Comments on: Hospitalists and referrals http://www.kevinmd.com/blog/2008/03/hospitalists-and-referrals.html Tue, 14 Feb 2012 17:18:00 +0000 hourly 1 By: Anonymoushttp://www.kevinmd.com/blog/2008/03/hospitalists-and-referrals.html#comment-84672 Anonymous Tue, 01 Apr 2008 01:01:00 +0000 http://clients.emmense.com/kevinmd/2008/03/hospitalists-and-referrals.html#comment-84672 I worked as a hospitalist in a poor inner city hospital for 4 months. (4 months too long) It was subsidized by the hospital because there were so many uninsured patients. The year I was there, the hospital was losing money. <br/><br/>While I was there, a few of the specialists just said outright--"we don't see your patients". GI especially. They knew that our mix was caustic. If the mix was closer to 80% insured/20% uninsured, they might agree, but it was probably the reverse.<br/><br/>At these poorer hospitals, the administration will occasionally say to the specialists--sign up for unassigned call or give up your priviliges. We would routinely have to call administration to lean on the hand surgeons who didn't want to operate on the homeless guys that rolled in with hand catastrophes.<br/><br/>The point in all this is that you want to avoid getting yourself in either of these situations, being the hospitalist in an 80/20 hospital and being a specialist in an 80/20 hospital, especially one whose business is dependent on hospital work. It is easier to move to a better location/better hospital.<br/>b I worked as a hospitalist in a poor inner city hospital for 4 months. (4 months too long) It was subsidized by the hospital because there were so many uninsured patients. The year I was there, the hospital was losing money.

While I was there, a few of the specialists just said outright–”we don’t see your patients”. GI especially. They knew that our mix was caustic. If the mix was closer to 80% insured/20% uninsured, they might agree, but it was probably the reverse.

At these poorer hospitals, the administration will occasionally say to the specialists–sign up for unassigned call or give up your priviliges. We would routinely have to call administration to lean on the hand surgeons who didn’t want to operate on the homeless guys that rolled in with hand catastrophes.

The point in all this is that you want to avoid getting yourself in either of these situations, being the hospitalist in an 80/20 hospital and being a specialist in an 80/20 hospital, especially one whose business is dependent on hospital work. It is easier to move to a better location/better hospital.
b

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/03/hospitalists-and-referrals.html#comment-84666 Anonymous Mon, 31 Mar 2008 19:41:00 +0000 http://clients.emmense.com/kevinmd/2008/03/hospitalists-and-referrals.html#comment-84666 I think happy is overestimating his impact. Specialists know who has outpatient practices and who does not and most adjust their "back stratching" accordingly. Since most hospitalists don't have an outpatient practice they don't have access to the 20 good paying outpatient procedures he suggests and tend to give nothing but no pay bogus consults on people that are prone to more complications in the first place. The office docs have that access. One specialist I know says take care of your office docs like they hold the mortgage to your house, piss off the hospitalists so they don't consult you and you'll never regret it. I think happy is overestimating his impact. Specialists know who has outpatient practices and who does not and most adjust their “back stratching” accordingly. Since most hospitalists don’t have an outpatient practice they don’t have access to the 20 good paying outpatient procedures he suggests and tend to give nothing but no pay bogus consults on people that are prone to more complications in the first place. The office docs have that access. One specialist I know says take care of your office docs like they hold the mortgage to your house, piss off the hospitalists so they don’t consult you and you’ll never regret it.

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