4 in 10 hospitalists deal with unsafe workloads at least once a week

A research letter published in JAMA Internal Medicine confirmed what many hospital-based physicians already know. Hospitalists are overworked. Researchers from Johns Hopkins University surveyed 506 hospitalists and found that 36% managed unsafe workloads at least once a week and that it negatively affected patient care. Respondents said time constraints prevented them from discussing treatment options, delayed patient admissions and discharges, and worsened patient satisfaction scores. More than 20% of respondents said their large workload likely contributed to patient transfers, morbidity, or even mortality. In an era of decreasing reimbursement, hospitals are doing what they can to increase patient volume and decrease length of stay. However, increasing hospitalist workload could end up costing hospitals as reimbursement rates are now being tied to patient satisfaction and quality of care. The letter’s author, Henry J. Michtalik, MD, told HealthLeaders Media “The typical response to reductions in payments and reimbursement (now impacting acute care revenue) is to increase patient flow and try to decrease length of stay, but what this would suggest is that while we’re being penny wise in increasing flow and decreasing stay, we might be pound foolish by paradoxically increasing costs.” In the same article, John Nelson, MD, co-founder and past president of the Society of Hospital Medicine (SHM), said the letter indicates hospitalists are in high demand and short supply. There are currently more than 34,000 hospitalists practicing in the country, and the SHM expects that number will expand to 40,000 in 2013. However, more and more hospitals are realizing the benefits of using hospitalists to manage inpatient care, and if the research letter is any indication, there are not enough hospitalists to meet demand. Fortunately, we here at Barton Associates have a large network of experienced locum tenens hospitalists and nurse practitioners who can help facilities effectively manage their hospitalist staffing levels. Staff managers can use locum tenens to help ease their hospitalists’ workloads or give employees some time off. Doing so could improve patient satisfaction and quality scores, as well as increase employee satisfaction and improve retention.