Home From The Editor Learning how to get along

Learning how to get along

August 2014

Published in the August 2014 issue of Today’s Hospitalist

As the latest wave of consolidation sweeps through American health care, hospitalists who now find themselves part of large multisite programs are learning to embrace the bigger-is-better mentality. But for a young specialty still struggling to define best practices in many areas, consolidation can pose challenges.

As our cover story points out, hospitalists who are now part of large care systems or networks are waking up to a new reality. One goal of putting together large multisite programs, after all, is to streamline operations. The thinking is that standardization will lead to both better care and lower costs.

But that thinking can quickly lead to problems. Hospitalists who are used to compensation based on productivity may have
to switch to a new, system-wide straight salary. Or doctors accustomed to doing their shift and then going home may need to start leading committees and designing quality improvement projects.

And even when it is easy to integrate schedules or compensation, old habits and loyalties die hard. Groups that may have competed for years for recruits and market share now find themselves part of the same network.

Fortunately, multisite programs are finding ways to work out
their differences and peacefully coexist. And in some cases, that means consciously preserving differences between groups. Leadership is realizing that hospitalists in separate groups don’t always have to work the same hours or see the same numbers of patients to all be part of one system. Some find it helpful to look at the individual groups in multisite programs more like partnerships than players in the classic merger scenario.

While standardization may be painful, I’m wondering if the current wave of consolidation might open hospitalists’ eyes to the benefits of streamlining the way they do things. That road may be long, but it could help a young specialty mature.

edoyleEdward Doyle
Editor & Publisher
edoyle@todayshospitalist.com