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The Hospital’s New “Home Team” How Hospitalists Can Help Shape the

Emerging Medical Staff Model

Practice Administrators' Roundtable Series X

February 9, 2012

Presenters

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

The Hospital Medicine “Drivers”

• 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

The Unintended Consequences

• 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

Medical Staff Bylaws

• 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

Polling Question

• Do your medical staff bylaws have a staff category for outpatient only providers?

o Yeso Noo Currently developing a new categoryo Unsure

Planning for the Future

• 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

Hospital MedicineShaping New Medical Staff Models

• 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 MedicineShaping New Medical Staff Models

• 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

Polling Question

• Hospital Medicine physicians fulfilling Medical Staff leadership responsibilities are a difficult commitment and burdensome.

o Agreeo Somewhat agreeo Disagreeo Unsure

Thank you for your time today