Hospitalists have transformed the delivery of hospital care in America. It's WIN-WIN on all fronts and hospitals have recognized the value they bring by supporting (some call it subsidizing) income and compensation to correct for the catastrophic compensation failures of evaluation and management which can viewed in relationship to the hospitalist RVU benchmarks and standards and the hospitalist compensation /wRVU standards.
Hospitalist salary and compensation survey data collected by a collaboration between the Society of Hospital Medicine (SHM) and the Medical Group Management Association (MGMA) for 2011 (using 2010 data), officially reported at the May 2011 HM conference and scheduled for sale in September, 2011, indicates that hospital payments to hospitalists have sky rocked almost 40% higher in the last year.
How high is the average hospitalist support payment now? Try $136,400 per hospitalist, per year. That's more than double the $60,000 reported in the original SHM data survey almost a decade ago and almost 40% higher than the average $98,253 subsidy payment per hospitalist per year reported on last year's Hospitalist Salary and Compensation Report for 2010 (SHM/MGMA). You can also review this years 2011 Hospitalist Salary Survey by Today's Hospitalist for great information.
How high is the average hospitalist support payment now? Try $136,400 per hospitalist, per year. That's more than double the $60,000 reported in the original SHM data survey almost a decade ago and almost 40% higher than the average $98,253 subsidy payment per hospitalist per year reported on last year's Hospitalist Salary and Compensation Report for 2010 (SHM/MGMA). You can also review this years 2011 Hospitalist Salary Survey by Today's Hospitalist for great information.
Richard Quinn over at The Hospitalist reports his take on this trend by suggesting that this trend is not sustainable. I disagree with that assertion and here's why. I think it has taken a decade for hospital administrators to stop viewing hospitalist support payments as an expense and to start viewing them as an asset. They are just now realizing how valuable we are. That's right folks, it's not every day an expense can be considered an asset. But it is for hospitalists. I believe the people writing those checks are just now getting it and you're seeing that with the rapid rise in support payments.
Strictly speaking, providing $136,000 per hospitalist per year seems like an extraordinary expense and burden for hospitals that are being buried under negative hospital Medicare margins and an expanding Medicaid program. Hospitals cannot survive on Medicaid and they know what's coming.
Hospitals have a lot of head winds in their future. Yet, they continue to cross subsidize hospitalists at rising rates not seen in any other area of medicine. There's only one reason why that makes sense. We are undervalued. The market is telling you we are undervalued. In fact, I'd liken hospitalists to a bar of gold:
We are expensive, but our value keeps rising with every peripheral event. Hospitals are paying a lot to hoard us knowing that their expense now means they will have an asset that protects them against the coming economic calamity they see brewing.
If you look at the 57 million dollar return on investment, administrators who get it understand that a great hospitalist group is worth their weight in gold. Is $136,000 a lot of money to pay a doctor to provide care? Yes. Is it a lot in the context of the direct and indirect benefits a hospital will see on the back end, now and into the future? Not even close.
I contend that hospital administrators could double or triple that support payment and still feel strongly that their return on investment is better than every other expense in the hospital, including their own salaries. Hospitalists are cheap and their return on investment would shock anyone who has actually sat down and understood the numbers.
Since this is an effort in collaboration, here's what hospitals can do for hospitalists. Make our jobs easier to provide excellent care at an affordable price. That means, you need to remove obstructions to our work flow. We need wireless, on the go, at the bedside access to patient information, past and present 24 hours a day with high reliability. We need systems that seemlessly implement quality measures without making our lives one obstuctive headache after another.
We need physicians deeply involved in every step of every IT initiative at all times and we need you to understand that the path of least resistince will be the path most often taken. That means, if the path of least resistance produces bad quality care, you're going to get bad quality care. Don't let that happen. Make it right from the beginning. We don't have cheap residents and medical students doing our work for us. Make our job hard to do and it's going to be very expensive for you to fix.
Now, if you can provide this amazing environment for us, and our patients, you will not only increase your market share, you will also need fewer hospitalists doing the same amount of work. That's how you can bring hospitalist efficiency to the forefront and save yourself some money on the back end. Because we're only going to get more expensive. That's what the market is telling you.
That's why I'm a fan of rounding with my iPad. That's why I'm a fan of the checklist prompting study. That's why I'm a fan of the computerized whiteboard.
Without IT support in our day, our patients lose. And you have to pay for more hospitalists to realize the same return on your investment. Spend the money. Make it right the first time and let us do our jobs. You'll realize no matter what you pay us, it will be worth it.
Also check out the effect of hospitalist salary vs productivity.
Also check out the effect of hospitalist salary vs productivity.
LINK TO E/M POCKET REFERENCE CARD POST
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- electronic medical records
- medical billing software
- scheduling software
- technology, security and certifications
Other useful information is available at my EHR Resource Center. 
