Cleveland-based University Hospitals marked its strongest year ever in 2007, netting an operating income of $104 million. The amount is nearly four times the $28 million earned in 2004. The system also posted operating losses from 1994 through 2003, said University representatives. The biggest challenges for University Hospitals this year are likely to be uncertainties posed by a presidential election year and state budget shortfall, as well as continued progress on its strategic plan, the representatives added.
Cleveland-based MetroHealth Medical Center plans to layoff 73 people in an effort to reduce costs by $17 million. The hospital lost $8 million in the first quarter of this year, after losing $6 million for all of 2007. MetroHealth is the safety-net hospital for the poor, and its loss came partly because of an increase in uninsured patients, said hospital representatives.
Twenty years ago, locum tenens physicians were a relative anomaly at hospitals and medical groups. Today, 77% of facilities are using locum tenens physicians to maintain services while they seek hard-to-find permanent staff, a trend driven in part by the physician shortage.
Locum tenens physicians are important to providing continuity of care, but their impact on revenue should also be considered. By treating patients who might otherwise not have been seen or who may have gone elsewhere, they can maintain revenue streams in the absence of permanent physicians.
Locum tenens physicians are paid on a per diem basis, and from the facility’s perspective, daily rates must be balanced against revenues that physicians are likely to generate while working as locum tenens to measure a return on investment. The daily rate for a family practitioner, for example, is in the $750–$800 range. Rates are similar for general internists and run several hundred dollars per day higher for surgeons.
On average, a family physician generates approximately $1,433,000 a year on behalf of his or her affiliated hospital, according to Merritt, Hawkins & Associates’ 2007 Survey of Physician Inpatient/Outpatient Revenue. This equates to approximately $4,000 per day.
Similarly, a general surgeon generates about $2 million a year on average for his or her affiliated hospital, based on the Merritt Hawkins survey. This equates to about $5,400 per day. In some situations, locum tenens physicians will be net revenue producers, in some cases they are a break-even proposition, and there are instances when they represent a net cost.
However, additional factors should be considered. By helping to alleviate physician burn-out, particularly in cases where deficits on the permanent staff are causing physicians to be overworked, locum tenens physicians can prevent the significant cost of physician turnover. Long-term, locum tenens physicians can help maintain patient satisfaction levels, which have a considerable impact on the reputation and market brand value of hospitals and medical groups.
Like other types of temporary clinical professionals, locum tenens physicians provide the most value when they are integrated into a facility’s strategic staff plan. Planning in advance to use locum tenens physicians during peak usage times, to transition the practices of retiring physicians, and in other situations, is less stressful and often less costly than turning to them in emergencies. As a growing number of doctors embrace alternative practice styles, locum tenens physicians are one more piece of an increasingly varied mosaic.
This story was adapted from one that first appeared in the May edition of Physician Compensation & Recruitment, a monthly publication by HealthLeaders Media.
A teacher at the Hospital of the University of Pennsylvania is leading a worldwide network of Myanmar-educated physicians in launching a relief effort to get aid to victims of a catastrophic cyclone in Myanmar. Jennifer Chu, a Philadelphia physician specializing in pain management, said her group's intention was to "get the relief directly to the people who need it." The organization is called the Alumni Myanmar Institutes of Medicine Association, and hopes to funnel donations directly to doctors on the ground or to the Yangon General Hospital, the one closest to the disaster.
Spanish health authorities have launched a virtual portal through the Second Life Web site designed to help young people too embarrassed to speak to a doctor about potentially embarrassing problems, such as addiction or sexually transmitted diseases. Real doctors will log on and offer advice to their anonymous patients, and both will see an image of a consulting room with a doctor and a typical patient. The authorities said the idea started as a way to connect health professionals and adolescents and to give internet users a reliable space to get health advice.
Scientists at McGill University in Montreal have developed an automated anesthesiologist, and believe they are the first in the world to perform surgery using a totally automated system for administering the drugs needed for general anesthetic. The computerized system administers three standard drugs used for putting patients under for surgery and monitors their separate effects automatically. Researchers say "McSleepy" can calculate the appropriate drug doses for any given moment of anesthesia faster and more precisely than a human.