Mods: Apologize in advance. This is my NSFW account. I am not here for Karma whoring or trolling, I just didnt get enough time to create a new account before I got to know about this sub.
I am a hospitalist in midwest US. Recently our hospital system went into overdrive and started buying all other hospitals in the area. like they bought / merged / acquired atleast 10 hospitals in the past 1-2 years. Prior to that they were only 2 hospitals. The big one in downtown and our hospital, a smaller one, just outside downtown (still in the city).
So because there were big mergers, a lot of focus has been put on what and how we do things and a new management was pushed upon us. When I started we were a group of 12 day time and 3 night time hospitalists. Then slowly the day numbers grew and people left nights and currently we have 13 day time and no nocturnists. The hospital has to work with a moonlighting agency to provide night coverage, and obviously its hemorrhaging money doing this. They claim that they have to hire 3 moonlighters for the floors and one for the ICU every night and that costs them a lot. But according to the hospital by laws, they only need 2 MD at night. There is one ER physician (employed) and one ICU moonlighter at night at all times.
Now the new admin thinks that we are not seeing enough patients. We have 4 hospitalist on a day and the average summer census is 35-50 and the average winter census is 50-65 (flu season). The management thinks that the average census for each hospitalist nationwide is 16-18 patients a day, where as we end up seeing 8-10 a day in summers and 10-13 in flu season. But the patients we see are without any MLP support and are incredibly social and dispo train wrecks, constantly abusing meth, no insurance, dont follow up, family leaves them abandoned in the hospital (guardianship takes months), iv dug user needs iv antibiotics ( cant discharge with central line for 6 weeks).
We also have PA's that work in the hospital, but they are usually working with the private and non teaching attendings (even though they are hospital employed).
Now unlike "traditional" hospitalist programs, where the hospitalists are usually young and dynamic and leave within 2-5 years, ours is a VERY stable program where people have been working for 10+ years. This is because even though we do not have mid level providers with us AND are paid pennies (the usual hourly rate for us $91, which is peanuts as compared to what other hospitalists are paid in the area), the best part is that our system is not 7on 7 off, we get to pick our own schedule, and this has resulted in physicians staying here, making flexible schedules around family life, have kids, go on vacations.
So that was a brief background. We have this big meeting today and I want to go in with some ideas. They want to reduce the number of day time shifts to 3 persons a day and to force us to provide night time coverage, which obviously isnt ideal for family life or for the amount of patients we will see without MLP support or the money we are being paid. Also a lot of physicians are older ( oldest one is in her 60's) and almost all except for 2 have kids, so I am pretty sure atleast 5-6 people will quit, although not right away.
Any suggestions are greatly appreciated. Thanks
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