Home Poll How do hospitalist groups cover nights?

How do hospitalist groups cover nights?

April 2014

Published in the April 2014 issue of Today’s Hospitalist

HOSPITALISTS DON’T WANT TO WORK NIGHTS, and they don’t like most solutions their groups have come up with to provide night coverage. That’s according to the 2013 Today’s Hospitalist Compensation & Career Survey, where we asked hospitalists about how they cover nights and what they’d prefer for that coverage. Here’s a look at what they had to say.

Coverage by specialty
While 57% of pediatric hospitalists cover nights with rotating daytime physicians, that figure is only 48% for adult hospitalists. And only 11% of pediatric hospitalists say their groups use nocturnists, while nocturnists are part of nearly one-third (31%) of adult hospitalist groups. Pediatric hospitalists are also more likely to take beeper call to cover nights (35% vs. 16% for adult hospitalists) and use fewer moonlighters (9% vs. 17% for adult hospitalists).

Group size
Larger groups are more likely to use nocturnists or a combination of nocturnists and daytime physicians rotating call. More than one-third (38%) of groups with 15+ hospitalists use nocturnists, compared to 24% of groups that have five or fewer physicians.

Larger groups are less likely to have physicians take beeper call and more likely to use moonlighters. Groups with higher patient loads are also less likely to ask daytime physicians to rotate nights and more likely to use moonlighters.

Hospitalists in the Mountain region rotate daytime physicians to cover nights more than other parts of the country. More than two-thirds (67%) of hospitalists in that region say their groups use this approach, with only 6% of hospitalists reporting the use of nocturnists.

In the Northeast, however, nocturnists are popular, with 40% of hospitalists saying their group has them. Giving physicians beeper call is not as popular, however, with only 12% of hospitalists reporting this strategy for night coverage.

What hospitalists want
When we asked hospitalists how they would like their groups to cover nights, one thing became clear: They don’t like most solutions their groups have come up with.

Just under half (44%) report not liking any options their groups are using, including the use of nocturnists. When it comes to nocturnists, for example, only 39% of hospitalists like having these physicians to cover nights.

The next most popular option to cover nights was to use nocturnists as primary nighttime coverage and rotate daytime physicians, but only 12% of our respondents like that option. All other solutions on our list received support from less than 10% of respondents.