Published in the September 2010 issue of Today’s Hospitalist
Do you have the autonomy you need to do your job?
While most administrators and physicians now fully accept the presence of hospitalists, many may be working in hospitals that haven’t changed much since the advent of hospital medicine. Some of you are expected to deliver 2010 medicine (and 2010 results) in an environment that may lag decades behind.
Several of the stories in this month’s issue touch on this theme. In his commentary, Erik DeLue, MD, points out that while hospitalists are put in the hot seat for their performance on indices like core measures and quality, their hands are sometimes tied because they don’t have the autonomy they need with inpatient decisions to really make a difference.
A similar theme surfaces in an article by Stella Fitzgibbons, MD, on “problem” consultants. Many of you have undoubtedly worked with medical subspecialists who want to be consulted on every patient “but then take their time getting back to you. You might be responsible for managing length of stay, but difficult consults can sure interfere with that goal.
Finally, in an interview, Adam Singer, MD, founder and CEO of IPC The Hospitalist Company Inc., talks about the factors that affect hospitalists’ working conditions. One issue that he describes is the political warfare that hospitalists often encounter among administrators, medical staff and nonmedical staff. Dr. Singer notes that while navigating these landmines is difficult, it can be particularly troublesome for the young physicians who dominate hospital medicine.
Is working as a hospitalist as bad as these excerpts make it out to be? Probably not, but it sounds like a lot of changes are needed if hospitalists are going to be able to meet their full potential.
Editor & Publisher