Home From The Editor Thriving on chaos, or settling down?

Thriving on chaos, or settling down?

June 2010

Published in the June 2010 issue of Today’s Hospitalist

WHILE THIS MONTH’S COVER STORY takes a look at how hospitalist programs are working out the kinks in unit-based staffing, it may also provide some deeper insights into the specialty.

Geographic rounding, or unit-based staffing, is largely a reaction to overworked hospitalists who are literally running around the hospital trying to care for patients sprinkled throughout various wards and units. But as the article points out, geographic rounding hasn’t always been a home run with hospitalists or hospitalist programs.

Hospitalist groups have to overcome some legitimate hurdles to make unit-based staffing work. But for some physicians, geographic rounding is a problem precisely because it eliminates the hustle and bustle from their daily routines. It turns out that some doctors like the exercise that comes from bouncing from unit to unit, or they may enjoy seeing different faces throughout the hospital.

How does this relate to hospital medicine as a whole? Just as individual hospitalists have been racing around different areas of the hospital to see their patients, the specialty has been working at a breakneck pace to meet the needs of factions throughout the hospital. These include specialists, nurses and hospital administrators.

I’ve heard hospitalists say that the specialty has been too young to say “no” to most requests for help. And while that argument makes sense, I’m wondering how many hospitalists actually thrive on the chaos that working in such a young specialty can bring.

The fact that so many hospitalist programs have had problems implementing unit-based staffing makes me wonder what other trouble lies ahead as the specialty begins to embrace tools to become better organized and more efficient. Chaos in small doses can be exciting, but at some point it becomes counterproductive “and as hospital medicine matures, the trend seems to be toward consolidation.

edoyleEdward Doyle
Editor & Publisher
edoyle@todayshospitalist.com