Hospitalist Recruitment and Retention: Building a Hospital Medicine Program
December 2009, Wiley-Blackwell
The Right Way to Build and Sustain a Successful Hospital Medicine Program
This first complete treatment of hospitalist recruitment and retention gives you all the tools and guidance needed to build a new hospital medicine program for your hospital. Moreover, it shows you how to reinvigorate and maintain an established hospitalist program, enabling your hospital to fully benefit from the improved clinical outcomes that a hospitalist approach can offer. All the key elements for building and maintaining an effective hospitalist program are covered, including:
Developing a recruitment plan that attracts the right people and clearly sets forth expectations
Hiring the best people to meet organizational objectives
Implementing an effective retention plan that keeps high-quality staff motivated and committed to excellence
Based on the author's extensive experience in both clinical practice and professional consultation with new and established hospital medicine programs, the book covers such critical topics as:
Significance of current trends in hospital medicine
Key factors in successful hospitalist recruitment and retention
Role of the hospitalist in recruitment, retention, and stabilization of physicians in their communities
Recruitment and retention of physicians in all specialties is a national challenge, and it is expected to become even more difficult due to an impending physician shortage. As more and more healthcare organizations come to understand and embrace the hospitalist movement, this book will prove essential in recruiting and retaining the staff they need to implement and sustain an effective hospitalist program.
1 Physician Supply and Demand.
1.1 The Aging Medical Workforce.
1.2 The Growing and Aging Population.
1.3 Decreased Medical School Matriculation.
1.4 The Changing Demographics of Medicine.
1.5 The Cost of Medical School and the Graduate Debt Burden.
1.6 The Changing Role of the Specialist.
1.7 The Changing Scope of Primary Care.
1.8 The Availability and Accessibility of Training Programs.
1.9 Technological Advances.
1.10 The Increasing Regulatory Responsibilities Placed on Physicians.
1.11 Rising Practice Expenses and Diminishing Returns from the Insurance Industry.
1.12 Utilization of Nonphysician Clinicians.
1.13 Government Policy.
1.14 Generational Expectations.
2 The Hospitalist Marketplace.
2.1 Age, Gender, and Years Employed as a Hospitalist.
2.2 Hospitalist Education.
2.3 Hospitalist Practice Location.
2.4 Hospitalist Employment Model and Hospital Teaching Status.
2.5 Control/Hospital Governance of Affiliated Hospital.
2.6 Hospital Size.
2.7 Hospitalist Staffing.
2.8 Coverage Schedule and Night Call Responsibility.
2.9 Hospitalist Program Growth and Turnover.
3 The Role of the Hospitalist.
3.1 Hospitalist Program Patient Type and Encounter Type.
3.2 Hospitalist Time Spent on Nonclinical Activities.
3.3 Leader Time Spent on Administrative Activities.
3.4 Hospitalist Activities Based on Location.
4 The Hospitalist Recruitment Pool.
4.1 Building Your Recruitment Network.
4.2 Identifying Your Candidate Pool.
5 Challenges Recruiting Hospitalists.
5.1 Physician Compensation.
5.2 Practice Model.
5.3 Work and Call Schedule.
5.4 Daily Workload.
5.5 Added-Value Benefits.
5.6 Medical Staff Support.
5.7 Hospital Culture and Systems.
5.9 Specialty Providers.
5.10 Referral Network.
5.11 Hospital Administrative Support.
5.12 Staff Stability.
5.13 Community and Practice Culture.
6 Incentive Plans.
6.1 Incentive Plan Objectives.
6.2 Data Systems.
6.5 Incentive Payout.
7 National Recruitment Initiatives.
7.1 Trend in Hospitalist Salary.
7.2 Type of Incentives Offered for All Specialties.
7.3 Relocation Pay, and Amount, for All Specialties.
7.4 Signing Bonus, and Amount, for All Specialties.
7.5 Amount of CME for All Specialties.
7.6 Additional Benefits.
7.7 Hospital-Employed Job Opportunities.
7.8 Assessment of Fair Market Value and Physician Compensation.
8 Retention Initiatives.
8.1 Defining Expectations and Finding the Appropriate Fit.
8.2 Work–Life Balance.
8.3 Integration of the Hospitalist Program and Hospitalist Physicians.
8.4 Support from the Clinical Director and Sponsoring Hospital.
8.5 Clinical and Operational Support.
8.6 Opportunities for Career Growth and Advancement.
8.7 Financial Opportunities.
8.8 Spousal/Significant Other and Family Integration Within the Community.
8.9 The Orientation Program.
8.10 The Exit Interview.
9 Putting It All Together: The Site Visit and Interview.
9.1 The Contact.
9.2 The Site Visit.
9.3 The Recruitment Team.
9.4 Discussion Topics.
9.5 The Interview.
9.6 The Postvisit Phase.
9.7 Hiring Protocol.
10 The Contract.
10.1 Employment Arrangement.
10.3 Standards of Service.
10.4 Physician Services.
10.5 Duties and Responsibilities of the Employer.
10.6 The Term of Employment.
10.7 Hours of Employment.
10.9 Professional Liability.
10.10 Employment Activities Outside the Practice.
10.11 Restrictive Covenants.
10.12 Termination of Employment.
10.13 Patient Record Ownership.
10.15 Financial Relationship Between Employer and Physician.
11 Practice Management Strategies.
11.1 The Hospitalist Budget.
11.2 Hospitalist Staffing.
11.3 Program Policies and Procedures.
11.4 Practice Support.
11.5 Strategic Planning.
11.6 Collaborative Systems of Care.
11.7 Marketing the Program.
12 Targeting Program Leadership.
12.1 Attributes of Effective Program Leadership.
12.2 Mentoring Potential Leaders.
12.3 Leadership Versus Management.
12.4 Identifying and Recruiting an Effective Leader.
12.5 Practice Culture and Career Satisfaction.
13 Concluding Thoughts.
KENNETH G. SIMONE, DO, FHM, is a board-certified family physician, Fellow of Hospital Medicine, and the founder and President of Hospitalist and Practice Solutions, a consulting company that develops, restructures, and redesigns hospitalist programs. Dr. Simone founded the first hospitalist program in Maine and served as its administrative director for ten years. In addition, he has developed and rebuilt numerous hospitalist programs nationwide. He is currently Chair of the Society of Hospital Medicine's Chapter Support Committee and a board member of the University of New England.
(Occupational Medicine Book Review, 1 November 2010)
Recruitment and retention of physicians in all specialties is a national challenge, and it is expected to become even more difficult due to an impending physician shortage. As relative newcomers to the long line of medical specialists, hospitalists pose special challenges. What will convince a hospitalist to join one organization over another? What might prevent a hospitalist from considering a certain assignment?
Now, recruiters can benefit from the experience of Kenneth G. Simone, the pioneer who founded the first successful hospitalist program in Maine. In his new book, Hospitalist Recruitment and Retention: Building a Hospital Medicine Program, he reveals what works, what doesn’t, and which issues seem to be emerging as the “deal-makers” and “deal-breakers” with these important specialists.
“A well-run hospitalist program will support the delivery of quality care, support patient safety, and support the delivery of cost effective and efficient care,” Dr. Simone explains. “This should provide the hospital with cost savings. It may also allow the hospital to capture more monies related to pay-for-performance initiatives. These are just some of the reasons why recruiting, and keeping, good hospitalists is essential.”
The movement toward evidence-based practice guidelines requires hospitalists to be aware of current trends in the healthcare industry, including Joint Commission Core measures, CMS initiatives (e.g. Pay for Performance, Do Not Pay, Value-Based Purchasing), and quality and patient safety initiatives by groups such as NQF (National Quality Forum), Leapfrog, IHI (Institute for Healthcare Improvement), and AHRQ (Agency for Healthcare Research and Quality). Because hospitalists serve on many of the key hospital committees that create quality care and patient safety initiatives, they can drive efficiencies and improved knowledge throughout the hospital.
Simone’s book is the first complete guide to recruiting and retaining these uniquely-positioned specialists. In addition to providing all the tools and guidance needed to build a new hospital medicine program, he shows how to reinvigorate and maintain an established hospitalist program.
The book explains how to:
- Develop a recruitment plan that attracts the right people and clearly sets forth expectations
- Hire the best people to meet organizational objectives
- Implement an effective retention plan that keeps high-quality staff motivated and committed to excellence
It also discusses:
- The significance of current trends in hospital medicine, such as how location, lifestyle, and practice model may be more important than salary for some hospitalists, and the impact of the increasing use of NPCs (Physician Assistants and Nurse Practitioners)
- Key factors and tips in successful hospitalist recruitment and retention, such as clearly discussing the vision, values, and objectives of both the practice and candidate as well as being transparent about the problems and potential solutions within the program
- The role of the hospitalist in recruitment, retention, and stabilization of physicians in their communities
With the hospital industry under enormous pressure to control costs without sacrificing quality of care, this practical guide should be mandatory reading for professionals involved in setting health care policy.