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Richard Quinn is an award-winning journalist with 15 years’ experience. He has worked at the Asbury Park Press in New Jersey and The Virginian-Pilot in Norfolk, Va., and currently is managing editor for a leading commercial real estate publication. His freelance work has appeared in The Jewish State, The Hospitalist, The Rheumatologist, ACEP Now, and ENT Today. He lives in New Jersey with his wife and three cats.
Report: Hospitalist Salaries Increase 6% from 2010 to 2011
Median compensation for adult hospitalists rose to $233,855 in 2011, a 6% increase from the year prior, while productivity remained nearly static, according to recently released data. This latest uptick in HM compensation means that hospitalist pay has jumped more than 27% since 2008, when unadjusted figures pegged median hospitalist compensation at $183,900 nationwide.
The data, which excludes academic hospitalists, were reported in the Medical Group Management Association's (MGMA) Physician Compensation and Production Survey: 2012 Report Based on 2011 Data. The rise comes despite little movement in the number of work relative-value units (wRVUs) hospitalists are producing. In 2011, the median physician wRVU rate was 4,159, a 0.17% drop from the year prior.
"Over time, the industry has recognized there is a strong demand and there is a need for these types of practitioners," says Todd Evenson, MGMA director of data solutions. Evenson says he sees no immediate hurdles to the continued growth of hospitalist compensation, as hospitalists have established themselves as major players in most hospitals.
Although wRVUs might appear stable—they've ticked up 1.26% since 2010—the measure might not be as closely tied to compensation as healthcare reform redefines payment and reimbursement models, Evenson says. For example, bundled payments tied to quality of care and outcomes could have a limited impact on wRVUs but be a major driver of compensation.
Just how high compensation can climb, Evenson says, will depend on "the payment mechanisms that we start to see fall out of the legislation that occurs. ... As that evolves, I can't say I know the ceiling."
The report compiled data on 3,192 full-time hospitalists nationwide. Slightly more than 54% of the respondents worked in hospital-owned practices, while 27% are in physician-owned groups. The rest reported "other" practice models.
The MGMA survey data will be incorporated into SHM's State of Hospital Medicine report, due out later next month. In addition to information on individual physicians collected by MGMA, SHM's report includes group-level data valuable to HM groups, including financial data (subsidies and CPT code distribution) and staffing and scheduling.
Median compensation for adult hospitalists rose to $233,855 in 2011, a 6% increase from the year prior, while productivity remained nearly static, according to recently released data. This latest uptick in HM compensation means that hospitalist pay has jumped more than 27% since 2008, when unadjusted figures pegged median hospitalist compensation at $183,900 nationwide.
The data, which excludes academic hospitalists, were reported in the Medical Group Management Association's (MGMA) Physician Compensation and Production Survey: 2012 Report Based on 2011 Data. The rise comes despite little movement in the number of work relative-value units (wRVUs) hospitalists are producing. In 2011, the median physician wRVU rate was 4,159, a 0.17% drop from the year prior.
"Over time, the industry has recognized there is a strong demand and there is a need for these types of practitioners," says Todd Evenson, MGMA director of data solutions. Evenson says he sees no immediate hurdles to the continued growth of hospitalist compensation, as hospitalists have established themselves as major players in most hospitals.
Although wRVUs might appear stable—they've ticked up 1.26% since 2010—the measure might not be as closely tied to compensation as healthcare reform redefines payment and reimbursement models, Evenson says. For example, bundled payments tied to quality of care and outcomes could have a limited impact on wRVUs but be a major driver of compensation.
Just how high compensation can climb, Evenson says, will depend on "the payment mechanisms that we start to see fall out of the legislation that occurs. ... As that evolves, I can't say I know the ceiling."
The report compiled data on 3,192 full-time hospitalists nationwide. Slightly more than 54% of the respondents worked in hospital-owned practices, while 27% are in physician-owned groups. The rest reported "other" practice models.
The MGMA survey data will be incorporated into SHM's State of Hospital Medicine report, due out later next month. In addition to information on individual physicians collected by MGMA, SHM's report includes group-level data valuable to HM groups, including financial data (subsidies and CPT code distribution) and staffing and scheduling.
Median compensation for adult hospitalists rose to $233,855 in 2011, a 6% increase from the year prior, while productivity remained nearly static, according to recently released data. This latest uptick in HM compensation means that hospitalist pay has jumped more than 27% since 2008, when unadjusted figures pegged median hospitalist compensation at $183,900 nationwide.
The data, which excludes academic hospitalists, were reported in the Medical Group Management Association's (MGMA) Physician Compensation and Production Survey: 2012 Report Based on 2011 Data. The rise comes despite little movement in the number of work relative-value units (wRVUs) hospitalists are producing. In 2011, the median physician wRVU rate was 4,159, a 0.17% drop from the year prior.
"Over time, the industry has recognized there is a strong demand and there is a need for these types of practitioners," says Todd Evenson, MGMA director of data solutions. Evenson says he sees no immediate hurdles to the continued growth of hospitalist compensation, as hospitalists have established themselves as major players in most hospitals.
Although wRVUs might appear stable—they've ticked up 1.26% since 2010—the measure might not be as closely tied to compensation as healthcare reform redefines payment and reimbursement models, Evenson says. For example, bundled payments tied to quality of care and outcomes could have a limited impact on wRVUs but be a major driver of compensation.
Just how high compensation can climb, Evenson says, will depend on "the payment mechanisms that we start to see fall out of the legislation that occurs. ... As that evolves, I can't say I know the ceiling."
The report compiled data on 3,192 full-time hospitalists nationwide. Slightly more than 54% of the respondents worked in hospital-owned practices, while 27% are in physician-owned groups. The rest reported "other" practice models.
The MGMA survey data will be incorporated into SHM's State of Hospital Medicine report, due out later next month. In addition to information on individual physicians collected by MGMA, SHM's report includes group-level data valuable to HM groups, including financial data (subsidies and CPT code distribution) and staffing and scheduling.
FDA Clears First Test to ID Bacteria Associated with Bloodstream Infections
Last month, the Food and Drug Administration cleared a test designed to quickly identify a dozen types of bacteria that can lead to bloodstream infections.
The Verigene GP Blood Culture Nucleic Acid Test, developed by molecular diagnostic firm Nanosphere Inc. of Northbrook, Ill., can identify Staphylococcus (including methicillin-resistant S. aureus, or MRSA), Streptococcus, Enterococcus (including vancomycin-resistant enterococci), and Listeria.
"The current standard of treatment is to provide broad-spectrum antibiotics, including some last-line therapies, such as vancomycin, in order to get coverage for everything," says Mike McGarrity, a Nanosphere executive. "With antibiotic stewardship programs in the majority of hospitals, there is an understanding of the overuse of these last-line therapies and the development of resistance."
Currently, blood cultures can take two to four days to identify certain types of bacteria and determine whether any present are resistant to certain therapies. Once a blood culture is positive, the Nanosphere test can identify bacteria and antimicrobial resistance genes in roughly two and half hours. In a pitch that McGarrity believes will resonate with HM groups, he positions the product as a cost-saver that can reduce length of stay (LOS) for hospitalized patients, as physicians don’t have to wait two days for test results. Quicker identification can also lead to lower mortality rates, he says.
McGarrity, who says Nanosphere will submit an application to the FDA this year for a similar rapid-results test for Clostridium difficile and a broad enteric panel, adds that the test is $75 per use. With LOS reduction and cost savings for targeted de-escalated therapies, he says, there is clear value in the test.
"This gets the attention of stakeholders," he says.
Last month, the Food and Drug Administration cleared a test designed to quickly identify a dozen types of bacteria that can lead to bloodstream infections.
The Verigene GP Blood Culture Nucleic Acid Test, developed by molecular diagnostic firm Nanosphere Inc. of Northbrook, Ill., can identify Staphylococcus (including methicillin-resistant S. aureus, or MRSA), Streptococcus, Enterococcus (including vancomycin-resistant enterococci), and Listeria.
"The current standard of treatment is to provide broad-spectrum antibiotics, including some last-line therapies, such as vancomycin, in order to get coverage for everything," says Mike McGarrity, a Nanosphere executive. "With antibiotic stewardship programs in the majority of hospitals, there is an understanding of the overuse of these last-line therapies and the development of resistance."
Currently, blood cultures can take two to four days to identify certain types of bacteria and determine whether any present are resistant to certain therapies. Once a blood culture is positive, the Nanosphere test can identify bacteria and antimicrobial resistance genes in roughly two and half hours. In a pitch that McGarrity believes will resonate with HM groups, he positions the product as a cost-saver that can reduce length of stay (LOS) for hospitalized patients, as physicians don’t have to wait two days for test results. Quicker identification can also lead to lower mortality rates, he says.
McGarrity, who says Nanosphere will submit an application to the FDA this year for a similar rapid-results test for Clostridium difficile and a broad enteric panel, adds that the test is $75 per use. With LOS reduction and cost savings for targeted de-escalated therapies, he says, there is clear value in the test.
"This gets the attention of stakeholders," he says.
Last month, the Food and Drug Administration cleared a test designed to quickly identify a dozen types of bacteria that can lead to bloodstream infections.
The Verigene GP Blood Culture Nucleic Acid Test, developed by molecular diagnostic firm Nanosphere Inc. of Northbrook, Ill., can identify Staphylococcus (including methicillin-resistant S. aureus, or MRSA), Streptococcus, Enterococcus (including vancomycin-resistant enterococci), and Listeria.
"The current standard of treatment is to provide broad-spectrum antibiotics, including some last-line therapies, such as vancomycin, in order to get coverage for everything," says Mike McGarrity, a Nanosphere executive. "With antibiotic stewardship programs in the majority of hospitals, there is an understanding of the overuse of these last-line therapies and the development of resistance."
Currently, blood cultures can take two to four days to identify certain types of bacteria and determine whether any present are resistant to certain therapies. Once a blood culture is positive, the Nanosphere test can identify bacteria and antimicrobial resistance genes in roughly two and half hours. In a pitch that McGarrity believes will resonate with HM groups, he positions the product as a cost-saver that can reduce length of stay (LOS) for hospitalized patients, as physicians don’t have to wait two days for test results. Quicker identification can also lead to lower mortality rates, he says.
McGarrity, who says Nanosphere will submit an application to the FDA this year for a similar rapid-results test for Clostridium difficile and a broad enteric panel, adds that the test is $75 per use. With LOS reduction and cost savings for targeted de-escalated therapies, he says, there is clear value in the test.
"This gets the attention of stakeholders," he says.
Report Finds Some Hospitalists Engage in Various Levels of Unprofessionalism
New research published in the Journal of Hospital Medicine found two-thirds of hospitalists at three Chicago academic health centers engaged in some level of unprofessional behavior.
The report, "Participation in Unprofessional Behaviors Among Hospitalists: A Multicenter Study," found 67.1% of the 77 respondents had medical or personal conversations in patient corridors, 62.3% had ordered a routine test as "urgent" to speed up results, and 40.3% poked fun at other physicians to colleagues. More troubling, the report showed that 6.5% of respondents had engaged in falsifying patient records and that 2.6% had performed medical or surgical procedures on a patient beyond their self-perceived level of skill. Both behaviors were defined as egregious.
Some media reports have played up the findings of unprofessionalism, but study authors note that the findings are more nuanced than that. "I would emphasize that participation in egregious behaviors was low especially related to trainees, which is a plus," says co-author Vineet Arora, MD, FHM, MAPP, associate professor of medicine and associate director of internal-medicine residency at the University of Chicago's Pritzker School of Medicine. "However, certain job characteristics change the likelihood of unprofessional behavior—that is probably the most interesting finding."
Dr. Arora says that the report's findings helped craft a video intervention that has been used at all three academic centers. The video, funded by the American Board of Internal Medicine (ABIM), is just a first step in stressing to hospitalists behaviors that are considered professional, she adds.
One of the surprises of the data, she says, is that hospitalists with lower amounts of clinical work on their plate were more likely to report making fun of other physicians or patients.
"We often think that too much clinical work leads to burnout and depersonalization, but this shows the opposite," she says. "It may be that those hospitalists who do a lot of clinical work value their relationships and understand the importance of setting a professional tone for their work."
New research published in the Journal of Hospital Medicine found two-thirds of hospitalists at three Chicago academic health centers engaged in some level of unprofessional behavior.
The report, "Participation in Unprofessional Behaviors Among Hospitalists: A Multicenter Study," found 67.1% of the 77 respondents had medical or personal conversations in patient corridors, 62.3% had ordered a routine test as "urgent" to speed up results, and 40.3% poked fun at other physicians to colleagues. More troubling, the report showed that 6.5% of respondents had engaged in falsifying patient records and that 2.6% had performed medical or surgical procedures on a patient beyond their self-perceived level of skill. Both behaviors were defined as egregious.
Some media reports have played up the findings of unprofessionalism, but study authors note that the findings are more nuanced than that. "I would emphasize that participation in egregious behaviors was low especially related to trainees, which is a plus," says co-author Vineet Arora, MD, FHM, MAPP, associate professor of medicine and associate director of internal-medicine residency at the University of Chicago's Pritzker School of Medicine. "However, certain job characteristics change the likelihood of unprofessional behavior—that is probably the most interesting finding."
Dr. Arora says that the report's findings helped craft a video intervention that has been used at all three academic centers. The video, funded by the American Board of Internal Medicine (ABIM), is just a first step in stressing to hospitalists behaviors that are considered professional, she adds.
One of the surprises of the data, she says, is that hospitalists with lower amounts of clinical work on their plate were more likely to report making fun of other physicians or patients.
"We often think that too much clinical work leads to burnout and depersonalization, but this shows the opposite," she says. "It may be that those hospitalists who do a lot of clinical work value their relationships and understand the importance of setting a professional tone for their work."
New research published in the Journal of Hospital Medicine found two-thirds of hospitalists at three Chicago academic health centers engaged in some level of unprofessional behavior.
The report, "Participation in Unprofessional Behaviors Among Hospitalists: A Multicenter Study," found 67.1% of the 77 respondents had medical or personal conversations in patient corridors, 62.3% had ordered a routine test as "urgent" to speed up results, and 40.3% poked fun at other physicians to colleagues. More troubling, the report showed that 6.5% of respondents had engaged in falsifying patient records and that 2.6% had performed medical or surgical procedures on a patient beyond their self-perceived level of skill. Both behaviors were defined as egregious.
Some media reports have played up the findings of unprofessionalism, but study authors note that the findings are more nuanced than that. "I would emphasize that participation in egregious behaviors was low especially related to trainees, which is a plus," says co-author Vineet Arora, MD, FHM, MAPP, associate professor of medicine and associate director of internal-medicine residency at the University of Chicago's Pritzker School of Medicine. "However, certain job characteristics change the likelihood of unprofessional behavior—that is probably the most interesting finding."
Dr. Arora says that the report's findings helped craft a video intervention that has been used at all three academic centers. The video, funded by the American Board of Internal Medicine (ABIM), is just a first step in stressing to hospitalists behaviors that are considered professional, she adds.
One of the surprises of the data, she says, is that hospitalists with lower amounts of clinical work on their plate were more likely to report making fun of other physicians or patients.
"We often think that too much clinical work leads to burnout and depersonalization, but this shows the opposite," she says. "It may be that those hospitalists who do a lot of clinical work value their relationships and understand the importance of setting a professional tone for their work."
New Study on Anticoagulation Therapies “Definitive Word” on Topic, Hospitalist Says
A recent report that states the choice between warfarin and aspirin in patients with heart failure and sinus rhythm should be individualized is the most definitive word to date on the topic, says a hospitalist focused on anticoagulation therapies.
The report, “Warfarin and Aspirin in Patients with Heart Failure and Sinus Rhythm,” focused on patients in sinus rhythm who had reduced left ventricular ejection fraction (LVEF). The authors concluded that the reduced risk of ischemic stroke with warfarin was offset by an increased risk of major hemorrhage.
“The new thing about this study is it’s really the definitive, well-designed, large trial that provides guidance to us as to what is right,” says Margaret Fang, MD, MPH, an associate professor of medicine at the University of California at San Francisco (UCSF) and medical director of the UCSF Anticoagulation Clinic. “Is warfarin really the right decision?”
Dr. Fang notes that the report, known more commonly as the Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction (WARCEF) trial, did find that, over time, warfarin began to show improvement over aspirin. But the improvements, which favored warfarin by the fourth year of the six-year trial, were deemed only marginally significant (P=.046).
A recent report that states the choice between warfarin and aspirin in patients with heart failure and sinus rhythm should be individualized is the most definitive word to date on the topic, says a hospitalist focused on anticoagulation therapies.
The report, “Warfarin and Aspirin in Patients with Heart Failure and Sinus Rhythm,” focused on patients in sinus rhythm who had reduced left ventricular ejection fraction (LVEF). The authors concluded that the reduced risk of ischemic stroke with warfarin was offset by an increased risk of major hemorrhage.
“The new thing about this study is it’s really the definitive, well-designed, large trial that provides guidance to us as to what is right,” says Margaret Fang, MD, MPH, an associate professor of medicine at the University of California at San Francisco (UCSF) and medical director of the UCSF Anticoagulation Clinic. “Is warfarin really the right decision?”
Dr. Fang notes that the report, known more commonly as the Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction (WARCEF) trial, did find that, over time, warfarin began to show improvement over aspirin. But the improvements, which favored warfarin by the fourth year of the six-year trial, were deemed only marginally significant (P=.046).
A recent report that states the choice between warfarin and aspirin in patients with heart failure and sinus rhythm should be individualized is the most definitive word to date on the topic, says a hospitalist focused on anticoagulation therapies.
The report, “Warfarin and Aspirin in Patients with Heart Failure and Sinus Rhythm,” focused on patients in sinus rhythm who had reduced left ventricular ejection fraction (LVEF). The authors concluded that the reduced risk of ischemic stroke with warfarin was offset by an increased risk of major hemorrhage.
“The new thing about this study is it’s really the definitive, well-designed, large trial that provides guidance to us as to what is right,” says Margaret Fang, MD, MPH, an associate professor of medicine at the University of California at San Francisco (UCSF) and medical director of the UCSF Anticoagulation Clinic. “Is warfarin really the right decision?”
Dr. Fang notes that the report, known more commonly as the Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction (WARCEF) trial, did find that, over time, warfarin began to show improvement over aspirin. But the improvements, which favored warfarin by the fourth year of the six-year trial, were deemed only marginally significant (P=.046).
Wave of Pertussis Cases Raises Questions About Diagnoses, Testing
Robert Gould, MD, a hospitalist in suburban Seattle, knows that his HM colleagues don't immediately think of pertussis as a diagnosis. But as an epidemic of whooping cough rolls through Washington state, he urges they keep the disease in mind.
"I'm thinking about it more," says Dr. Gould, a hospitalist at Swedish/Edmonds Hospital in Edmonds, Wash., who has treated one patient who tested positive for the illness. "One thing I think about is if someone comes in with a primary respiratory issue and they have underlying COPD and they're having a cough. Do you test for it? Do you consider it? It's just so hard, because do you test everyone who comes in with one week of cough?"
The topic is timely. The Washington State Department of Health reports that through May 26, the state reported 1,947 cases of whooping cough, up from just 154 cases for the same time period last year.
Dr. Gould says the outbreak of pertussis brings up an interesting question for hospitalists. HM physicians don't want to order unnecessary tests—particularly in light of recent initiatives to combat the practice—but not testing can leave a person vulnerable to the disease's progression. When suspicions are high that whooping cough is the diagnosis, one solution is simply to order one of the most common therapies: azithromycin. That eliminates the testing cost, which can run up to several hundred dollars, while giving the patient a medication not greatly associated with Clostridium difficile or other negative outcomes, Dr. Gould says.
"Thinking about it is the biggest thing," he adds.
Robert Gould, MD, a hospitalist in suburban Seattle, knows that his HM colleagues don't immediately think of pertussis as a diagnosis. But as an epidemic of whooping cough rolls through Washington state, he urges they keep the disease in mind.
"I'm thinking about it more," says Dr. Gould, a hospitalist at Swedish/Edmonds Hospital in Edmonds, Wash., who has treated one patient who tested positive for the illness. "One thing I think about is if someone comes in with a primary respiratory issue and they have underlying COPD and they're having a cough. Do you test for it? Do you consider it? It's just so hard, because do you test everyone who comes in with one week of cough?"
The topic is timely. The Washington State Department of Health reports that through May 26, the state reported 1,947 cases of whooping cough, up from just 154 cases for the same time period last year.
Dr. Gould says the outbreak of pertussis brings up an interesting question for hospitalists. HM physicians don't want to order unnecessary tests—particularly in light of recent initiatives to combat the practice—but not testing can leave a person vulnerable to the disease's progression. When suspicions are high that whooping cough is the diagnosis, one solution is simply to order one of the most common therapies: azithromycin. That eliminates the testing cost, which can run up to several hundred dollars, while giving the patient a medication not greatly associated with Clostridium difficile or other negative outcomes, Dr. Gould says.
"Thinking about it is the biggest thing," he adds.
Robert Gould, MD, a hospitalist in suburban Seattle, knows that his HM colleagues don't immediately think of pertussis as a diagnosis. But as an epidemic of whooping cough rolls through Washington state, he urges they keep the disease in mind.
"I'm thinking about it more," says Dr. Gould, a hospitalist at Swedish/Edmonds Hospital in Edmonds, Wash., who has treated one patient who tested positive for the illness. "One thing I think about is if someone comes in with a primary respiratory issue and they have underlying COPD and they're having a cough. Do you test for it? Do you consider it? It's just so hard, because do you test everyone who comes in with one week of cough?"
The topic is timely. The Washington State Department of Health reports that through May 26, the state reported 1,947 cases of whooping cough, up from just 154 cases for the same time period last year.
Dr. Gould says the outbreak of pertussis brings up an interesting question for hospitalists. HM physicians don't want to order unnecessary tests—particularly in light of recent initiatives to combat the practice—but not testing can leave a person vulnerable to the disease's progression. When suspicions are high that whooping cough is the diagnosis, one solution is simply to order one of the most common therapies: azithromycin. That eliminates the testing cost, which can run up to several hundred dollars, while giving the patient a medication not greatly associated with Clostridium difficile or other negative outcomes, Dr. Gould says.
"Thinking about it is the biggest thing," he adds.
Society of Hospital Medicine (SHM) Backs Anti-SGR Legislation
SHM has joined the growing number of professional medical societies calling for the repeal of the sustainable growth rate (SGR) formula, and they want you to join the fight.
In the past few weeks, SHM, the Medical Group Management Association (MGMA), and the American Medical Association (AMA) have decried the Medicare payment system and called for its end. All were responding to a U.S. House of Representatives request for comments on how to rebuild Medicare reimbursement for physicians.
Unless Congress repeals the formula or approves the latest in a series of extensions, Medicare physician payments will be reduced by 30.9% on Jan. 1, 2013. And while most observers doubt the deep cuts will ever be implemented, the specter of them is cause for concern.
"It's hugely disruptive to the planning process for any business, no matter what size," says Ron Greeno, MD, MHM, Cogent HMG's chief medical officer and the chair of SHM's Public Policy Committee.
SHM has thrown its support behind one potential solution, a bipartisan bill drafted by U.S. Reps. Allyson Schwartz (D-Pa.) and Joe Heck (R-Nev.). If passed, it would eliminate the SGR formula and push for new payment models.
Dr. Greeno, who is "hopeful but not optimistic" that the bill can pass, says hospitalists need to step up and support those who are supporting hospitalists. To that end, the society is urging members to contact their local representatives to support the legislation.
"You have to be vocal, you have to be consistently vocal," he says. "We have to be diligent, continue to advance this as an issue, continue to support the people that are seeking reasonable solutions. Despite everything that gets put in our way, we have to continue to be vocal and continue to support this. One of these times, it’s going to work."
For more information, check out SHM's Advocacy portal. Use this directory to find and email your elected officials.
SHM has joined the growing number of professional medical societies calling for the repeal of the sustainable growth rate (SGR) formula, and they want you to join the fight.
In the past few weeks, SHM, the Medical Group Management Association (MGMA), and the American Medical Association (AMA) have decried the Medicare payment system and called for its end. All were responding to a U.S. House of Representatives request for comments on how to rebuild Medicare reimbursement for physicians.
Unless Congress repeals the formula or approves the latest in a series of extensions, Medicare physician payments will be reduced by 30.9% on Jan. 1, 2013. And while most observers doubt the deep cuts will ever be implemented, the specter of them is cause for concern.
"It's hugely disruptive to the planning process for any business, no matter what size," says Ron Greeno, MD, MHM, Cogent HMG's chief medical officer and the chair of SHM's Public Policy Committee.
SHM has thrown its support behind one potential solution, a bipartisan bill drafted by U.S. Reps. Allyson Schwartz (D-Pa.) and Joe Heck (R-Nev.). If passed, it would eliminate the SGR formula and push for new payment models.
Dr. Greeno, who is "hopeful but not optimistic" that the bill can pass, says hospitalists need to step up and support those who are supporting hospitalists. To that end, the society is urging members to contact their local representatives to support the legislation.
"You have to be vocal, you have to be consistently vocal," he says. "We have to be diligent, continue to advance this as an issue, continue to support the people that are seeking reasonable solutions. Despite everything that gets put in our way, we have to continue to be vocal and continue to support this. One of these times, it’s going to work."
For more information, check out SHM's Advocacy portal. Use this directory to find and email your elected officials.
SHM has joined the growing number of professional medical societies calling for the repeal of the sustainable growth rate (SGR) formula, and they want you to join the fight.
In the past few weeks, SHM, the Medical Group Management Association (MGMA), and the American Medical Association (AMA) have decried the Medicare payment system and called for its end. All were responding to a U.S. House of Representatives request for comments on how to rebuild Medicare reimbursement for physicians.
Unless Congress repeals the formula or approves the latest in a series of extensions, Medicare physician payments will be reduced by 30.9% on Jan. 1, 2013. And while most observers doubt the deep cuts will ever be implemented, the specter of them is cause for concern.
"It's hugely disruptive to the planning process for any business, no matter what size," says Ron Greeno, MD, MHM, Cogent HMG's chief medical officer and the chair of SHM's Public Policy Committee.
SHM has thrown its support behind one potential solution, a bipartisan bill drafted by U.S. Reps. Allyson Schwartz (D-Pa.) and Joe Heck (R-Nev.). If passed, it would eliminate the SGR formula and push for new payment models.
Dr. Greeno, who is "hopeful but not optimistic" that the bill can pass, says hospitalists need to step up and support those who are supporting hospitalists. To that end, the society is urging members to contact their local representatives to support the legislation.
"You have to be vocal, you have to be consistently vocal," he says. "We have to be diligent, continue to advance this as an issue, continue to support the people that are seeking reasonable solutions. Despite everything that gets put in our way, we have to continue to be vocal and continue to support this. One of these times, it’s going to work."
For more information, check out SHM's Advocacy portal. Use this directory to find and email your elected officials.
Report Highlights Strategies for Reducing AMI Mortality Rates
A new report on acute myocardial infarction (AMI) suggests that implementing a handful of relatively easy strategies can improve mortality rates.
The research, "Hospital Strategies for Reducing Risk-Standardized Mortality Rates in Acute Myocardial Infarction," highlights several techniques for lowering risk-standardized mortality rates (RSMR) in this patient population:
• Holding monthly meetings to review AMI cases (lowered RSMR by 0.7%);
• Fostering an environment that encourages clinicians to solve problems creatively (lowered RSMR by 0.84%);
• Having 24-hour coverage by cardiologists (lowered RSMR by 0.54%);
• Having both a nurse and physician champion for quality in AMI (lowered RSMR by 0.88%); and
• Avoiding cross-training nurses from ICUs for cardiac catheterization laboratories (lowered RSMR by 0.44%).
Fewer than 10% of the 537 hospitals in the cross-sectional survey reported using at least four of the five strategies. Lead author Elizabeth H. Bradley, PhD, faculty director of the Global Health Leadership Institute and professor of public health at Yale University, says the challenge in implementing the strategies lies in changing the often-obstinate culture of healthcare institutions.
"The root of this is the culture," she says, adding if nothing else, "begin with the problems, begin with an analytical mind when errors occur." Dr. Bradley adds that culture of teamwork works only when it has buy-in from in-the-trenches physicians, such as hospitalists and C-suite executives.
"It has to come from the front line and from the top," she says. "In all of our studies over the last decade, [physicians and administrators] need to be supportive of an environment in which problem solving can happen."
A new report on acute myocardial infarction (AMI) suggests that implementing a handful of relatively easy strategies can improve mortality rates.
The research, "Hospital Strategies for Reducing Risk-Standardized Mortality Rates in Acute Myocardial Infarction," highlights several techniques for lowering risk-standardized mortality rates (RSMR) in this patient population:
• Holding monthly meetings to review AMI cases (lowered RSMR by 0.7%);
• Fostering an environment that encourages clinicians to solve problems creatively (lowered RSMR by 0.84%);
• Having 24-hour coverage by cardiologists (lowered RSMR by 0.54%);
• Having both a nurse and physician champion for quality in AMI (lowered RSMR by 0.88%); and
• Avoiding cross-training nurses from ICUs for cardiac catheterization laboratories (lowered RSMR by 0.44%).
Fewer than 10% of the 537 hospitals in the cross-sectional survey reported using at least four of the five strategies. Lead author Elizabeth H. Bradley, PhD, faculty director of the Global Health Leadership Institute and professor of public health at Yale University, says the challenge in implementing the strategies lies in changing the often-obstinate culture of healthcare institutions.
"The root of this is the culture," she says, adding if nothing else, "begin with the problems, begin with an analytical mind when errors occur." Dr. Bradley adds that culture of teamwork works only when it has buy-in from in-the-trenches physicians, such as hospitalists and C-suite executives.
"It has to come from the front line and from the top," she says. "In all of our studies over the last decade, [physicians and administrators] need to be supportive of an environment in which problem solving can happen."
A new report on acute myocardial infarction (AMI) suggests that implementing a handful of relatively easy strategies can improve mortality rates.
The research, "Hospital Strategies for Reducing Risk-Standardized Mortality Rates in Acute Myocardial Infarction," highlights several techniques for lowering risk-standardized mortality rates (RSMR) in this patient population:
• Holding monthly meetings to review AMI cases (lowered RSMR by 0.7%);
• Fostering an environment that encourages clinicians to solve problems creatively (lowered RSMR by 0.84%);
• Having 24-hour coverage by cardiologists (lowered RSMR by 0.54%);
• Having both a nurse and physician champion for quality in AMI (lowered RSMR by 0.88%); and
• Avoiding cross-training nurses from ICUs for cardiac catheterization laboratories (lowered RSMR by 0.44%).
Fewer than 10% of the 537 hospitals in the cross-sectional survey reported using at least four of the five strategies. Lead author Elizabeth H. Bradley, PhD, faculty director of the Global Health Leadership Institute and professor of public health at Yale University, says the challenge in implementing the strategies lies in changing the often-obstinate culture of healthcare institutions.
"The root of this is the culture," she says, adding if nothing else, "begin with the problems, begin with an analytical mind when errors occur." Dr. Bradley adds that culture of teamwork works only when it has buy-in from in-the-trenches physicians, such as hospitalists and C-suite executives.
"It has to come from the front line and from the top," she says. "In all of our studies over the last decade, [physicians and administrators] need to be supportive of an environment in which problem solving can happen."
Report: EHR Implementation Associated with Quality
Hospitals that have made it to the advanced stages of electronic health record (EHR) implementation are significantly more likely to set national benchmarks for quality and safety performance, according to the 2012 HIMSS Analytics Report.
The research (PDF), sponsored by Thomson Reuters and HIMSS Analytics, found a correlation between hospitals that are both ranked in the Thomson Reuters 100 Top Hospitals and at the upper end of the seven-stage HIMMS scale for EHR adoption.
While the link between electronic implementation and quality is important, William Bria, MD, chief medical information officer at Shriners Hospitals for Children in Philadelphia, cautions hospitalists and others from taking too much comfort in it. Simply implementing EHR and other technologies doesn't work, he says; the system has to be crafted in conjunction with its users.
"The best-led organizations in the country are using the metrics of safety and quality of care right alongside the implementation plan of their [health IT] programs," says Dr. Bria. "And the only way this occurs, of course, is if the partnering between executive and technological leadership and clinical leadership occurs."
Dr. Bria views research on the success of EHRs in improving hospital performance as an opportunity for hospitalists to get more involved in both the planning and implementation processes. He urges hospitalists to work with other physicians and IT staffers to learn how best to use their EHR, and not assume they can master complex software systems as easily as they understand smartphones and tablet computers.
"You can buy a piano and bang on it with your fist, and you won't really attract anybody to listen to your music," Dr. Bria says. "On the other hand, if you learn how to play, you study hard, and you learn the nuances of musicianship, you can become a Van Cliburn."
Hospitals that have made it to the advanced stages of electronic health record (EHR) implementation are significantly more likely to set national benchmarks for quality and safety performance, according to the 2012 HIMSS Analytics Report.
The research (PDF), sponsored by Thomson Reuters and HIMSS Analytics, found a correlation between hospitals that are both ranked in the Thomson Reuters 100 Top Hospitals and at the upper end of the seven-stage HIMMS scale for EHR adoption.
While the link between electronic implementation and quality is important, William Bria, MD, chief medical information officer at Shriners Hospitals for Children in Philadelphia, cautions hospitalists and others from taking too much comfort in it. Simply implementing EHR and other technologies doesn't work, he says; the system has to be crafted in conjunction with its users.
"The best-led organizations in the country are using the metrics of safety and quality of care right alongside the implementation plan of their [health IT] programs," says Dr. Bria. "And the only way this occurs, of course, is if the partnering between executive and technological leadership and clinical leadership occurs."
Dr. Bria views research on the success of EHRs in improving hospital performance as an opportunity for hospitalists to get more involved in both the planning and implementation processes. He urges hospitalists to work with other physicians and IT staffers to learn how best to use their EHR, and not assume they can master complex software systems as easily as they understand smartphones and tablet computers.
"You can buy a piano and bang on it with your fist, and you won't really attract anybody to listen to your music," Dr. Bria says. "On the other hand, if you learn how to play, you study hard, and you learn the nuances of musicianship, you can become a Van Cliburn."
Hospitals that have made it to the advanced stages of electronic health record (EHR) implementation are significantly more likely to set national benchmarks for quality and safety performance, according to the 2012 HIMSS Analytics Report.
The research (PDF), sponsored by Thomson Reuters and HIMSS Analytics, found a correlation between hospitals that are both ranked in the Thomson Reuters 100 Top Hospitals and at the upper end of the seven-stage HIMMS scale for EHR adoption.
While the link between electronic implementation and quality is important, William Bria, MD, chief medical information officer at Shriners Hospitals for Children in Philadelphia, cautions hospitalists and others from taking too much comfort in it. Simply implementing EHR and other technologies doesn't work, he says; the system has to be crafted in conjunction with its users.
"The best-led organizations in the country are using the metrics of safety and quality of care right alongside the implementation plan of their [health IT] programs," says Dr. Bria. "And the only way this occurs, of course, is if the partnering between executive and technological leadership and clinical leadership occurs."
Dr. Bria views research on the success of EHRs in improving hospital performance as an opportunity for hospitalists to get more involved in both the planning and implementation processes. He urges hospitalists to work with other physicians and IT staffers to learn how best to use their EHR, and not assume they can master complex software systems as easily as they understand smartphones and tablet computers.
"You can buy a piano and bang on it with your fist, and you won't really attract anybody to listen to your music," Dr. Bria says. "On the other hand, if you learn how to play, you study hard, and you learn the nuances of musicianship, you can become a Van Cliburn."
Hospitalists On the Move
Kenneth Donovan, MD, FHM and Sarada Sripada, MD, SFHM have been named the 2011 Hospitalists of the Year, and Donald Quinn, MD, MBA, SFHM was named the 2011 Post Acute Hospitalist of the Year by IPC: The Hospitalist Company Inc. Selected by IPC’s senior management team, the award includes an honorarium to each of the recipients. Additionally, IPC will make a $2,500 donation to the charity of their choice for each of the recipients.
Paul Fu Jr., MD, MPH, FAAP, recently was named chief medical informatics officer (CMIO) at Harbor-UCLA Medical Center in Los Angeles. He has served as chief of the division of pediatric hospital medicine since July 2011.
Former Cogent HMG senior vice president in charge of quality initiatives Anna-Gene O’Neal has taken a CEO position with Alive Hospice, a Nashville, Tenn.-based end-of-life care and grief support company. As CEO, O’Neal will oversee hospice and palliative care, as well as grief-support programs in a service area of 12 Middle Tennessee counties.
Kasra Djalayer, MD, a hospitalist based in Franklin, N.H., has received the 2011 Patients’ Choice Award from Patients’ Choice, an organization that collects and analyzes rankings from various patient-feedback websites, such as Vitals.com. Dr. Djalayer was honored based on a top ranking among physicians across the nation.
Hospitalist Glenn Rosenbluth, MD, has been appointed director of quality and safety programs for graduate medical education (GME) at University of California at San Francisco Medical Center. In his new role, Dr. Rosenbluth will lead multiple GME-related programs while still continuing his leadership as associated director of the pediatrics residency training program.
Business Moves
Cogent HMG has established a new critical-care program at Saint Francis Hospital in Brentwood, Tenn., which marks the hospitalist management company’s 11th full-service intensivist program. The new program will be operated by The Intensivist Group, recently acquired by Cogent HMG, and will include the development and implementation of literature-based ICU guidelines, a staff intensivist in the hospital seven days a week, and intensivist consultation and comanagement for all ICU patients.
IPC: The Hospitalist Company Inc. has acquired the facility-based practice of Asana Integrated Medical Group, a professional medical corporation that serves Southern California and Phoenix. Headquartered in Agoura Hills, Calif., the acquisition will add approximately 65,000 patient encounters annually to IPC.
IPC: The Hospitalist Company Inc. has entered into agreements to provide hospitalist services to four Methodist Healthcare System hospitals in San Antonio. The agreements are with Methodist Stone Oak Hospital, Methodist Specialty and Transplant Hospital, Northeast Methodist Hospital, and Metropolitan Methodist Hospital.
Apollo Medical Holdings Inc. has appointed Gary Augusta to its board of directors. Augusta brings more than 20 years of experience as an executive to the job.
University of Pittsburgh Medical Center has extended its hospitalist program to three additional Pennsylvania campuses, including the McKeesport, Greenville and Farrell hospitals.
Colquitt Regional Medical Center in Moultrie, Ga., has started a hospitalist program. The new team will be led by Marshall Tanner, MD, and will also include Alan Brown, MD, MBA, Frank Wilson, MD, and Ndubuisi Apu Ndukwe, MD.
—Alexandra Schultz
Kenneth Donovan, MD, FHM and Sarada Sripada, MD, SFHM have been named the 2011 Hospitalists of the Year, and Donald Quinn, MD, MBA, SFHM was named the 2011 Post Acute Hospitalist of the Year by IPC: The Hospitalist Company Inc. Selected by IPC’s senior management team, the award includes an honorarium to each of the recipients. Additionally, IPC will make a $2,500 donation to the charity of their choice for each of the recipients.
Paul Fu Jr., MD, MPH, FAAP, recently was named chief medical informatics officer (CMIO) at Harbor-UCLA Medical Center in Los Angeles. He has served as chief of the division of pediatric hospital medicine since July 2011.
Former Cogent HMG senior vice president in charge of quality initiatives Anna-Gene O’Neal has taken a CEO position with Alive Hospice, a Nashville, Tenn.-based end-of-life care and grief support company. As CEO, O’Neal will oversee hospice and palliative care, as well as grief-support programs in a service area of 12 Middle Tennessee counties.
Kasra Djalayer, MD, a hospitalist based in Franklin, N.H., has received the 2011 Patients’ Choice Award from Patients’ Choice, an organization that collects and analyzes rankings from various patient-feedback websites, such as Vitals.com. Dr. Djalayer was honored based on a top ranking among physicians across the nation.
Hospitalist Glenn Rosenbluth, MD, has been appointed director of quality and safety programs for graduate medical education (GME) at University of California at San Francisco Medical Center. In his new role, Dr. Rosenbluth will lead multiple GME-related programs while still continuing his leadership as associated director of the pediatrics residency training program.
Business Moves
Cogent HMG has established a new critical-care program at Saint Francis Hospital in Brentwood, Tenn., which marks the hospitalist management company’s 11th full-service intensivist program. The new program will be operated by The Intensivist Group, recently acquired by Cogent HMG, and will include the development and implementation of literature-based ICU guidelines, a staff intensivist in the hospital seven days a week, and intensivist consultation and comanagement for all ICU patients.
IPC: The Hospitalist Company Inc. has acquired the facility-based practice of Asana Integrated Medical Group, a professional medical corporation that serves Southern California and Phoenix. Headquartered in Agoura Hills, Calif., the acquisition will add approximately 65,000 patient encounters annually to IPC.
IPC: The Hospitalist Company Inc. has entered into agreements to provide hospitalist services to four Methodist Healthcare System hospitals in San Antonio. The agreements are with Methodist Stone Oak Hospital, Methodist Specialty and Transplant Hospital, Northeast Methodist Hospital, and Metropolitan Methodist Hospital.
Apollo Medical Holdings Inc. has appointed Gary Augusta to its board of directors. Augusta brings more than 20 years of experience as an executive to the job.
University of Pittsburgh Medical Center has extended its hospitalist program to three additional Pennsylvania campuses, including the McKeesport, Greenville and Farrell hospitals.
Colquitt Regional Medical Center in Moultrie, Ga., has started a hospitalist program. The new team will be led by Marshall Tanner, MD, and will also include Alan Brown, MD, MBA, Frank Wilson, MD, and Ndubuisi Apu Ndukwe, MD.
—Alexandra Schultz
Kenneth Donovan, MD, FHM and Sarada Sripada, MD, SFHM have been named the 2011 Hospitalists of the Year, and Donald Quinn, MD, MBA, SFHM was named the 2011 Post Acute Hospitalist of the Year by IPC: The Hospitalist Company Inc. Selected by IPC’s senior management team, the award includes an honorarium to each of the recipients. Additionally, IPC will make a $2,500 donation to the charity of their choice for each of the recipients.
Paul Fu Jr., MD, MPH, FAAP, recently was named chief medical informatics officer (CMIO) at Harbor-UCLA Medical Center in Los Angeles. He has served as chief of the division of pediatric hospital medicine since July 2011.
Former Cogent HMG senior vice president in charge of quality initiatives Anna-Gene O’Neal has taken a CEO position with Alive Hospice, a Nashville, Tenn.-based end-of-life care and grief support company. As CEO, O’Neal will oversee hospice and palliative care, as well as grief-support programs in a service area of 12 Middle Tennessee counties.
Kasra Djalayer, MD, a hospitalist based in Franklin, N.H., has received the 2011 Patients’ Choice Award from Patients’ Choice, an organization that collects and analyzes rankings from various patient-feedback websites, such as Vitals.com. Dr. Djalayer was honored based on a top ranking among physicians across the nation.
Hospitalist Glenn Rosenbluth, MD, has been appointed director of quality and safety programs for graduate medical education (GME) at University of California at San Francisco Medical Center. In his new role, Dr. Rosenbluth will lead multiple GME-related programs while still continuing his leadership as associated director of the pediatrics residency training program.
Business Moves
Cogent HMG has established a new critical-care program at Saint Francis Hospital in Brentwood, Tenn., which marks the hospitalist management company’s 11th full-service intensivist program. The new program will be operated by The Intensivist Group, recently acquired by Cogent HMG, and will include the development and implementation of literature-based ICU guidelines, a staff intensivist in the hospital seven days a week, and intensivist consultation and comanagement for all ICU patients.
IPC: The Hospitalist Company Inc. has acquired the facility-based practice of Asana Integrated Medical Group, a professional medical corporation that serves Southern California and Phoenix. Headquartered in Agoura Hills, Calif., the acquisition will add approximately 65,000 patient encounters annually to IPC.
IPC: The Hospitalist Company Inc. has entered into agreements to provide hospitalist services to four Methodist Healthcare System hospitals in San Antonio. The agreements are with Methodist Stone Oak Hospital, Methodist Specialty and Transplant Hospital, Northeast Methodist Hospital, and Metropolitan Methodist Hospital.
Apollo Medical Holdings Inc. has appointed Gary Augusta to its board of directors. Augusta brings more than 20 years of experience as an executive to the job.
University of Pittsburgh Medical Center has extended its hospitalist program to three additional Pennsylvania campuses, including the McKeesport, Greenville and Farrell hospitals.
Colquitt Regional Medical Center in Moultrie, Ga., has started a hospitalist program. The new team will be led by Marshall Tanner, MD, and will also include Alan Brown, MD, MBA, Frank Wilson, MD, and Ndubuisi Apu Ndukwe, MD.
—Alexandra Schultz
Hospitalists Can Help Alleviate Intensivist Shortage
Creating a sanctioned pathway to turn hospitalists into intensivists can help fill the growing shortage of trained physicians in ICUs, according to a new position paper from SHM and the Society of Critical Care Medicine.
"Training a Hospitalist Workforce to Address the Intensivist Shortage in American Hospitals," published online in the Journal of Hospital Medicine, suggests that if 5% of the projected hospitalist workforce were to complete a critical-care certification pathway created by the Accreditation Council for Graduate Medical Education (ACGME), 2,500 new intensivists could enter hospitals in the coming years.
"The ICU is in crisis because of the workforce shortage," says Mary Jo Gorman, MD, MBA, MHM, CEO of St. Louis-based Advanced ICU Care and former SHM president. "It's only going to get worse. [Hospitalists] need to be strategically trying to figure out how they are going to solve this problem. This is one of the calls for action that we think can really help the problem across the country. It won't be 100% of the solution, but we think it can contribute to the solution."
Lead author Eric Siegal, MD, SFHM, director of critical care medicine at Aurora St Luke's Medical Center in Milwaukee and a SHM board member, says it may take years to craft a formal pathway to accredit HM physicians in critical care, but the task is important as hospitalists already are being pressed into duty as intensivists.
"The real question is, how do we ensure that the hospitalists who are in those hospitals are qualified to handle the work that they already perform?" he says. "Hospitalists are de facto intensivists in many ICUs, whether they are qualified to do so or not ... so this seems like a logical evolution of HM."
Creating a sanctioned pathway to turn hospitalists into intensivists can help fill the growing shortage of trained physicians in ICUs, according to a new position paper from SHM and the Society of Critical Care Medicine.
"Training a Hospitalist Workforce to Address the Intensivist Shortage in American Hospitals," published online in the Journal of Hospital Medicine, suggests that if 5% of the projected hospitalist workforce were to complete a critical-care certification pathway created by the Accreditation Council for Graduate Medical Education (ACGME), 2,500 new intensivists could enter hospitals in the coming years.
"The ICU is in crisis because of the workforce shortage," says Mary Jo Gorman, MD, MBA, MHM, CEO of St. Louis-based Advanced ICU Care and former SHM president. "It's only going to get worse. [Hospitalists] need to be strategically trying to figure out how they are going to solve this problem. This is one of the calls for action that we think can really help the problem across the country. It won't be 100% of the solution, but we think it can contribute to the solution."
Lead author Eric Siegal, MD, SFHM, director of critical care medicine at Aurora St Luke's Medical Center in Milwaukee and a SHM board member, says it may take years to craft a formal pathway to accredit HM physicians in critical care, but the task is important as hospitalists already are being pressed into duty as intensivists.
"The real question is, how do we ensure that the hospitalists who are in those hospitals are qualified to handle the work that they already perform?" he says. "Hospitalists are de facto intensivists in many ICUs, whether they are qualified to do so or not ... so this seems like a logical evolution of HM."
Creating a sanctioned pathway to turn hospitalists into intensivists can help fill the growing shortage of trained physicians in ICUs, according to a new position paper from SHM and the Society of Critical Care Medicine.
"Training a Hospitalist Workforce to Address the Intensivist Shortage in American Hospitals," published online in the Journal of Hospital Medicine, suggests that if 5% of the projected hospitalist workforce were to complete a critical-care certification pathway created by the Accreditation Council for Graduate Medical Education (ACGME), 2,500 new intensivists could enter hospitals in the coming years.
"The ICU is in crisis because of the workforce shortage," says Mary Jo Gorman, MD, MBA, MHM, CEO of St. Louis-based Advanced ICU Care and former SHM president. "It's only going to get worse. [Hospitalists] need to be strategically trying to figure out how they are going to solve this problem. This is one of the calls for action that we think can really help the problem across the country. It won't be 100% of the solution, but we think it can contribute to the solution."
Lead author Eric Siegal, MD, SFHM, director of critical care medicine at Aurora St Luke's Medical Center in Milwaukee and a SHM board member, says it may take years to craft a formal pathway to accredit HM physicians in critical care, but the task is important as hospitalists already are being pressed into duty as intensivists.
"The real question is, how do we ensure that the hospitalists who are in those hospitals are qualified to handle the work that they already perform?" he says. "Hospitalists are de facto intensivists in many ICUs, whether they are qualified to do so or not ... so this seems like a logical evolution of HM."