Help! No One Is Using Our Hospitalists!

1Division of Hospital Medicine, St. Josephs Mercy Health Center, Hot Springs, AR

Meeting: Hospital Medicine 2008, April 3-5, San Diego, Calif.

Abstract number: 93


During their fledgling state, many hospitalist programs have struggled from a lack of acceptance among primary care physicians. Multiple stereotypical reasons exist for this problem including financial incentives and personal physician/patient preferences. We present a unique method for the acceptance of a new hospitalist group in a community hospital via the innovation of “social rounding.”


To report a distinctive approach directed toward gaining the acceptance and use of newly established hospitalist programs.


Our facility is a 280‐bed community hospital that directly employed hospitalists to care for unassigned patients and satellite clinics owned by the facility. The local private FP/IM practice was not supportive of such a program for various reasons. A large percentage of primary care physicians were unwilling to part with their patients because of a perceived threat of losing their patients to hospitalists and hospital‐owned practices. There was concern about personal revenue and breaks in long‐established patterns of referral. Last, patient‐related concerns of the seeming void of not having direct contact with their physician were cited as reasons for not using the program. Thus, hospitalists left because of alienation from the medical staff, higher stress from handling complex, uninsured patients, and a lack of financial compensation for nonpayers. A unique methodology to help attract referrals was needed in order to keep the program viable for retention and recruitment.


The social‐rounding system was devised and implemented to help address these concerns. Under this scheme, a hospitalist was designated a “social rounder,” and was freed from clinical responsibilities at preset time intervals to meet with and escort primary physicians to their patients for rounds. During these visits, billing was performed only by the primary physicians and not by the hospitalist team. This practice, though time consuming, served 3 key purposes: (a) built a vital bridge of trust and rapport among PCPs and hospitalists, (b) fostered a team approach such that expectations and concerns of both PCP and hospitalists were communicated, and (c) helped to reassure hospitalist‐naive patients that their physician was still involved in their care. The implementation of a social‐rounding option served to attract many PCPs wary of the hospitalist program to a noncommittal trial of hospitalist services. This has helped salvage, rebuild, and expand hospitalist services.

Author Disclosure:

V. Chopra, none.

To cite this abstract:

Chopra V. Help! No One Is Using Our Hospitalists!. Abstract published at Hospital Medicine 2008, April 3-5, San Diego, Calif. Abstract 93. Journal of Hospital Medicine. 2008; 3 (suppl 1). Accessed March 31, 2020.

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