continuity rounding in a rural location

[linguistafeliz]

Hello all,

I am considering a job in a rural area which would be mostly clinic with some pediatric call.

It looks like I will have the option to do hospitalist work (adults) if I choose. However, the other docs in the practice don't currently do this (they have a separate hospitalist group), so I would be going against the grain. I am trying to decide what to propose to the group that wouldn't totally destroy my lifestyle (but also that would be acceptable to the hospitalist group already working there). My ideas were--

1. Offering to round only on my patients (hospitalist group does initial H&P) and only on weekdays
2. offering to do initial H&P on my patients, and let hospitalist group do rounding
3. seeing my patients in the hospital and doing full H&P and rounding and calls but not doing this 24/7 (I.e. take some weeks off)
4. Giving up the continuity of care and just doing shift work such as on the weekends

It sounds like rounding will be totally doable (I can start my clinic a little later on those days). However what worries me is the possibility of being called in to admit one of my patients basically anytime if I open myself up to that. (would constantly have thought of being called in to hospital hanging over me)

I was wondering if anyone here has thoughts/wisdom on how any of these options could work or has experience. I also have no idea how this would affect billing as I'm not completely sure how billing could work for these different options hospitalized patients, i.e. would RVUs get split between me and the hospitalist group?

Complicating everything is that I was considering living a ways from the hospital so would have a commute (likely won't work if I choose continuity rounding).

Please let me know if you have any advice!

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[Bacchus]

The hospitalists would rather do the H&P than the rounds. Pays more, from what I know. I was offered inpatient privileges as I’m at a residency site. Ultimately I said no and I think it was a wise decision. That’s based on gut feeling alone.

 

[Keona]

I am in a rural setting and technically have full hospital staff privileges at the hospital in town. I have no desire to round on patients in patient. The group used to and has now stopped. It is intrusive into the day to have to take hospital calls all day on your patient in the hospital. The continuity aspect would be great though but I think it would negatively impact work life balance.

 

[deleted87716]

the other docs in the practice don't currently do this (they have a separate hospitalist group), so I would be going against the grain.

Well, there ya' go.