These specialties don't compete or take patients with them once they leave their current job.
Why?
How patients chose ED/Hospitals in an emergency?
- Most of the time it is chosen for patients.
- Based on critical illness, location, a nearby hospital, capabilities of that hospital, and related factors
- ED room is not chosen based on ED doc or hospitalist or ICU doc.
A city with Non-compete Agreement health systems:
- Physicians --> can't work at other hospitals during their off week/weekends --> artificial shortage of physicians
-Physician --> work at other hospitals during off week/weekend --> no/less need for locums --> save money
-Health systems easy to recruit physicians --> no need to leave city --> for new job
Benefits for Health Systems:
- Millions of dollars in savings per year in staffing at hospitalist, ICU and ED dept
-Easy to recruit physicians
-No lawsuit headache
I have made schedules in both situations and personally, it is 100X easy to make schedule when docs can work.
Non-Compete Clause:
Healthcare CEOs -- Time fo cancel the non-compete clause of all hospital-based physicians.
- Save money for system
- Easy to recruit
Hospital HR
It is a time to work towards a common goal of patient care.
Without physicians, --> can not provide care.
- You can push for the removal of non-compete clause from all physicians' contracts.
Physicians:
-It's time to punch the face of the "non-compete clause". It is unfair, so don't sign. Discuss and negotiate.
- It's win-win for you and health systems.
- Enjoy Freedom while you are working and when you get new job.
Why retain a #hospitalist?
- cost 50 to 100 k in lost productivity, recruitment of new hire
- extra cost of having #Locums and #PRNs
- Quality of care may be affected
- LOS increases by .5 days or more as per data
-takes from 6 to 12 months to get the replacement
- unstable team
What to do: I believe follows a simple process.
1. Listening/Feedback Session:
Listen to individual hospitalists:
- #surveymonkey is not okay here
- Set up a 1:1 #listening session and act on the feedback
-feel to be heard and problems acted upon
#patient Volume:
- in 12-hour shifts, 15-18 encounters are common
- above 18, difficult to provide quality of care and high risk for errors and burnout risk
-it's okay to have a few days with a high census, but not with every day.
Night Shifts - Nocturnist
- Does the program have a dedicated nocturnist team?
- or rotation with all team members
- In 12 hr, shift 10 new admissions are doable
- Cross-Coverage: If a hospital is small (<150 beds), it's manageable, beyond it is difficult.