Home From The Editor A new power base

A new power base

October 2008

Published in the October 2008 issue of Today’s Hospitalist

IN THIS MONTH’S ISSUE, two stories give a glimpse of how the growth of hospital medicine is causing a shift in power at some hospitals.

Our cover story talks about a problem that hospitalists have faced since the infancy of the specialty: consultants who are unhappy that hospitalists are disrupting long-held referral patterns.

As young physicians practicing in a young specialty, hospitalists have often tried to tread delicately around this issue. Hospitals, after all, have treated cardiologists and surgeons like royalty because those physicians bring in so much revenue.

It appears that some cracks are beginning to form in that power base. Several of the hospitalists we talked to say that they feel increasingly under pressure to meet their objectives, whether that’s improving overall quality of care, reducing length of stay or meeting performance measures. These hospitalists say that when it comes to making a case for choosing the specialists they think are best, they’re finding a receptive audience among hospital administrators.

Why are some administrators siding with hospitalists when it comes to a sticky issue like referral patterns? Our feature, which looks at possible payment plans coming down the pike, provides some clues.

Hospitalists have always known that they’re vital to efforts like quality improvement, but initiatives like pay for performance and Medicare’s no-pay plan are showing hospital administrators just how much they’re going to need hospitalists.

That doesn’t mean that hospitals are no longer trying to keep revenue producers like surgeons happy. (You need only look at the rapid growth of surgical comanagement arrangements for proof.) But it shows that in some hospitals, at least, hospitalists are beginning to get some of the respect they deserve.

edoyleEdward Doyle
Editor and Publisher
edoyle@todayshospitalist.com