Why hospitalists may need a dose of self-assertiveness

March 2007

I’ve just returned from the first meeting of the Spring 2007 CME Series for Hospitalists, and I’ve been giving some thought to comments made by presenters during our practice management sessions.

Several of the speakers at our Los Angeles meeting were puzzled by the fact that many hospitalists have no idea of how important they are, both to their hospital and to hospital administrators. While there is a surge in demand “and salaries “for hospitalists, the specialty’s front-line practitioners often don’t make the most of their clout when it comes to advocating for their programs.

One speaker told this story to make his point: When he was working as a hospital administrator, he used to dread meetings with surgeons and other subspecialists, because those meetings tended to be contentious and packed with demands. Meetings with internists and pediatricians, on the other hand, tended to be much more congenial, with little in the way of requests, let alone ultimatums.

This is not to say that hospitalists should become the new prima donnas of medicine and make unreasonable demands of their hospitals. But there does appear to be an opportunity for hospitalists to step up and assert themselves to advance their interests.

The obvious example is asking for additional resources, whether to increase staffing levels or to add a new service. But hospitalists can also use their growing influence to say no to requests for services that they’re simply not ready to handle.

I realize that negotiating with hospital administrators can be a tricky business, and that more than self-confidence is needed to get the job done. But if hospitalists as a group don’t understand just how much weight they carry at the hospitals where they work, they may never take the lead when it comes to effecting change.

Edward Doyle
Editor and Publisher