Thriving and Surviving in a New Medical Career: The Case of Hospitalist Physicians

Hoff, Timothy; Whitcomb, Winthrop F.; Nelson, John

doi:10.2307/3090246

Cited by 89 publications

(36 citation statements)

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“…The patient's primary physician does not visit the patient on a daily basis. Rather, he or she allocates his or her patient's care to the hospitalist during the patient's hospital stay (Hoff, Whitcomb, & Nelson, 2002). The hospitalist's duty, specifically, is to manage various aspects of the patient's care.…”

Section: Meaning Of Medical Encountersmentioning

confidence: 99%

Effective Doctor–Patient Communication: An Updated Examination

Matusitz

Spear

2014

Social Work in Public Health

130

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This article examines, in detail, the quality of doctor-patient interaction. Doctor-patient communication is such a powerful indicator of health care quality that it can determine patients' self-management behavior and health outcomes. The medical visit (i.e., the medical encounter) plays a pivotal role in the health care process. In fact, doctor-patient communication is one of the most essential dynamics in health care, affecting the course of patient care and patient compliance with recommendations for care. Unlike many other analyses (that often look at only one or two specific aspects of doctor-patient relationships), this analysis is more encompassing; it looks at doctor-patient communication from multiple perspectives.

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Section: Meaning Of Medical Encountersmentioning

confidence: 99%

Effective Doctor–Patient Communication: An Updated Examination

Matusitz

Spear

2014

Social Work in Public Health

130

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“…Also, unlike Keeton et al, [74] we found no independent multivariate effect (despite a significant bivariate effect) for autonomy probably due to some confounding with relatedness. The more significant multivariate effect of relational needs when compared to autonomy contradicts the popular stereotype of providers, especially physicians, [53] as "lone wolf" professionals. The respondents reported professional social interactions as being central to their well-being.…”

Section: Discussionmentioning

confidence: 92%

“…[50,51] Healthy professional relationships help providers to cope with job stresses/strains [52] and are associated with lower burnout. [53] Supportive relationships with their professional colleagues are valued more than employee assistance programs instituted by management. [54] The lower the amount of self-determination/autonomy that practitioners can exercise, the more they tend to lean on supportive relationships.…”

Section: Discussionmentioning

confidence: 99%

“…[55] Workplace relationships influence providers' attrition from practice. [53,56] Among employed providers, social relationships influence the quality of work life more significantly than staff support, job control, income, or time pressure. [57] Electronic medical records (EMRs) have diminished the time that providers spend in direct contact with patients.…”

Section: Discussionmentioning

confidence: 99%

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Predictors of burnout among physicians and advanced-practice clinicians in central New York

Waddimba

Nieves

Scribani

et al. 2015

JHA

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Background: Provider wellbeing is a barometer of the strength of healthcare systems/organizations. Burnout prevalence among physicians exceeds that among other adult workers in the United States. Rural-based practitioners might be at greater risk. Objective: We investigated predictors of burnout among group-employed providers within an integrated healthcare network. Methods: In a prospective observational study of physicians/advanced-practice clinicians serving an 8-county region of central New York, we linked administrative practice-setting data with responses to a questionnaire-survey comprising validated measures of burnout, resilience, work meaningfulness, satisfaction, risk aversion, and uncertainty/ambiguity tolerance. We included providers on the official payroll, excepting advisory board and/or research team members plus those who retired, resigned or were fired. 308 (65.1%) of 473 eligible clinicians completed the survey. 59.1% of these were physicians/doctoral-level practitioners; 40.9% advanced-practice clinicians. We assessed burnout using a validated 5-level single-item measure formatted as a binary outcome of "burned out/burning out" (levels 3-5) versus not. We derived a parsimonious generalized linear mixed-effects regression of this outcome on provider demographics, work-related needs, risk aversion, satisfaction, and unit characteristics. Results: Perceived workload, relatedness needs, practice satisfaction ≥ 75% of the time, dissatisfaction ≥ 50%, resilience, and practicing on a small unit were the significant, independent predictors. Conclusions: Heavy workloads, unmet relational needs, frequent dissatisfaction, low resilience, and serving on a small unit were most significantly associated with being "burned out/burning out". Feeling satisfied most of the time and high resilience were protective. Profession, specialty, autonomy, and support staffing were not statistically significant.

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“…There is already a recognized trend for many PCPs to focus on office practice and reduce or eliminate responsibility for hospital inpatients (Chesanow 1997). Time spent out of the office by PCPs to provide care for hospitalized patients is seldom time efficient or cost-effective (Bagley 2002), especially in a reimbursement environment in which each new outpatient represents additional income for the PCP through capitation (Hoff, Whitcomb, and Nelson 2002). Primary care groups using hospitalists gain 4 hours of office time per week to see patients because they no longer must do rounds (Plocher, Stanford, and Meltzer 1998).…”

Section: Expansion Of the Pilot Hospitalist Programmentioning

confidence: 99%

Hospitalists at an Academic Medical Center, Part 2: Guidelines and Suggestions for the Successful Expansion of a Voluntary Pilot Hospitalist Program

2011

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Previously, the authors discussed the successful introduction of a pilot hospitalist program at an academic medical center. Here they examine best practices for the expansion of such a program. Many studies have shown hospitalists to be associated with improvements in hospital quality indicators such as decreased length of stay, but the conditions necessary for the expansion of a hospitalist program have received considerably less attention. The authors review guidelines and empirical evidence from the literature for the successful implementation of hospitalist programs generally and present specific recommendations for a previously described pilot hospitalist program at an academic medical center.

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Thriving and Surviving in a New Medical Career: The Case of Hospitalist Physicians

Cited by 89 publications

References 0 publications

Effective Doctor–Patient Communication: An Updated Examination

Effective Doctor–Patient Communication: An Updated Examination

Predictors of burnout among physicians and advanced-practice clinicians in central New York

Hospitalists at an Academic Medical Center, Part 2: Guidelines and Suggestions for the Successful Expansion of a Voluntary Pilot Hospitalist Program

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