Poor design can be fixed

Message Topic Search Topic Options Post Reply Create New Topic Printable Version

   From my past work for other doctors in the hospital I know  an crucial flaw in our current relationship with hospitalists which can be fixed.

I have expalined this to the hospitalist groups, but there will need to be an insistence from us to get them to make this change - read below;

Each individual hospitalist and outpatient doctor need to form an exclusive relationship with one of the other.  Currently outpatient doctors are covered by the group of hospitalists equally.  Exclusive relationships mean that any outpatient doctor's admissions are always handled by HIS hospital doctor during normal working hours and when that hospitalist is on call. Off duty they go to the other covering hospitalists.

This fixes several problems - 

1)Continuity I think is obvious enough to skip an explanation, but it is worth noting that the hospitalist will have more of his work from a small number of doctors (4 was plenty to keep my income good) which makes it easy to accustom to the outpatient doctors charts, office, and preferences. 

2) Competition and the inevitable quality improvement this brings - The hospitalist will earn according to his own ability, maintain and form new relationships with outpatient doctors based on his performance noted by the outpatient physicians from experience and word of mouth.  The partners of the hospitalist will protect there relationships and demand better care from the associate hospitalist when they cover for them.  

3) A derivative of the competition is that they will start to resent the waste of money currently put into the administrative/owner functions and strive to reduce it or break off in to small or solo groups.  No-compete clauses should be squashed by us because as this is OUR community and OUR patients, and not theirs to claim in such a manner - especially as non-compete clauses in this case do the community serious harm.

Author	Message Topic Search Topic Options Post Reply Create New Topic Printable Version
jjgreen Members Profile Find Members Posts Newbie Joined: 01 Nov 2009 Online Status: Offline Posts: 1	Quote Reply Topic: Poor design can be fixed Posted: 01 Nov 2009 at 11:13pm
	From my past work for other doctors in the hospital I know an crucial flaw in our current relationship with hospitalists which can be fixed. I have expalined this to the hospitalist groups, but there will need to be an insistence from us to get them to make this change - read below; Each individual hospitalist and outpatient doctor need to form an exclusive relationship with one of the other. Currently outpatient doctors are covered by the group of hospitalists equally. Exclusive relationships mean that any outpatient doctor's admissions are always handled by HIS hospital doctor during normal working hours and when that hospitalist is on call. Off duty they go to the other covering hospitalists. This fixes several problems - 1)Continuity I think is obvious enough to skip an explanation, but it is worth noting that the hospitalist will have more of his work from a small number of doctors (4 was plenty to keep my income good) which makes it easy to accustom to the outpatient doctors charts, office, and preferences. 2) Competition and the inevitable quality improvement this brings - The hospitalist will earn according to his own ability, maintain and form new relationships with outpatient doctors based on his performance noted by the outpatient physicians from experience and word of mouth. The partners of the hospitalist will protect there relationships and demand better care from the associate hospitalist when they cover for them. 3) A derivative of the competition is that they will start to resent the waste of money currently put into the administrative/owner functions and strive to reduce it or break off in to small or solo groups. No-compete clauses should be squashed by us because as this is OUR community and OUR patients, and not theirs to claim in such a manner - especially as non-compete clauses in this case do the community serious harm.

ironpony Members Profile Find Members Posts Newbie Joined: 04 Nov 2009 Online Status: Offline Posts: 2	Quote Reply Posted: 04 Nov 2009 at 9:54pm
	Proposed Hospitalist Standards are designed to kill competition completely. I wonder who is going to pay all individual doctors to stay idle in the hospital just for the sake to be available to respond within 15 minutes of request for assistance. And what is the purpose of highly paid Intensivist services in this case.

ironpony Members Profile Find Members Posts Newbie Joined: 04 Nov 2009 Online Status: Offline Posts: 2	Quote Reply Posted: 16 Jan 2010 at 9:06pm
	Hospitalist standards ( Paragraf: Responsibilities regarding response time) If LMHS Board is so concerned about Hospitalist Standards why they are not so much concerned about lack of standards for ICU care across the System. There is no "ICU team" in Cape or Lee. What's the point for hospitalists or private physicians to see the patient "at once" if there is no intensivists in those hospitals to help with central line, intubation, sedation, critical care plan etc. The unstable patient should be stabilized by ED with central line placed before admission to ICU. This is the standard worth pushing for. The verbiage " If unstable, the patient to be evaluated at once" should not be accepted. Period. It is unbearable burden for on call physicians without any gain in patient's outcome.

We welcome your comments and questions

regarding health care in Lee County, Florida

Discussion Forum

Return to IPALC home page

Poor design can be fixed