Home Poll A look at hospitalist services and procedures

A look at hospitalist services and procedures

May 2011

Published in the May 2011 issue of Today’s Hospitalist

WHEN IT COMES TO THE SERVICES that hospitalists offer, the list is long and still growing. According to data from the 2010 Today’s Hospitalist Compensation & Career Survey, nearly all hospitalists offer the old standards like caring for unassigned patients and accepting referrals from primary care physicians. These numbers have gone up by a few percentage points since we last asked on our 2008 survey. But there are new services being offered, and some of those might surprise you.

Clinical services
Compared to data from our 2008 survey, the number of hospitalists caring for unassigned patients has grown by a few percentage points, while the number of hospitalists taking on primary care referrals has grown by nearly 8%.

However, there are some differences in the type of clinical services hospitalists provide depending on where they work. Hospitalists in multispecialty/primary care groups, for example, are less likely to care for unassigned patients (76%). And while the majority of hospitalists at hospitals/hospital corporations work on rapid response teams (62%), that’s not the case for hospitalists at universities/medical schools (29%).

Looking ahead, 18.1% of our respondents say they plan to introduce rapid response team coverage in the near future. In addition, 23.8% say they’re planning to follow patients into long-term acute care settings.

Procedures
When it comes to procedures, there are some major differences between adult hospitalists and their pediatric colleagues.

Hospitalists who treat children, for example, are much more likely to perform a lumbar puncture (69.5%) than their adult counterparts (36.6%). Adult hospitalists, on the other hand, are much more likely to place a central line (41.7%) than pediatric hospitalists (20.6%)

And while hospitalists working at universities/medical schools are likely to do a lumbar puncture (60.3%), they’re the least likely among hospitalist groups to intubate patients (7.9%).

Specialty comanagement
While orthopedic comanagement is very popular among hospitalists, our data show some variation on that trend. Orthopedic comanagement is more prevalent among adult hospitalists (81.4%), but still popular among their pediatric colleagues (71.8%).

Among hospitalists, orthopedic comanagement seems to be the most popular at national hospitalist management companies, where 78.6% physicians say they offer the service. National hospitalist management companies, however, are less involved in comanaging neurology patients (58.6%).

In some categories, hospitalists at universities/medical schools “not surprisingly “tend to do less comanagement for all patients. Only 44.4% of academic hospitalists, for instance, report providing comanagement services for general surgery.

Other services
When looking at who accepts direct admissions, there isn’t much variation by patient type or employer. Pediatric hospitalists, however, are slightly more likely to provide direct admissions (93.1%) than adult hospitalists (89.4%).

About one-third of the hospitalists we surveyed said that they admit patients overnight and then return those patients to another physician in the morning. Hospitalists working for local hospitalist groups said they were more likely to offer that service (41.1%) than hospitalists working in other business models.

And when it comes to providing weekend/holiday coverage for nonhospitalists, hospitalists at national hospitalist management companies led the way with 60% (compared to a mean of 35.5%).

What among these other services did hospitalists say they were planning to provide? Nearly one in five (17.5%) said they were planning to offer weekend/holiday coverage for nonhospitalist groups in the future. As for admitting other physicians’ patients overnight, 12.5% said they were planning on doing so, while 7.5% were planning to offer direct admissions.

Want more data about hospitalist pay, work hours and more? Go to the 2010 survey results online at www.todayshospitalist.com and look for the "Survey Results" button on the left side of the page.