Learn to spot the signs of dissatisfaction.
Hospitalist group leaders say there are classic indicators that a hospitalist is not feeling fulfilled on the job.
“Usually, job performance falls off,” Dr. Scarpinato says. “People will have an attitude and you’ll say, ‘Where’d that come from?’ You’ll be surprised that they’re not pitching in to help with the team or they’re developing a cynical attitude or something like that. Those are the clues for me, as a leader.”
Martin Austin, MD, medical director of the 23-physician inpatient medical group at Gwinnett Medical Center in Lawrenceville, Ga., says he sometimes notices a recurring theme. “There are some people where it’s really a pattern,” he says. “Either they consistently complain about something, or other people in the hospital start complaining about them.”
—David Bowman, MD, executive director, Tucson, Ariz., region, IPC: The Hospitalist Company
David Bowman, MD, executive director of the Tucson, Ariz., region for IPC: The Hospitalist Company, says that if a physician isn’t fulfilled by the varied, interesting cases offered by working in a hospital, it just may not be the right fit.
“The cases that you’re admitting are the best of the best compared to outpatient medicine, where things are stable and it’s a chronic disease process,” he says. “You’re dealing with the most exciting clinical stuff that goes on in the hospital.
“You know, it’s a challenge for most physicians, and they’re glad they’re involved in that,” he adds. “If they’re not, if they’re fearful of that, they probably are not in hospital medicine very long.”
Be honest in your assessment of situations involving unfulfilled hospitalists.
Whether it stems from an annual evaluation or just a conversation with a hospitalist, when considering a case of dissatisfaction, decide whether it is really a situation that can be fixed. Sometimes, it’s not.
“You have to triage the person you’re talking to,” Dr. Austin says.
If the situation can be fixed, don’t judge the physician for their concerns; identify the problem and do whatever you can to fix it, Dr. Austin says.
“I think most people will warm up to you doing that—taking the emotion out of whatever the problem is—then trying to do something for them, if you can, and if it’s appropriate,” he explains.
Use annual evaluations to assess doctors’ ambitions beyond the clinic.
Just as important to assessment is the follow-up—checking back with hospitalists to see whether they’ve pursued new projects or committee work.
“When we sit down for our annual [performance evaluations] with the docs, we have those discussions,” says Christine Lum Lung, MD, SFHM, medical director of Northern Colorado Hospitalists, which was founded in 2004. “Where do you see yourself in five years? What can we do to help get you there?”
Many times, group leaders will discover that their hospitalists haven’t followed through on what they said they would do a year before. That affords group leaders a chance to motivate the hospitalist or steer them in another direction.
Flexible schedules are key to hospitalists pursuing a professional or academic ambition, as those interests take time. The annual evaluation is a good time to reassess a hospitalist’s schedule.
Develop a “committee rotation.”
Matching committee posts with physician experience levels helps promote professional involvement beyond routine patient care. If hospitalists receive assistance with a committee match, they are more likely to participate in committees and enjoy it when they do, says Dr. Lum Lung.