Summary
If your current contract specifies numbers of days—or weeks or hours—of vacation time and that works well, without any confusion about what constitutes a vacation day, then there is no reason to change anything right now. But you should think about what a day of vacation might mean if you change your current schedule a great deal—if you changed the duration of shifts, for example. If that might cast uncertainty on what a day of vacation means, then consider developing a contract that is silent on vacation and just specifies how much work is expected of the doctor.
I want to emphasize again that a hospitalist will have exactly the same amount of time off for vacation or any other purpose in a contract that just specifies the number of shifts/days worked and is silent on vacation time. This does not take anything away from the doctor. It is simply a different way to address the issue in the contract, while eliminating a lot of potential confusion and frustration.
If you want to know if this is really a reasonable and workable approach to vacation time, you should talk with the emergency department (ED) doctors at your hospital. If you ask them how much vacation they get, they’re likely to look puzzled and say something like, “I don’t know how much vacation time I get. All I know is that I work 14 shifts a month.” Years ago, the non-traditional working schedule used by ED doctors led many or most groups to adopt the approach to vacation I’m suggesting for hospitalists. TH
Dr. Nelson has been a practicing hospitalist since 1988 and is a co-founder and past-president of SHM. He is a principal in Nelson/Flores Associates, a national hospitalist practice management consulting firm. This column represents his views and is not intended to reflect an official position of SHM.