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Battling Hospitalist Burnout Higher Salaries Are Not Sufficient September 2019 KEY CLINICAL QUESTION IN THE LITERATURE PEDIATRIC HM 2019 Volume 23 No. 9 Alcohol withdrawal in Antiplatelet therapy Conference coverage p13 hospitalized patients p16 after ICH p20 starts here Battling hospitalist burnout Higher salaries are not sufficient By Thomas R. Collins ospitalist Rahul C. Borsadia, MD, had been working with Orlando Health Inpatient Medicine Group since the year of its founding in 2011. HThe salaries of the practice’s physicians back then were based on relative value units (RVU) – the more patients that physicians saw, the higher their salaries. But a problem arose, Dr. Borsadia said. Physicians were trying to squeeze in two dozen or more patients a day “in a practice that is modeled for quality.” “By the time the end of the day comes, it’s 9 or 10 p.m. and you are leaving but coming back at 6:30 the next morning. So, lack of sleep, more patients, striving to earn that higher salary,” he said. “The desire to perform quality work with that kind of patient load was not fulfilled and that led to dissatisfac- tion and stress, which led to irritation and exodus from the group.” Three years ago, the practice transitioned to a throughput process with a census limit of 18 patients or fewer, without an RVU system, but with salary incentives based on patient satis- faction, billing, and documentation. Continued on page 11 ® the-hospitalist.org Dr. Mangla Gulati Photograph by Christopher Lewkovich SURVEY INSIGHTS GUIDELINES Isha Puri, MD, MPH Matthew Tuck, MD, MEd, FACP Observation versus Reversal agents for direct- Lebanon Jct. KY Jct. Lebanon Denville, NJ 07834-3000 NJ Denville, Permit No. 384 No. Permit p9 inpatient status. p31 acting oral anticoagulants. PAID 3000, Box P.O. U.S. Postage U.S. CHANGE SERVICE REQUESTED SERVICE CHANGE THE HOSPITALIST THE Presorted Standard Standard Presorted September 2019 Volume 23 No. 9 PHYSICIAN EDITOR THE SOCIETY OF HOSPITAL MEDICINE Danielle B. Scheurer, MD, SFHM, MSCR; Phone: 800-843-3360 Come for the Education. [email protected] Fax: 267-702-2690 Website: www.HospitalMedicine.org Stay for the Movement. PEDIATRIC EDITOR Laurence Wellikson, MD, MHM, CEO Anika Kumar, MD, FAAP Vice President of Marketing & [email protected] Communications COORDINATING EDITORS Lisa Zoks Dennis Chang, MD [email protected] THE FUTURE HOSPITALIST Marketing Communications Manager Brett Radler Jonathan Pell, MD [email protected] KEY CLINICAL GUIDELINES Marketing Communications Specialist CONTRIBUTING WRITERS Caitlin Cowan [email protected] Veevek Agrawal, DO; Svetlana Chernyavsky, DO; Thomas R. Collins; SHM BOARD OF DIRECTORS Jeff Craven; Steven Deitelzweig, MD, President SFHM, MMM; Patricia Dharapak, MD; Halle Christopher Frost, MD, SFHM Field, MD; Erica Grabscheid, MD; Caley President-Elect McIntyre, MD; Eve Merrill, MD; Danielle Scheurer, MD, MSCR, SFHM Ryan Nelson, MD; Jeremiah Newsom, MD, Treasurer MSPH; M. Alexander Otto; Matt Pesyna; Tracy Cardin, ACNP-BC, SFHM Kamana Pillay, MD; Isha Puri, MD, MPH; Secretary Dahlia Rizk, DO, MPH; Kristen Rogers, MD, Rachel Thompson, MD, MPH, SFHM MPH; Matthew Tuck, MD, MEd, FACP Immediate Past President Nasim Afsar, MD, MBA, SFHM FRONTLINE MEDICAL Board of Directors COMMUNICATIONS EDITORIAL STAFF Steven B. Deitelzweig, MD, MMM, SFHM Editor in Chief Mary Jo M. Dales Bryce Gartland, MD, FHM Executive Editors Denise Fulton, Flora Kisuule, MD, MPH, SFHM Kathy Scarbeck Kris Rehm, MD, SFHM Editor Richard Pizzi Mark W. Shen, MD, SFHM Creative Director Louise A. Koenig Jerome C. Siy, MD, SFHM Director, Production/Manufacturing Chad T. 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Trask, FACHE, MBA, MHA, Linda Wilson, 973-290-8243 SFHM; Amit Vashist, MD, FACP; [email protected] Jill Waldman, MD, SFHM Senior Director of Classified Sales HM20 is the largest national Tim LaPella, 484-921-5001 cell 610-506-3474 [email protected] gathering of hospitalists in Advertising Offices 7 Century Drive, Suite 302, Parsippany, NJ 07054-4609 the United States, and offers 973-206-3434, fax 973-206-9378 a comprehensive array of THE HOSPITALIST is the official newspaper of the THE HOSPITALIST (ISSN 1553-085X) is published Society of Hospital Medicine, reporting on issues monthly for the Society of Hospital Medicine by and trends in hospital medicine. THE HOSPITALIST Frontline Medical Communications Inc., 7 Century educational and networking reaches more than 35,000 hospitalists, physician Drive, Suite 302, Parsippany, NJ 07054-4609. Print assistants, nurse practitioners, medical residents, and subscriptions are free for Society of Hospital Medi- health care administrators interested in the practice cine members. Annual paid subscriptions are avail- opportunities designed and business of hospital medicine. Content for able to all others for the following rates: THE HOSPITALIST is provided by Frontline Medical Domestic specifically for the hospital Communications. Content for the Society Pages is Individual: – $184 (One Year), provided by the Society of Hospital Medicine. $343 (Two Years), $495 (Three Years), Canada/Mexico – $271 (One Year), $489 (Two Years), Copyright 2019 Society of Hospital Medicine. All $753 (Three Years), Other Nations-Surface – $335 medicine professional. rights reserved. No part of this publication may be (One Year), $646 (Two Years), $946 (Three Years), reproduced, stored, or transmitted in any form or by Other Nations - Air – $431 (One Year), any means and without the prior permission in writing $835 (Two Years), $1,264 (Three Years) from the copyright holder. The ideas and opinions New to SHM? expressed in The Hospitalist do not necessarily Institution: United States – $382; reflect those of the Society or the Publisher. The Canada/Mexico – $463 All Other Nations – $537 Society of Hospital Medicine and Frontline Medical Student/Resident: $51 Receive one year of FREE Communications will not assume responsibility for damages, loss, or claims of any kind arising from Single Issue: Current – $35 (US), $47 (Canada/ membership with registration! or related to the information contained in this Mexico), $59 (All Other Nations) Back Issue – $47 publication, including any claims related to the (US), $59 (Canada/Mexico), $71 (All Other Nations) products, drugs, or services mentioned herein. POSTMASTER: Send changes of address (with old SHMANNUALCONFERENCE.ORG Letters to the Editor: [email protected] mailing label) to THE HOSPITALIST, Subscription Services, P.O. Box 3000, Denville, NJ 07834-3000. The Society of Hospital Medicine’s headquarters is located at 1500 Spring Garden, Suite 501, RECIPIENT: To subscribe, change your address, Philadelphia, PA 19130. purchase a single issue, file a missing issue claim, or have any questions or changes related to your Editorial Offices: 2275 Research Blvd, Suite 400, subscription, call Subscription Services at 1-833-836- Rockville, MD 20850, 240-221-2400, fax 240-221-2548 2705 or e-mail [email protected]. BPA Worldwide is a global industry resource for verified audience data and The Hospitalist is a member. To learn more about SHM’s relationship with industry partners, visit www.hospitalmedicine.com/industry. September 2019 | 2 | The Hospitalist HOSP_3.indd 1 7/25/2019 1:38:55 PM FROM THE SOCIETY Laurence Wellikson, MD, MHM, announces retirement as CEO of SHM Society recognizes Dr. Wellikson’s leadership, retains Spencer Stuart for successor search fter serving as the first bership but also its diverse portfolio hospitalist specialty code, and earned “On behalf of the society and its and only chief executive of offerings for hospital medicine the John M. Eisenberg Patient Safety members, I want to extend a sincere officer of the Society of professionals under Dr. Wellikson’s and Quality Award for its quality im- thank you to Larry for his years Hospital Medicine since leadership. Its first annual confer- provement programs. These are just of dedication and service to SHM, AJanuary of 2000, Laurence Wellik- ence welcomed approximately 300 a few of the noteworthy accomplish- its staff, and the hospital medicine son, MD, MHM, has announced his attendees; the most recent confer- ments that professionals we serve,” said Chris- retirement effective on Dec. 31, 2020. ence, Hospital Medicine 2019, saw have elevat- topher Frost, MD, SFHM, president In parallel, the SHM Board of Direc- that number increase more than ed SHM as a of SHM’s Board of Directors. “His tors has commenced a search for his 10-fold to nearly 4,000. Its con- key partner legacy will allow SHM to continue successor. ferences, publications, online for hospital- its growth trajectory through key “When I began as CEO 20 years education, chapter program, advo- ists and their programs and services supporting ago, SHM – then known as the cacy efforts, quality improvement institutions. members’ needs for years to come. National Association of Inpatient programs, and more have evolved To assist Larry has taken the specialty of Physicians – was a young national significantly to ensure hospitalists with the hospital medicine and created a organization with approximately at all stages of their careers – and search for movement in SHM, where the entire 500 members, and there was mini- those who support them – have ac- SHM’s next hospital medicine team can come mal understanding as to the value cess to resources to keep them up to CEO, the for education, community, and that hospitalists could add to their date and demonstrate their value in Dr.
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