The Hospital’s New “Home Team” How Hospitalists Can Help Shape the Emerging Medical Staff Model

Jasen W. Gundersen, M.D., MBA, CPE, SFHM President & Chief Medical Officer TeamHealth Hospital Medicine Mark Sey, Pharm.D., MBA Vice President & Chief Administrative Officer Lodi Memorial Hospital

Care for the uninsured Provider preference for employment models Improve costs / length of stay “Demand” from other providers –Co-management of surgical patients Quality / Patient Safety Hospital initiatives –Electronic Health Record –Avoiding unnecessary readmissions –Bundled payments

Provider passive separation from the Hospital Active separation by directly competing with Hospital Provider disillusion with Hospital “change” Reduction in focus within Medical Staff Departments

Complicating the evolutionary changes of traditional Medical Staff models –Changing or altering the bylaws is not easy –May not be in sync with current practice patterns Affect on the ‘new medical staff’ –More time demands on limited providers –The role of the EMR Staff Categories Maintaining synchronization with hospital administration

Do your medical staff bylaws have a staff category for outpatient only providers? o Yes o No o Currently developing a new category o Unsure

Community provider involvement remains CRITICAL –Care transition programs –Role in admission/readmission management –Improving ambulatory care sensitive admissions Develop new staff categories –Maintain ‘active’ role Maintain relationships between inpatient & outpatient providers –Quarterly Meetings –Newsletters

Department or Division –Depends on size of program Credentialing/Delineation of Privileges –Assure current with practice patterns Block scheduling and provider participation Supporting committee work and development The high cost of turnover –Individual vs. Group –A ‘problem’ for the specialty

Hospital Medicine physician engagement –Varying levels of commitment –Identifying areas of interest –Encouraging program/project “ownership” Shaping more than the Medical Staff Compensation –Direct –Workload reductions

Hospital Medicine physicians fulfilling Medical Staff leadership responsibilities are a difficult commitment and burdensome. o Agree o Somewhat agree o Disagree o Unsure