As you will see, our whole system is geared toward achieving a balanced and rewarding lifestyle for the hospitalists. We hope that this dialogue will help you to learn how:
What schedule will I be asked to work?
How far in advance is the schedule prepared?
How are the different shifts assigned?
What about the night calls?
What workload can I expect to work?
How many new admissions can I get?
What system do you use to capture my daily charges?
What about compensation, benefits, etc.?
What about any quality and/or productivity bonus?
Will I have any partnership benefits?
Do you sponsor H1b or J1 visas?
Q: What schedule will I be asked to work? - Back To Top
A: Flexible scheduling is the name of the game. You will not be asked to work any schedule. You are in charge of deciding what schedule you will work based on your own needs and preferences. We can accommodate a block schedule (e.g., 7 on 7 off), but given a choice, most hospitalists prefer a more flexible schedule. They also want to work (and earn) more than at the 50% rate that 7 on, 7 off offers. Many have told us that Starbucks becomes quite boring after a couple of months! So we give the hospitalists a choice to decide how many days in a month on average they would want to work. Most of our doctors prefer to work 16-20 days a month and make proportionately more money in the process. This system ensures flexibility for hospitalists and continuity of care for the patients.
Q: How far in advance is the schedule prepared? - Back To Top
A: We typically create, finalize, and publish the schedule in our online system for a given month several weeks ahead. That way, our hospitalists can make future plans well in advance. As much as possible, we take into account each physician's requests for specific days off. Sometimes we will tweak the schedule during the month to accommodate any last-minute requests and changes.
Q: How are the different shifts assigned? - Back To Top
A: Shifts are assigned so that hospitalists have a steady workflow and there is continuity of care. On the days that you are on, you will round and care for established patients from 7a-7p. You may also be assigned to accept new admissions and consults either from 7a-1p or 1p-7p. The new admission assignments vary depending on various factors, but you can rest assured that you will not be doing new admissions for 24 hours straight!
Q: What about the night calls? - Back To Top
A: Our night calls (7p-7a) are offsite. You will take the calls from the comfort of your own home. During the night call, the hospitalist cross-covers the entire practice and gives orders for new admissions and established patients. The hospitalist doing the night call is expected to do the H&P the next morning and admit the patients. As much as possible and depending on the staffing levels, we try to keep the day of and the day after the night call light for the hospitalist doing the night call.
Q: What workload can I expect to work? - Back To Top
A: Typically 15-20 patients on average over time. At the higher end of that in the winter months and at the lower end of that in the summer months. Of course, any given day can spike high or low. In the hospital business, it's highly unpredictable, but we keep track of the individual workload systematically and monitor this closely to determine staffing levels. We do have an open ICU, but our hospitalists are not required to do any procedures or run code.
Our shifts are "relatively" stress-fee. The hospitalists have a great support system and everyone, including the nursing staff, case managers, ED, specialists, and other ancillary services, is eager to help. The patient population is majority Medicare and they and their families are very appreciative and respectful.
That’s why our hospitalists are hardly ever stuck in the hospital for 12 straight hours. During most day shifts (7a-7p) they can easily get a 2-4 hour break during the day when they can be home relaxing, spending time with the family, taking a nap, or working out. Of course, they have to be accessible and must accept calls for established patients and new admissions and consults if they are scheduled.
Q: How many new admissions can I get? - Back To Top
A: If you have done inpatient work before, you know that it varies from day to day. Depending on the season, month, and day of the week, we can get 10-15 admissions in a 24 hour period. Having said that, one physician is never on for 24 hours straight. On certain days if one physician gets overloaded with too many admissions, we encourage them to seek help from others. We believe in the principle that what goes around, comes around. For the same reason, we look for and hire physicians who believe in teamwork and in working together as a group.
Q: What system do you use to capture my daily charges? - Back To Top
A: Polaris Medical has developed a HIPAA-compliant, state-of-the-art, web-based system called Acute Care Management System (ACMS) to integrate end-to-end hospitalist work processes. This system, readily available on the web, minimizes hassles and enhances accuracy and timeliness by automating routine administrative tasks.
- Physician scheduling
- Census Management
- Patient Assignment
- ICD/CPT Coding and Charge Capture
- Automated Answering Service to Provide Near-instant Access to the Hospitalist
- Core Measures
- Automated Notification to the PCP on Admission and Discharge
- Individual Hospitalist Workload Monitoring
- Billing Interface
Q: What about compensation, benefits, etc.? - Back To Top
A: We customize each offer to the needs of the physician. The compensation would depend on the number of days the hospitalist works on average in a month. What we also offer for experienced physicians is 100% productivity model—if the doctor chooses to work in that system. In the productivity model, we share a pre-determined % of collected $ amounts directly with the physician. It's the next best thing to owning your own business with a low overhead and without any administrative hassles! We pay customized allowances for various benefits, but we have no "group" benefits per se. With the prospect of 8-12 job changes in one's career, it doesn't make sense to become beholden to any "group" coverage.
Regardless, as highly skilled professionals, our docs typically prefer to be independent contractors (1099s) so they can work solo or form their own company. This frees them to do outside work if they choose to, and deduct all business-related expenses, as allowed by the IRS, to reduce their tax burden.
Q: What about any quality and/or productivity bonus? - Back To Top
A: We expect the hospitalists to be board certified and provide quality care. We expect the hospitalists to work collaboratively and responsively with others, involve patients and their families in their own care, complete admission/discharges and rounds, maintain medical records, and dictate summaries in a timely manner, participate in quality programs to improve patient outcomes, and perform consistently well on Core Measures. In addition to the base compensation, we offer bonus opportunities in four key areas:
- Core Measures
- Patient Satisfaction
- Productivity
- Committee Meeting Participation
Q: Will I have any partnership benefits? - Back To Top
A: Typically not. Most doctors are neither interested in nor qualified to do any management or partner work. Hospitalist tenure is also very short (1-3 years) so a long-term partnership doesn't make sense. However, if you believe that you have leadership skills and wish to work in a leadership capacity, please feel free to discuss the possibility.
Q: Do you sponsor H1b or J1 visas? - Back To Top
A: Typically we cannot sponsor if the requirement is for a) the hospital or the employer to be non-profit b) hospital to have academic affiliation or c) the area to be medically underserved.
