the degree of instruction and support for billing.

Take the opportunity to meet the current hospitalists—and note that their input often is solicited as to whether or not to hire a candidate—and ask them questions away from the ears of the program leadership; most hospitalists like to meet potential colleagues.

Closing the Deal

If you make it past the interview stage, be sure additional deliverables, such as letters of recommendation, are on time. Now is the time to ask about salary. Don’t be afraid to inquire about relocation or sign-on bonuses. At this point, the employer likes you and has invested time in recruiting you. You can gently leverage this in your negotiations. Consult your program director or other mentors at this point—they can provide guidance.

If you are uncertain about accepting an offer, be open about this with the employer. Your honesty in the process is essential, will be viewed positively, and can trigger additional dialogue that may help you decide. Juggling multiple offers dishonestly is not ethical and can backfire, as many hospitalist directors know each other.

Have an attorney familiar with physician contracts review yours. Look at whether “tail coverage,” which insures legal actions brought against you after you have left, is provided. Take note of “non-compete” clauses; they may limit your ability to practice in the area if you leave a practice. Find out if moonlighting is allowed and if the hospital requires you to give them a percentage of your outside earnings.

If you secure a position, whether as a career hospitalist or just for a year or two before fellowship, you should be excited. HM is a wonderful field with tremendous and varied opportunities. Dive in, enjoy, and explore everything it has to offer!

---

 

Dr. Bryson is medical director of teaching services, associate program director of internal medicine residency, and assistant professor at Tufts University, and a hospitalist at Baystate Medical Center in Springfield, Mass. Dr. Steinberg is residency program director in the Department of Medicine at Beth Israel Medical Center, and associate professor of medicine at the Icahn School of Medicine at Mount Sinai in New York City. Both are members of SHM’s Physicians in Training Committee.

Finding the right hospitalist position can help make the transition from resident to attending enjoyable as you adjust to a new level of responsibility. But the wrong job can leave you feeling overwhelmed and unsupported. So what is a busy senior resident to do? Here we offer selected pearls and pitfalls to help you find a great position.

Initial Steps and Things to Consider

Start applying in the fall of your PGY-3 year. The process of interviewing applicants, finalizing contracts, arranging for hospital privileges, and enrolling a new hire in insurance plans can take many months. Many employers start looking early.

Meet with your residency program director and your hospitalist group director to discuss your plans. They can help you clarify your goals, serving as coaches throughout the process, and they may know people at the places you are interested in. Recruiters can be helpful, but remember—many are incentivized to find you a position. Advertisements in the back of journals and professional society publications are useful resources.

Obtain your medical license as early as possible. Getting licensed in the state you will be working in can be much faster if you already have a license from another state. Applicants have lost positions because they didn’t have their medical license in time.

Don’t shop for a job based on schedule and salary alone. There are reasons some jobs pay better than most, and they aren’t always good (home call, for example). A seven-on, seven-off schedule affords a lot of free time, but while you are on service, family life often takes a back seat. Conversely, working every Monday to Friday offers less free time for travel or moonlighting.

Think about the care model you prefer. Do you want to work with residents, physician assistants, nurse practitioners, or in a “direct care” model where it’s just you and the nurses caring for patients? Salaries often are inversely related to the number of providers between you and the patients. Positions without resident support might require procedural competence. Demonstrating academic productivity, especially in the area of quality improvement or patient safety, can help you secure a position working with residents. Some programs first place new hires on the non-teaching service to earn the chance to work with residents and medical students.

Think about what type of career you want. Do you only want to see patients, or do you want a career that includes a non-clinical role for which you will be paid? Some hospitalists find that becoming a patient safety officer or residency program director, trying out a medical student clerkship, or growing into another administrative role is a great complement to their clinical time and prevents burnout.

How to Stand Out

Start off by getting the basics right. Make sure your e-mail address sounds professional. A well-formatted CV, with no spelling errors or unexplained time gaps, is a must. A cover letter that succinctly describes the type of position you are looking for, highlights your strengths, and does not wax on about why you wanted to become a doctor—that was your personal statement for med school—is helpful. Don’t correspond with employers using your smartphone if you’re prone to autocorrect or spelling errors, or if you tend to write too casually from a mobile device. Before you shoot off that immediate e-mail response, make sure you’re addressing people properly and not mixing up employers.

Join SHM (they have trainee rates!), and attend an SHM conference or local chapter meeting if you can (www.hospitalmedicine.org/events). SHM membership reflects your commitment to the specialty. Membership in other professional societies is a plus as well.

 

Quality improvement (QI), patient safety, and patient satisfaction are central to hospital medicine. Medication reconciliation, infection control, handoff, transitions of care, listening carefully to patients, and explaining things to them are likely things you’ve done throughout residency. Communicate to employers your experience in and appreciation of these areas. Completing a QI or patient safety project and participating on a hospital committee will help make you a competitive applicant.

Interview Do’s and Don’ts

The advice most were given when applying to residency still holds. Be on time, dress professionally, research the program, and be prepared to speak about why you want to work at a particular place. Speak to hospitalists in the group, and be very courteous to everyone.

Don’t start off by asking about salary—if you move along in the process, compensation will be discussed. Get a clear picture of the schedule and how time off/non-clinical time occurs, but don’t come off as inflexible or too needy.

Ask why hospitalists have left a group. Frequent turnover without good reason could be a red flag. If the hospitalist director and/or department chair are new or will be leaving, you should ask how that might affect the group. If the current leadership has been stable, ask what growth has occurred for the group overall and among individuals during their tenure.

Find out whether hospitalists have been promoted academically and if there are career growth opportunities in areas you are interested in. Try to determine if the group has a “voice” with administration by asking for examples of how hospitalist concerns have been positively addressed.

Having a clear picture of how much nursing, social work, case management, subspecialist, and intensivist support is available is critical. Whether billing is done electronically or on paper is important, as is the degree of instruction and support for billing.

Take the opportunity to meet the current hospitalists—and note that their input often is solicited as to whether or not to hire a candidate—and ask them questions away from the ears of the program leadership; most hospitalists like to meet potential colleagues.

Closing the Deal

If you make it past the interview stage, be sure additional deliverables, such as letters of recommendation, are on time. Now is the time to ask about salary. Don’t be afraid to inquire about relocation or sign-on bonuses. At this point, the employer likes you and has invested time in recruiting you. You can gently leverage this in your negotiations. Consult your program director or other mentors at this point—they can provide guidance.

If you are uncertain about accepting an offer, be open about this with the employer. Your honesty in the process is essential, will be viewed positively, and can trigger additional dialogue that may help you decide. Juggling multiple offers dishonestly is not ethical and can backfire, as many hospitalist directors know each other.

Have an attorney familiar with physician contracts review yours. Look at whether “tail coverage,” which insures legal actions brought against you after you have left, is provided. Take note of “non-compete” clauses; they may limit your ability to practice in the area if you leave a practice. Find out if moonlighting is allowed and if the hospital requires you to give them a percentage of your outside earnings.

If you secure a position, whether as a career hospitalist or just for a year or two before fellowship, you should be excited. HM is a wonderful field with tremendous and varied opportunities. Dive in, enjoy, and explore everything it has to offer!

---

 

Dr. Bryson is medical director of teaching services, associate program director of internal medicine residency, and assistant professor at Tufts University, and a hospitalist at Baystate Medical Center in Springfield, Mass. Dr. Steinberg is residency program director in the Department of Medicine at Beth Israel Medical Center, and associate professor of medicine at the Icahn School of Medicine at Mount Sinai in New York City. Both are members of SHM’s Physicians in Training Committee.

Finding the right hospitalist position can help make the transition from resident to attending enjoyable as you adjust to a new level of responsibility. But the wrong job can leave you feeling overwhelmed and unsupported. So what is a busy senior resident to do? Here we offer selected pearls and pitfalls to help you find a great position.

Initial Steps and Things to Consider

Start applying in the fall of your PGY-3 year. The process of interviewing applicants, finalizing contracts, arranging for hospital privileges, and enrolling a new hire in insurance plans can take many months. Many employers start looking early.

Meet with your residency program director and your hospitalist group director to discuss your plans. They can help you clarify your goals, serving as coaches throughout the process, and they may know people at the places you are interested in. Recruiters can be helpful, but remember—many are incentivized to find you a position. Advertisements in the back of journals and professional society publications are useful resources.

Obtain your medical license as early as possible. Getting licensed in the state you will be working in can be much faster if you already have a license from another state. Applicants have lost positions because they didn’t have their medical license in time.

Don’t shop for a job based on schedule and salary alone. There are reasons some jobs pay better than most, and they aren’t always good (home call, for example). A seven-on, seven-off schedule affords a lot of free time, but while you are on service, family life often takes a back seat. Conversely, working every Monday to Friday offers less free time for travel or moonlighting.

Think about the care model you prefer. Do you want to work with residents, physician assistants, nurse practitioners, or in a “direct care” model where it’s just you and the nurses caring for patients? Salaries often are inversely related to the number of providers between you and the patients. Positions without resident support might require procedural competence. Demonstrating academic productivity, especially in the area of quality improvement or patient safety, can help you secure a position working with residents. Some programs first place new hires on the non-teaching service to earn the chance to work with residents and medical students.

Think about what type of career you want. Do you only want to see patients, or do you want a career that includes a non-clinical role for which you will be paid? Some hospitalists find that becoming a patient safety officer or residency program director, trying out a medical student clerkship, or growing into another administrative role is a great complement to their clinical time and prevents burnout.

How to Stand Out

Start off by getting the basics right. Make sure your e-mail address sounds professional. A well-formatted CV, with no spelling errors or unexplained time gaps, is a must. A cover letter that succinctly describes the type of position you are looking for, highlights your strengths, and does not wax on about why you wanted to become a doctor—that was your personal statement for med school—is helpful. Don’t correspond with employers using your smartphone if you’re prone to autocorrect or spelling errors, or if you tend to write too casually from a mobile device. Before you shoot off that immediate e-mail response, make sure you’re addressing people properly and not mixing up employers.

Join SHM (they have trainee rates!), and attend an SHM conference or local chapter meeting if you can (www.hospitalmedicine.org/events). SHM membership reflects your commitment to the specialty. Membership in other professional societies is a plus as well.

 

Quality improvement (QI), patient safety, and patient satisfaction are central to hospital medicine. Medication reconciliation, infection control, handoff, transitions of care, listening carefully to patients, and explaining things to them are likely things you’ve done throughout residency. Communicate to employers your experience in and appreciation of these areas. Completing a QI or patient safety project and participating on a hospital committee will help make you a competitive applicant.

Interview Do’s and Don’ts

The advice most were given when applying to residency still holds. Be on time, dress professionally, research the program, and be prepared to speak about why you want to work at a particular place. Speak to hospitalists in the group, and be very courteous to everyone.

Don’t start off by asking about salary—if you move along in the process, compensation will be discussed. Get a clear picture of the schedule and how time off/non-clinical time occurs, but don’t come off as inflexible or too needy.

Ask why hospitalists have left a group. Frequent turnover without good reason could be a red flag. If the hospitalist director and/or department chair are new or will be leaving, you should ask how that might affect the group. If the current leadership has been stable, ask what growth has occurred for the group overall and among individuals during their tenure.

Find out whether hospitalists have been promoted academically and if there are career growth opportunities in areas you are interested in. Try to determine if the group has a “voice” with administration by asking for examples of how hospitalist concerns have been positively addressed.

Having a clear picture of how much nursing, social work, case management, subspecialist, and intensivist support is available is critical. Whether billing is done electronically or on paper is important, as is the degree of instruction and support for billing.

Take the opportunity to meet the current hospitalists—and note that their input often is solicited as to whether or not to hire a candidate—and ask them questions away from the ears of the program leadership; most hospitalists like to meet potential colleagues.

Closing the Deal

If you make it past the interview stage, be sure additional deliverables, such as letters of recommendation, are on time. Now is the time to ask about salary. Don’t be afraid to inquire about relocation or sign-on bonuses. At this point, the employer likes you and has invested time in recruiting you. You can gently leverage this in your negotiations. Consult your program director or other mentors at this point—they can provide guidance.

If you are uncertain about accepting an offer, be open about this with the employer. Your honesty in the process is essential, will be viewed positively, and can trigger additional dialogue that may help you decide. Juggling multiple offers dishonestly is not ethical and can backfire, as many hospitalist directors know each other.

Have an attorney familiar with physician contracts review yours. Look at whether “tail coverage,” which insures legal actions brought against you after you have left, is provided. Take note of “non-compete” clauses; they may limit your ability to practice in the area if you leave a practice. Find out if moonlighting is allowed and if the hospital requires you to give them a percentage of your outside earnings.

If you secure a position, whether as a career hospitalist or just for a year or two before fellowship, you should be excited. HM is a wonderful field with tremendous and varied opportunities. Dive in, enjoy, and explore everything it has to offer!

---

 

Dr. Bryson is medical director of teaching services, associate program director of internal medicine residency, and assistant professor at Tufts University, and a hospitalist at Baystate Medical Center in Springfield, Mass. Dr. Steinberg is residency program director in the Department of Medicine at Beth Israel Medical Center, and associate professor of medicine at the Icahn School of Medicine at Mount Sinai in New York City. Both are members of SHM’s Physicians in Training Committee.

Middle age is typically a difficult passage for many professionals. It is a developmental phase involving the mourning of lost opportunities and the acceptance of one’s limits. One also reflects on his or her identity, takes note of regrets, and reevaluates how one will apportion time in the future.—Glen Gabbard, MD¹

Hospital medicine is a relatively young specialty, but we are growing up, with many hospitalists now firmly in the middle phase of their careers. In 1999, 15% of our peers had been hospitalists for more than five years; by 2010, that number had grown to 50%.² As the ranks of hospitalists grow older, we are faced with questions reflecting a life station marked by a little more wisdom, a few more gray hairs, and an occasional reflection on the legacy we will leave.

Drybye and colleagues recently released further analysis on a survey that had been previously reported, shedding new light on mid-career physician satisfaction and burnout and revealing important implications for hospital medicine.³ The study looked at responses to the Maslach Burnout Inventory for physicians from a range of specialties who had been in practice 10 years or less (early career), 11 to 20 years (mid-career), and 21 years or more (late career).

The study demonstrated that while early and late career have their challenges, middle career is a particularly difficult time for physicians. Mid-career physicians had the lowest satisfaction with their specialty choice and their work-life balance and the highest rates of emotional exhaustion and burnout. Strikingly, mid-career physicians were more than twice as likely as those in early and late career to plan to leave the practice of medicine for reasons other than retirement in the next 24 months.

What does this mean for hospital medicine? Because the survey findings are drawn from multiple specialties, we must use caution in extrapolating the results to hospitalists; however, if hospitalists are leaving the specialty mid-career, a more pressing problem may exist for hospital medicine than for other specialties. Why? First, the specialty has grown so rapidly over the last 15 years that it has been difficult to generate a sufficient supply of physicians to meet the demand. If a large number of mid-career hospitalists leave the specialty, our field may be stuck in a state of “arrested development” without the sufficient presence of mature clinicians. Second, effective hospitalists possess “system” skills that are learned on the job, so seasoned hospitalists often play an integrative and problem-solving role within the hospital. Third, there could be a downward spiral of career satisfaction in the specialty if onlookers like trainees and stakeholders in the healthcare ecosystem see hospitalists as dissatisfied and disengaged. Will the promise of hospital medicine be fulfilled?

In an accompanying editorial, Spinelli suggests three principles for physician well-being, which hospitalist programs would do well to consider:⁴

1. Elevate well-being metrics to the same level of importance as financial, quality, and patient satisfaction metrics. (Place such metrics on the organizational dashboard.)
2. Design system and care processes that include intentional plans for physician and staff wellness. (Redesign of care models and workflows should consider physician and staff wellness.)
3. Adopt a robust set of self-care strategies for those experiencing burnout.

SHM’s Role

SHM has taken up the issue of hospitalist career satisfaction on a number of occasions over the years, initially engendered by field observations of the stressful nature of hospitalist work and a 2001 study reporting that 25% of hospitalists were “at risk” of burnout and 13% were “burned out.”⁵ Subsequently, SHM released a white paper with a number of specific recommendations organized around a career satisfaction framework consisting of autonomy, reward/recognition, occupational solidarity, and connection with one’s professional and broader community.⁶

 

Recently, the SHM Practice Management Committee has once again taken up the issue of “physician engagement.” Over the next few months, the committee plans to:

1. Create a repository of related resources on the SHM website, including physician engagement profiles for some hospitalist practices;
2. Initiate a dialogue on the topic of physician engagement on HMX (connect.hospitalmedicine.org), SHM’s social networking platform; and
3. Publish a “public domain” survey questionnaire that hospitalist practices can use. This is a crucial matter that remains a central concern for our specialty and for the safety and well-being of our patients.

Conclusion

The Institute for Healthcare Improvement advanced the idea of the Triple Aim (better care, better health, lower costs) several years ago as a guiding principle in the transformation of healthcare. More recently, a growing number of voices suggest that physician satisfaction is a crucial foundation of the Triple Aim.⁴ I submit that for hospitalists to fulfill their potential as healthcare change agents, we will need to build a professional experience that enables them to traverse mid-career challenges and make it to the professional finish line as engaged and well-adjusted members of the healthcare community.

---

Dr. Whitcomb is Chief Medical Officer of Remedy Partners. He is co-founder and past president of SHM. Email him at [email protected].

References

1. Gabbard GO. Medicine and its discontents. Mayo Clin Proc. 2013;88(12):1347-1349.
2. Hinami K, Whelan CT, Wolosin RJ, Miller JA, Wetterneck TB. Worklife and satisfaction of hospitalists: Toward flourishing careers. J Gen Intern Med. 2012;27(1):28-36.
3. Drybye LN, Varkey P, Boone SL, Satele DV, Sloan JA, Shanafelt TD. Physician satisfaction and burnout at different career stages. Mayo Clin Proc. 2013;88(12):1358-1367.
4. Spinelli WM. The phantom limb of the triple aim. Mayo Clin Proc. 2013;88(12):1356-1357.
5. Hoff TH, Whitcomb WF, Williams K, Nelson JR, Cheesman RA. Characteristics and work experiences of hospitalists in the United States. Arch Intern Med. 2001;161(6):851-858.
6. Society of Hospital Medicine. A challenge for a new specialty: a white paper on hospitalist career satisfaction. Available at: http://www.hospitalmedicine.org/Content/NavigationMenu/Publications/WhitePapers/White_Papers.htm. Accessed January 4, 2014.

Middle age is typically a difficult passage for many professionals. It is a developmental phase involving the mourning of lost opportunities and the acceptance of one’s limits. One also reflects on his or her identity, takes note of regrets, and reevaluates how one will apportion time in the future.—Glen Gabbard, MD¹

Hospital medicine is a relatively young specialty, but we are growing up, with many hospitalists now firmly in the middle phase of their careers. In 1999, 15% of our peers had been hospitalists for more than five years; by 2010, that number had grown to 50%.² As the ranks of hospitalists grow older, we are faced with questions reflecting a life station marked by a little more wisdom, a few more gray hairs, and an occasional reflection on the legacy we will leave.

Drybye and colleagues recently released further analysis on a survey that had been previously reported, shedding new light on mid-career physician satisfaction and burnout and revealing important implications for hospital medicine.³ The study looked at responses to the Maslach Burnout Inventory for physicians from a range of specialties who had been in practice 10 years or less (early career), 11 to 20 years (mid-career), and 21 years or more (late career).

The study demonstrated that while early and late career have their challenges, middle career is a particularly difficult time for physicians. Mid-career physicians had the lowest satisfaction with their specialty choice and their work-life balance and the highest rates of emotional exhaustion and burnout. Strikingly, mid-career physicians were more than twice as likely as those in early and late career to plan to leave the practice of medicine for reasons other than retirement in the next 24 months.

What does this mean for hospital medicine? Because the survey findings are drawn from multiple specialties, we must use caution in extrapolating the results to hospitalists; however, if hospitalists are leaving the specialty mid-career, a more pressing problem may exist for hospital medicine than for other specialties. Why? First, the specialty has grown so rapidly over the last 15 years that it has been difficult to generate a sufficient supply of physicians to meet the demand. If a large number of mid-career hospitalists leave the specialty, our field may be stuck in a state of “arrested development” without the sufficient presence of mature clinicians. Second, effective hospitalists possess “system” skills that are learned on the job, so seasoned hospitalists often play an integrative and problem-solving role within the hospital. Third, there could be a downward spiral of career satisfaction in the specialty if onlookers like trainees and stakeholders in the healthcare ecosystem see hospitalists as dissatisfied and disengaged. Will the promise of hospital medicine be fulfilled?

In an accompanying editorial, Spinelli suggests three principles for physician well-being, which hospitalist programs would do well to consider:⁴

1. Elevate well-being metrics to the same level of importance as financial, quality, and patient satisfaction metrics. (Place such metrics on the organizational dashboard.)
2. Design system and care processes that include intentional plans for physician and staff wellness. (Redesign of care models and workflows should consider physician and staff wellness.)
3. Adopt a robust set of self-care strategies for those experiencing burnout.

SHM’s Role

SHM has taken up the issue of hospitalist career satisfaction on a number of occasions over the years, initially engendered by field observations of the stressful nature of hospitalist work and a 2001 study reporting that 25% of hospitalists were “at risk” of burnout and 13% were “burned out.”⁵ Subsequently, SHM released a white paper with a number of specific recommendations organized around a career satisfaction framework consisting of autonomy, reward/recognition, occupational solidarity, and connection with one’s professional and broader community.⁶

 

Recently, the SHM Practice Management Committee has once again taken up the issue of “physician engagement.” Over the next few months, the committee plans to:

1. Create a repository of related resources on the SHM website, including physician engagement profiles for some hospitalist practices;
2. Initiate a dialogue on the topic of physician engagement on HMX (connect.hospitalmedicine.org), SHM’s social networking platform; and
3. Publish a “public domain” survey questionnaire that hospitalist practices can use. This is a crucial matter that remains a central concern for our specialty and for the safety and well-being of our patients.

Conclusion

The Institute for Healthcare Improvement advanced the idea of the Triple Aim (better care, better health, lower costs) several years ago as a guiding principle in the transformation of healthcare. More recently, a growing number of voices suggest that physician satisfaction is a crucial foundation of the Triple Aim.⁴ I submit that for hospitalists to fulfill their potential as healthcare change agents, we will need to build a professional experience that enables them to traverse mid-career challenges and make it to the professional finish line as engaged and well-adjusted members of the healthcare community.

---

Dr. Whitcomb is Chief Medical Officer of Remedy Partners. He is co-founder and past president of SHM. Email him at [email protected].

References

1. Gabbard GO. Medicine and its discontents. Mayo Clin Proc. 2013;88(12):1347-1349.
2. Hinami K, Whelan CT, Wolosin RJ, Miller JA, Wetterneck TB. Worklife and satisfaction of hospitalists: Toward flourishing careers. J Gen Intern Med. 2012;27(1):28-36.
3. Drybye LN, Varkey P, Boone SL, Satele DV, Sloan JA, Shanafelt TD. Physician satisfaction and burnout at different career stages. Mayo Clin Proc. 2013;88(12):1358-1367.
4. Spinelli WM. The phantom limb of the triple aim. Mayo Clin Proc. 2013;88(12):1356-1357.
5. Hoff TH, Whitcomb WF, Williams K, Nelson JR, Cheesman RA. Characteristics and work experiences of hospitalists in the United States. Arch Intern Med. 2001;161(6):851-858.
6. Society of Hospital Medicine. A challenge for a new specialty: a white paper on hospitalist career satisfaction. Available at: http://www.hospitalmedicine.org/Content/NavigationMenu/Publications/WhitePapers/White_Papers.htm. Accessed January 4, 2014.

Middle age is typically a difficult passage for many professionals. It is a developmental phase involving the mourning of lost opportunities and the acceptance of one’s limits. One also reflects on his or her identity, takes note of regrets, and reevaluates how one will apportion time in the future.—Glen Gabbard, MD¹

Hospital medicine is a relatively young specialty, but we are growing up, with many hospitalists now firmly in the middle phase of their careers. In 1999, 15% of our peers had been hospitalists for more than five years; by 2010, that number had grown to 50%.² As the ranks of hospitalists grow older, we are faced with questions reflecting a life station marked by a little more wisdom, a few more gray hairs, and an occasional reflection on the legacy we will leave.

Drybye and colleagues recently released further analysis on a survey that had been previously reported, shedding new light on mid-career physician satisfaction and burnout and revealing important implications for hospital medicine.³ The study looked at responses to the Maslach Burnout Inventory for physicians from a range of specialties who had been in practice 10 years or less (early career), 11 to 20 years (mid-career), and 21 years or more (late career).

The study demonstrated that while early and late career have their challenges, middle career is a particularly difficult time for physicians. Mid-career physicians had the lowest satisfaction with their specialty choice and their work-life balance and the highest rates of emotional exhaustion and burnout. Strikingly, mid-career physicians were more than twice as likely as those in early and late career to plan to leave the practice of medicine for reasons other than retirement in the next 24 months.

What does this mean for hospital medicine? Because the survey findings are drawn from multiple specialties, we must use caution in extrapolating the results to hospitalists; however, if hospitalists are leaving the specialty mid-career, a more pressing problem may exist for hospital medicine than for other specialties. Why? First, the specialty has grown so rapidly over the last 15 years that it has been difficult to generate a sufficient supply of physicians to meet the demand. If a large number of mid-career hospitalists leave the specialty, our field may be stuck in a state of “arrested development” without the sufficient presence of mature clinicians. Second, effective hospitalists possess “system” skills that are learned on the job, so seasoned hospitalists often play an integrative and problem-solving role within the hospital. Third, there could be a downward spiral of career satisfaction in the specialty if onlookers like trainees and stakeholders in the healthcare ecosystem see hospitalists as dissatisfied and disengaged. Will the promise of hospital medicine be fulfilled?

In an accompanying editorial, Spinelli suggests three principles for physician well-being, which hospitalist programs would do well to consider:⁴

1. Elevate well-being metrics to the same level of importance as financial, quality, and patient satisfaction metrics. (Place such metrics on the organizational dashboard.)
2. Design system and care processes that include intentional plans for physician and staff wellness. (Redesign of care models and workflows should consider physician and staff wellness.)
3. Adopt a robust set of self-care strategies for those experiencing burnout.

SHM’s Role

SHM has taken up the issue of hospitalist career satisfaction on a number of occasions over the years, initially engendered by field observations of the stressful nature of hospitalist work and a 2001 study reporting that 25% of hospitalists were “at risk” of burnout and 13% were “burned out.”⁵ Subsequently, SHM released a white paper with a number of specific recommendations organized around a career satisfaction framework consisting of autonomy, reward/recognition, occupational solidarity, and connection with one’s professional and broader community.⁶

 

Recently, the SHM Practice Management Committee has once again taken up the issue of “physician engagement.” Over the next few months, the committee plans to:

1. Create a repository of related resources on the SHM website, including physician engagement profiles for some hospitalist practices;
2. Initiate a dialogue on the topic of physician engagement on HMX (connect.hospitalmedicine.org), SHM’s social networking platform; and
3. Publish a “public domain” survey questionnaire that hospitalist practices can use. This is a crucial matter that remains a central concern for our specialty and for the safety and well-being of our patients.

Conclusion

The Institute for Healthcare Improvement advanced the idea of the Triple Aim (better care, better health, lower costs) several years ago as a guiding principle in the transformation of healthcare. More recently, a growing number of voices suggest that physician satisfaction is a crucial foundation of the Triple Aim.⁴ I submit that for hospitalists to fulfill their potential as healthcare change agents, we will need to build a professional experience that enables them to traverse mid-career challenges and make it to the professional finish line as engaged and well-adjusted members of the healthcare community.

---

Dr. Whitcomb is Chief Medical Officer of Remedy Partners. He is co-founder and past president of SHM. Email him at [email protected].

References

1. Gabbard GO. Medicine and its discontents. Mayo Clin Proc. 2013;88(12):1347-1349.
2. Hinami K, Whelan CT, Wolosin RJ, Miller JA, Wetterneck TB. Worklife and satisfaction of hospitalists: Toward flourishing careers. J Gen Intern Med. 2012;27(1):28-36.
3. Drybye LN, Varkey P, Boone SL, Satele DV, Sloan JA, Shanafelt TD. Physician satisfaction and burnout at different career stages. Mayo Clin Proc. 2013;88(12):1358-1367.
4. Spinelli WM. The phantom limb of the triple aim. Mayo Clin Proc. 2013;88(12):1356-1357.
5. Hoff TH, Whitcomb WF, Williams K, Nelson JR, Cheesman RA. Characteristics and work experiences of hospitalists in the United States. Arch Intern Med. 2001;161(6):851-858.
6. Society of Hospital Medicine. A challenge for a new specialty: a white paper on hospitalist career satisfaction. Available at: http://www.hospitalmedicine.org/Content/NavigationMenu/Publications/WhitePapers/White_Papers.htm. Accessed January 4, 2014.

Increase in the number of “top performer” hospitals in 2012 accreditation surveys conducted by the Joint Commission. Those 1,099 hospitals making the list had to receive a composite score of 95% or above for selected accountability measures.

Increase in the number of “top performer” hospitals in 2012 accreditation surveys conducted by the Joint Commission. Those 1,099 hospitals making the list had to receive a composite score of 95% or above for selected accountability measures.

Increase in the number of “top performer” hospitals in 2012 accreditation surveys conducted by the Joint Commission. Those 1,099 hospitals making the list had to receive a composite score of 95% or above for selected accountability measures.

Basic Principles for Pediatric Hospital Medicine Published A recent policy statement from the American Academy of Pediatrics (AAP), published online in Pediatrics, urges recognition of the expanded roles and responsibilities of pediatric hospitalists and offers basic principles for pediatric hospital medicine (PHM) programs, including focusing on the unique culture of each program within its parent institution and the importance of coordinated, patient-centered care.⁴

The article outlines settings available for PHM programs, optimal processes for care transitions, and the need for leadership and goal setting.

“It is implicit in all the aforementioned recommendations that the overarching goal is always to provide the best possible care for children and protect the safety of children in the hospital setting,” the authors note.

AAP’s Section on Hospital Medicine supports a policy of voluntary referrals to pediatric hospital medicine programs.

Basic Principles for Pediatric Hospital Medicine Published A recent policy statement from the American Academy of Pediatrics (AAP), published online in Pediatrics, urges recognition of the expanded roles and responsibilities of pediatric hospitalists and offers basic principles for pediatric hospital medicine (PHM) programs, including focusing on the unique culture of each program within its parent institution and the importance of coordinated, patient-centered care.⁴

The article outlines settings available for PHM programs, optimal processes for care transitions, and the need for leadership and goal setting.

“It is implicit in all the aforementioned recommendations that the overarching goal is always to provide the best possible care for children and protect the safety of children in the hospital setting,” the authors note.

AAP’s Section on Hospital Medicine supports a policy of voluntary referrals to pediatric hospital medicine programs.

Basic Principles for Pediatric Hospital Medicine Published A recent policy statement from the American Academy of Pediatrics (AAP), published online in Pediatrics, urges recognition of the expanded roles and responsibilities of pediatric hospitalists and offers basic principles for pediatric hospital medicine (PHM) programs, including focusing on the unique culture of each program within its parent institution and the importance of coordinated, patient-centered care.⁴

The article outlines settings available for PHM programs, optimal processes for care transitions, and the need for leadership and goal setting.

“It is implicit in all the aforementioned recommendations that the overarching goal is always to provide the best possible care for children and protect the safety of children in the hospital setting,” the authors note.

AAP’s Section on Hospital Medicine supports a policy of voluntary referrals to pediatric hospital medicine programs.

Study Suggests Medical Trainees Need More Manners

Researchers at Johns Hopkins Hospital and the University of Maryland Medical Center, both in Baltimore, identified an overall lack of “common courtesy” shown by internal medicine trainees in their interactions with patients.³ Such behavior can lead to lower patient satisfaction and worse medical outcomes, note the authors of the study, which included hospitalist Leonard Feldman, MD, FACP, FAAP, SFHM, an assistant professor of medicine at Hopkins.

The study, published in the November issue of the Journal of Hospital Medicine, followed 29 interns on rounds for three weeks and looked for five key strategies of etiquette-based communication. Researchers found that while the interns asked open-ended questions 75% of the time, they explained their role to the patient only 37% of the time and sat down to talk eye to eye during an encounter only 9% of the time.

The interns performed all five recommended behaviors only 4% of the time.

“These are things that matter to patients and are relatively easy to do,” Dr. Feldman said in a prepared statement. “They’re not being done to the extent they should be.”

---

Larry Beresford is a freelance writer in Alameda, Calif.

References

1. Rizk D, Calabrese R, Page C, Bookbinder M, Flores S, Portenoy R. A unique hospitalist/pain management collaboration to improve pain outcomes [abstract]. Available at: http://www.shmabstracts.com/abstract.asp?MeetingID=793&id=104310. Accessed November 29, 2013.
2. American Society for Parenteral and Enteral Nutrition. A.S.P.E.N. supports major medical device changes for improved patient safety. Available at: http://www.nutritioncare.org/Press_Room/Press_Releases/A_S_P_E_N__Supports_Major_Medical_Device_Changes_for_Improved_Patient_Safety/. Accessed November 29, 2013.
3. Block LB, Hutzler L, Habicht R, Wu AW, et al. Do internal medicine interns practice etiquette-based communication? A critical look at the inpatient encounter. J Hosp Med. 2013;8(11):631-634.
4. Mirkinson LJ, Section on Hospital Medicine. Guiding principles for pediatric hospital medicine programs. Pediatrics. 2013;132(4):782-786.

Study Suggests Medical Trainees Need More Manners

Researchers at Johns Hopkins Hospital and the University of Maryland Medical Center, both in Baltimore, identified an overall lack of “common courtesy” shown by internal medicine trainees in their interactions with patients.³ Such behavior can lead to lower patient satisfaction and worse medical outcomes, note the authors of the study, which included hospitalist Leonard Feldman, MD, FACP, FAAP, SFHM, an assistant professor of medicine at Hopkins.

The study, published in the November issue of the Journal of Hospital Medicine, followed 29 interns on rounds for three weeks and looked for five key strategies of etiquette-based communication. Researchers found that while the interns asked open-ended questions 75% of the time, they explained their role to the patient only 37% of the time and sat down to talk eye to eye during an encounter only 9% of the time.

The interns performed all five recommended behaviors only 4% of the time.

“These are things that matter to patients and are relatively easy to do,” Dr. Feldman said in a prepared statement. “They’re not being done to the extent they should be.”

---

Larry Beresford is a freelance writer in Alameda, Calif.

References

1. Rizk D, Calabrese R, Page C, Bookbinder M, Flores S, Portenoy R. A unique hospitalist/pain management collaboration to improve pain outcomes [abstract]. Available at: http://www.shmabstracts.com/abstract.asp?MeetingID=793&id=104310. Accessed November 29, 2013.
2. American Society for Parenteral and Enteral Nutrition. A.S.P.E.N. supports major medical device changes for improved patient safety. Available at: http://www.nutritioncare.org/Press_Room/Press_Releases/A_S_P_E_N__Supports_Major_Medical_Device_Changes_for_Improved_Patient_Safety/. Accessed November 29, 2013.
3. Block LB, Hutzler L, Habicht R, Wu AW, et al. Do internal medicine interns practice etiquette-based communication? A critical look at the inpatient encounter. J Hosp Med. 2013;8(11):631-634.
4. Mirkinson LJ, Section on Hospital Medicine. Guiding principles for pediatric hospital medicine programs. Pediatrics. 2013;132(4):782-786.

Study Suggests Medical Trainees Need More Manners

Researchers at Johns Hopkins Hospital and the University of Maryland Medical Center, both in Baltimore, identified an overall lack of “common courtesy” shown by internal medicine trainees in their interactions with patients.³ Such behavior can lead to lower patient satisfaction and worse medical outcomes, note the authors of the study, which included hospitalist Leonard Feldman, MD, FACP, FAAP, SFHM, an assistant professor of medicine at Hopkins.

The study, published in the November issue of the Journal of Hospital Medicine, followed 29 interns on rounds for three weeks and looked for five key strategies of etiquette-based communication. Researchers found that while the interns asked open-ended questions 75% of the time, they explained their role to the patient only 37% of the time and sat down to talk eye to eye during an encounter only 9% of the time.

The interns performed all five recommended behaviors only 4% of the time.

“These are things that matter to patients and are relatively easy to do,” Dr. Feldman said in a prepared statement. “They’re not being done to the extent they should be.”

---

Larry Beresford is a freelance writer in Alameda, Calif.

References

1. Rizk D, Calabrese R, Page C, Bookbinder M, Flores S, Portenoy R. A unique hospitalist/pain management collaboration to improve pain outcomes [abstract]. Available at: http://www.shmabstracts.com/abstract.asp?MeetingID=793&id=104310. Accessed November 29, 2013.
2. American Society for Parenteral and Enteral Nutrition. A.S.P.E.N. supports major medical device changes for improved patient safety. Available at: http://www.nutritioncare.org/Press_Room/Press_Releases/A_S_P_E_N__Supports_Major_Medical_Device_Changes_for_Improved_Patient_Safety/. Accessed November 29, 2013.
3. Block LB, Hutzler L, Habicht R, Wu AW, et al. Do internal medicine interns practice etiquette-based communication? A critical look at the inpatient encounter. J Hosp Med. 2013;8(11):631-634.
4. Mirkinson LJ, Section on Hospital Medicine. Guiding principles for pediatric hospital medicine programs. Pediatrics. 2013;132(4):782-786.

The American Society for Parenteral and Enteral Nutrition (ASPEN), the Global Enteral Device Supplier Association (GEDSA) and a number of other quality-oriented groups, including the FDA, Centers for Medicare & Medicaid Services (CMS), and the Joint Commission, are working to address tubing misconnections for medical device small-bore connectors—used for enteral, luer, neuro-cranial, respiratory, and other medical tubing equipment.²

Misconnections, although rare, can be harmful or even fatal to patients. The task force conducted a panel discussion Oct. 22 in Washington, D.C., focused on redesign issues, and is collaborating with the International Standards Organization to develop new small-bore connector standards.

GEDSA’s “Stay Connected” is an education campaign to inform and prepare the healthcare community for impending changes in standards for small-bore connectors. For more information, visit www.stayconnected2014.org.

The American Society for Parenteral and Enteral Nutrition (ASPEN), the Global Enteral Device Supplier Association (GEDSA) and a number of other quality-oriented groups, including the FDA, Centers for Medicare & Medicaid Services (CMS), and the Joint Commission, are working to address tubing misconnections for medical device small-bore connectors—used for enteral, luer, neuro-cranial, respiratory, and other medical tubing equipment.²

Misconnections, although rare, can be harmful or even fatal to patients. The task force conducted a panel discussion Oct. 22 in Washington, D.C., focused on redesign issues, and is collaborating with the International Standards Organization to develop new small-bore connector standards.

GEDSA’s “Stay Connected” is an education campaign to inform and prepare the healthcare community for impending changes in standards for small-bore connectors. For more information, visit www.stayconnected2014.org.

The American Society for Parenteral and Enteral Nutrition (ASPEN), the Global Enteral Device Supplier Association (GEDSA) and a number of other quality-oriented groups, including the FDA, Centers for Medicare & Medicaid Services (CMS), and the Joint Commission, are working to address tubing misconnections for medical device small-bore connectors—used for enteral, luer, neuro-cranial, respiratory, and other medical tubing equipment.²

Misconnections, although rare, can be harmful or even fatal to patients. The task force conducted a panel discussion Oct. 22 in Washington, D.C., focused on redesign issues, and is collaborating with the International Standards Organization to develop new small-bore connector standards.

GEDSA’s “Stay Connected” is an education campaign to inform and prepare the healthcare community for impending changes in standards for small-bore connectors. For more information, visit www.stayconnected2014.org.

A collaboration between hospitalists and the pain department at Beth Israel Medical Center in New York City is helping hospitalists address moderate to severe pain and complicating factors in their patients.

“The idea was to impart knowledge from a small group of experts to the hospitalists who manage pain in the majority of hospitalized patients,” says Dahlia Rizk, DO, chief of hospital medicine at Beth Israel and lead author on a poster that described the program and was presented at HM13 in Washington, D.C.¹

Dr. Rizk first approached Russell Portenoy, MD, internationally recognized chair of the Department of Pain Management and Palliative Care at Beth Israel, to draw upon his specialized knowledge. Grant funding supported protected time for two hospitalist champions and a nurse practitioner; they reviewed charts on participating units and conducted focus groups with hospitalists to identify barriers to effective pain management. Barriers were compiled into a 56-item menu and shaped the curriculum for weekly training sessions presented by the pain service.

Dr. Portenoy and the project team also established a metric for “high sustained pain,” patients reporting three or more days of three or more episodes of moderate to severe pain, according to the hospital’s standardized pain assessment scale. The information was captured in a computerized, tablet-based “Live View” tool that shows all of the patients on a unit and their incidences of high sustained pain over a week. The tool is used for rounding on patients and identifying those needing an immediate interdisciplinary focus.

Project results, Dr. Rizk reported, include improvements in high sustained pain scores on six of seven participating units and average reductions in the number of identified barriers to pain. Hospitalists reported increased comfort with adjusting pain therapies, while patient satisfaction scores with pain management also increased.

“Not everyone has access to an expert like Dr. Portenoy, but we’ve now done the root cause analysis and barriers list,” Dr. Rizk says. “I also think this approach could be applied more widely to other problem areas. We plan to try something similar with geriatrics.”

For more information about the collaborative and its pain problem list, contact Dr. Rizk at [email protected].

A collaboration between hospitalists and the pain department at Beth Israel Medical Center in New York City is helping hospitalists address moderate to severe pain and complicating factors in their patients.

“The idea was to impart knowledge from a small group of experts to the hospitalists who manage pain in the majority of hospitalized patients,” says Dahlia Rizk, DO, chief of hospital medicine at Beth Israel and lead author on a poster that described the program and was presented at HM13 in Washington, D.C.¹

Dr. Rizk first approached Russell Portenoy, MD, internationally recognized chair of the Department of Pain Management and Palliative Care at Beth Israel, to draw upon his specialized knowledge. Grant funding supported protected time for two hospitalist champions and a nurse practitioner; they reviewed charts on participating units and conducted focus groups with hospitalists to identify barriers to effective pain management. Barriers were compiled into a 56-item menu and shaped the curriculum for weekly training sessions presented by the pain service.

Dr. Portenoy and the project team also established a metric for “high sustained pain,” patients reporting three or more days of three or more episodes of moderate to severe pain, according to the hospital’s standardized pain assessment scale. The information was captured in a computerized, tablet-based “Live View” tool that shows all of the patients on a unit and their incidences of high sustained pain over a week. The tool is used for rounding on patients and identifying those needing an immediate interdisciplinary focus.

Project results, Dr. Rizk reported, include improvements in high sustained pain scores on six of seven participating units and average reductions in the number of identified barriers to pain. Hospitalists reported increased comfort with adjusting pain therapies, while patient satisfaction scores with pain management also increased.

“Not everyone has access to an expert like Dr. Portenoy, but we’ve now done the root cause analysis and barriers list,” Dr. Rizk says. “I also think this approach could be applied more widely to other problem areas. We plan to try something similar with geriatrics.”

For more information about the collaborative and its pain problem list, contact Dr. Rizk at [email protected].

A collaboration between hospitalists and the pain department at Beth Israel Medical Center in New York City is helping hospitalists address moderate to severe pain and complicating factors in their patients.

“The idea was to impart knowledge from a small group of experts to the hospitalists who manage pain in the majority of hospitalized patients,” says Dahlia Rizk, DO, chief of hospital medicine at Beth Israel and lead author on a poster that described the program and was presented at HM13 in Washington, D.C.¹

Dr. Rizk first approached Russell Portenoy, MD, internationally recognized chair of the Department of Pain Management and Palliative Care at Beth Israel, to draw upon his specialized knowledge. Grant funding supported protected time for two hospitalist champions and a nurse practitioner; they reviewed charts on participating units and conducted focus groups with hospitalists to identify barriers to effective pain management. Barriers were compiled into a 56-item menu and shaped the curriculum for weekly training sessions presented by the pain service.

Dr. Portenoy and the project team also established a metric for “high sustained pain,” patients reporting three or more days of three or more episodes of moderate to severe pain, according to the hospital’s standardized pain assessment scale. The information was captured in a computerized, tablet-based “Live View” tool that shows all of the patients on a unit and their incidences of high sustained pain over a week. The tool is used for rounding on patients and identifying those needing an immediate interdisciplinary focus.

Project results, Dr. Rizk reported, include improvements in high sustained pain scores on six of seven participating units and average reductions in the number of identified barriers to pain. Hospitalists reported increased comfort with adjusting pain therapies, while patient satisfaction scores with pain management also increased.

“Not everyone has access to an expert like Dr. Portenoy, but we’ve now done the root cause analysis and barriers list,” Dr. Rizk says. “I also think this approach could be applied more widely to other problem areas. We plan to try something similar with geriatrics.”

For more information about the collaborative and its pain problem list, contact Dr. Rizk at [email protected].

Clinical question: What is the appropriate length of hospitalization necessary for infants <30 days admitted for fever without source?

Background: Infants ≤30 days old are routinely hospitalized for fever without source (FWS). From 1988-2006, 2.5 million infants younger than three months old were admitted for sepsis, according to National Hospital Discharge Survey data. Term infants <7 days of age accounted for 33% of these hospitalizations. Current national guidelines recommend observation in the hospital for 48-72 hours after cultures of blood, urine, and cerebrospinal fluid (CSF) are initiated. Whether this length of hospitalization is appropriate for well-appearing infants in this age group is not clear, based on current data.

Study design: Single-center, retrospective, cohort study.

Setting: 574-bed tertiary medical center with a 30-bed general pediatric inpatient unit.

Synopsis: Researchers identified infants ≤30 days old who had blood and/or CSF cultures performed from 1999 to 2010. After excluding infants with cultures from the NICU and PICU, infants hospitalized with FWS were identified by chart review. A pediatric infectious disease specialist reviewed positive cultures from blood and CSF to exclude skin contaminants. Time to notification was defined as the time between sample collection and medical staff notification. Blood cultures were monitored continuously for growth at this institution, with staff being notified of positive results immediately during the day but not until 8 a.m. if this occurred overnight. Microbiology laboratory staff reviewed CSF cultures once daily. Of the 408 confirmed FWS hospitalizations, 26 resulted in positive cultures of blood and/or CSF. Time to notification of >24 hours occurred in six of these hospitalizations. Overall, of the 388 FWS hospitalizations with no positive blood or CSF cultures at 24 hours, six went on to develop positive cultures after 24 hours, a rate of 1.5%. All six had at least one high-risk characteristic (WBC <5,000 or >15,000 per µL, a band count >1,500 per per µL, or abnormal urinalysis). However, five patients with no high-risk characteristics and a normal urinalysis on admission were diagnosed with a UTI after 24 hours.

Bottom line: Infants ≤30 days old with no high-risk characteristics for sepsis may not need a full 48 hours of hospitalization for FWS, although this approach could lead rarely to a diagnosis of UTI after discharge.

Citation: Fielding-Singh V, Hong DK, Harris SJ, et al. Ruling out bacteremia and bacterial meningitis in infants less than one month of age: is 48 hours of hospitalization necessary? Hosp Pediatrics. 2013;3(4):355-361.

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Reviewed by Pediatric Editor Weijen Chang, MD, SFHM, FAAP, associate clinical professor of medicine and pediatrics at the University of California at San Diego School of Medicine, and a hospitalist at both UCSD Medical Center and Rady Children’s Hospital.

Clinical question: What is the appropriate length of hospitalization necessary for infants <30 days admitted for fever without source?

Background: Infants ≤30 days old are routinely hospitalized for fever without source (FWS). From 1988-2006, 2.5 million infants younger than three months old were admitted for sepsis, according to National Hospital Discharge Survey data. Term infants <7 days of age accounted for 33% of these hospitalizations. Current national guidelines recommend observation in the hospital for 48-72 hours after cultures of blood, urine, and cerebrospinal fluid (CSF) are initiated. Whether this length of hospitalization is appropriate for well-appearing infants in this age group is not clear, based on current data.

Study design: Single-center, retrospective, cohort study.

Setting: 574-bed tertiary medical center with a 30-bed general pediatric inpatient unit.

Synopsis: Researchers identified infants ≤30 days old who had blood and/or CSF cultures performed from 1999 to 2010. After excluding infants with cultures from the NICU and PICU, infants hospitalized with FWS were identified by chart review. A pediatric infectious disease specialist reviewed positive cultures from blood and CSF to exclude skin contaminants. Time to notification was defined as the time between sample collection and medical staff notification. Blood cultures were monitored continuously for growth at this institution, with staff being notified of positive results immediately during the day but not until 8 a.m. if this occurred overnight. Microbiology laboratory staff reviewed CSF cultures once daily. Of the 408 confirmed FWS hospitalizations, 26 resulted in positive cultures of blood and/or CSF. Time to notification of >24 hours occurred in six of these hospitalizations. Overall, of the 388 FWS hospitalizations with no positive blood or CSF cultures at 24 hours, six went on to develop positive cultures after 24 hours, a rate of 1.5%. All six had at least one high-risk characteristic (WBC <5,000 or >15,000 per µL, a band count >1,500 per per µL, or abnormal urinalysis). However, five patients with no high-risk characteristics and a normal urinalysis on admission were diagnosed with a UTI after 24 hours.

Bottom line: Infants ≤30 days old with no high-risk characteristics for sepsis may not need a full 48 hours of hospitalization for FWS, although this approach could lead rarely to a diagnosis of UTI after discharge.

Citation: Fielding-Singh V, Hong DK, Harris SJ, et al. Ruling out bacteremia and bacterial meningitis in infants less than one month of age: is 48 hours of hospitalization necessary? Hosp Pediatrics. 2013;3(4):355-361.

---

Reviewed by Pediatric Editor Weijen Chang, MD, SFHM, FAAP, associate clinical professor of medicine and pediatrics at the University of California at San Diego School of Medicine, and a hospitalist at both UCSD Medical Center and Rady Children’s Hospital.

Clinical question: What is the appropriate length of hospitalization necessary for infants <30 days admitted for fever without source?

Background: Infants ≤30 days old are routinely hospitalized for fever without source (FWS). From 1988-2006, 2.5 million infants younger than three months old were admitted for sepsis, according to National Hospital Discharge Survey data. Term infants <7 days of age accounted for 33% of these hospitalizations. Current national guidelines recommend observation in the hospital for 48-72 hours after cultures of blood, urine, and cerebrospinal fluid (CSF) are initiated. Whether this length of hospitalization is appropriate for well-appearing infants in this age group is not clear, based on current data.

Study design: Single-center, retrospective, cohort study.

Setting: 574-bed tertiary medical center with a 30-bed general pediatric inpatient unit.

Synopsis: Researchers identified infants ≤30 days old who had blood and/or CSF cultures performed from 1999 to 2010. After excluding infants with cultures from the NICU and PICU, infants hospitalized with FWS were identified by chart review. A pediatric infectious disease specialist reviewed positive cultures from blood and CSF to exclude skin contaminants. Time to notification was defined as the time between sample collection and medical staff notification. Blood cultures were monitored continuously for growth at this institution, with staff being notified of positive results immediately during the day but not until 8 a.m. if this occurred overnight. Microbiology laboratory staff reviewed CSF cultures once daily. Of the 408 confirmed FWS hospitalizations, 26 resulted in positive cultures of blood and/or CSF. Time to notification of >24 hours occurred in six of these hospitalizations. Overall, of the 388 FWS hospitalizations with no positive blood or CSF cultures at 24 hours, six went on to develop positive cultures after 24 hours, a rate of 1.5%. All six had at least one high-risk characteristic (WBC <5,000 or >15,000 per µL, a band count >1,500 per per µL, or abnormal urinalysis). However, five patients with no high-risk characteristics and a normal urinalysis on admission were diagnosed with a UTI after 24 hours.

Bottom line: Infants ≤30 days old with no high-risk characteristics for sepsis may not need a full 48 hours of hospitalization for FWS, although this approach could lead rarely to a diagnosis of UTI after discharge.

Citation: Fielding-Singh V, Hong DK, Harris SJ, et al. Ruling out bacteremia and bacterial meningitis in infants less than one month of age: is 48 hours of hospitalization necessary? Hosp Pediatrics. 2013;3(4):355-361.

---

Reviewed by Pediatric Editor Weijen Chang, MD, SFHM, FAAP, associate clinical professor of medicine and pediatrics at the University of California at San Diego School of Medicine, and a hospitalist at both UCSD Medical Center and Rady Children’s Hospital.

HM MOVERS AND SHAKERS

Sereen Sharp, MD, has been named director of the hospital medicine program at Fairview Range Medical Center (FRMC) in Hibbing, Minn. Dr. Sharp has been a practicing hospitalist at FRMC since the program launched in 2010.

James Matsuda, MD, PhD, has been hired as a pediatric hospitalist and director of pediatrics at Mercy Medical Center in Cedar Rapids, Iowa. Dr. Matsuda comes to Mercy from St. Luke’s Hospital in Cedar Rapids, where he served as director of the pediatric hospitalist program and pediatric intensive care unit.

 

 

Robert Maloney, MD, chief hospitalist at Sault Area Hospital (SAH) in Sault Ste. Marie, Ontario, Canada, was awarded the Canadian Society of Hospital Medicine’s 2013 clinical excellence award. Dr. Maloney was recognized for his excellent patient care, professionalism, and leadership. He is credited with helping to launch SAH’s hospitalist program, which has improved inpatient healthcare for the community since its 2004 introduction. Dr. Maloney is also an assistant professor of family medicine at the Northern Ontario School of Medicine.

 

Sanin Syed, MD, has been named medical director of the newly founded hospitalist program at Lawrence Hospital Center in Bronxville, N.Y. Dr. Syed previously served as a hospitalist at Mt. Sinai Hospital in New York City.

Business Moves

Tacoma, Wash.-based Sound Physicians has agreed to provide hospitalist services at Wyckoff Heights Medical Center in Brooklyn, N.Y., and Covenant Medical Center in Lubbock, Texas. Sound also has acquired hospitalist-related assets of Inpatient Care United, Inc., a private hospitalist staffing company in northeast Ohio, which already provides hospitalist services to Akron General Medical Center and Summa Akron City Hospital in Akron, Ohio.

Ob Hospitalist Group (OBHG), based in Mauldin, S.C., has been named one of the best places to work in South Carolina by the South Carolina Chamber of Commerce, the Best Companies Group, and the publishers of SCBIZ News. The private OB-GYN hospitalist staffing company was ranked 5th among South Carolina companies in the same size category. Additionally, OBHG was recognized as one of Inc.’s 500/5000 list of fastest-growing private companies, as well as one of South Carolina’s 25 fastest-growing companies. OBHG has been staffing private OB hospitalists at hospitals throughout the country since 2006.

North Hollywood, Calif.-based IPC The Hospitalist Company recently acquired the following hospitalist practices:

Greater Orlando Hospitalists (GOH), P.A., in Orlando, Fla.

The Hospitalist Group (THG) in Mission, Texas, consisting of three affiliated hospitalist practices: THG The Hospitalist Group, LP; The Hospitalist Management Group, LLC; and MD @ Home Ltd., all serving the greater Rio Grande Valley area of Southwest Texas.

Naples, Fla.-based Neapolitan Inpatient Care, LLC , and Venetian Hospitalist Services, LLC, headquartered in Venice, Fla.

Hospitalist-related assets of Metropolitan Pulmonary and Hospital Medicine, P.C., based in Kansas City, Mo.

IPC has signed definitive agreements to acquire Park Avenue Health Care Management, LLC; Park Avenue Medical Associates, P.C.; Park Avenue Medical Associates, LLC; and Geriatric Services, P.C., collectively known as Park Avenue and headquartered in White Plains, N.Y.

TeamHealth Hospital Medicine has acquired Marshall Physician Services, LLC, also known as MESA Medical Group, in Lexington, Ky. MESA already oversees hospitalist and emergency medicine services at 24 different hospitals throughout Indiana, Ohio, West Virginia, and Kentucky. TeamHealth now operates specialty hospital medicine programs in more than 850 acute and post-acute care centers throughout the U.S.

The Children’s Hospital of San Antonio and Baylor College of Medicine have collaborated to initiate a pediatric hospitalist program at the facility in San Antonio, Texas. The new program will staff 10 pediatric hospitalists and will be led by professor Ricardo Quiñonez, who comes to San Antonio from Texas Children’s Hospital in Houston, Texas.

 

Methodist Hospital in Henderson, Ky.,has partnered with the Dallas, Texas-based Eagle Hospital Physicians to provide hospitalist services at the privately owned facility. Eagle provides hospitalist and emergency medicine services to hospitals in 17 states.

HM MOVERS AND SHAKERS

Sereen Sharp, MD, has been named director of the hospital medicine program at Fairview Range Medical Center (FRMC) in Hibbing, Minn. Dr. Sharp has been a practicing hospitalist at FRMC since the program launched in 2010.

James Matsuda, MD, PhD, has been hired as a pediatric hospitalist and director of pediatrics at Mercy Medical Center in Cedar Rapids, Iowa. Dr. Matsuda comes to Mercy from St. Luke’s Hospital in Cedar Rapids, where he served as director of the pediatric hospitalist program and pediatric intensive care unit.

 

 

Robert Maloney, MD, chief hospitalist at Sault Area Hospital (SAH) in Sault Ste. Marie, Ontario, Canada, was awarded the Canadian Society of Hospital Medicine’s 2013 clinical excellence award. Dr. Maloney was recognized for his excellent patient care, professionalism, and leadership. He is credited with helping to launch SAH’s hospitalist program, which has improved inpatient healthcare for the community since its 2004 introduction. Dr. Maloney is also an assistant professor of family medicine at the Northern Ontario School of Medicine.

 

Sanin Syed, MD, has been named medical director of the newly founded hospitalist program at Lawrence Hospital Center in Bronxville, N.Y. Dr. Syed previously served as a hospitalist at Mt. Sinai Hospital in New York City.

Business Moves

Tacoma, Wash.-based Sound Physicians has agreed to provide hospitalist services at Wyckoff Heights Medical Center in Brooklyn, N.Y., and Covenant Medical Center in Lubbock, Texas. Sound also has acquired hospitalist-related assets of Inpatient Care United, Inc., a private hospitalist staffing company in northeast Ohio, which already provides hospitalist services to Akron General Medical Center and Summa Akron City Hospital in Akron, Ohio.

Ob Hospitalist Group (OBHG), based in Mauldin, S.C., has been named one of the best places to work in South Carolina by the South Carolina Chamber of Commerce, the Best Companies Group, and the publishers of SCBIZ News. The private OB-GYN hospitalist staffing company was ranked 5th among South Carolina companies in the same size category. Additionally, OBHG was recognized as one of Inc.’s 500/5000 list of fastest-growing private companies, as well as one of South Carolina’s 25 fastest-growing companies. OBHG has been staffing private OB hospitalists at hospitals throughout the country since 2006.

North Hollywood, Calif.-based IPC The Hospitalist Company recently acquired the following hospitalist practices:

Greater Orlando Hospitalists (GOH), P.A., in Orlando, Fla.

The Hospitalist Group (THG) in Mission, Texas, consisting of three affiliated hospitalist practices: THG The Hospitalist Group, LP; The Hospitalist Management Group, LLC; and MD @ Home Ltd., all serving the greater Rio Grande Valley area of Southwest Texas.

Naples, Fla.-based Neapolitan Inpatient Care, LLC , and Venetian Hospitalist Services, LLC, headquartered in Venice, Fla.

Hospitalist-related assets of Metropolitan Pulmonary and Hospital Medicine, P.C., based in Kansas City, Mo.

IPC has signed definitive agreements to acquire Park Avenue Health Care Management, LLC; Park Avenue Medical Associates, P.C.; Park Avenue Medical Associates, LLC; and Geriatric Services, P.C., collectively known as Park Avenue and headquartered in White Plains, N.Y.

TeamHealth Hospital Medicine has acquired Marshall Physician Services, LLC, also known as MESA Medical Group, in Lexington, Ky. MESA already oversees hospitalist and emergency medicine services at 24 different hospitals throughout Indiana, Ohio, West Virginia, and Kentucky. TeamHealth now operates specialty hospital medicine programs in more than 850 acute and post-acute care centers throughout the U.S.

The Children’s Hospital of San Antonio and Baylor College of Medicine have collaborated to initiate a pediatric hospitalist program at the facility in San Antonio, Texas. The new program will staff 10 pediatric hospitalists and will be led by professor Ricardo Quiñonez, who comes to San Antonio from Texas Children’s Hospital in Houston, Texas.

 

Methodist Hospital in Henderson, Ky.,has partnered with the Dallas, Texas-based Eagle Hospital Physicians to provide hospitalist services at the privately owned facility. Eagle provides hospitalist and emergency medicine services to hospitals in 17 states.

HM MOVERS AND SHAKERS

Sereen Sharp, MD, has been named director of the hospital medicine program at Fairview Range Medical Center (FRMC) in Hibbing, Minn. Dr. Sharp has been a practicing hospitalist at FRMC since the program launched in 2010.

James Matsuda, MD, PhD, has been hired as a pediatric hospitalist and director of pediatrics at Mercy Medical Center in Cedar Rapids, Iowa. Dr. Matsuda comes to Mercy from St. Luke’s Hospital in Cedar Rapids, where he served as director of the pediatric hospitalist program and pediatric intensive care unit.

 

 

Robert Maloney, MD, chief hospitalist at Sault Area Hospital (SAH) in Sault Ste. Marie, Ontario, Canada, was awarded the Canadian Society of Hospital Medicine’s 2013 clinical excellence award. Dr. Maloney was recognized for his excellent patient care, professionalism, and leadership. He is credited with helping to launch SAH’s hospitalist program, which has improved inpatient healthcare for the community since its 2004 introduction. Dr. Maloney is also an assistant professor of family medicine at the Northern Ontario School of Medicine.

 

Sanin Syed, MD, has been named medical director of the newly founded hospitalist program at Lawrence Hospital Center in Bronxville, N.Y. Dr. Syed previously served as a hospitalist at Mt. Sinai Hospital in New York City.

Business Moves

Tacoma, Wash.-based Sound Physicians has agreed to provide hospitalist services at Wyckoff Heights Medical Center in Brooklyn, N.Y., and Covenant Medical Center in Lubbock, Texas. Sound also has acquired hospitalist-related assets of Inpatient Care United, Inc., a private hospitalist staffing company in northeast Ohio, which already provides hospitalist services to Akron General Medical Center and Summa Akron City Hospital in Akron, Ohio.

Ob Hospitalist Group (OBHG), based in Mauldin, S.C., has been named one of the best places to work in South Carolina by the South Carolina Chamber of Commerce, the Best Companies Group, and the publishers of SCBIZ News. The private OB-GYN hospitalist staffing company was ranked 5th among South Carolina companies in the same size category. Additionally, OBHG was recognized as one of Inc.’s 500/5000 list of fastest-growing private companies, as well as one of South Carolina’s 25 fastest-growing companies. OBHG has been staffing private OB hospitalists at hospitals throughout the country since 2006.

North Hollywood, Calif.-based IPC The Hospitalist Company recently acquired the following hospitalist practices:

Greater Orlando Hospitalists (GOH), P.A., in Orlando, Fla.

The Hospitalist Group (THG) in Mission, Texas, consisting of three affiliated hospitalist practices: THG The Hospitalist Group, LP; The Hospitalist Management Group, LLC; and MD @ Home Ltd., all serving the greater Rio Grande Valley area of Southwest Texas.

Naples, Fla.-based Neapolitan Inpatient Care, LLC , and Venetian Hospitalist Services, LLC, headquartered in Venice, Fla.

Hospitalist-related assets of Metropolitan Pulmonary and Hospital Medicine, P.C., based in Kansas City, Mo.

IPC has signed definitive agreements to acquire Park Avenue Health Care Management, LLC; Park Avenue Medical Associates, P.C.; Park Avenue Medical Associates, LLC; and Geriatric Services, P.C., collectively known as Park Avenue and headquartered in White Plains, N.Y.

TeamHealth Hospital Medicine has acquired Marshall Physician Services, LLC, also known as MESA Medical Group, in Lexington, Ky. MESA already oversees hospitalist and emergency medicine services at 24 different hospitals throughout Indiana, Ohio, West Virginia, and Kentucky. TeamHealth now operates specialty hospital medicine programs in more than 850 acute and post-acute care centers throughout the U.S.

The Children’s Hospital of San Antonio and Baylor College of Medicine have collaborated to initiate a pediatric hospitalist program at the facility in San Antonio, Texas. The new program will staff 10 pediatric hospitalists and will be led by professor Ricardo Quiñonez, who comes to San Antonio from Texas Children’s Hospital in Houston, Texas.

 

Methodist Hospital in Henderson, Ky.,has partnered with the Dallas, Texas-based Eagle Hospital Physicians to provide hospitalist services at the privately owned facility. Eagle provides hospitalist and emergency medicine services to hospitals in 17 states.