Posts by admin

Survey data is often much more complicated to interpret than it first appears

John Nelson writes... Compensation and production surveys generally set the standard on physician compensation and production.  The longer I spend looking at survey methodologies and results, the more I’m convinced that there are a lot of devils in the details that may misled many people who rely on these surveys.  As an example, I’ve adapted below something originally written by, Leslie Flores, who is the director of SHM’s Practice Management Institute and my consulting colleague.  What follows was written in response to a question about the differences in the SHM and MGMA surveys of hospitalist productivity and compensation, especially related to their results in the South.  It serves an example of the complexity of interpreting the surveys. (more…)

How much is enough? Issues related to what defines full-time work for a hospitalist

John Nelson writes... In my work with practices around the country, I’m struck by the wide variation in how each practice defines what constitutes full-time work.  This is a pretty big deal for reasons that are obvious and not so obvious. Say you’re in a practice that defines full-time as 181 shifts annually.  The practice across town provides higher compensation and also requires 181 shifts annually.  The other practice gets a better deal, right?  (more…)

Readmissions – A Case Study on Managing Expectations

Robert Chang writes... Stephen Jencks, Mark Williams and Eric Coleman recently published what some rightfully consider a landmark article in NEJM 2009 that discusses the readmission rates in the Medicare population.  Most of us have some awareness that the readmission rate is high although I doubt most would have empirically said 1 in 5. Some significant proportion of these readmissions is preventable.  The Society of Hospital Medicine has collected a large number of resources in Project BOOST and hospitalists in our institution are eagerly participating.  We all can recollect patients that “if only”…perhaps they wouldn’t have had to return to the hospital.   (more…)

The Question No One is Asking

Rob Bessler writes... When is the conversation going to switch to the rationing of care? Everyone knows about all the costs in the system during the end stage of life. Should the government pay for this for everyone? (more…)

Giving meaningful evaluations

Rob Chang writes... It’s the end of the year and evaluation time has come around again. It’s a laborious process.  Self-assessments, peer assessments, nursing assessments, patient assessments, director assessments….  Thick stapled sheets of papers coated with numbers and ratings lay stacked and scattered across the lined dark carpet and desk in my office, each pile somehow representing the culmination of a year’s worth of effort.  The sheer amount of paperwork could likely reconstitute a small forest. (more…)