Recruiting hospitalists could help primary care workforce shortage

0 | Health Care Delivery, Workforce, Health Reform

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courtesy Via Christi

Drs. Matt Voth, left, and Brooke Grizzell, hold a newborn during a shift at Via Christi hospital in Wichita. They are among the growing number of physicians who choose to work exclusively in hospitals, a job they say allows more flexibility and free time.

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— Hospitals in cities such as Wichita and Topeka are finding that hospitalist positions are becoming an important recruiting tool.

“Wichita, Kansas is not at the top of everybody’s list,” said Dr. Hewitt Goodpasture, vice president for clinical quality and patient safety at Via Christi. “(Physicians) want to go to San Diego or wherever they think the quality of life away from the hospital will be better.”

Via Christi is preparing to almost double the number of hospitalists from five to nine next month, said Laura Hill, the hospital’s executive director of medical staff operations and physician employment. Other hospitalists who work for private practice groups also practice in their facilities.

The flexible schedules remain the biggest draw for young physicians who fear long days and too much time away from family.

“One thing you hear universally is that physicians want balance in their lives and predictability,” Hill said. “But medicine is not predictable.”

Having hospitalists on staff also helps with the recruiting of primary care physicians who are equally concerned about long hours and family time cut short, said Dr. Kent Palmberg, senior vice president and chief medical officer for Stormont-Vail HealthCare in Topeka.

“I could not effectively recruit new primary care docs to this community without a strong hospitalist program. I just couldn’t do it,” he said. “And I think a lot of hospitalists would say ‘our job is to help the primary care providers have a life.’ They work very, very hard when they’re here, and then they go home and have a life as well.”

About half of primary care physicians graduating from residency programs are women, Palmberg said.

Many of those women are becoming increasingly interested in hospitalist positions, he said.

“Many have families and want to know if we have a hospitalist program,” he said. “They say they can’t do office work, hospital work and be a mom. Most female primary care docs don’t do hospital work. And most patients are really understanding of that.”

Times are changing, Goodpasture said, from the days when a primary care physician graduated from medical school, moved to a new town and built their own practice.

“It takes a while to do that,” he said. “It takes a while for that physician to leave and go someplace else. There’s a strong incentive to stay someplace once you’ve gotten established. Hospitalists obviously don’t have the same relationships. There’s a lot more mobility, and a lot more turnover. That’s a challenge for us.”

Via Christi has overcome some of those challenges by being flexible with its programs.

Dr. Matt Voth, who works as a laborist for Via Christi, is starting a “hybrid” practice with four other doctors who will provide inpatient obstetrics for the organization’s newest hospital in West Wichita.

Beginning in July, the physicians will accept patients in a clinic adjacent to the hospital. The proximity will allow them to conduct outpatient office visits but be close enough to deliver babies when the time comes without a long drive across town.

The arrangement allows Voth and the others to develop relationships to their patients that they otherwise wouldn’t experience, he said.

“I can’t tell you how many people have told me that if this had been available when they came out of residency they would have done this,” he said. “It wasn’t very difficult to recruit at all. A couple came to me when they heard I was thinking about doing this.”