While retaining experienced, motivated staff is a goal of hospitals, lower caseloads mean “more doctors to do the work if doctors work fewer hours,” says Rusty Holman, MD, Cogent’s chief operating officer and SHM’s immediate past president. To meet that need, hospitals are turning to community-based physicians, fellows, and residents to work weekends and evenings. This, in turn, offers the perk of part-time work for those who want more personal time in their schedule.
The demand for nocturnists also is growing (The Hospitalist, January 2008, p. 22). Nocturnists work at night and on weekends and usually work shorter hours. These physicians prefer this schedule so they can have their days free for family or other pursuits. They also enjoy higher compensation, fewer workdays per month, and lower productivity expectations.
In addition to the having the options of part-time hours, temporary work, or job sharing, hospitalists also can negotiate other schedule perks. Some request and receive a two-week-on, two-week-off schedule. Many ask about the shift model, which demands nothing beyond the full eight or 12 hours of work. Still other applicants find a swing shift fits their lifestyle. There are even short-term choices: the hospitalist program at the University of California at Irvine offers recent residents the opportunity to work for one year while deciding about their career. With scheduling choices as part of an incentive package, many hospitalists achieve Dr. Polk’s goal of being eager to come to work each morning.
Physicians are not the only beneficiaries of these perks. Cogent, for example, recruits physician assistants and nurse practitioners when forming hospitalist groups. These employees also enjoy incentives, including tuition for continuing education and the same schedule flexibility as hospitalists.
Seller’s Market
Hospital medicine faces a shortage of qualified applicants. The need for hospitalists far surpasses the supply of physicians, who are in the enviable position of sifting through incentives and perks when selecting a hospitalist job.
This has become a national concern, according to Vikas Parekh, MD, assistant director of the hospitalist program and assistant professor of medicine at the University of Michigan Health Center in Ann Arbor. “We’re not seeing a pool of applicants because top residents are not pursuing hospitalist careers,” Dr. Parekh says.
Alpesh Amin, MD, MBA, a member of SHM’s Board of Directors, concurs but also points out that the number of hospitalist jobs is growing. “The need for a few hundred hospitalists 10 years ago has grown to 20,000 to 30,000 today, thus creating a need much greater than the supply,” says Dr. Amin, professor and chief, general internal medicine, executive director and founder of the hospitalist program at the University of California Irvine.