Academic Hospitalists

Hello everyone,

I hope this message finds you well. I have a question regarding how clinical service is counted toward annual requirements in your programs. In our GIM division, we have long been dualist physicians, but I'm encountering some pushback from leadership regarding how hospital service with residents is viewed. Specifically, they suggest that service with residents may be considered less intense than shifts with direct patient care, and therefore may not count the same toward clinical service weeks.

I'm interested in understanding how other programs handle this distinction. Do you count hospitalist service with residents differently than direct care when calculating clinical service weeks?

Thank you in advance for your insights.

Best regards,
David

Our direct care attendings carry fewer patients (max 12) than our teaching teams (target 16, max 20), so we consider them equivalent.

Hello everyone,

I hope this message finds you well. I have a question regarding how clinical service is counted toward annual requirements in your programs. In our GIM division, we have long been dualist physicians, but I'm encountering some pushback from leadership regarding how hospital service with residents is viewed. Specifically, they suggest that service with residents may be considered less intense than shifts with direct patient care, and therefore may not count the same toward clinical service weeks.

I'm interested in understanding how other programs handle this distinction. Do you count hospitalist service with residents differently than direct care when calculating clinical service weeks?

Thank you in advance for your insights.

Best regards,
David

Hello everyone,

I hope this message finds you well. I have a question regarding how clinical service is counted toward annual requirements in your programs. In our GIM division, we have long been dualist physicians, but I'm encountering some pushback from leadership regarding how hospital service with residents is viewed. Specifically, they suggest that service with residents may be considered less intense than shifts with direct patient care, and therefore may not count the same toward clinical service weeks.

I'm interested in understanding how other programs handle this distinction. Do you count hospitalist service with residents differently than direct care when calculating clinical service weeks?

Thank you in advance for your insights.

Best regards,
David

David

As we are moving to introduce non-teaching teams, I have been struggling with how to do this also.
As Randy stated, I envision the direct care teams to have fewer patients, so that kind of offsets the patient workload.

The challenge for me is coverage. A direct patient care team needs someone in the building 24/7, whereas the teaching teams, the attendings can sneak out early as the residents are the ones in the building 24/7.  Direct patient care may have a lower census, but they are there for longer hours.
Instead of thinking of it in terms of clinical service weeks, I'd like to define it as salary per effort.
I am trying to get to 24 weeks total for our hospitalist faculty, and use that as 80% clinical, 100% full time for everyone.
Then figure out how much service on direct care vs teaching and translate that into percent effort terms: 12 weeks teaching = 40%, + 12 weeks direct 40%, then the 20% admin.
I am going to propose a base salary differential based on that.

I got this idea from Jennifer Scmidt at Wash U and expanded on it.

Hello everyone,

I hope this message finds you well. I have a question regarding how clinical service is counted toward annual requirements in your programs. In our GIM division, we have long been dualist physicians, but I'm encountering some pushback from leadership regarding how hospital service with residents is viewed. Specifically, they suggest that service with residents may be considered less intense than shifts with direct patient care, and therefore may not count the same toward clinical service weeks.

I'm interested in understanding how other programs handle this distinction. Do you count hospitalist service with residents differently than direct care when calculating clinical service weeks?

Thank you in advance for your insights.

Best regards,
David

David

As we are moving to introduce non-teaching teams, I have been struggling with how to do this also.
As Randy stated, I envision the direct care teams to have fewer patients, so that kind of offsets the patient workload.

The challenge for me is coverage. A direct patient care team needs someone in the building 24/7, whereas the teaching teams, the attendings can sneak out early as the residents are the ones in the building 24/7.  Direct patient care may have a lower census, but they are there for longer hours.
Instead of thinking of it in terms of clinical service weeks, I'd like to define it as salary per effort.
I am trying to get to 24 weeks total for our hospitalist faculty, and use that as 80% clinical, 100% full time for everyone.
Then figure out how much service on direct care vs teaching and translate that into percent effort terms: 12 weeks teaching = 40%, + 12 weeks direct 40%, then the 20% admin.
I am going to propose a base salary differential based on that.

I got this idea from Jennifer Scmidt at Wash U and expanded on it.

Hello everyone,

I hope this message finds you well. I have a question regarding how clinical service is counted toward annual requirements in your programs. In our GIM division, we have long been dualist physicians, but I'm encountering some pushback from leadership regarding how hospital service with residents is viewed. Specifically, they suggest that service with residents may be considered less intense than shifts with direct patient care, and therefore may not count the same toward clinical service weeks.

I'm interested in understanding how other programs handle this distinction. Do you count hospitalist service with residents differently than direct care when calculating clinical service weeks?

Thank you in advance for your insights.

Best regards,
David