Trends and Benefits for Hospitalists, and How They Help With Recruitment and Retention

Photo Credit: Vitalii Vodolazskyi - stock.adobe

Every incentive counts when it comes to recruiting and retaining top talent. In particular, today’s hospitalists view funding for continuing medical education (CME) and getting paid time off (PTO) as some of the most important benefits.

“I’ve seen a growing trend in younger candidates asking about CME and PTO during their initial recruitment screening call,” said Vineet Gupta, MD, FACP, CHCQM, SFHM, chair of the recruitment and retention committee and a clinical professor in the department of hospital medicine at the University of California San Diego in San Diego, an academic hospital system with around 800 beds.

Charles LoPresti, MD, SFHM, chief of hospital medicine at University Hospitals in Cleveland, which has 13 adult medical centers, including an academic center and community-based centers, agreed that CME and PTO are extremely important to hospitalists today. “A shift in how hospitalists value work-life balance has occurred,” he said.

According to Thomas Haugh, MBA, FACMPE, executive service line director in the department of adult and pediatric hospital medicine at WakeMed Health & Hospitals in Raleigh, N.C., a not-for-profit community health system with 973 licensed beds, any significant gap in a recruitment package will impact recruitment success. “A comprehensive benefits package along with a competitive salary is vital to recruiting and retaining quality hospitalists,” he said. “If you’re competing against other local hospital systems for talent, your recruitment package must be in line with the competition.” 

Funding for CME

Many medical institutions give a stipend or provide reimbursement for CME. WakeMed Health & Hospitals, for example, gives an annual CME stipend to hospitalists, who are then responsible for remaining compliant with their CME and licensure requirements. Physicians from .75 to 1.0 full-time equivalents receive the full amount in a taxed, lump sum payment, which avoids the hassles of having to track receipts and provide reimbursements, Mr. Haugh said. The allowance is prorated for physicians from .5 to .74 full-time equivalents.

University Hospitals encourages hospitalists to pursue any CME that benefits their knowledge and career. Hospitalists can be reimbursed up to a certain amount for expenses related to society membership fees, travel, online courses, and books.

“Not only do hospitalists benefit by either continuing their medical education or professional development, but our organization also benefits by having hospitalists stay current on changing best practices or gain knowledge that will help them prepare for leadership roles,” Dr. LoPresti said.

Hospitalists at UCSD receive complimentary institutional access to UpToDate, a resource which provides healthcare professionals with clinical and drug information, as well as access to a multitude of CME courses offered by the institution for free or at deeply discounted rates, Dr. Gupta said.

UCSD also covers expenses related to external professional conferences and encourages members to speak at these events as well. Although the university doesn’t offer individual discretionary funds, this may change in the future based on prevailing national trends, Dr. Gupta said.

Amanda Green, MD, chief medical officer in the department of hospital medicine at Paris Regional Health in Paris, Texas, a 152-bed rural community hospital, said hospitalists can submit for reimbursement for CME-related activities and expenses, such as in-person course tuition, books, travel expenses related to taking out-of-town courses, online courses, and memberships to professional organizations. The only requirement is that the expense must be designated as an appropriate education reimbursement expense according to the Internal Revenue Service.

PTO ranks highly

Hospitalists often work in high-stress environments with long shifts, making PTO a critical factor in preventing burnout. Institutions offering more generous PTO policies are therefore more attractive, particularly to younger physicians who prioritize flexibility and mental well-being, Dr. Gupta said.

UCSD gives hospitalists PTO for various reasons, such as childbirth and extended illness, for up to six weeks. PTO is also given for bereavement, jury duty, and family care.

Some may argue that if a hospitalist gets seven days off every other week, they don’t need PTO. “But it’s not necessarily about need,” Dr. LoPresti said. “Hospitalists compress their work into a single work week, so it’s only fair that they’re allowed to have some PTO like their colleagues who work more traditional workweeks.” PTO can be used for vacation and sick days. A separate allowance of days can be used for bereavement, short-term leave, and maternity and paternity leave.

Despite the appeal of PTO, WakeMed Health & Hospitals doesn’t offer it in the traditional way. Full-time hospitalists work an average of 16, 10-hour shifts per month (prorated for part-time), equating to 1,920 annual hours. A traditional full-time employee works 2,080 annual hours and accrues PTO. “In essence, PTO is built into their monthly-annual hours’ requirement,” Mr. Haugh said. “Scheduling flexibility allows physicians to block periods of time to allow for extended time off.”

For example, shifts can be front-loaded for one month and back-loaded the next month to provide an extended gap of no-shift requirements. “Scheduling flexibility is a huge satisfier for our hospitalist team,” Mr. Haugh said. Hospitalists receive three paid sick days annually, which are only to be used for personal sickness, not family care.

Paris Regional Health doesn’t offer PTO, either. Hospitalists are paid by the shift, at an hourly rate, with a quality bonus at the end of the year based on five metrics (i.e., discharge before noon, response to queries, medical record completion, using stroke order sets, and computerized provider order entry use), Dr. Green said.

Unlike others, Dr. Green doesn’t think that CME and PTO sway recruiting decisions significantly. “The base pay rate and scheduling flexibility seem to be the main drivers for decision making beyond location and family needs,” she said. Flexible scheduling works by having everyone provide their desired shifts. Hospitalists can request certain days off rather than having a required pattern, such as seven days on and seven days off. A coordinator arranges the schedule around this with a few needed adjustments.

Working 12, 12-hour shifts a month is the minimum to maintain full-time benefits. Hospitalists can either choose to work that minimum, or they can work much more (which several hospitalists do), Dr. Green said.

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The bottom line

Although base compensation continues to be the most important component in the eyes of new recruits, CME, PTO, and other non-mainstream benefits can be the deciding factor when choosing between two offers, Dr. LoPresti said. Because salary trends and fair-market-value compensation are widely published, the base salary between two similar jobs is often fairly close.  

 

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