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Is hospitalist workload unsafe for patients?

March 2013

Published in the March 2013 issue of Today’s Hospitalist

Is hospitalist workload unsafe for patients?

SURVEY RESULTS indicate that 36% of hospitalists think they experience unsafe patient volumes more than once a week, a workload that many survey respondents tie to delays in care and higher complication rates.

The study, which surveyed more than 500 hospitalists in both community and academic settings in November 2010, was published online in January by JAMA Internal Medicine. The authors found that among the hospitalists surveyed, 40% reported unsafe patient census levels at least monthly during day shifts. (Hospitalists defined “safe” levels as seeing only 15 patients per shift.)

Among respondents, 25% believed unsafe volumes prevented them from fully discussing treatment options with patients or families, while 22% said problems with workload had resulted in delayed admissions and discharges as well as unnecessary orders for tests and consults.

Among surveyed hospitalists, 7% linked unsafe patient volumes to higher complication rates, while 5% pegged higher volumes to increased patient mortality. Respondents also linked higher volume to reduced levels of patient satisfaction.

Doc gifts and payments about to go public

The Centers for Medicare and Medicaid Services last month released the final rule of the so-called “Sunshine Act,” the section of the Affordable Care Act that mandates public reporting of all gifts and payments to physicians from companies that produce drugs, medical devices and biologics.

Companies are also supposed to report physician ownership and investment in those firms. According to the final rule, companies must begin reporting those data to the Department of Health and Human Services by Aug. 1. Data will be publicly posted on a Web site in September 2014.

Publicly reported information will include physician names and addresses, payment or gift amounts, and the purpose for the payments. Gifts or payments of less than $10 are exempt unless physicians receive more than $100 annually from that specific company. Also exempt are fees paid to physician speakers at industry-sponsored CME events where the sponsoring company doesn’t choose the speaker.

Doctors have the option to review payment data before they are published.