Hospitalists help bring efficiency, savings
Medical facilities reap reduced stays, strong outcomes, fewer readmissions
Some of the larger medical facilities in Albuquerque are relying on hospitalists — hospital-based internal medicine specialists who coordinate the often-complex care of inpatients.
After working with a physician staffing firm to fill its hospitalist ranks for several years, Lovelace Health System has gone from contracting talent to hiring 32 doctors to be part of its medical group.
In this role, they manage the clinical problems, especially those of the acutely ill, taking over from the patients’ general practitioners or specialists while they are hospitalized.
Conceived as a strategy by health-care systems to cut hospital costs with more efficient care, this new breed of doctors now manages most regular adult patient care inside several hospitals operated by Lovelace, as well as those hospitals run by Presbyterian Healthcare Services and UNM.
Unlike traditional doctors, most hospitalists don’t see patients in clinics and don’t have private offices in medical buildings.
“We get a really cohesive patient care experience with reduced hospital stays and strong outcomes,” said Dr. John Cruickshank, chief medical officer of Lovelace Health System. The system employs a team of dedicated hospitalists at three of its sites: Lovelace Medical Center and its Westside and Women’s hospitals.
Hospitalists who support patients through their stay also plan their discharge with the goal of avoiding readmissions, which come with financial consequences, Cruickshank said. Medicare readmission penalties enacted in 2012 reduce payments to hospitals that see the return of an excessive number of patients within 30 days after dis-
charge for specified conditions.
Hospital-based medicine also has increased around the country as a way to address coverage issues created by the physician shortage and lifestyle expectations of new providers.
Cruickshank said some, especially young women and a few men with small children, “want a little more flexibility in their schedules, but they need to generate income, so many are happy pulling seven (12-hour) shifts a month,” he said. A few “nocturnalists” work overnight, he said.
He said Lovelace parent company Ardent agreed that the $2 million investment (sign-on bonuses, salaries, benefits, relocation costs in some cases) over the course of the last year to recruit hospitalists is worth the expense in the long run.
“It cost us more money to have contracted labor,” he said.