Consultant model at Lifepoint

[PMRorBUST]

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I currently work at a lifepoint facility where PM&R is primary and we typically have medicine covering all of our patients. Nursing typically calls primary first for medical issues especially overnight.

I wanted to pitch to the program director if we can switch to a consultant model but I’m not sure how to go about it. I have heard of Encompass using this model in some facilities but has anyone heard about Lifepoint using this model anywhere?

 

[RangerBob]

I know of at least one Lifepoint facility that does this--it's a location that has been really hard to recruit sufficient physiatrists to, so I think it was primarily done to prevent burnout for their physiatrist.

There are obviously downsides to being a consultant (you usually can't bill as high a level, it's harder to justify seeing the patient daily/more than 3x per week if you're not changing anything, down the line there's the question of why even pay PM&R to consult when the hospitalist has enough experience to serve as a "rehab physician," etc. But there are upsides as well (mostly for the physiatrist's QOL).

Why is nursing calling primary for medical issues overnight? We have 24/7 hospitalist coverage as well. Anything rehab goes to PM&R, anything medical (including abrupt change in status) goes to IM, then we get an "FYI" call/text if needed during waking hours unless we need to put in orders to transfer a patient overnight. While nursing often has trouble differentiating who to call/sometimes gets lazy and just calls primary (us), the night team has pretty well learned what's worthwhile to wake a doc up for, and what goes to the hospitalist. As a result, I get perhaps one call a month overnight.

 

[piviti]

Just do a bad job so they have no choice but to make you a consultant.