When working out a relationship with a PCP, hospitalists should engage the PCP in a discussion about how they should communicate. For example, the hospitalist and PCP may agree that each time a patient presents for admission, the hospitalist will ask the hospitalist administrative assistant to fax the PCP office. A fax with admission diagnoses will not only serve as notification of admission but also as a request for information from the PCP.
As important as it is for the hospitalist to get his staff to fax the request in a timely manner, the PCP will have to do the same with his/her office staff. In such a system, the hospitalist and the PCP communicate about admissions via their administrative staff. If the PCP or hospitalist has further questions, the expectation may be that a page will be in order. But for the majority of admissions, that won’t be necessary.
I have seen hospitalists and PCPs handle routine communication in a variety of ways: phone calls, face-to-face discussion, e-mail, voicemail, discharge summaries/letters, fax notification of admission, pages. No single method works well with all groups all the time. To succeed, communication:
- Must be timely, easy to understand, and concise;
- Must be efficient for the communicator and the recipient, not labor intensive;
- Should occur at each transition in care; and
- Should meet privacy guidelines.
Communicators must understand the rules of engagement and share common expectations. Ideally, there should be a paper trail or other record.
Hiring is Work
Question: My group is having a hard time recruiting physicians. How can we do better?
Need Help, Richmond, Va.
Dr. Hospitalist responds: If it’s any consolation, you’re not alone. Look at the number of pages devoted to job ads in this issue of The Hospitalist and you’ll understand the high demand for hospitalists. There are about 20,000 hospitalists in the country, and many believe there is room for double that number. Advertising and hiring qualified staff is not a challenge unique to hospital medicine, but most hospitalists received no training on how to do it. Most hospitalists underestimate the time and resources it takes to recruit and hire staff.
Here are some hiring hints to help you and your hospitalist program maximize your success.
The first step is to create a job description. Before you can describe the job to prospective hospitalists, you need a clear understanding yourself. I would expect applicants to ask some of the following questions:
- Do your hospitalists to work days, nights or a combination of both?
- What about weekdays versus weekends?
- How does your group handle admissions versus daily rounding?
- Do your hospitalists provide consultative services?
- Are there teaching responsibilities?
- How many patients do you expect each hospitalists to see daily?
Based on your job description, how do you expect to compensate your hospitalists? Do your homework and find out what competitors are paying for similar job descriptions. While there are many reasons prospective hospitalists might accept an offer, salary is often not the only reason. What else is part of your compensation package? It might include some of the following:
- A retirement plan, like a 401k/ 403b or a pension;
- Paid parking;
- Continuing-education stipend;
- Productivity incentive;
- Access to health, life and/or disability insurance;
- Paid malpractice insurance; and
- Ownership/equity opportunity.
Once you create an attractive job description with a competitive compensation package, it’s time to get the word out. There are many options for reaching prospective candidates: