Wednesday, November 18, 2009

How should hospitalists be cultivated?

Here are the two competing models: 1) as clinicians at the top of their game and 2) as stage performers. I’ve been in the field since its beginnings and over the years I’ve seen it devolve from model number 1 towards model number 2. If the practice management track at SHM 2009 is any indication, model 2 is winning. Not a good thing, in my opinion.

The title of hospitalist leader Mary Jo Gorman’s talk about running a program is a dead giveaway: “Performance Reviews: Dealing with the Problem Performer.” I don’t run a hospitalist program but if I did I’d be more interested in how my hospitalists functioned as clinicians than how they performed. Anyway, the focus of the talk was on behavior and conformity. Clinical skills were mentioned only in passing.

There were some good points in the talk. Most importantly, don’t expect the hospitalists on your team to read minds. Be clear in your expectations. Good, explicit communication (not just abstract goals like “be a team player”) solves a lot of problems. And yes, rules are important, but tools---tools that help the hospitalist function optimally as a clinician---are even better.

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